Peds Exam 1
According to Freud's theory, in what order do the stages of child development occur?
1. Oral 2. Anal 3. Oedipal 4. Latency 5. Genital Rationale: Freud's theory sets forth five stages of child development. The oral stage (stage 1) spans the period from birth to 12 to 18 months. The anal stage (stage 2) occurs between the ages of 18 months and 3 years. The Oedipal stage (stage 3) occurs between 3 and 6 years of age. The latency stage (stage 4) occurs between the ages of 6 and 12 years. Finally, the genital stage (stage 5) lasts from puberty through adulthood.
Children's patterns of play change as they grow from infancy through school-age. Rank the order of appearance of each type of play, starting with infant play.
1. Solitary 2. Parallel 3. Associative 4. Cooperative Rationale: The infant plays alone, with others initiating the play activity. Toddlers' play activity is described as parallel; they play beside other children but not with them. Preschoolers' play is associative in loose groups, with activities involving interaction among players. The school-age child is capable of cooperative play, which includes organized play such as sports, board games, and card games.
Arrange in order of occurrence the steps involved in the changes during puberty.
1. Triggering of GnRH by the hypothalamus 2. Movement of GnRH through a network of capillaries to the anterior pituitary gland 3. Stimulation of production and secretion of FSH and LH 4. Stimulation of the gonadal response. Rationale: Some events trigger the production of gonadotropin-releasing hormone (GnRH) by the hypothalamus. GnRH travels through a network of capillaries to the anterior pituitary gland and stimulates the production and secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). When the levels of these hormones increase, they in turn stimulate the gonadal response.
How many days is the neonatal period?
28
If hearing loss is detected early, proper intervention can help a child achieve normal language development. Which should be the latest age that hearing loss should be detected to ensure that a child achieves normal language development?
3 Months Rationale: If a health care provider detects hearing loss before the child is 3 months old and an intervention is initiated within 6 months, the child can achieve normal language development.
Which statement is true for toddlers? a. the incidence of poisoning is very common in toddlers b. an 18-month-old child uses up to 300 words c. the average toddler gains 2 to 3 pounds (0.9-1.4 kg) each year d. toddlers prefer to engage in parallel rather than solitary play
a. the incidence of poisoning is very common in toddlers Rationale: Poisonings occur frequently because children of around 2 years of age place objects or substances in their mouths to learn about them. The 18-month-old child uses approximately 10 words. A toddler gains approximately 5 to 7 pounds (2.3-3.2 kg) each year. The toddler begins to engage in parallel play during toddlerhood but also engages in solitary play.
An infant has been admitted with failure to thrive. The nurse knows that more education is needed when one of the parents makes which statement? a. "I can double the amount of water in the formula to save money" b. "I need to hold her head up a little higher than her stomach when I feed her" c. "I need to burp the baby when the feeding is done to get rid of swallowed air" d. "I need to make sure that the formula is in the nipple so she doesn't swallow so much air."
a. "I can double the amount of water in the formula to save money" Rationale: Doubling the amount of water in the formula reduces the baby's caloric intake. Holding the head up, burping the baby, and making sure that formula is in the nipple are all ways to increase caloric intake and reduce the chance of postfeeding vomiting due to air swallowing.
A new mother is concerned that her 1-month-old infant is nursing every 2 hours. Which response by the nurse is most appropriate? a. "It's common for newborns to nurse this often. Let's talk about how you're adjusting with the new baby." b. "Breast milk is easily digested; giving your infant a little rice cereal will keep him full longer" c. "It sounds as though your baby is a little spoiled; try to resist feeding more often than every 4 hours" d. "You may not be producing enough milk; it'll be important for you to supplement feedings with formula"
a. "It's common for newborns to nurse this often. Let's talk about how you're adjusting with the new baby." Rationale: Newborns typically nurse every 2 to 3 hours. Although breast milk is easily digested, feeding solids to an infant is not recommended at this age. Feeding satisfies a fundamental need; one does not spoil an infant by nursing as needed. Adequate intake is evidenced in infant weight gain and adequate urinary and bowel elimination. Supplementing feedings with formula may lead to decreased milk production.
Which is the maximum recommended dose of an intramuscular injection in a toddler? a. 0.5 mL b. 1 mL c. 1.5 mL d. 2 mL
b. 1 mL Rationale: An intramuscular dose is very small and usually does not exceed 1 mL in toddlers or 0.5 mL in infants. The other options, 1.5 mL and 2 mL, are incorrect.
How would the nurse respond to parents who are concerned about separation anxiety in their 15-month-old child? a. "This is an expected developmental reaction" b. "You may be spending too much time with your child" c. "It might be helpful to leave your child with someone else once in awhile" d. "Toddlers who have separation anxiety may have difficulty when they start school."
a. "This is an expected developmental reaction" Rationale: Understanding that separation anxiety is an expected developmental occurrence will be reassuring to the parents. Commenting that the parents my be spending too much time with their child is a value judgment and does not address this expected stage of development. Giving advice is not therapeutic and does not address the child's separation anxiety. There is no connection between separation anxiety in a 15-month-old child and difficulty starting school.
Which clinical sign or reflex entails spasm of the hamstring muscles during leg extension? a. Kernig sign b. Babinski reflex c. Chvostek sign d. Cremasteric reflex
a. Kernig sign Rationale: The Kernig sign is indicative of meningitis; it is demonstrated by a spasm of the hamstring muscles when the legs are extended. The Babinski reflex is dorsiflexion and fanning of the toes when the sole is stroked; adults with neuromuscular impairment and healthy infants exhibit this sign. The Chvostek sign is elicited by tapping on the facial nerve in the region of the parotid gland; spasm indicates tetany. In a male, the cremasteric reflex is elicited by stroking the inner thigh; this should cause the testes to retract into the scrotal sac.
According to Kohlberg's theory of moral development, which statement about conventional reasoning is true? a. a person wants to fulfill family expectations b. a child's thinking is mostly based on likes and pleasures c. a child recognizes that there is more than one correct view d. an individual moves away from moral decision based on authority
a. a person wants to fulfill family expectations Rationale: During the 'convention reasoning' level, a person wants to fulfill the expectations of his or her family, group, or nation. During the 'preconventional reasoning' level, a child's thinking is mostly based on likes and pleasures. During this stage, the child also recognizes that there is more than one correct view. During the 'postconventional stage,' individuals move away from moral decisions based on authority or conformity to groups to define their own moral values and principles.
The parent of an infant with heart failure questions the necessity of weighing the baby every morning. Which would the nurse say that this daily information is important in determining? a. fluid retention b. kidney function c. nutritional status d. medication dosage
a. fluid retention Rationale: Fluid retention is reflected by an excessive weight gain in a short period. Inadequate cardiac output decreased blood flow to the kidneys and thus leads to increased intracellular fluid and hypervolemia. Although this assessment may add information to the data regarding kidney function, other assessments, such as hourly urine output, blood urea nitrogen concentration, and creatinine level more significantly reflect kidney function. Weight gain resulting from nutritional intake is gradual and will not vary greatly on a day-to-day basis. Although, weight is used to determine medication dosages, dosages do not need to be recalculated according to changes in daily weights.
In which settings would the nurse prepare to administer developmental assessment for pediatric clients? Select all that apply a. home b. school c. hospital d. daycare center e. assisted living center
a. home b. school c. hospital d. daycare center Rationale: Pediatric developmental assessments are performed in many settings, including the home, school, hospital, and daycare center environments. It is unlikely that a pediatric developmental assessment would be performed in an assisted living center.
Which treatment would the nurse anticipate for an infant admitted with bronchiolitis caused by respiratory syncytial virus (RSV)? a. humidified cool air and adequate hydration b. postural drainage and oxygen by hood c. bronchodilators and cough suppressants d. corticosteroids and broad-spectrum antibiotics
a. humidified cool air and adequate hydration Rationale: Humidified cool air and hydration are essential to facilitating improvement in the child's physical status. Postural drainage is not effective with this disorder; oxygen is used only if the infant has severe dyspnea and hypoxia. Bronchodilators are not used, because the bronchial tree is not in spasm; cough suppressants are ineffective. Corticosteroids are ineffective; antibiotics are also ineffective, because the causative agent is viral.
Which teeth would the nurse expect to erupt first in a typically developing 6-month-old infant? a. incisors b. canines c. upper molars d. lower molars
a. incisors Rationale: The bottom incisors are the first teeth to erupt, between 6 and 8 months of age. The canine teeth appear around 18 months. The first molars, both upper and lower, appear around 20 months.
In which stage of Piaget's theory of growth and development does an infant develop an action pattern to deal with the environment? a. sensorimotor b. preoperational c. formal operations d. concrete operations
a. sensorimotor Rationale: In Piaget's theory, child development is divided into four periods. During the sensorimotor period, an infant develops a schema or action pattern for dealing with the environment. During the preoperational period, children learn to think with the use of symbols and mental images. During the formal operations period, egocentric thought prevails. During the concrete operations period, the child thinks about a recently performed physical action.
Which period of Piaget's theory describes the idea of object permanence? a. sensorimotor period b. preoperational period c. formal operation period d. concrete operations period
a. sensorimotor period Rationale: There are four periods of Piaget's theory of cognitive development. The first period is the sensorimotor period; this period describes object permanence. During the ages of birth to 2 years, the child understands that objects continue to exist even when they are not visible. The second period is the preoperational period, which is observed in children between the ages of 2 and 7 years. During this time, children learn to think about the use of symbols and have mental images. The third period is the concrete operations period, which is observed between the ages of 7 and 11 years. During this period, the child thinks about an action before performing it. The formal operations period is the fourth period, which is observed in children from the ages of 11 years old throughout adulthood. During this period, there is a prevalence of egocentric thought.
Which hematocrit result would the nurse recognize as normal in a healthy 12-month-old infant? a. 19% to 32% b. 29% to 41% c. 37% to 47% d. 42% to 69%
b. 29% to 41% Rationale: The expected hematocrit range for a 1-year-old infant is 29% to 41%. A range of 19% to 32% is too low; these readings occur with problems such as prolonged blood loss. A range of 37% to 47% is too high; this is the expected hematocrit range for an adult female. A range of 42% to 69% is too high; this is the expected hematocrit range for a newborn.
How many hours of sleep would the nurse recommend for the 11-year-old client? a. 8 b. 9 c. 11 d. 12
b. 9 Rationale: A school-age client who is 11 years of age would require 9 hours of sleep each night. Ten hours of sleep is not recommended for the school-age client.
According to Piaget's theory, which of these statements about the period of concrete operations is true? a. a child develops a scheme for dealing with the environment b. a child is able to describe a process without actually doing it c. a child has the capacity to reason with respect to possibilities d. a child believes that everyone experiences the world exactly as her or she does
b. a child is able to describe a process without actually doing it Rationale: According to Piaget's theory, a child is able to describe a process without actually carrying it out in the concrete operations period. A child develops a scheme for dealing with the environment during the sensorimotor period. A child gains the capacity to reason with respect to possibilities during the formal operations period. A child believes that everyone experiences the world exactly as he or she does during the preoperational period.
According to the Piaget's theory, which behavior does a 9-year-old child show? a. logical reasoning b. concrete thinking c. object permanence d. imaginary audience
b. concrete thinking Rationale: A child of 9 years of age will exhibit concrete thinking. Logical reasoning is observed in individuals starting from the age of 11 years. Object permanence is observed in children between birth and 2 years old. The idea of being constantly observed by an imaginary audience is observed in individuals starting from the age of 11 years.
According to Kohlberg's theory, which stage comes before the society-maintaining orientation stage? a. social contract orientation b. good boy-nice girl orientation c. instrumental relativist orientation d. punishment and obedience orientation
b. good boy-nice girl orientation Rationale: According to Kohlberg's theory, the good boy-nice girl orientation phase (stage 3) occurs before the society-maintaining orientation phase (stage 4). Social contract orientation is the fifth stage. Instrumental relativist orientation is the second stage.
Which surgical procedure involves urinary diversion in which the ureters are transplanted to a resected section of the small intestines, with one end attached to the abdominal wall? a. cystostomy b. ileal conduit c. ureterosigmoidostomy d. cutaneous ureterostomy
b. ideal conduit Rationale: An ileal conduit is the transplantation of the ureters into a resected portion of the ileum, which is then used to create a stoma on the abdominal wall for drainage of urine. Cystostomy is an opening into the bladder through the abdominal wall that allows urine to flow out. In ureterosigmoidostomy, the ureter is transplanted into the colon and urine is excreted through the rectum. In cutaneous ureterostomy, the ureter is transplanted through the abdomen and attached to the skin.
A 2-year-old toddler has hearing loss caused by recurrent otitis media. Which treatment would the nurse anticipate that the practitioner will recommend? a. eardrops b. myringotomy c. mastoidectomy d. steroid therapy
b. myringotomy Rationale: Myringotomy is a surgical opening into the eardrum to permit drainage of accumulated fluid associated with otitis media. Ear drops are not used because they will obscure the view of the tympanic membrane. Removal of the mastoid will not relieve pressure within inflamed ears. Antibiotics, not steroids, are used for an infectious process.
Which of these statements about the transition from intrauterine to extrauterine life is true? a. hyperthermia is observed in the newborn b. newborns are susceptible to heat loss and cold stress c. apgar assessments are conducted 5 and 10 minutes after birth d. physiological changes in the newborn occur during the first 12 hours of life
b. newborns are susceptible to heat loss and cold stress Rationale: During the transition from intrauterine to extrauterine life, newborns are susceptible to heat loss and cold stress. Newborns are susceptible to hypothermia, not hyperthermia. Apgar assessments are generally conducted between 1 and 5 minutes after birth. Physiological changes in the newborn are seen during the first 24 hours of life.
Which type of play do 2-year-old toddlers engage in? a. group b. parallel c. dramatic d. cooperative
b. parallel Rationale: Toddlers play independently but beside other children; they are aware of the other children, often grabbing toys from them, but do not socially interact with them. Group play is characteristic of older children. Dramatic play or acting is characteristic of older children; starting at the preschool age, they assume and act out roles. Cooperative play is also characteristic of older children; starting at the preschool age; they learn to share, wait their turn, and become sensitive to their peers' needs.
Which toys would the nurse suggest to the parent of a 4-month-old infant to help promote the child's growth and development? a. push-pull toys b. soft squeeze toys c. nesting blocks and cups d. wooden hammer and pegboard
b. soft squeeze toys Rationale: Soft, noisy squeeze toys are appropriate for a 4-month-old; the infant enjoys squeezing and hearing the sound of the squeaker. Push-pull toys are appropriate for a toddler 12- to 24-months of age. Nesting toys are appropriate for a toddler 16-months of age. Banging toys are appropriate for children from 12- to 18-months of age.
Which stage describes the Oedipus complex, according to Freud's theory? a. stage 2 b. stage 3 c. stage 4 d. stage 5
b. stage 3 Rationale: According to Freud's theory, there are five stages in a child's development. Stage 3 is the Oedipal stage, which is also known as the phallic stage. Stage 2 is the anal stage. Stage 4 is the latency stage. Stage 5 is the genital stage.
To which client would the nurse provide education regarding the pubertal growth spurt? a. an 8-year-old school-age male client b. a 16-year-old adolescent male client c. a 12-year-old school-age female client d. an 18-year-old adolescent female client
c. a 12-year-old school-age female client Rationale: The pubertal growth spurt reaches a peak for female clients at 12 years of age; therefore the nurse would provide education to this client regarding expected growth during this time period. The 8-year-old male client would not be expected to experience the pubertal growth spurt until the age of 14 years. The 16-year-old and the 18-year-old adolescent clients would have already experienced the pubertal growth spurt.
In which stage of Erikson's theory does the child initiate self-care activities? a. initiative vs guilt b. integrity vs despair c. autonomy vs sense of shame and doubt d. generativity vs self-absorption and stagnation
c. autonomy vs sense of shame and doubt Rationale: The development of self-care activities in a toddler occurs at the stage of autonomy versus a sense of shame and doubt; this is the second stage of Erikson's theory. The initiative versus guilt stage is the third stage of Erikson's theory. During this stage, children like to pretend and try out new roles. Integrity versus despair is the eighth stage of Erikson's theory. At this stage, many older adults view their lives with a sense of satisfaction. Middle-age adults achieve success at the stage of generativity versus self-absorption and stagnation. Individuals contribute to future generations through parenthood, teaching, and community involvement.
Which would the nurse identify as a group of hospitalized toddlers' most important need? a. stimulating play b. therapeutic play c. contact with their parents d. gentle discipline from the nurse
c. contact with their parents Rationale: Separation anxiety becomes an issue at this age; toddlers need contact with parents, who provide a sense of security. Stimulating play may offer a distraction, but the greater need is for parental contact. Toddlers are too young for therapeutic play, which is more successful with preschoolers and young school-age children. Gentle discipline from the nurse may be necessary at times, but the greatest need of hospitalized toddlers is to have parental contact.
According to the Erikson's theory, which stage in a young adult describes the development of the sense of caring for others? a. initiative vs guilt b. integrity vs despair c. intimacy vs isolation d. identity vs role confusion
c. intimacy vs isolation Rationale: The development of a sense of caring for others in a young adult occurs at the stage of intimacy vs. isolation. During the initiative vs guilt stage, a child likes to pretend and try out new roles. At the integrity vs despair stage, many older adults view their lives with a sense of satisfaction. During the identity vs role confusion stage, a child's identity development begins with the goal of achieving some perspective or direction.
The nurse on the pediatric unit is observing the developmental skills of several 2-year-old children in the playroom. Which child would the nurse continue to evaluate? a. one who cannot stand on one foot b. one who builds a tower of seven blocks c. one who exhibits echolalia when speaking d. one who colors outside the lines of a picture
c. one who exhibits echolalia when speaking Rationale: Echolalia in a 2-year-old child may be a sign of autism; imitation of sounds begins around 6 months of age and may continue for several more months. The average 2-year-old child has a 300-word vocabulary and uses two- and three-word phrases. It is not until 30 months of age that the toddler is able to stand on one foot. Building a tower of five or six blocks is expected at the age of 2 years. Although the pincer grasp is achieved at 11 months, it is not until the age of 30 months that the toddler is expected to hold crayons with the fingers rather than the fists and color within the lines of a picture.
A 9-month-old infant appears well nourished, alert, and happy. Using Freud's psychosexual stages of development, the nurse determines that the infant is in which stage? a. genital stage b. latency stage c. oral-sensory stage d. anal-urethral stage
c. oral-sensory stage Rationale: According to Freud's psychosexual stages, the oral-sensory stage extends from birth to 18 months. In the first stage of personality development, the libido is centered in a baby's mouth. It gets much satisfaction from putting all sorts of things in the mouth to satisfy the libido and the demands of the id. The id demands at this stage in life are oral, or mouth orientated, such as sucking, biting, and breast-feeding. The genital stage runs from puberty to early adulthood. The latency stage is around age 6. The anal-urethral stage extends from 1 to 3 years of age.
The nurse notes that a child in a crib has a clamped jaw and is having a tonic-clonic seizure. Which is the priority nursing responsibility at this time? a. applying restraints b. administering oxygen c. protecting the child from self-injury d. inserting a plastic airway in the child's mouth
c. protecting the child from self-injury Rationale: Because the child is in a crib, the nurse would remain, observe, and protect the child from injury to the head or extremities during seizure activity. An individual never should be restrained during a seizure; fractured bones or torn muscles and ligaments may result. Administering oxygen is useless until the seizure is over; the child is apneic during the seizure. Attempts at inserting an airway are futile and may damage the child's teeth and jaws.
Which stage of development classifies boys and girls as differing very little in terms of size? a. toddler b. preschool c. school-age d. adolescence
c. school-age Rationale: During the school-age stage of development, boys and girl differ very little in terms of size. During the toddler, preschool, and adolescence stages of development boys are often larger than girls.
At which age is a toddler physiologically and psychologically prepared for toilet training? a. 13 months b. 16 months c. 19 months d. 22 months
d. 22 months Rationale: The 22-month-old toddler is both physiologically and psychologically prepared for toilet training. . The 13-month-old, 16-month old, and 19-month old are not yet physiologically and psychologically prepared for toilet training.
Which statement is true about Piaget's theory of cognitive development? a. Piaget's theory includes five periods that are related to age. b. In the late preoperational stage, the children experience animism c. In the preoperational stage, children are able to perform mental operations. d. During the sensorimotor stage, infants develop an action pattern for dealing with their environment.
d. During the sensorimotor stage, infants develop an action patter for dealing with their environment. Rationale: According to Piaget's theory, during the sensorimotor stage, infants develop a schema or action pattern for dealing with the environment. Piaget's theory includes four periods that are related to age. In the early preoperational stage, children experience animism. During the concrete operations stage, children are able to perform mental operations.
An infant is found to have developmental dysplasia of the hip 6 weeks after birth. The parents ask the nurse why their infant must be restrained in a harness at such an early age. How would the nurse respond? a. Infants are easier to manage in a harness than toddlers b. Mobility will be delayed if correction is postponed until later c. Adduction devices cannot be used as effectively after the toddler age. d. Infants' hip joints are cartilaginous, allowing molding of the acetabulum.
d. Infants' hip joints are cartilaginous, allowing molding of the acetabulum. Rationale: The cartilaginous nature of infants' hip joints is the basis for the use of abduction devices (e.g., Pavlik harness) when the infant is very young. Although an infant is easier to manage in a harness than is a toddler, the main reason for the use of a harness so early in life is the easy moldability of the bones at this age. Traction may be used before surgery to correct contractures; these treatments are more traumatic than the harness, which is applied before the infant can walk. Hip dysplasia is usually not painful and does not limit ambulation for the young child. Abduction, not adduction, devices are used; abduction devices are ineffective by the time the child reaches the toddler age.
The nurse confirms that a 9-month-old infant's immunization schedule is up to date. Which immunization will the infant receive at 15 months of age? a. hepatitis b (HepB) b. polio vaccine (IPV) c. Rotavirus d. Measles, mumps, and rubella (MMR)
d. Measles, mumps, and rubella (MMR) Rationale: It is recommended that infants be given the MMR combination vaccine at 12 to 15 months of age. The first dose of HepB vaccine is given at birth, the second between 1 and 2 months, and the third 24 weeks after the second dose. The inactivated poliovirus vaccine (IPV) is given at 2 months, 4 months, and 6 to 18 months of age; the next booster (fourth) is given at 4 to 6 years of age. Rotavirus is given at 2 months, 4 months, and 6 months (8 months is the latest for the dose).
Which is the priority intervention for the infant with developmental dysplasia of the hip? a. flexion of the hip b. extension of the hip c. adduction of the hip d. abduction of the hip
d. abduction of the hip Rationale: Abduction will enable the head of the femur to fit into the acetabulum, thereby correcting the dysplasia. Flexion causes the head of the femur to move away from the acetabulum. Extension causes the head of the femur to move away from the acetabulum. Adduction causes the head of the femur to move away from the acetabulum.
Which type of cerebral palsy (CP) is associated with slow writhing movements? a. ataxic b. spastic c. dystonic d. athetoid
d. athetoid Rationale: The athetoid type of CP consists of slow, wormlike, writhing movements. The ataxic type of CP is characterized by rapid, repetitive movements. The spastic type of CP is characterized by hypertonicity of muscles. The dystonic type of CP is a combination of the spastic and athetoid types.
According to Piaget's theory of cognitive development, which milestone would the nurse expect a 6-month-old infant to demonstrate? a. early traces of memory b. beginning sense of time c. repetitious reflex responses d. beginning of object permanence
d. beginning of object permanence Rationale: The concept of object permanence begins to develop around 6 months of age. Early traces of memory and beginning sense of time occur at between 13 and 24 months. Repetitious reflex responses occur during the first several months of life. These diminish as the newborn grows.
The nurse is teaching the parents of an 18-month-old child the procedure for instilling eardrops. How would this procedure be done? a. by cleansing the ear canal before instilling the drops b. by applying medicated ear wicks after instilling the drops c. by pulling the pinna up and back after drop instillation to promote distribution of the drops d. by pulling the pinna down and back to straighten the auditory canal before instillation of the drops
d. by pulling the pinna down and back to straighten the auditory canal before instillation of the drops Rationale: The ear canal curves upward in children younger than 3 years of age; pulling the pinna down straightens the canal so medication will reach the eardrum. The ear canal is not cleansed before eardrops are instilled; this could exacerbate the infection. Applying ear wicks is contraindicated because it increases pressure within the ear. Pulling the pinna up and back after instillation of drops is unnecessary; pressing on the tragus several times will help disperse the drops.
The weight of a 3-month-old infant with tetralogy of Fallot has declined from the 25th percentile to the 5th. Which mechanism would the nurse suspect is the reason for this inadequate weight gain? a. cyanosis resulting in cerebral changes b. decreased arterial oxygen level resulting in polycythemia c. pulmonary hypertension resulting in recurrent respiratory infections d. inadequate oxygen perfusion leading to activity intolerance, resulting in diminished energy to nurse
d. inadequate oxygen perfusion leading to activity intolerance, resulting in diminished energy to nurse Rationale: Because of quick fatigue, it is difficult for the infant to consume sufficient calories for adequate weight gain. Increased caloric intake is needed to meet the infant's nutritional needs. Although cyanosis is present, it may not lead to cerebral changes. Cyanosis is not directly related to inadequate weight gain. Although decreased Po2 does lead to polycythemia, it does not affect the infant's ability to gain adequate weight. Although there is pulmonary hypertension, it is not directly related to inadequate weight gain or respiratory infections.
Which statement is true about an appropriate diet for toddlers? a. fingers foods should not be served b. toddlers need 4 to 6 cups of milk per day c. low-fat or skim milk should be given until the child is 2 years old d. milk should be supplemented with solid food items like vegetables and fruits
d. milk should be supplemented with solid food items like vegetables and fruits Rationale: Parents of toddlers should supplement the child's intake of milk with solid foods, ensuring a balanced diet for adequate growth. Serving finger foods to toddlers allows them to eat by themselves and satisfy their need for independence and control. The intake of milk should be limited to 2 to 3 cups because the consumption of more than a quart of milk per day tends to decrease the child's appetite for essential solid foods and results in inadequate iron intake. Children under 2 years of age should not be given low-fat or skim milk because fat is important for physical and intellectual growth.
A parent asks the nurse what to do when the toddler has temper tantrums. Which play materials would the nurse suggest that the child be offered as another means of expressing anger? a. ball and bat b. wad of clay c. punching bag d. pegs and pounding board
d. pegs and pounding board Rationale: A pounding board with pegs to hammer into holes is a safe toy for toddlers because it is fairly large, easy to manipulate, and sturdy. It also provides an acceptable way for anger to be expressed. The child's motor and hand-eye coordination are too immature for the child to use a ball and bat. A wad of clay is not as effective for releasing anger as a pounding board. A punching bag is appropriate for an older child with more mature motor coordination to compensate for a moving object.
Which stage of Kohlberg's theory of moral development defines 'right' by the decision of the conscience? a. social contract orientation b. society-maintaining orientation c. instrumental relativist orientation d. universal ethical principle orientation
d. universal ethical principle orientation Rationale: Kohlberg's theory of moral development consists of six stages. Universal ethical principle orientation is the sixth stage. It defines 'right' by the decision of the conscience in accordance with self-chosen ethical principles. Social contract orientation is the fifth stage of Kohlberg's theory. During this stage, an individual follows societal law but recognizes the possibility of changing the law to improve society. Society-maintaining orientation stage is the fourth stage. Individuals expand their focus from a relationship with others to societal concerns during this stage. Instrumental relativist orientation is the second stage. In this stage, the child recognizes that there is more than one right view.
Which order should parents introduce new foods to a 5-month-old who is now eating fortified cereal mixed with formula? a. meats and fish b. eggs and cheeses c. citrus fruits and bread d. vegetables and non-citrus fruits
d. vegetables and non-citrus fruits Rationale: Generally it is recommended that vegetables and non-citrus fruits be introduced after cereals because they are easily digested. The introduction of meats and fish, eggs and cheeses, and citrus fruit and bread should be delayed until after 6 months of age.
