Pediatrics exam 3
In order to make verbal communication more effective, the nurse will: a. be brief, clear, and relevant in speech b. use a consistent tone, never varying it c. avoid speaking slowly d. use medical terms
b. use a consistent tone, never varying it
In inspecting the eyes of a child, the nurse notes that there are some small white flecks around the perimeter of the iris. These white flecks are called: a. cotton patches b. snow spots c. Brushfield spots d. northern lights
c. Brushfield spots
The mother of a 9-month-old infant is concerned that the head circumference of her baby is greater than the chest circumference. The best response by the nurse is: a. "This is normal until the age of 1 year, and then the chest will be greater." b. "Perhaps your baby was small for gestational age or premature." c. "Let me ask you a few questions, and perhaps we can figure out the cause of this difference." d. "These circumferences normally are the same, but in some babies this just differs."
a. "This is normal until the age of 1 year, and then the chest will be greater."
A mother asks the nurse to tell her the normal amount of milk a bottle-feeding infant takes in per day in the first month after birth. The nurse's answer would be that an infant at this age would take up to: a. 32 ounces b. 56 ounces c. 46 ounces d. 64 ounces
a. 32 ounces
The nurse would expect to find which of the following resting respiratory rates in the normal newborn? a. 40 b. 20 c. 30 d. 15
a. 40
A child's height must fall in what percentile range to be considered normal enough not to warrant further investigation? a. 5% -95% b. 20%-80% c. 10%-90% d. 25%-75%
a. 5% -95%
In teaching the caregivers about giving juice to their preschool-aged child, the nurse would advise the caregivers to give the child no more than how many ounces of juice per day? a. 8-12 b. 18-24 c. 16 d. 28
a. 8-12
A preschool child asks the nurse if the X-ray will hurt and why he needs an X-ray. The best response by the nurse is: a. "The X-ray is a picture of your tummy to see what makes it hurt. The X-ray will not hurt." b. "I will go get a book that describes the special rays involved in X-rays, the different types of X-rays, and how the film is developed to provide a picture." c. "Let me get someone from X-ray to explain this to you and to take you down to X-ray so you can see all the different equipment." d. "Your health care practitioner will explain this complicated process to you and your caregivers just before you have the X-ray."
a. "The X-ray is a picture of your tummy to see what makes it hurt. The X-ray will not hurt."
The nurse is working with a group of older children and adolescents who have diabetes. The nurse wants to explore the feelings of the children and encourage them to wear a MedicAlert bracelet and carry hard candy. The nurse will probably have the greatest success in getting the children to talk about feelings and to comply with the bracelet and candy if the nurse uses which of the following approaches? a. Tell the story in the third person, using the case of another girl unknown to the group to get the points across. b. Contract with the children in writing what the nurse is expected to do and what the children are expected to do. c. Use behavior modification, rewarding the children with candy if they comply and having consequences if they do not. d. Have a contest to see who can comply the fastest and the longest in wearing the bracelet and carrying candy.
a. Tell the story in the third person, using the case of another girl unknown to the group to get the points across.
The nurse is ready to take the temperature of a child who is to be discharged from the hospital if the temperature is within the normal range. The health care practitioner and family are waiting to hear about the temperature. The nurse considers taking an axillary temperature but decides instead to take the temperature orally. What is the most likely reason that the nurse decided to take the temperature orally in this case? a. The axilla is not sensitive to early temperature changes, and accuracy was critical in this case. b. An oral temperature is much quicker to determine than an axillary temperature. c. Locating an axillary thermometer might be more difficult than finding an oral one. d. The oral temperature reading is easier and safer to get then compared to an axillary temperature.
a. The axilla is not sensitive to early temperature changes, and accuracy was critical in this case.
Empathy is best described in which of the following situations? a. The nurse gets down on the floor to see the world as a toddler sees it. b. Condolences are offered by a nurse then the caregivers lose a child. c. Working with a dying child, the nurse feels sorry for the child and his family. d. The nurse is subjective in interactions with the child and caregivers.
a. The nurse gets down on the floor to see the world as a toddler sees it.
You are the nurse working with a preschool child who has just drawn an interesting picture of his family. Your best action is to: a. ask the child to tell a story about the picture b. ask the child questions to ascertain the meaning of the picture c. interpret the picture and give the child a chance to approve or deny your interpretation d. get another child to tell you about the picture
a. ask the child to tell a story about the picture
In conflict management, the win-win approach occurs then: a. both parties involved are committed to solving the conflict b. there are two conflicts and the parties agree to each win one c. each party gives in on 50% of the disagreements making up the conflict d. the conflict is settled out of court so the legal system and the parties win
a. both parties involved are committed to solving the conflict
The optical blink reflex occurs then the newborn's pupil reaction to light is assessed and a newborn blinks and: a. flexes the head closer to the body b. arches the back c. extends the chin away from the body d. throws up the hands in the air
a. flexes the head closer to the body
When the nurse is caring for an infant who is experiencing stranger anxiety, the nurse tries to get the caregiver involved in the care. If the caregiver is not able to be involved, the nurse needs to: a. hold the infant so the caregiver is in view b. swaddle the baby and hold the baby so he or she cannot see the caregiver c. keep the caregiver away so the baby will not fuss d. feed the baby, as babies bond with whoever feeds them
a. hold the infant so the caregiver is in view
While assessing a child, the nurse pinches up a small section of the child's skin between the thumb and forefinger, and then quickly releases it. The nurse is assessing for: a. hydration b. excess fat c. skin tension d. pain tracks
a. hydration
The major components of the communication process are: a. message, sender, channel, receiver, and feedback b. facial expression, tone of voice, and gestures c. verbal, written, and nonverbal d. speaker, listener, and reply
a. message, sender, channel, receiver, and feedback
Preschoolers are able to see things from which of the following perspectives? a. only their own b. their own and their caregivers' c. their own and their mother's d. their peers'
a. only their own
Which of the following best defines craniosynostosis? a. premature ossification of suture lines resulting in early fusion of the bones of the skull b. sinus openings into the cranium allowing for changes in intracranial pressure c. wider spaces than normal between the bones of the cranium d. changes in the size and shape of the skull due to the absence of lymph and sinus openings
a. premature ossification of suture lines resulting in early fusion of the bones of the skull
If the nurse finds a yellowish or white light reflex (cat's eye reflex) then inspecting the retina, he or she knows this may indicate: a. retinoblastoma b. retrolental fibroplasia c. albino characteristics d. retinitis pigmentosa
a. retinoblastoma
The most reliable indicator of body fat is: a. skinfold thickness b. fit of clothing c. weight d. comparison with peers
a. skinfold thickness
In working with the caregivers of a child with an acute or chronic illness, the nurse would: a. teach care early and allow the caregivers to provide daily care for as many aspects of the child's care as possible b. delegate care of the child to a nurse's aide and make certain he or she understands the care delegated and completes it c. take responsibility for the child's care until the day before the child leaves, and then give caregivers instructions d. teach care daily and let the caregivers do a return demonstration just before discharge
a. teach care early and allow the caregivers to provide daily care for as many aspects of the child's care as possible
The nurse using the Hirschberg test would expect to find which of the following in a child with normal eyes? a. the light reflected symmetrically in the center of both corneas b. the light reflecting red on the optic nerve c. arteries and veins in the proper proportion d. no evidence of retinal detachment
a. the light reflected symmetrically in the center of both corneas
When taking the health history of a child whose family is at the poverty level and has no insurance, you discover that the child has been seen in the emergency room of the hospital ten times in the last 6 months. During the interview, you would first try to find out from the family if: a. they use the emergency room for episodic health care or if the child has a regular health care provider b. there is a history of child or spousal abuse or incestuous relationships in the family c. the child has a chronic health problem with acute exacerbations presenting an emergency situation d. the child is hyperactive or has a history of inattention to safety and suffers accidents on a regular basis
a. they use the emergency room for episodic health care or if the child has a regular health care provider
The pediatric nurse practitioner has a small toy hooked onto the stethoscope and is observed to be humming at times during the physical examination of a child. The reason for the toy and humming is most likely: a. to provide a distraction to increase cooperativeness b. to entertain and keep the nurse in a good mood to work with children c. something that has little to do with the examination of the child d. to keep the child focused so he or she won't get into things in the exam room
a. to provide a distraction to increase cooperativeness
A mother tells you that her 4-year-old child has begun to have night waking and has started thumb sucking again. Otherwise the child seems very healthy. From this brief history, your immediate response is: a. "It is normal for preschool-aged children to go through some short periods of regression." b. "What changes have happened in your family or with your child?" c. "Is there any possibility of pinforms or some other type of parasite that your child might have?" d. "You need to call your pediatrician right away and get a complete physical on this child."
b. "What changes have happened in your family or with your child?"
When you are the nurse taking the health history of a child, the historian is most likely going to be an adult. Which of the following questions would be the most important to ask before admitting or treating the child? a. "What is the birth date of the child?" b. "Who is the legal guardian?" c. "What is your relationship to the child?" d. "What problems occurred during pregnancy?"
b. "Who is the legal guardian?"
The nurse is preparing to give a preschool child some oral medicine. Which of the following statements by the nurse would be most helpful to the child's development? a. "This medicine is good for you. Take it, or your mother will be upset." b. "Would you like water or a mouthful of flavored gelatin after your medicine?" c. "The health care practitioner has ordered this medicine especially for you." d. "Do you want to take this medicine? I'd like for you to take it."
b. "Would you like water or a mouthful of flavored gelatin after your medicine?"
Two-word utterances by a child become common around which of the following ages? a. 12 months b. 2 years c. 16 months d. 3 years
b. 2 years
Which of the following approaches will work best then the nurse is communicating with an infant? a. Communicate through the caregivers. b. Allow the child time to warm up to the nurse. c. Respond only after the child cries for a little while. d. Use an adult voice just as you would for anyone.
b. Allow the child time to warm up to the nurse.
When infants are born prematurely, the chronological age on the growth chart: a. is the same as for other children after 6 months b. is not accurate, and a special chart for preemies must be used c. must be corrected subtracting weeks or months of prematurity until age 18 months old d. must be corrected until age 18, subtracting the period of prematurity from the age
c. must be corrected subtracting weeks or months of prematurity until age 18 months old
Which of the following best describes a difference in communicating with school-age children versus toddlers? a. The number of words is more then communicating with a toddler than it is with a school-aged child. b. For toddlers, preparation for procedures is just before the procedure and much earlier for school-aged children. c. Toddlers require more empathy and more touching and holding. d. Caregivers need less information then care involves a school-aged child.
b. For toddlers, preparation for procedures is just before the procedure and much earlier for school-aged children.
Most communication is: a. verbal b. spatial c. nonverbal d. ineffective
c. nonverbal
Touch is one of the most important communicative behaviors that nurses use; however, nurses must keep in mind which of the following facts before using touch? a. Everyone likes to be touched, but most prefer a light touch on the upper body. b. Touch can have many different meanings to different children and their families. c. Touch needs to be used very sparingly and only then necessary and asked for. d. The opposite gender almost always interprets touch as having a sexual meaning.
b. Touch can have many different meanings to different children and their families.
Which of the following statements best describes dacryocystitis? a. a bladder infection brought about by wearing Dacron fabrics b. an infection of the lacrimal sac caused by the obstruction of the lacrimal duct c. repeated bladder infections that are resistant to antibiotics d. eye infection secondary to a bladder infection
b. an infection of the lacrimal sac caused by the obstruction of the lacrimal duct
When working with a child in isolation, the nurse knows that smiling while wearing a mask: a. is unnecessary, as the child cannot see the smile b. can be seen in the actions of the eyes and the area around the eyes c. makes the nurse feel better even if the child cannot tell d. is not good, as it allows germs to escape from the open mouth
b. can be seen in the actions of the eyes and the area around the eyes
Atopic dermatitis (AD) is a skin lesion that is: a. due to an allergy to the mother or father b. common and involves the epidermis and superficial dermis c. rarely seen outside the tropical climates d. seen only in children over age 4
b. common and involves the epidermis and superficial dermis
While palpating the outer layer of the cranial bones behind and above the ears, the nurse finds a softening of this area and has the sensation of pressing on a table-tennis ball then palpating the area. The nurse knows this finding is indicative of: a. shaken baby syndrome b. craniotabes c. skull fracture d. crepitus
b. craniotabes
You are the nurse preparing to meet with a client for the first time. You realize that before effective communication can take place, you must: a. share personal information about yourself b. develop trust and rapport with the client c. set some rules of communication with the client d. clarify your purpose in talking with the client
b. develop trust and rapport with the client
While working in a public health clinic, the nurse assesses a child who is 3 years old. The nurse finds an open and wide anterior fontanel. The nurse is aware that an open anterior fontanel at this age most likely is: a. normal b. due to disease, such as rickets c. a result of prolonged dehydration d. due to a congenital disorder
b. due to disease, such as rickets
Which of the following factors is most important in determining the success of relationships used in delivering care? a. transference and countertransference b. effective communication c. personality of the participants d. type of illness of the client
b. effective communication
White flecks around the perimeter of the iris in children are: a. normally found in 40% of children b. found in a child with Down syndrome c. seen in children with congenital cataracts d. observed in children with retinal detachment
b. found in a child with Down syndrome
When the nurse communicates with a preschool child, he or she should communicate with: a. fantasy and abstract language b. honesty and concrete language c. magical language d. stories about a hypothetical child
b. honesty and concrete language
Which of the following approaches has been recognized as most healing and capable of bridging communication gaps with children and families? a. limit setting b. humor c. authoritarian d. direct communication
b. humor
The nurse will perform all invasive or uncomfortable procedures such as ear inspection at what point during the physical examination? a. in a sequential manner b. last c. first d. optional
b. last
Barriers to communication include: a. open-ended questions b. preconceived ideas c. encouragement d. selective reflection
b. preconceived ideas
The nurse on the pediatric unit is assigned to care for four children. One of the children is 18 months old and the rest are 3, 4, and 4-1/2 years old. The youngest is in for observation, the 3-year-old has a cardiac problem, and the two older children are in for tests. After a report the nurse takes the children's vital signs. The nurse would need to take the pulses in which of the following ways? a. radial pulse on all the children b. radial on the two older children and apical on the 18-month-old and the child with a cardiac problem c. apical on all children under 5 d. apical only on the child with a cardiac problem
b. radial on the two older children and apical on the 18-month-old and the child with a cardiac problem
When the nurse is assigned to a child and his or her family, shares personal information such as home addresses and telephone numbers, or socializes with the family, this behavior on the part of the nurse: a. is helpful in developing trust and rapport b. signals over-involvement on the part of the nurse c. keeps the nurse from becoming burned out d. makes the nurse feel like part of the family
b. signals over-involvement on the part of the nurse
When one person allows the conflict to be resolved at his or her own expense, this is referred to in conflict management as: a. winning while losing b. the lose-win approach c. the win-lose approach d. losing
b. the lose-win approach
The nurse inspecting the optic disc of a child with intracranial hemorrhage would find: a. the disc to be edematous and larger than usual b. the margins of the optic disc to be poorly defined (blurred) c. a small-sized disc d. the color of the disc to be bright red and darker than usual
b. the margins of the optic disc to be poorly defined (blurred)
You are the nurse working with a child who is fearful, has difficulty trusting the staff, and says very little. Which of the following methods would be best for you to try in order to get this child to relax, focus on your message, and respond verbally? a. taking turns reading a book b. using a puppet or stuffed toy in third-party communication c. asking the mother to talk to the child and get the answers you want d. asking the health care practitioner for an order to medicate the child with a mild tranquilizer
b. using a puppet or stuffed toy in third-party communication
A thick, cheesy, protective deposit of sebum and shed epithelial cells on the surface of the skin is referred to as: a. sebum epithelium b. vernix caseosa c. epitheliosis d. the third skin
b. vernix caseosa
A nurse is providing family education on conflict resolution through communication. Which of the following statements made by the parent indicates that the teaching has been effective? Select all that apply. a. "I will try to overlook our differences." b. "I'm willing to compromise and accept my spouse's solutions to our problems." c. "I will actively listen to our child." d. "I am going to take your feelings seriously."
c. "I will actively listen to our child." d. "I am going to take your feelings seriously."
During a talk with the nurse, the mother of a 6-month-old baby says that she gets her to go to sleep by giving her a bottle of milk to suck on until she falls asleep. The nurse's best response would be: a. "You need to be watching your baby on a monitor or there the baby cannot see you." b. "Be sure you prop the bottle well and the baby's head is slightly elevated." c. "Letting a child fall asleep with a bottle of milk or other liquid containing sugar will cause cavities." d. "Your baby is old enough to hold her own bottle, and this builds independence and self-esteem."
c. "Letting a child fall asleep with a bottle of milk or other liquid containing sugar will cause cavities."
The nurse administers the Denver Developmental Screening Test II to a child. The child fails to successfully complete a series of items. The nurse learns that the child has an infection, did not sleep well the night before, and is on antibiotics. Which of the following actions would be best on the part of the nurse? a. Do nothing, as the test results are not affected by the child's condition. b. Do not readminister the series that was failed or the entire test, as retakes are invalid. c. Administer the test again in 1 month if the child is then well and sleeping well. d. Wait at least 2 years to administer the test, moving up to the Denver III.
c. Administer the test again in 1 month if the child is then well and sleeping well.
The nurse is talking with the caregivers about a child's developmental and health history. The child interrupts to add something and the caregivers direct the child to be quiet. The nurse's best course of action would be based mostly on which of the following ideas? a. Caregivers have the right to govern their own children. b. Children are not as accurate as caregivers in the recall of developmental and health histories. c. Children need to be included in their own health care as much as possible, considering age and development. d. The caregivers are the decision makers in terms of care and will be paying for the cost of the care.
c. Children need to be included in their own health care as much as possible, considering age and development.
You are working with a child and the child's family. Which of the following actions on your part would most help to establish trust? a. Call caregivers at least 24 hours before canceling appointments. b. Explain procedures in a way that you feel comfortable with. c. Don't make promises you cannot keep, and keep all the ones you make. d. Maintain client confidentiality for information that would upset the client if disclosed.
c. Don't make promises you cannot keep, and keep all the ones you make.
A nurse coworker, who has been working with a child and his family, asks you for advice about buying a gift for the child and the family. Which of the following would be the best advice you could give this nurse? a. Do not buy them a gift unless they buy you one first. b. If you buy a gift, be certain that it is a small token only. c. Not giving gifts or receiving them is part of being professional. d. You should not buy gifts, but it is all right to receive them.
c. Not giving gifts or receiving them is part of being professional.
The nurse is assessing an 8-month-old infant for head lag, pulling the infant by the hands from a supine to a sitting position. The head does not stay in line with the body then being pulled forward. Which of the following statements best represents the significance of this finding? a. This is a normal finding, as the infant's head will not stay in line until after 8 months of age. b. The nurse has not conducted the test correctly and must do it again using proper technique. c. Significant head lag after the age of 6 months may indicate brain injury and needs further investigations. d. Head lag should not be tested until the child is over 1 year of age.
c. Significant head lag after the age of 6 months may indicate brain injury and needs further investigations.
A nurse is providing education to an adolescent who is planning to have surgery. Which of the following developmentally appropriate strategies should the nurse implement? Select all that apply. a. Prepare the adolescent up to 24 hours prior to the procedure. b. Include the peer group since the adolescent does not prefer to have privacy. c. Use appropriate medical terminology. d. Draw a diagram of the surgery to describe the procedure if the adolescent questions how the procedure will be done.
c. Use appropriate medical terminology. d. Draw a diagram of the surgery to describe the procedure if the adolescent questions how the procedure will be done.
The nurse doing vision screenings on 3- to 4-year-old children would refer a child to the ophthalmologist if both eyes score less than 15/30 or scores for the child's right and left eye differ by how many feet? a. 1 b. 3 c. 2 d. 5
d. 5
Which of the following statements best describes "motherese"? a. being oversolicitous to a child b. patting a child and touching frequently c. a type of speech using short, simple sentences in a high-pitched voice d. the way that mothers always seem to know what their babies need and want
c. a type of speech using short, simple sentences in a high-pitched voice
The caregivers notice that the baby has a dark-black tuft of hair and a dimple over the lumbosacral area. This occurrence is: a. normal and common b. normal and rare c. abnormal and may indicate spina bifida occulta d. abnormal and may indicate cancer
c. abnormal and may indicate spina bifida occulta
You are working with a family that has nicknames for all the members. Mother is called Mimi and Father is called Papa. The children are called Bubby and Sissy. After introductions, you would: a. call the children Bubby and Sissy and refer to the caregivers as Mother and Dad b. address the caregivers as Mimi and Papa and the children as Bubby and Sissy c. ask each family member what he or she would prefer to be called d. call the children Miss and Mr. and the caregivers Mr. and Mrs.
c. ask each family member what he or she would prefer to be called
The nurse asks the caregivers how many wet diapers their infant has in 24 hours. The nurse is comparing the wet diapers of this infant against the norm, which is the equivalent of: a. 2 saturated diapers b. no less than 8 very wet diapers c. at least 6 very wet diapers d. 10 or more saturated diapers
c. at least 6 very wet diapers
Swelling over the occipitoparietal region of the skull is called by which of the following terms? a. occipitocapus b. edematous capitus c. caput succedaneum d. parietus sepitus
c. caput succedaneum
When working with clients who are from Mexico or have been raised with Hispanic customs, the nurse would keep in mind that people of these cultural groups tend to: a. avoid direct eye contact b. use few gestures and tend not to vary voice tone c. find discussions of personal topics easier if the nurse is the same gender as the client d. get right to the point in any discussion, as they view small talk as a waste of time
c. find discussions of personal topics easier if the nurse is the same gender as the client
Informal communication takes place then individuals talk and is best described by saying the participants: a. are relaxed b. are involved in a preexisting informal relationship c. have no particular agenda or protocol d. talk with slang words
c. have no particular agenda or protocol
In the health history interview, the nurse asks the caregivers if they give their 4-month-old baby honey. If the answer is "yes," the nurse would do some teaching to: a. reinforce the caregivers for supplying this added source of immunity b. let the caregivers know that honey is helpful then the infant has vomiting and diarrhea c. inform the caregivers of the dangers of botulism from honey until the infant is 1 year old d. advise the caregivers not to give more than 4 ounces of honey per day
c. inform the caregivers of the dangers of botulism from honey until the infant is 1 year old
To encourage caregivers to share their concerns and ask questions, a nurse would: a. let the family know that the nurse's time is limited b. periodically advise the family of the amount of time left c. let the family know that the nurse has time to spend with them d. socialize with the family and child so they feel comfortable with the nurse
c. let the family know that the nurse has time to spend with them
Rhymes, chants, and rituals such as knocking on wood serve which of the following purposes for school-aged children? a. substitute for aggressive acts toward peers and adults in their environment b. door opener for friendships with other children participating in these activities c. means of emotional-social control in frightening and confusing contexts d. entertainment in an otherwise dull and dreary world run by adults
c. means of emotional-social control in frightening and confusing contexts
At what age are children old enough to have their temperature taken orally? a. 10 months b. 3 years c. 18 months d. 5 to 6 years or more
d. 5 to 6 years or more
The nurse takes the temperature of a newborn and gets a reading of 37.7 degrees C (99.6 degrees F). The nurse interprets this temperature as: a. very high for a newborn and calls the health care practitioner b. high for an infant of this age and decides to retake it in 20 minutes c. normal and proceeds to chart the temperature in the infant's record d. below normal and adds a warmed blanket to the infant's crib
c. normal and proceeds to chart the temperature in the infant's record
The tone and pitch of the voice, volume, inflection, speed, grunts, and other vocalizations are referred to by which of the following terms? a. third element b. ancillary speech c. paraverbal clues d. enhancements
c. paraverbal clues
Which of the following methods of taking the temperature of a child is considered to be most accurate? a. oral b. axillary c. rectal d. tympanic
c. rectal
A nurse is sitting with a family who has just heard some upsetting news about their child's prognosis. The nurse sits with the family in silence. The nurse's silence is best interpreted as: a. not knowing what to say b. fear of saying the wrong thing c. respect, concern, and a desire to comfort the caregivers d. waiting for the family to speak and tell the nurse what they need
c. respect, concern, and a desire to comfort the caregivers
In working with school-aged children, the nurse keeps in mind that the child of this age has which of the following skills mastered? a. understanding of words with double meanings b. ability to understand philosophical meanings c. spatial, temporal, and numerical concepts d. interest in and ability to create metaphors
c. spatial, temporal, and numerical concepts
The caregivers notice a swelling over the cranial bones of their newborn. The nurse examines the baby and tells the caregivers that this appears to be a cephalhematoma and will disappear with time. The nurse is reasonably certain this is a cephalhematoma and not some other abnormality because the: a. mother had a forceps delivery b. color is the same as a cephalhematoma c. swelling does not cross suture lines d. swelling is over a large area of the head
c. swelling does not cross suture lines
A caregiver asks the nurse to explain his infant's weight loss of 10% of birth weight, which occurred by the third or fourth day after birth. The nurse would explain that this weight loss is known as physiological weight loss and is due to which of the following causes? a. not being nourished any longer by the rich placenta b. the exhaustion of the baby after the birth experience c. the loss of extracellular fluid and meconium d. the time it takes to learn to suckle adequately
c. the loss of extracellular fluid and meconium
Which of the following is likely to be the most effective method of communicating with older school-age children and adolescents? a. direct communication b. nonverbal body language c. written communication d. telephone conversation
c. written communication
You are the nurse trying to get a child to take his medication. The child refuses to take the medicine, saying, "I hate this medicine because it tastes yucky." Your best response is: a. "Your daddy and mommy will be upset if you don't take this medicine. Your health care practitioner will be upset with you too." b. "You will not get well if you don't take this medicine. It is good for you and will make you well again." c. "Good boys and girls always take their medicine. If you are a good little child, you will take your medicine and Santa will bring you a present." d. "I understand that the medicine does not taste good and you don't want to take it, but I am so proud of you then you take it and you can be proud of yourself."
d. "I understand that the medicine does not taste good and you don't want to take it, but I am so proud of you then you take it and you can be proud of yourself."
Which of the following questions or statements is most important during the health history interview of the family seeking care for a toddler? a. "What does your child prefer to eat?" b. "When did your child say the first word?" c. "Tell me about the toilet training and how that is going." d. "Tell me how you have childproofed your home."
d. "Tell me how you have childproofed your home."
The nurse is preparing to count the respirations of an infant. The nurse will count the respirations for: a. 15 seconds, watching the chest b. 1 minute, watching the chest c. 30 seconds, watching the abdomen d. 1 minute, watching the abdomen
d. 1 minute, watching the abdomen
Head circumference is measured in children with known or suspected hydrocephalus and children less than how many months old? a. 40 b. 32 c. 36 d. 24
d. 24
When the nurse is doing vision screenings on young children, which of the following tests would be used on a child who is 6 years old and able to read the alphabet? a. finger point b. Snellen E c. Snellen X d. adult Snellen
d. adult Snellen
The nurse inspects a child's red reflex with an ophthalmoscope and finds black spots or opacities within the red reflex. The nurse knows these findings: a. are normal in 95% of children b. indicate congenital permanent blindness c. suggest the child has experienced trauma d. are abnormal and may indicate a cataract
d. are abnormal and may indicate a cataract
The nurse notices that a 6-month-old infant born to Latino caregivers has deep-blue, almost black coloration over the lumbar and sacral areas of the spine and the buttocks. The nurse's first guess in looking for causes would be: a. child abuse b. lack of bathing c. ritual painting d. Mongolian spots
d. Mongolian spots
You are the nurse working with a small child who is in a four-bed ward. You need to do an assessment with the caregivers. Which of the following actions would be best on your part? a. Provide the assessment on a written form so caregivers can fill it out in the room. b. Ask all the other visitors to step out while you do the assessment with the caregivers. c. Talk low so others in the room will not hear. d. Take the caregivers to a nearby quiet, private area.
d. Take the caregivers to a nearby quiet, private area.
Which of the following skills does the toddler master? a. ability to take responsibility for his or her own actions b. mastery of spatial, temporal, and numerical concepts and serialization c. capacity to do abstract thinking some of the time d. ability to participate in turn-taking rules of social communication
d. ability to participate in turn-taking rules of social communication
Children will experience less stress, irritability, and fatigue in caregiving situations then the nurse and other caregivers: a. make the child adhere to the hospital schedule and fit the unit's needs b. give instructions and information about tests the day before they take place c. tell the child that he or she has nothing to fear, as lots of kids have experienced this d. assist the child to remain in control of physical and personal space whenever possible
d. assist the child to remain in control of physical and personal space whenever possible
When working with clients who are Japanese and who were raised with Japanese customs, you would keep in mind that the Japanese tend to: a. use a lot of touch and appreciate touch from health care professionals b. speak a lot and view feelings as less important than words c. complain then something, such as pain, is bothering them d. avoid direct eye contact, as this is seen as a lack of respect
d. avoid direct eye contact, as this is seen as a lack of respect
In maintaining professional boundaries in therapeutic relationships, the nurse must commit to which of the following behaviors? a. accepting and giving gifts b. becoming emotionally involved c. doing all the care for the child d. being a nurse and not a social friend
d. being a nurse and not a social friend
While palpating the fontanels of a 1-month-old infant, the nurse finds the posterior fontanel to be 2 to 3 cm. The nurse is aware that this finding occurs with which of the following conditions or disorders? a. diabetes b. cerebral palsy c. premature birth d. congenital hypothyroidism
d. congenital hypothyroidism
A nurse is volunteering in a clinic in a developing country. The mother tells the nurse she is bottle-feeding with formula given to her by an earlier group of volunteers. The nurse will most want to check to be sure the mother has sufficient formula and that the formula contains: a. zinc b. sodium c. magnesium d. iron
d. iron
Adolescents most need people to: a. talk with them and explain the world to them b. honestly tell them then their ideas are wrong c. agree with them and give positive reinforcement then they are right d. listen to them verbalize what the world should be like
d. listen to them verbalize what the world should be like
Which of the following types of lighting would be best for the nurse to use during the pediatric physical assessment? a. fluorescent b. yellow c. halogen d. natural
d. natural
The nurse is assessing a newborn for jaundice. The nurse knows that jaundice is easiest to detect in the newborn in certain areas. Because of this knowledge, the nurse will assess which of the following? a. the scapula, under the arm, and in the groin b. under the chin and under the knee c. under the scrotum or inside the labia d. on the tip of nose, external ear, lips, hands, and feet
d. on the tip of nose, external ear, lips, hands, and feet
When obtaining a child's past health history, the nurse would ask questions aimed at getting pertinent information, beginning with the: a. Apgar score and birth itself b. labor and delivery c. postnatal period d. prenatal period
d. prenatal period
The nurse is preparing to give the child an intramuscular injection. The nurse's best approach would be to: a. smile and laugh about the injection b. say, "I am going to give you a little stick." c. say, "Good little children don't cry." d. say, "I am going to give you an injection that may hurt a little."
d. say, "I am going to give you an injection that may hurt a little."
Children who are suspected of not having adequate calorie and protein intake might have which of the following laboratory tests ordered by their health care practitioner, which provide a picture of whether calorie or protein intake is sufficient or not? a. serum sodium and potassium b. arterial blood gases c. cerebral spinal fluid analysis d. serum albumin and prealbumin
d. serum albumin and prealbumin
