Peds Exam 1

An 8 yo boy who says he wants to be a doctor when he grows up pleads with the nurse to let him put on his own band-aid after receiving an injection. The nurse agrees and watches as the boy very carefully lines the band-aid up with the mark left by the injection and applies it to his skin. Then he asks, "Did I do it right?" and waits eagerly for the nurse's feedback. The nurse recognizes in this situation the boy's attempt to master the primary developmental step of school age. What is that step?

Industry

The nurse is preparing to conduct the cover test with a preschool-age child. Which body system is the nurse preparing to assess? a. Eyes b. Ears c. Nose d. Neck

a. Eyes

While evaluating the development of a 10-month-old boy, a nurse hides the boy's stuffed animal behind her back. The boy crawls around the examination table to look behind the nurse's back for the stuffed animal. Which developmental phenomena has this infant demonstrated? a. Hand regard b. Binocular vision c. Object permanence d. Depth perception

c. Object permanence

The nurse is doing a health history for a 14-year-old pregnant girl during a health supervision visit. For which condition should she be screened? a. lead level b. congenital problems c. iron-deficiency anemia d. hyperlipidemia

c. iron-deficiency anemia

The father of a 2-year-old girl tells the nurse that he and his wife would like to begin toilet training their daughter soon. He asks when the right time is to begin this process. What should the nurse say in response?

d. "When she starts tugging on a wet or dirty diaper, she is letting you know she's ready."

Which milestone would the nurse expect an infant to accomplish by 8 months of age? a. Pulling self to a standing position b. Creeping on all fours c. Being able to sit from a standing position d. Sitting without support

d. Sitting without support

Nursing students are learning about the importance of therapeutic communication in their pediatric course. The nursing instructor identifies a need for further teaching when a student makes which statement? a. "It is best to stand when listening to a child to demonstrate knowledge." b. "It is good to lean forward when listening." c. "It is good to sit, not stand when listening." d. "It is best to stoop to a child's level when listening."

a. "It is best to stand when listening to a child to demonstrate knowledge."

A family is anxious for information about the status of their ill infant. The parents do not understand the dominant language, but their 14-year-old child is competent in the language, both spoken and written. The HCP is present, but an interpreter is unavailable. What should the nurse do?

b. Coordinate HCP and interpreter schedules and arrange an information-sharing session for later in the day.

When providing anticipatory guidance to a group of parents with school-aged children, what would the nurse describe as the most important aspect of social interaction? a. Temperament b. Peer relationships c. Family d. School

b. Peer relationships

The nurse is discussing home safety with the parents of a 10-year-old client. Which statement by the client's parents most concerns the nurse? a. "Our child is home alone for an hour each day." b. "We do our best to keep no-cook snacks in the home." c. "Our child swims alone before we get home from work." d. "Our child refuses to eat any green vegetables."

c. "Our child swims alone before we get home from work."

The nurse needs to purchase toys or activities for preschool-aged children for the clinic waiting room. Which toy would be the best choice for this age? a. toy with dials and switches b. brightly colored mobile c. play kitchen and food d. 50-piece jigsaw puzzle

c. play kitchen and food

Which would be a nutritional goal for a preschool client? a. Eat everything on the plate. b. Let the child eat only what the child wants. c. Reduce messiness and spills. d. Introduce new food gradually and include variety.

d. Introduce new food gradually and include variety.

The parent of a toddler notices the child plays nicely next to another toddler but does not play with that child. The parent expresses concern about this behavior to the nurse during an examination. Which response by the nurse is appropriate?

"This is called parallel play and is normal for this age group."

The nurse enters her client's room and finds the infant on a pillow with a bottle propped up while the mother is dressing. What statement should the nurse make?

"You should always hold your baby for feedings instead of propping the bottles."

The nurse is providing anticipatory guidance to the parent of a 2-month-old infant in relation to growth and development. Which statement from the parent demonstrates proper understanding? a. "I can expect my infant to be able to raise the head up when on the stomach within the next month." b. "I can expect my infant to be able to hold a rattle within the next month." c. "I can expect my infant to become clingy around strangers within the next month." d. "I can expect my infant to laugh out lou

a. "I can expect my infant to be able to raise the head up when on the stomach within the next month."

A 16-year-old adolescent is talking with the nurse at a local health clinic about skin care. Which comments by the teen does the nurse determine require additional conversation? Select all that apply. a. "I only tan before going on spring break to get a base tan so I won't burn." b. "My favorite time of day to be outside is the middle of the day, around noon." c. "The more exposure and burns I get now will toughen my skin so I won't get skin cancer when I'm older."

a. "I only tan before going on spring break to get a base tan so I won't burn." b. . "My favorite time of day to be outside is the middle of the day, around noon." c. "The more exposure and burns I get now will toughen my skin so I won't get skin cancer when I'm older."

The mother of a 13-year-old boy confides to the pediatric nurse practitioner that her son has recently had a nocturnal seminal emission. The mother is concerned, and the nurse explains "wet dreams" and the other male traits of puberty to the mother. Which response indicates a need for further discussion? a. "My son must be sexually active or having overly sexual thoughts to have a nocturnal emission." b. "My son's spontaneous erections and nocturnal emissions are very normal."

a. "My son must be sexually active or having overly sexual thoughts to have a nocturnal emission."

A mother reports to the nurse that her 4-year-old does everything that she does. She says she is becoming somewhat frustrated with these actions. What would be the best response by the nurse to this mother? a. "Preschoolers' imitating is a healthy behavior. It is part of their imagination and normal growth and development." b. "I can imagine that it would be very irritating." c. "I am sure there are ways to get your daughter to stop imitating you."

a. "Preschoolers' imitating is a healthy behavior. It is part of their imagination and normal growth and development."

The nurse is obtaining a health history on a toddler and asks the parents about their health history, the health history of their other children, and of their parents' health history. The parents ask the nurse why this information is necessary. What is the best response by the nurse? a. "The information can alert us to any disease process that might run in families." b. "The health history helps us get to know our clients and their families better."

a. "The information can alert us to any disease process that might run in families."

The mother of a 2-year-old asks the clinic nurse why her child's blood pressure is never measured. The mother states, "My blood pressure is measured during each visit to the doctor." What is the best response by the nurse? a. "Typically, children younger than 3 don't need blood pressure measured unless they have a serious or chronic condition." b. "I'm not sure why we don't measure the blood pressure. Maybe you could talk with the doctor about why."

a. "Typically, children younger than 3 don't need blood pressure measured unless they have a serious or chronic condition."

The nurse is speaking to a parent of a 5-year-old child. Which statement by the parent would indicate a potential hearing impairment in the child? a. "When my son is watching TV, I can't stand to be in the room. The sound is always turned up so loud." b. "My son is always listening to music with headphones on." c. "My daughter is learning sign language in school." d. "My daughter loves to talk on the phone to her grandparents."

a. "When my son is watching TV, I can't stand to be in the room. The sound is always turned up so loud."

A 17-year-old female is meeting with the nurse for an annual well-visit and is asking the nurse questions about how to know when one is in love. The nurse should point out which factor to help decide if both individuals have reached a mutual agreement and are ready for an intimate relationship? a. A sense of trust and identity b. A willingness to take initiative c. An ability to be autonomous d. An understanding of socialization and of isolation

a. A sense of trust and identity

The nurse needs to discontinue the urinary catheter of a 4-year-old child who is afraid of the procedure. What strategy(ies) will the nurse use to help the child to cope with this procedure? Select all that apply. a. Be honest with the child about what to expect with catheter removal. b. Have a doll available that the child can play with and demonstrate on. c. Answer all of the child's questions before starting the catheter removal. d. Remove at 1100 e. Ask parents to wait in the hall.

a. Be honest with the child about what to expect with catheter removal. b. Have a doll available that the child can play with and demonstrate on. c. Answer all of the child's questions before starting the catheter removal.

The nurse is preparing to educate the child about a procedure scheduled for the following morning. Which techniques should the nurse use when communicating with this child? Select all that apply. a. Being patient with the child. b. Looking for nonverbal cues. c. Standing at the foot of the child's bed while teaching the child. d. Using terms that the child will likely understand. e. Requesting that the parents leave the room during the education.

a. Being patient with the child. b. Looking for nonverbal cues. d. Using terms that the child will likely understand.

The nurse is caring for a hospitalized 10-year-old client. Which nursing action is most appropriate? a. Consistently reinforce the child's self-worth. b. Discourage the child from assisting with dressing change. c . Correct each of the child's mistakes to ensure learning. d. Structure a competitive environment between clients.

a. Consistently reinforce the child's self-worth.

Once a temper tantrum has started, which intervention is appropriate? a. Move objects out of the way or move the toddler to prevent injury. b. Engage the toddler's behavior. c. Speak to the toddler during the tantrum. d. Have a long talk with the toddler regarding the tantrum.

a. Move objects out of the way or move the toddler to prevent injury.

A nurse, who is also a mother of a 2-year-old child, attends a party at a friend's house and notes some safety concerns that she would like to share with the other mother privately. Which observations during the party would be considered a safety concern that should be addressed privately when appropriate? Select all that apply.

a. The nurse/mother notes that the toddler's car seat is located in the passenger front seat. d. The parent is busy entertaining guests and did not notice the toddler running out in the neighborhood street to get a toy. e. The parents allow the toddler to climb up on the counter and watch as food is stirred on the stove.

According to Erikson, the adolescent develops their own sense of being an independent person with individual thoughts and goals. This stage is referred to as: a. identity vs. role confusion. b. autonomy vs. doubt and shame. c. industry vs. inferiority. d. intimacy vs. isolation.

a. identity vs. role confusion.

The nurse is preparing to administer the diphtheria, tetanus, and pertussis (DTaP) vaccine to an infant. Which route will the nurse utilize? a. intramuscular b. subcutaneous c. intrathecal d. oral

a. intramuscular

A parent and their 4-year-old child are waiting in an exam room when the nurse enters and greets and observes them. Which activity of the child best demonstrates the primary developmental task of the preschool-age child, according to Erikson? a. opening drawers in the room, pulling out and examining supplies b. roughhousing with their parent c. singing a song they learned at preschool d. reading a book

a. opening drawers in the room, pulling out and examining supplies

A 2-year-old toddler holds his breath until passing out when he wants something the parent does not want him to have. The nurse would decide whether these temper tantrums are a form of seizure based on the fact that: a. seizures are not provoked; temper tantrums are. b. with seizures, cyanosis rarely develops. c. seizures rarely occur in toddlers. c. seizures typically occur with fever; temper tantrums do not.

a. seizures are not provoked; temper tantrums are.

A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms? a. the development of a 3-month-old b. the growth of a 2-month-old c. the development of a 10-week-old d. the growth of a 5-month-old

a. the development of a 3-month-old

The nurse is caring for a 4-year-old girl following an appendectomy. The girl becomes fearful and starts to cry as soon as the nurse walks into the room. When the nurse asks about the crying, the girl says, "Nurses who wear shirts with flowers give shots. "The nurse understands that this statement is an example of: a. transduction. b. beginning empathy. c. magical thinking. d. animism.

a. transduction.

During a well-child check-up, the parents of a 9-year-old boy tell the nurse that their son's friends told him that soccer is a stupid game, and now he wants to play baseball. Which comment by the nurse best explains the effects of peer groups? a. "Your child will rarely talk to you about his friends." b. "Acceptance by friends, especially of the same sex, is very important at this age." c. "The children will cheer for each other regardless of the sport being played."

b. "Acceptance by friends, especially of the same sex, is very important at this age."

The mother of a 2-month-old child reports her baby "breathes fast." When questioned further, the child's mother states she has counted the times using her watch and it was sometimes as high as 30 breaths per minute. What is the best response by the nurse? a. "That is a little high for his age and we will need to evaluate this." b. "Babies breathe rapidly and the amount you are reporting is within normal limits." c. "There is not cause for concern."

b. "Babies breathe rapidly and the amount you are reporting is within normal limits."

The student nurse asks the nursing instructor why nurses must be adept at understanding normal growth and development in children when providing care. How should the nursing instructor respond? a. "If a nurse understands normal growth and development, he or she will be able to identify normal milestones in children." b. "By knowing normal growth and development, the nurse is able to identify problems in growth and development."

b. "By knowing normal growth and development, the nurse is able to identify problems in growth and development."

A nurse is conducting a physical examination of an uncooperative preschooler. In order to encourage deep breathing during lung auscultation what could the nurse say? a. "You may not leave until I listen to your breathing." b. "Do you think you can blow out my light bulb on this pen?" c. "You must breathe deeply so I can hear your lungs." d. "Do you want your mother to listen to your lungs?"

b. "Do you think you can blow out my light bulb on this pen?"

The nurse is measuring the head circumference of a 1-year-old infant during a well-child visit. The parent asks the nurse why this assessment is being performed. Which response will the nurse provide to the parent? a. "We measure head circumference to help determine when your infant's suture lines will fuse together." b. "Head circumference is typically assessed until age 2 or 3 to help determine if growth is appropriate."

b. "Head circumference is typically assessed until age 2 or 3 to help determine if growth is appropriate."

A nurse is caring for a very shy 4-year-old girl. During the course of a well-child assessment, the nurse must take the girl's blood pressure. Which approach is best? a. "Your sister did a great job when I took hers." b. "Help me take your doll's blood pressure" c. "May I take your blood pressure?" d. "Will you let me put this cuff on your arm?"

b. "Help me take your doll's blood pressure"

A nurse is teaching an 11-year-old child about the use of incentive spirometry prior to abdominal surgery. The child yells, "I am not going to use this stupid thing, and I wish you would just leave me alone!" What is the priority therapeutic response by the nurse? a. "If you yell at me, I will leave the room and call your parents." b. "I understand that you are angry and nervous about your surgery, but please don't yell."

b. "I understand that you are angry and nervous about your surgery, but please don't yell."

A 2-year-old child is hospitalized for asthma exacerbation. The parents tell the nurse that they have been treating the wheezing with traditional herbal medicines. How should the nurse respond? a. "If these remedies worked then your child would not have needed hospitalization; there is no reason to continue them." b. "Please tell me about how you use the herbal medications so we can assess for herb-drug interactions."

b. "Please tell me about how you use the herbal medications so we can assess for herb-drug interactions."

The nurse is providing education on adolescent safety to a group of caregivers. Which statement by a caregiver indicates additional teaching is needed? a. "Firearms should be kept in locked boxes, closets, or cabinets." b. "Taking a course on driving safety is sufficient to teach safe driving skills." c. "Setting limits is beneficial when rearing teenagers." d. "Teenagers should not cook on the stove when home alone."

b. "Taking a course on driving safety is sufficient to teach safe driving skills."

The nurse is discussing vaccination for Haemophilus influenzae type B (Hib) with the mother of a 6-month-old child. Which comment provides the most compelling reason to get the vaccination? a. "You have a choice of two excellent vaccines." b. "Young children are especially susceptible to these bacteria." c. "Your child needs this final dose for protection." d. "These bacteria live in every human."

b. "Young children are especially susceptible to these bacteria."

The infant weighs 7 lb 4 oz (3300 g) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months? a. 14 lb 8 oz (6.6 kg) b. 21 lb 12 oz (9.9 kg) c. 25 lb (11.3 kg) d. 28 lb 4 oz (12.8 kg)

b. 21 lb 12 oz (9.9 kg)

A 15-year-old is hospitalized for acute appendicitis. Which activities would the nurse include in the client's plan of care? Select all that apply. a. Have the nurse control the patient's care as much as possible. b. Allow friends to visit during visiting hours. c. Include the parents when educating the client. d. Keep the client in hospital gowns for sanitary reasons. e. Arrange care to provide for extra rest and sleep.

b. Allow friends to visit during visiting hours. c. Include the parents when educating the client. e. Arrange care to provide for extra rest and sleep.

A 12-year-old client comes to the clinic for an annual checkup. The nurse needs to take a health history and perform a physical exam. Which method would be the most appropriate when obtaining the client's health history? a. Ask the client to wait outside while the nurse talks with the parent. b. Ask the client if it's OK for the parent to be in the room. c. Ask the parent to leave the room. d. Ask the client to fill out the health form.

b. Ask the client if it's OK for the parent to be in the room.

The nurse is performing an admission assessment of an adolescent with the teen and the parents. During the assessment the nurse suspects that the teen may be pregnant. What is the best way for the nurse to address this situation? a. Ask the teen, with the parents present, if she might be pregnant. b. Ask the parents to wait in the family lounge while finishing the assessment, then ask the teen during the assessment.

b. Ask the parents to wait in the family lounge while finishing the assessment, then ask the teen during the assessment.

The nurse is caring for a child who appears fearful and is reluctant to talk. The nurse uses therapeutic communication skills to interact with the child. What initial goal does the nurse accomplish when using these skills to communicate with the child? a. Assist the child to control emotions. b. Assess the perception of the problem. c. Provide a plan of action. d. Inform the child of priority problems.

b. Assess the perception of the problem.

The nurse is educating a new parent regarding nutritional needs for the newborn. Which statement is accurate and should be taught regarding the nutritional needs of a newborn? a. Newborns require additional water to supplement their diet if they are only formula feeding. b. Formula is designed to provide similar amounts of calories as breast milk would provide. c. Cow's milk is similar to breast milk in terms of calories and nutrients and is appropriate for the newborn. d. Growth during newborn

b. Formula is designed to provide similar amounts of calories as breast milk would provide.

A child is diagnosed with type 1 diabetes. The parents are devastated. They state, "No one in our family has ever had any problems like this." What interventions can the nurse provide to promote a sense of control and reduce fear of the unknown for the child and family? a. Show them how to administer injections so that the child will not have to do it. b. Provide a comprehensive education program regarding the care of the child with diabetes.

b. Provide a comprehensive education program regarding the care of the child with diabetes.

The father of a toddler reports his son says "no" every time he attempts to correct him. What is the best advice the nurse can offer to the parent? a. This is a normal part of toddlerhood. b. Saying no is your son's way of trying to exert his independence and is expected. c. Continue to correct him because he needs discipline. d. You may need to lessen the amount of correction being given to the child as he seems to be responding to feeling "overly restricted."

b. Saying no is your son's way of trying to exert his independence and is expected.

The nurse is admitting a 15-year-old adolescent to the hospital pediatric unit. What does the nurse recognize as a priority for this adolescent? a. The adolescent should be given freedom to participate in unit activities as desired. b. The adolescent's need for privacy should be respected. c. The adolescent's need for parental support should be discussed. d. The adolescent should be encouraged to call friends often.

b. The adolescent's need for privacy should be respected.

A nurse is packing a bag with all of the equipment she will need to perform a complete physical assessment at a client's home. What will the nurse need? Select all that apply. a. Syringe b. Thermometer c. Tongue depressor d. Ophthalmoscope e. Stethoscope f. IV bag

b. Thermometer c. Tongue depressor d. Ophthalmoscope e. Stethoscope

The nurse is assessing a 2-year-old boy during a well-child visit. The nurse correctly identifies the child's current stage of Erikson's growth and development as: a. industry versus inferiority b. autonomy versus shame and doubt c. trust versus mistrust d. initiative versus guilt

b. autonomy versus shame and doubt

While observing a group of 9-year-old children at school, the nurse is concerned that one of the children is not cognitively developing according to Piaget's stage of concrete-operational thought processes. With which activity is the nurse concerned? a. believed that not turning in homework on time was acceptable, but has since decided it is not acceptable b. does not understand the phrase "slow as molasses" when used by the teacher

b. does not understand the phrase "slow as molasses" when used by the teacher

A nurse is describing growth and development during the preschool period. What would the nurse identify as a predominant and heightened characteristic for this age group? a. vocabulary b. imagination c. gross motor skills d. fine motor skills

b. imagination

The nurse is caring for a 14-year-old boy who has just been diagnosed with a malignant tumor on his liver. Which intervention is most important to this child and family? a. arranging an additional meeting with the nurse practitioner b. involving the child and family in decision-making c. discussing treatment options with the child and parents d. describing postoperative home care for the child

b. involving the child and family in decision-making

The nurse is interacting with several families with children during their health visits. Which child would the nurse prioritize to receive a hearing screening? a. the 8-week-old who had an initial hearing screening reported as negative b. the 3-week-old infant who was discharged without a hearing screening c. the 3-month-old whose mother reports the child turns his head to noises d. the 6-month-old who attempts to mimic sounds the parents make

b. the 3-week-old infant who was discharged without a hearing screening

A nurse is reviewing the health records of several 4-month-old infants who were seen in the pediatric office today. Which infant behavior will require referral for further evaluation of growth and development? a. rolls from prone to supine position b. unable to support their head c. reaches for nearby objects d. cannot sit without assistance

b. unable to support their head

The nurse is teaching safety to a group of adolescents. Which common cause of death among adolescents will the nurse include in the teaching? a. falls b. unintentional injuries c. diseases d. poisoning

b. unintentional injuries

The nurse is collecting data from a 15-year-old boy who is being seen at the ambulatory care clinic for immunizations. During the initial assessment, he voices concerns about being shorter than his peers. What response by the nurse is indicated? a. "I am sure you are not the shortest guy in your class." b. "Being short is nothing to be ashamed of." c. "Boys your age will often continue growing for a few more years." d. "Are the other men in your family short?"

c. "Boys your age will often continue growing for a few more years."

The nurse is counseling a pregnant adolescent about the health benefits associated with breastfeeding. Which statement by the client indicates understanding? a. "Breastfeeding my baby will pass on a type of active immunity." b. "Breastfeeding my baby will provide lifelong immunity against certain diseases." c. "Breastfeeding my baby will pass on passive immunity." d. "Breastfeeding my baby will help to stimulate my baby's immune system to activate."

c. "Breastfeeding my baby will pass on passive immunity."

The parents of an 8-year-old boy report their son is being bullied and teased by a group of boys in the neighborhood. Which response by the nurse is best? a. "Fortunately the scars of being picked on will fade as your son grows up." b. "Perhaps teaching your son self-defense courses will help him to have a greater sense of control and safety." c. "Bullying can have lifelong effects on the self-esteem of a child."

c. "Bullying can have lifelong effects on the self-esteem of a child."

The nurse is caring for a 10-year-old girl and is trying to obtain clues about the child's state of physical, emotional, and moral development. Which question is most likely to elicit the desired information? a. "Do you have a lot of friends at school?" b. "Would you say that you are a good student?" c. "Tell me about your favorite activity at school?" d. "Do you like your school and your teacher?"

c. "Tell me about your favorite activity at school?"

The nurse is discussing measles, mumps, and rubella vaccination with a mother who is concerned about using the combined vaccine for her 12-month-old. Which statement by the nurse will be most helpful to the mother in accepting the vaccine? a. "This vaccine is approved by the American Academy of Pediatrics." b. "It is one of the most commonly used childhood vaccines." c. "The vaccine is shown to be effective and safe and will reduce the number of injections your child will need."

c. "The vaccine is shown to be effective and safe and will reduce the number of injections your child will need."

A parent tells the nurse that the 6-year-old child has been biting his fingernails since beginning first grade. After analysis, the cause is determined to be increased stress. What advice would the nurse give the parent regarding this behavior? a. Allow the child to choose a reward for not biting the nails. b. Encourage the child to drink more milk for stronger nails. c. Allow some time every day for the child to talk about new experiences

c. Allow some time every day for the child to talk about new experiences

A 3-year-old is hospitalized unexpectedly and is frightened about the experience. What action could the nurse take to minimize the anxiety the child is experiencing? a. Tell the child that everything will be fine and not to worry. b. Insist that the parents stay with the child at all times. c. Allow the child to handle the equipment before it is used on the child. d. Provide all of the child's care, including all ADLs.

c. Allow the child to handle the equipment before it is used on the child.

Which is the best way for parents to aid a toddler in achieving the developmental task? a. Help the toddler learn to count b. Urge the toddler to dress oneself completely alone c. Allow the toddler to make simple decisions d. Give the toddler small household chores to do

c. Allow the toddler to make simple decisions

The nurse enters a room to perform an assessment and finds the 9-month-old client asleep in the father's arms. Which action will the nurse take first? a. Obtain the infant's temperature. b. Instruct the father to call when the infant wakes c. Assess the infant's respiratory status. d. Monitor how long the infant sleeps.

c. Assess the infant's respiratory status.

A mother and her 4-week-old infant have arrived for a health maintenance visit. Which activity will the nurse perform? a. Take a health history for a minor injury. b. Administer a varicella injection. c. Plot the child's head circumference on a growth chart. d. Assess the child for an upper respiratory infection.

c. Plot the child's head circumference on a growth chart.

The nurse is teaching the parents of a newborn with a metabolic problem about the disorder and its treatment. What is the least effective teaching technique? a. Discuss how to handle a possible emergency situation. b. Explain the disorder in common terms. c. Provide literature for the parents to read and then have them ask questions. d. Use the USDAs "MyPlate" diagram to teach necessary nutrition alterations.

c. Provide literature for the parents to read and then have them ask questions.

A nurse is talking with a school-age child with asthma who expresses concerns that peers will not want to be friends because of the disease. What therapeutic communication technique would be beneficial for the nurse to use? a. Inform the child that the parents must be present during a personal conversation like this one. b. Have the child sit down in a chair and the nurse stand next to the child. c. Sit at the child's level and allow the child time for self-expression.

c. Sit at the child's level and allow the child time for self-expression.

A nurse is conducting visual acuity screening for a 6-year-old child. Assessment reveals that the child knows the alphabet. Which tool would be most appropriate for the nurse to use to screen this child's vision? a. tumbling E b. Ishihara tool c. Snellen eye chart d. Allen object recognition tool

c. Snellen eye chart

The pediatric nurse is planning quiet activities for a hospitalized 18-month-old. What would be an appropriate activity for this age group? a. Using crayons to color in a coloring book b. Putting shapes into appropriate holes c. Stacking blocks d. Painting by number

c. Stacking blocks

The home health nurse is visiting a 2-year-old client's home. Which finding will cause the nurse to intervene? a. The toddler goes to the bathroom alone to urinate. b. The toddler in not allowed in the kitchen while food is being prepared. c. The family's medications are located in a kitchen drawer. d. All of the windows in the home are locked.

c. The family's medications are located in a kitchen drawer.

The nurse is caring for a 4-year-old child who is hospitalized and in traction. The child talks about an invisible friend to the nurse. Which action by the nurse is indicated? a. The nurse should document the reports of hallucinations by the child. b. The nurse should explain to the child that there are no friends present. c. The nurse should recognize this behavior as normal for the child's developmental age and do nothing.

c. The nurse should recognize this behavior as normal for the child's developmental age and do nothing.

The parents of a 12-year-old girl report their daughter is missing an increasing amount of school. They further share that the child says she feels ill and begs to stay home. What action by the parents will be most therapeutic? a. The parents need to demand the child go to school. b. The parents should allow the child to stay home if necessary. c. The parents need to attempt to determine why the child is avoiding school.

c. The parents need to attempt to determine why the child is avoiding school.

A parent is concerned because the toddler refuses to share. What is the nurse's best response to the parent regarding this concern? a. Play time with other toddlers should be cut back until your toddler learns to share. b. Behavior modification techniques can change the toddler's behavior. c. This is normal toddler behavior; sharing is learned later. d. The toddler is probably reacting to some family crisis.

c. This is normal toddler behavior; sharing is learned later.

The nurse is caring for a toddler who is scheduled for an outpatient lumbar puncture. Which action by the nurse would be appropriate? a. explaining the procedure with a picture and diagram to ensure cooperation of the toddler b. educating the parents to begin preparing the toddler for the procedure about 1 week in advance c. having a child life specialist interact with the toddler before and during the procedure

c. having a child life specialist interact with the toddler before and during the procedure

The nurse is assessing an adolescent's risk for harm from guns being present in the home. What question would be best to ask during the assessment? a. "Have you been taught how to use a gun?" b. "Do you understand that it is important for you not to handle a gun?" c. "Do you and your dad hunt?" d. "Are the guns in your home locked in a safe?"

d. "Are the guns in your home locked in a safe?"

The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching? a. "He is allowed out of time-out when he is calm." b. "The time-out doesn't just have to be in his room." c. "I put him in time-out when the problem occurs." d. "I usually have him in time-out for about 10 minutes."

d. "I usually have him in time-out for about 10 minutes."

The nurse is caring for an 8-year-old girl. She is reviewing her nutritional requirements and describing interventions that promote healthy eating habits. Which response by the girl's mother indicates a need for further discussion? a. "My daughter eats one item at a time." b. "My daughter likes to have a glass of milk with her meal." c. "My daughter likes many different kinds of fruits and vegetables." d. "My daughter must stay at the table until she has cleaned her plate."

d. "My daughter must stay at the table until she has cleaned her plate."

A hospitalized 7-year-old is recovering from a head injury. Occupational therapy has been ordered to assist the child in regaining eye/hand coordination. If the child cannot master this skill, what feelings may arise? a. A sense of mistrust b. A sense of shame c. A sense of doubt d. A feeling of inferiority

d. A feeling of inferiority

The nurse is conducting a physical examination of a healthy 6-year-old. Which action should the nurse do first? a. Tap with the knee with a reflex hammer to check for deep tendon reflexes. b. Palpate the skin for texture and hydration status. c. Auscultate the heart, lungs, and the abdomen. d. Observe the skin for its overall color and characteristics.

d. Observe the skin for its overall color and characteristics.

Nursing students are reviewing information about the cognitive development of preschoolers. The students demonstrate understanding of the information when they identify that a 3-year-old is in what stage as identified by Piaget? a. Coordination of secondary schema b. Primary circular reaction c. Tertiary circular reaction d. Preoperational thought

d. Preoperational thought

The nurse is presenting nutritional information at a community health fair. Which suggestion should the nurse prioritize when illustrating proper nutrition for preschoolers? a. Need three big meals a day due to rapid growth b. Should drink at least 4 cups of milk each day c. Need extra calcium for proper muscle growth d. Snacks throughout the day help the child meet nutritional requirements

d. Snacks throughout the day help the child meet nutritional requirements.

The community nurse is preparing an educational session on how to provide anticipatory guidance to clients for other nurses. Which example will the nurse include in the teaching? a. Providing vaccinations to the children in a community. b. Ordering the prescribed diet for a child who had surgery. c. Taking a child's vital signs. d. Teaching handwashing at an elementary school.

d. Teaching handwashing at an elementary school.

The nurse knows that the school-age child is in Erikson's stage of industry versus inferiority. Which best exemplifies a school-aged child working toward accomplishing this developmental task? a. The child becomes aware of the opposite sex. b. The child performs his bedtime preparations autonomously. c. The child is developing a conscience. d. The child signs up for after-school activities.

d. The child signs up for after-school activities.

Following a principle of learning, the nurse can anticipate that school-age children will best learn a skill such as bandaging if they: a. have it demonstrated to them by a teacher. b. are shown a photo of someone important doing it. c. are criticized for not learning it well. d. are allowed to practice it.

d. are allowed to practice it.

Anticipatory guidance for an infant for the 4th month should include the fact that the infant will be able to achieve which developmental milestone? a. develop a fear of strangers b. have many "blue" or moody periods c. insist on things being done the infant's way d. be able to turn over onto the back

d. be able to turn over onto the back

The nurse is watching a 4-year-old child play with another preschool child. The children are playing a game with rules. The nurse notes that the child is demonstrating what type of play? a. dramatic play b. parallel play c. associative play d. cooperative play

d. cooperative play

The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex: a. should be pronounced and easy to elicit. b. is a protective reflex and retained for life. c. is expected to appear within 1 month. d. should have disappeared.

d. should have disappeared.