Pediatrics Midterm

Which statement by the nurse is most appropriate prior to giving an intramuscular injection to a 2-1/2-year-old child?

"It is all right to cry, I know that this hurts. After we are done you can go to the box and pick out your favorite sticker."

The nurse is admitting a school-age Vietnamese client who hit a parked car while riding a bike. The child has a fracture of the left radius and femur in addition to a fractured orbit. The child is stoic and denies pain. Which nursing actions are most appropriate in this situation? Select all that apply.

- The flacc scale - Administer pain medication now and continue on a regular basis. - Ask the child's parents to notify the nurse if the child com

Play serves many purposes. In teaching parents about appropriate activities, the nurse should inform them that play serves the all that apply.)

- intellectual development - self awareness - creativity

Place the nursing assessments of a toddler in the best order.

1. Developmental assessment 2. Auscultation of chest 3. Palpation of abdomen 4. Examination of eyes, ears, and throat

Match the behaviors with its stage of separation anxiety the child may exhibit.

1. Withdrawal or compliant behavior — Despair 2. Appearance of being happy and content with everyone — denial 3. Clinging to parents — Protest 4. Lack of protest when parents leave — Denial 5. Screaming and crying— Protest 6. Sadness — despair

A new mother is worried about a "soft spot" on the top of her newborn infant's head. The nurse informs her that this is a normal physical finding called the anterior fontanel. At what age will the nurse educate the mother that the soft spot will close? 1. 2 to 3 months of age 2. 6 to 9 months of age 3. 12 to 18 months of age 4. Approximately 2 years of age

12 to 18 months of age

The nurse should expect the anterior fontanel to close at age:

12-18 months

At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?

2 months

By what age does birth length usually double?

4 years

When is the best age for solid food to be introduced into the infant's diet?

4-6 month

A parent asks the nurse "At what age do most babies begin to fear strangers?" The nurse responds that most infants begin to fear strangers at what age?

6 months

By what age does the posterior fontanel usually close?

6-8 weeks

At which age can most infants sit steadily unsupported

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.

A nurse is assessing language development in all the infants presenting at the doctor's office for well-child visits. At which age range would the nurse expect a child to verbalize the words "dada" and "mama"?

9 and 12 months

Which behavior indicates that an infant has developed object permanence

Actively searches for a hidden object

The parent of a 16 month old asks, "What is the best way to keep our toddler from getting into our medicines at home?" The nurse should provide which advice?

All meds should be locked away

The nurse is working with a school-age child who is hospitalized. Which action by the nurse will promote a sense of industry in this child?

Allow the child to assist with her care

When examining a 7-year-old, which action by the nurse would be most appropriate

Allow the child to participate in the exam

A 27-month-old toddler who is in the pediatric office for a well-child visit begins to cry the moment he is placed on the examination table. The parent attempts to comfort the toddler; however, nothing is effective. Which of these actions by the nurse takes priority?

Allow the told her to sit on the parents lap and begin the assessment

The nurse is working in an adolescent medical clinic. What can the nurse anticipate when comparing adolescents in the clinic with chronic conditions to their peers?

Altered body image

The parent of a 6-month-old infant asks the nurse for advice about his son's thumb sucking. What would be the nurse's best response to this parent?

"Thumb sucking is a healthy self-comforting activity."

The nurse is preparing to assess a toddler client. Which activities would gain cooperation from the toddler? Select all that apply.

- Allowing the client to sit in the parents lab - Handing the client a stethoscope while taking the health history

A nurse plans therapeutic play time for a hospitalized child. Which are the benefits of therapeutic play? (Select all that apply.)

- Allows the child to express feelings - The nurse can gain insight into the child's feelings - The child can deal with concerns and feelings

The nurse observes an infant interacting with his parents. What are normal social behavioral developments for this age group? Select all that apply.

- Around 2 months the infant exhibits a first real smile. - Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. - Around 3 months the infant will mimic the parent's facial movements, such as sticking out the tongue. - Separation anxiety may also start in the last few months of infancy.

The nurse caring for newborns knows that infants exhibit phenomenal increases in their gross motor skills over the first 12 months of life. Which statements accurately describe the typical infant's achievement of these milestones? Select all answers that apply.

- At 1 month the infant lifts and turns the head to the side in the prone position. - At 7 months the infant sits alone with some use of hands for support. - At 9 months the infant crawls with the abdomen off the floor. - At 12 months the infant walks independently.

A young school-age client is hospitalized with a fractured femur. Which assessment tools are appropriate for this client? Select all that apply.

- FACES pain scale - Ouches scale - Poker chip-tool

The nurse in the newborn nursery is admitting a neonate. To determine the health and development of the newborn, what will the nurse include in the assessment? Select all that apply.

- Head Circumference - Body length (Height) - Weight - length of pregnancy

While in the pediatrician's office for their child's 12-month well-child exam, the parents ask the nurse for advice on age-appropriate toys for their child. Based on the child's developmental level, which types of toys would the nurse suggest? Select all that apply.

- Soft toys that can be manipulated - jack in the box - Push and pull toys

4) The nurse is working in a pediatric surgical unit. In discussing patient-controlled analgesia (PCA) in a preoperative parental meeting, which client would be a candidate for PCA?

- Spinal fusion

The preschool-age child has been back from surgery for removal of a Wilm's tumor for 6 hours, the nurse anticipates the preschooler will need pain medication very soon. The nurse is aware that the preschool-age child may not complain of pain because Select all that apply.

Cannot give a description of his pain. may assume the nurse knows he has pain. may be afraid it may hurt more to have the pain treated. believes he must be brave.

Parent guidelines for relieving colic in an infant include:

Changing the infant's position frequently.

What type of family is one in which all members are related by blood?

Consanguinous

A parent asks the nurse if there is anything that can be done to reduce the pain that his 3-year-old experiences each morning when blood is drawn for lab studies. Which intervention would the nurse implement- based on the parent's concern?

EMLA cream

The theorist who viewed developmental progression as a lifelong series of conflicts that need resolution is:

Erikson

The nurse is caring for a toddler client in the postoperative period. Which pain assessment tool is most appropriate for this client?

FLACC scale

Which stressor is common in the hospitalized toddler with a chronic disorder? Select all that apply.

Fear of painful procedure Interruption of normal routines Unfamiliarity of caregivers

Which is the most fatal type of burn in the toddler age-group?

Flame burn from playing with matches

A young adolescent tells the nurse, "I feel gawky." The nurse should explain that this occurs in adolescents because of what physiological event?

Growth of the extremities and neck precedes growth in other areas.

The parents of a 12-month-old child ask the nurse if the child can eat hot dogs. The nurse's reply should be based on what understanding?

Hot dogs must be cut into small, regular pieces

A toddler's parent asks the nurse for suggestions on dealing with temper tantrums. What intervention is the most appropriate recommendation?

Ignore it

Which should the nurse expect for a toddler's language development at age 18 months?

Increasing level of comprehension

The parents of an 8-year-old* state that their son seems very interested in trying new activities. When the parents ask for suggested activities for this age child, the nurse recommends scouts as an activity that will foster growth and development. In which stage of Erikson's "psychosocial stages of development" is this child?

Industry vs inferiority

A nurse is preparing to perform a physical assessment on a toddler. Which action is most appropriate for the nurse to take?

Leave intrusive procedures such as ear and eye examinations until the end.

An obese adolescent who adamantly denies sexual activity has a positive pregnancy test, which was performed in the adolescent clinic. Which statement by the nurse is the most appropriate in this situation?

Let's discuss some activities that you have done within the past few months that could possibly lead to pregnancy."

In terms of cognitive development, the preschooler would be expected to engage in what behavior?

Magical thinking

While assessing the development of a 9-month-old infant, the nurse asks the mother if the child actively looks for toys when they are placed out of sight. Which developmental task is the nurse assessing this infant for?

Object permanence

The nurse is planning activities for a toddler with a birth injury of a torn brachial plexus that resulted in muscle atrophy and weakness of his right arm. Which nursing intervention is most appropriate for this client?

Offering the toddler a choice

The nurse is watching toddlers at play. Which normal behavior would the nurse observe?

Parallel play

Two 3-year-olds are playing in a hospital playroom together. One is working on a puzzle while the other is stacking blocks. Which type of play are these children exhibiting? 1. Cooperative play 2. Associative play 3. Parallel play 4. Solitary play

Parallel play

A new parent group inquires about the stages through which their children will progress as they grow older. The nurse is discussing Piaget's developmental stages. In what order would the nurse expect the child to progress through Piaget's stages of development?

Piaget's stages of development? 1. Sensorimotor (birth to 2 years) 2. Preoperational (2 to 7 years) 3. Concrete operational (7 to 11 years) 4. Formal operational (11 to adult good)

With the goal of preventing plagiocephaly, the nurse should teach new parents to consider which intervention?

Place infant prone for 30-60 min per day

A 4-year-old child tells the nurse, "I do not want another blood sample drawn because I need all my insides, and I do not want anyone taking them out." Which is the nurse's best interpretation of this statement?

Preschoolers have poorly defined body boundaries

While being comforted in the emergency department, a young school-age sibling of a pediatric trauma victim blurts out to the nurse, "It's my fault! When we were fighting yesterday, I told him I wished he was dead!" Which response is most appropriate by the nurse?

Reassuring the child that it is normal to get angry and say things that we do not mean but that we have no control over whether or not an accident happens

Which is the most fatal type of burn in the toddler age-group?

Reduces anxiety

A mother of a school-age client who recently had surgery for the removal of tonsils and adenoids complains that the child has begun sucking his thumb again. Which coping mechanisms is the child using to cope with the surgery and hospitalization?

Regression

A 4 year old is hospitalized with a serious bacterial infection. The child tells the nurse that, "I am sick because I was bad." What is the nurse's best interpretation of this comment?

This is common

Two toddlers are playing in a sandbox when one child suddenly grabs a toy from the other child. What is the best interpretation of this behavior?

This is typical behavior because toddlers are egocentr

What skill that the nurse should expect a 5-year-old child to be able to

Tie shoes

The nurse determines an infant of 7 months is demonstrating appropriate fine motor development when performing which action?

Transferring a rattler from one hand to the other

A mother asks which developmental milestones she can expect when her baby is 6 months old. Which response by the nurse is the most appropriate?

Transfers objects from one hand to the other

What information should a nurse provide a mother who is concerned about preventing sleep problems in her 2-year-old child?

Use a Night light

The nurse is teaching a mother of a 2-month-old that she will begin to introduce certain foods to the diet between 4 and 6 months. The nurse should recommend what foods? Select all that apply.

Vegtables Rice cereal Fruits

The parents of a 1-year-old infant are concerned that this baby seems more shy and scared of new situations than their other child and ask the nurse if this is normal. The nurse knows that the infant is exhibiting a characteristic of the "slow-to-warm-up." Which statement to the parents is most appropriate by the nurse?

Your infant initially reacts to new situations by withdrawing

In what type of play are children engaged in similar or identical activity without organization, division of labor, or mutual goal?

associative

A mother reports that her 6-year-old child is highly active and irritable and that she has irregular habits and adapts slowly to new routines, people, or situations. Which category of temperament best describes this child?

difficult child

What is probably the single most important influence on growth at all stages of development?

nutrition

Which predisposes the adolescent to feel an increased need for sleep?

rapid physical growth

What is an important consideration for the nurse who is communicating with a very young child?

use transition objects such as a doll

Which characteristic best describes the gross motor skills of a 24-month-old child

walks up and down stairs

Which characteristics best describes the language of a 3-year-old child?

Talks incessantly, regarding of whether any one is listening

The nurse, talking with the parents of a toddler who is struggling with toilet training, reassures them that their child is demonstrating a typical developmental stage. According to Erikson, which developmental stage will the nurse document in the medical record for this toddler?

Autonomy vs Shame and Doubt

Which statement accurately describes an event associated with an infant's physical development?

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

The nurse is teaching a new mother about the drastic growth and developmental changes her infant will experience in the first year of life. Which statement describes a developmental milestone occurring in infancy?

By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months, the brain weighs 2.5 times what it did at birth

In terms of gross motor development, what hallmark action should the nurse identify for the parents of a 5-month-old infant to anticipate?

Roll from abdomen to back

The nurse can instruct parents to expect children in which age group to begin to assume more independent responsibility for their own management of a chronic condition, such as blood-glucose monitoring, insulin administration, intermittent self-catheterization, and appropriate inhaler use?

School age

Which of these developmental milestones should the nurse expect to find in children who are between 2 and 3 years old? Select all that apply.

Scribbles Kicks a ball Goes up and down stairs

What is a normal characteristic of the language development of a preschool-age child?

Stammering

The nurse is preparing to perform a heel stick on a neonate. Which complementary therapy is appropriate for the nurse to use decrease pain during this quick but painful procedure?

Sucrose pacifier

The parents of a 4-year-old ask the nurse when their child will be able to differentiate right from wrong and develop morals. What would be the best response of the nurse?

The preschooler is developing a conscience.'

Identify the statement that is the most accurate about moral development in the 9-year-old school-age child.

The school-age child conforms to rules to please others.

What describes moral development in younger school-age children?

They know the rules and behaviors expected of them but do not understand the reasons behind them.

The head-to-tail direction of growth is referred to as:

cephalocaudal

Three children playing a board game would be an example of:

cooperative play