PEDS exam 1 mastery quizzes
The parents of a first grader ask the nurse for guidance in helping to promote success for their child in school and with his homework. Which suggestion would the nurse provide to help the parents meet that goal? Select all that apply.
"Be sure that the area for homework is quiet and without distractions." "Provide assistance but avoid doing the homework for your child." "Try setting up a specific time for homework to be done.
The parent of a 14-year-old adolescent states to the nurse that the adolescent is moody, shuts oneself in the bedroom, and fights with a younger sibling. Which comment is most helpful to support the parent?
"Calmly talk to your adolescent about your concerns."
The nurse has completed an educational program on normal growth and development in children. Which statement by a participant would indicate a need for further education?
"I am so glad I can get rid of all of those bath toys because they take up so much room."
The nurse is talking with the mother of a 6-month-old who was born at 32 weeks' gestation about nutrition-related concerns. The mother questions the nurse about when additional foods may be added to the diet. She remarks that her older child was started on additional foods between 4 and 6 months of age. What response by the nurse is most appropriate?
"The addition of foods to your baby's diet may be slightly delayed because of his prematurity."
The parent of a 4-year-old child tells the nurse about being frustrated because all the parent seems to do lately is fight with the child over what the child wants to eat and wear. The parent notes sometimes wanting to spank the child for always disagreeing. What would be the best suggestion for the nurse to make to this parent?
"Use the time-out technique for discipline."
The nurse is caring for a 9-year-old boy with episodes of chronic pain. The nurse is educating the parents how to help the child manage pain nonpharmacologically. Which statement indicates a need for further teaching?
"We should start the method after he feels pain."
The nurse is explaining safety precautions for young children to the mother of a normal 30-month-old boy. Which of the following activities might the nurse suggest may be done without supervision?
Undressing himself
The nursing student identifies which technique as the correct one to use when giving oral medications to an infant?
Use a dropper and slowly inject the liquid into the side of the infant's mouth.
The mother and her 8-year-old daughter come to the clinic for a well-child visit. The mother asks the nurse, "About how much sleep should my daughter be getting?" The nurse responds by saying:
10-12 hours.
A nurse is assessing a 3-year-old child. Which would be appropriate ways to approach the child during the exam? Select all that apply.
=Ask the child if he/she would prefer to sit on the parent's lap for the exam. =Give reassurance to the child during the exam.
A 6-month-old infant is admitted to the hospital because of a fever. When the nurse obtains a health history, what data would be obtained first?
=Details about the fever
A parent asks the nurse what symptoms to expect with normal teething in the infant. How should the nurse respond?
=the infants gumline will be tender
While treating a minor playground injury for an 8-year-old girl, the school nurse discovers that the injury was the result of bullying. What should be the nurse's first action?
Assess the situation with the help of the school staff and parents.
A mother brings her 2-year-old child to the pediatrician's office, voicing concerns about her toddler's growth over the last year. According to the child's records, the toddler has gained 6 pounds (2.7 kg ) and grown 2.5 in (6.25 cm) since his last visit a year ago. How should the nurse respond to this mother's concerns?
Inform the mother that her toddler's growth is within normal limits and there is nothing to be worried about.
The nurse is preparing to assess the abdomen of a preschool-aged child. Which technique should the nurse use first?
Inspection
The school nurse is planning to teach a segment on smoking during the freshman health classes. The nurse is aware that this needs to be a forum rather than a lecture. Which of the following techniques will also help deliver a "don't smoke" message?
Listening to all comments nonjudgmentally
While caring for a 16-year-old client expected to be hospitalized for several months, the nurse will perform which action to assist the client in meeting the current stage of psychosocial development?
Permit peers to visit during open visitation hours.
The nursing staff at the clinic are discussing the best way to encourage cooperation from young pediatric clients during screenings. Which suggestion would be appropriate?
Purchase stickers or make coloring pages to be given to the children after the screening is completed.
The nurse is examining a 15-month-old child who was able to walk at the last visit and now can no longer walk. What would be the nurse's best intervention in this case?
Schedule a full evaluation since this may indicate a neurologic disorder.
The school nurse is performing a vision screening for a 7-year-old child. Which finding should trigger a referral?
Slight misalignment of the eyes
During therapeutic play, a 4-year-old child draws a girl with a head and body but no arms or legs. Your best action in response to this would be to
appreciate that 4-year-olds often draw people with only three or four body parts.
The nurse is discussing Varicella immunization with a mother of a 13-month-old. The mother is reluctant to vaccinate because she feels it is "not necessary." Which comment by the nurse will be most persuasive for immunization?
"Children not immunized are at risk if exposed to the disease."
A parent asks the nurse, "What is precocious puberty?" The nurse's response should be based on which statement?
"Precocious puberty is early sexual development."
A 13-year-old girl has recently begun menstruating. She is active in sports at school. Increased intake of which of the following nutrients should the nurse recommend to the girl to prevent anemia associated with menstruation?
Iron
Parents tell the nurse their 3½-year-old refuses to eat meat but are pleased she drinks "lots of milk." What risk does the nurse identify?
Iron deficiency
The nurse is talking with parents of a depressed 16-year-old boy. Which question is of the most importance?
Is there a gun in your home?
A nurse is administering ear drops to a 7-year-old girl. What should the nurse do?
Pull the pinna of the ear up and back to straighten the external ear canal.
A 4-year-old is going to finger paint for the first time. What is the best action for the adult supervisor of this activity?
Support whatever the child paints.
A new parent asks the nurse, "About how many wet diapers should my infant have in a day. Which response by the nurse would be most appropriate?
"Typically, an infant has 6 to 8 wet diapers a day."
A 15-year-old male patient diagnosed with gonorrhea states, "I can't tell my partner about this." What is the best response by the nurse?
"What concerns you about telling your partner?"
The nurse is providing postsurgical care for a 5-year-old. The nurse knows to avoid which question when assessing the child's pain level?
Would you say that the pain you are feeling is sharp or dull?
The best way for an infant's parent to help the child complete the developmental task of the first year is to:
respond to the infant consistently.
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:
seizures are not provoked; temper tantrums are.
In counseling a group of parents regarding the development of school readiness in preschoolers, it is most important to emphasize:
the home environment.
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:
transduction.
The nurse is assessing Julie, a 3-month-old infant. Which developmental milestone would the nurse expect?
=Julie can hold her head erect and steady
A parent asks if her newborn's undescended testicles will need surgery to repair. What is the best response by the nurse?
=there is a chance the testicles will descend on their own
The parents of a 12-month-old child tell the nurse the child has stopped walking and is now only crawling or sitting with support. How should the nurse respond?
=this is a concer. Let's be sure the physician is aware of theis change
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 sense of trust and identity
The parents express concern about their child who has an imaginary friend. The nurse explains that as long as the imaginary friend does not become the center of attention and also the child has real friends, this can be beneficial. What benefits are discussed? Select all that apply.
=Encourages language development by conversation. =Provides an outlet by which the child can express innermost feelings. =Serves as someone to blame or decrease the child's guilt
The school nurse is teaching parents risk factors for suicide in adolescents. What would the nurse discuss? Select all that apply.
=Mental health changes =History of previous suicide attempt =Family disorganization =Substance use disorder
Parents of a toddler are expressing concern about their child's extreme negativism. Every question is answered with a forceful, "no." Which information would be most appropriate for the nurse to share with this couple about their toddler's negativity? Select all that apply.
=This is not only normal for toddlers but demonstrates a positive stage of development. =This is a step in the child's development toward independence and to take care of his or her own needs.\ =Rather than ask, "Do you want to come to dinner now?" instead state, "It's dinner time. Do you want to drink milk or water with your dinner?"
A nurse is developing a teaching plan for parents of preschoolers about how to address the issue of strangers and safety. Which would the nurse expect to include in the teaching? Select all that apply.
=Urge children never to talk to or accept a ride from a stranger. =Encourage children to tell you or another trusted adult if someone asks them to keep a secret about anything uncomfortable. =Urge your children to report others who are bullying. =Teach your children to say "no" to anyone whose touching makes them feel uncomfortable.
An infant is breastfed. When assessing the stools, which findings would be typical?
=less constipation than bottle-fed infants
The nurse is examining the genitals of a healthy newborn girl. The nurse should observe which normal finding?
=swollen labia minora
During a health history assessment, the mother of a 10-year-old girl tells you that her daughter does not have time to "play" because she is busy going to gymnastics, cheerleading, art class, flute lessons, reading club, and soccer. What should the nurse's response be?
"Play is important for your daughter's overall growth and development."
A mother tells the nurse that her 5-year-old son always pretends his toy rake is a fishing pole no matter how many times she shows him how a rake is used. How should the nurse respond?
"Preschoolers have a vivid imagination so it is very common for them to invent ways to use their toys."
During a health history, the nurse explores the sleeping habits of a 3-year-old boy by interviewing his parents. Which statement from the parents reflects a recommended guideline for promoting healthy sleep in this age group?
"We keep a strict bedtime ritual for our son, which includes a bath and bedtime story."
The parents of a 9-year-old child voice concern that the child seems to be gaining weight rapidly. The nurse reviews the medical record and notes the child has increased weight by 6 or 7 lb (2.7 to 3.2 kg) per year for the past 2 years. What response by the nurse is indicated?
"Weight gains of about 7 lb (3.2 kg) per year are normal for children in this age range."
A 15-year-old client tells the nurse he has been having wet dreams and is ashamed and afraid he will get into trouble because he believes his parents think he is too young to understand or know about sex. To which statement would be the most appropriate for the nurse to respond?
"Wet dreams are not the result of anything you are doing but are simply the body's way of ridding itself of excess semen."
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?
"Young children are especially susceptible to these bacteria."
A 3-year-old child is hospitalized. The parents are concerned because the child is now refusing to use the potty and is wetting the bed, even though the child has achieved toilet training. Which response by the nurse is most appropriate?
"Your child is experiencing regression as a result of stress."
A mother comes to the clinic and is concerned about the size of her 3-month-old infant's head. She states that the infant's head is larger than his chest. The nurse's response should be based on her knowledge that an infant's head and chest circumference will be approximately equal by what age?
6 months
A parent asks the nurse what symptoms to expect with normal teething in the infant. How should the nurse respond?
= The infant's gumline will be tender.
The nurse is instructing a 12½-year-old boy who says, "I am too short! Girls are taller than I am. Guess I won't be playing basketball." What instructions are best included in the plan of care? Select all that apply.
="Girls begin to grow rapidly at a younger age than boys do. Boys start later and grow longer." -"There are a lot of size differences in your age group now because everyone enters puberty and grows at slightly different times than others." -"You could add as much as 12 inches to your height before you stop growing.
The parents of a 5-year-old tell the nurse that it "seems like our child is afraid of everything from fireworks to butterflies." What actions should the nurse take? Select all that apply.
=Ask the parents if they can identify anything that may be causing their child be fearful. =Suggest to the parents to talk with their child about his fears. =Work with the parents and child to devise strategies to help deal with the fears
The parents of a 5-year-old tell the nurse that it "seems like our child is afraid of everything from fireworks to butterflies." What actions should the nurse take? Select all that apply.
=Ask the parents if they can identify anything that may be causing their child be fearful. =Suggest to the parents to talk with their child about his fears. =Work with the parents and child to devise strategies to help deal with the fears.
Anticipatory guidance for an infant for the 4th month should include the fact that the infant will be able to achieve which developmental milestone?
= be able to turn over onto the back
The parents of a 12-month-old child tell the nurse the child has stopped walking and is now only crawling or sitting with support. How should the nurse respond?
=This is a concern. Let's be sure the physician is aware of this change.
A mother of a 9-month-old 18-pound (8.2 kg) infant asks the nurse about choosing the best car seat. What should the nurse recommend?
=a reaer facing 5 point harness restraint
A newborn requires skin care that includes bathing. Besides hygiene, what is another reason for bathing the newborn?
=bathig is time for bonding with the parents
A mother brings a 15-month-old child to the clinic for a routine health maintenance visit. Which immunization should the nurse prepare to administer to this child?
MMR
The nurse is educating a parent regarding child safety for the 14-month-old toddler. What would the nurse include in the educational plan?
Maintain supervision when the child is near stoves, ovens, irons and other hot items the child could reach.
The nurse is preparing a female toddler for the repair of an eyebrow laceration. The girl is most likely to demonstrate which response in anticipation of the procedure?
Scream and cling tightly to her parent.
The nurse is examining the posture of a toddler and notes lordosis. What would be the appropriate reaction of the nurse to this finding?
Do nothing; this is a normal condition for toddlers.
An adolescent with a new piercing comes to the health center at the school. The client reports feeling hot. Which action will the nurse complete first?
Assess the client for signs of infection
A 2-week-old child responds to a bell during an initial health supervision examination. The child's records do not show that a newborn hearing screening was done. Which is the best action for the nurse to take?
Immediately schedule the infant for a newborn hearing screening.
The nurse is meeting with a group of caregivers of adolescents. Which example should the nurse point out is most effective for the caregiver to support the adolescent?
Let them choose their hairstyle, even though it may not look the best for them.
A high school football player comes to the clinic with malaise, fever, headache, and anorexia that have been present for the last few days. Upon physical examination, the nurse notes that the cervical lymph nodes are firm and tender. Tonsils are red and enlarged and appear to have a white covering. What should the nurse suspect the diagnosis to be for this patient?
Mononucleosis
A nurse is conducting a presentation for a local high school about injury prevention. When describing the various risks, which of the following would the nurse include as the leading cause of death among adolescents?
Motor vehicle crashes
The school nurse is preparing health promotion presentations regarding unintentional injuries for a high school health fair. On which topic should the nurse place as the priority when preparing the presentation?
Motor vehicle safety
A parent has brought the child into the clinic for a routine health assessment. The parent asks when routine screening for back symmetry will begin. Which response by the nurse is most accurate?
School age
The nurse is preparing to participate in a community discussion on the needs of the adolescents in the local school. The nurse should point out which goal is the primary concern for these young individuals as the committee makes plans?
Teens are busy developing their own personal identity.
The nurse explains to parents of school-age children that according to Kohlberg's theory of moral development, their child is at the conventional stage of moral development. What motivation for school-age children to follow rules must parents realize?
They follow rules out of a sense of being a "good person."
The father of a 15-year-old daughter is concerned she is not getting adequate nutrition to play high school basketball. Her games are on Friday nights. Which suggestion should the nurse point out will best suit the needs of this adolescent?
Three daily meals that include choices from each of the food groups; Friday's lunch eaten around 2 p.m. with a small amount of fat and a somewhat larger than usual portion of complex carbohydrates.
The mother of an adolescent has called to talk to the pediatric nurse over concern that her daughter is not getting proper nutrition now that she has started following a vegetarian diet. Which response should the nurse prioritize for this mother?
Vegetarian diets can be healthy; ensure she includes whole-grain products, legumes, nuts, seeds, and soy dairy substitutes.
A young adult female is suspected of having gonorrhea. The nurse would anticipate additional testing for which sexually transmitted infection?
chlamydia
A school-aged child with a motor deficit is attempting to feed herself independently, with little success. When speaking to the child after the attempted feeding, the nurse should:
provide genuine praise for the child's efforts.
The mother of a 6-year-old is asking the nurse how to handle the child's lying and fabricated stories when confronted with questionable actions. Which response would be most appropriate by the nurse?
"Children this age sometimes can't distinguish between fantasy and reality."
The parent of a 2-year-old client states it is the child's naptime. The child is refusing to take a nap and cries, "I have to put my babies to sleep first!" The parent states, "I am so sorry, I do not know what is wrong. My child does not act this way at home. My child has 2 baby dolls we rock to sleep each day at home before nap." Which response by the nurse is most appropriate?
"A 2-year-old child's behavior can be greatly altered if rituals are not maintained."
A mother calls the pediatric nurse practitioner about her 7-year-old daughter's dental hygiene. The daughter has had three cavities. She does not know what to do and asks the nurse for guidance. How should the nurse respond?
"Are you able to supervise her brushing?"
Which question would be most important for a nurse to ask when taking a history from a client who is suspected of having amenorrhea?
"Are you sexually active?"
A nurse is caring for a 4-year-old child. The parents indicate that their child often reports that objects in the house are his friends. The parents are concerned because the child says that the grandfather clock in the hallway smiles and sings to him. Which response by the nurse is best?
"Attributing lifelike qualities to inanimate objects is quite normal at this age."
The nurse is caring for a 13-year-old girl. The child has been identified as overweight with no underlying psychological or secondary causes. The nurse is reviewing the child's weight-loss progress and nutrition at a follow-up visit. What finding indicates a need for further discussion and teaching?
"Her goal is to be a size smaller by our vacation in two weeks."
A nurse is educating a 15-year-old obese teen who is not very active about nutrition. The nurse educates the teen about menu choices so that the teen can make his/her own choices. The nurse knows the teaching is effective by which of the teen's responses?
"I need to choose 2 servings of fruit each day of the week."
The mother of an 18-month-old girl voices concerns about her child's social skills. She reports that the child does not play well with others and seems to ignore other children who are playing at the same time. What response by the nurse is indicated?
"It is normal for children to engage in play alongside other children at this age."
After teaching the mother of a 13-month-old boy old about suggestions for bathing and hygiene, the nurse determines that the teaching was successful when the mother states which of the following?
"It might be best to give him a bath in the evening."
The nurse is discussing an adolescent's development with the client's parents. Which statement by the parents indicate an understanding of the nurse's teaching?
"Our adolescent is working toward achieving a sense of personal identity."
The nurse is providing teaching about car safety to the parents of a 5-year-old girl who weighs 45 pounds. What should the nurse instruct the parents to do?
"Place her in a booster seat with lap and shoulder belts in the back seat."
Parents of a 2-year-old girl are having a conversation with the nurse about tantrums and how best to deal with them. Which technique would the nurse be most likely to suggest?
"Stay calm and ignore the child's behavior."
The nurse is conducting a physical examination of a young preschooler and detects the odor of tobacco smoke on the parents' hair and clothing. How should the nurse respond?
"Tell me about your child's exposure to tobacco smoke."
During a health check-up without the parents present, a 17-year-old adolescent tells the nurse about being gay. Which statement from the nurse is best?
"Tell me what makes you think you are gay."
The nurse is reinforcing education to the parents of a 10-year-old child who are seeking to improve the nutritional status of their son. Which statement(s) by the parents indicate an understanding of the education? Select all that apply.
"The caloric needs of my child are based upon his level of activity." "Age is one of the determinants of the caloric needs for my son." "The largest components of my son's diet should be carbohydrates
The nurse is caring for a school-aged child in the primary care setting. The parent of the child asks how often the child should see the dentist. Which is the best response made by the nurse?
"The child should see a dentist twice a year."
A single male caregiver of a 14-year-old girl accompanies his daughter to her pre-high school physical. In the course of discussion about how his daughter is developing, he remarks, "She's terrific most of the time. Of course when she gets her period, she's miserable and mean, but I tell her that's just what it's like to be a woman." What would be the most appropriate response by the nurse?
"There are nutritional and medical things she can do to lessen the symptoms; I'll give both of you information about some strategies and we'll track her for a few months."
During a wellness check up for a 4-year-old client, the parents state, "We just moved into a new home and our child has begun wetting and defecating in the underwear. Which response by the nurse is appropriate?
"This is a normal response to stress during childhood."
During an examination, an adolescent client tells the nurse about being anxious and frustrated because of the facial acne. Which nursing response is appropriate?
"This is one of the most common physical changes during adolescence."
A 3 1/2 year-old child is found masturbating in the family living room. Which response by the parent would best address this behavior?
"We do not touch ourselves in public. Please go to your room if you want to continue this behavior."
The nurse is performing a health history on a 6-year-old child who is having trouble adjusting to a new school. Which question will elicit valuable information?
"What are your new classmates like?"
A 5-year-old who is visiting her hospitalized sister states, "It's my fault my sister is sick." What is the best response by the nurse?
"You didn't cause your sister to be sick."
A 7-year-old child has taken money from a sibling's dresser on two occasions. When counseling the parent about this behavior, what would the nurse advise?
"You may need to remind your child about property rights."
The school nurse is assessing a 15-year-old female client. The client states, "I just want to be pretty and to look like everyone else." Which response by the nurse is appropriate?
"You seem concerned. Let's talk about your feelings."
A mother of a toddler asks the nurse, "How will I know that my daughter is ready for toilet training?" Which response by the nurse would be most appropriate?
"You'll probably notice that your daughter is uncomfortable in wet diapers."
The nurse is assessing a 16-year-old girl at an annual well-clinic visit and notes the girl started menses at 13 years of age and grew 1 inch (2.5 cm) over the past year. When questioned by the young lady if this is normal, which answer should the nurse prioritize?
"You're following expected patterns of growth."
The nursing instructor is conducting a clinical session on the proper techniques for assessing a child's head circumference. The instructor should point out which factor concerning this assessment?
=place tape measure just above the eyebrows
The nurse is teaching the parents of a 6-month-old infant about proper dental care. Which action will the nurse indicate as most likely to cause dental caries in this infant?
=putting the infant to bed with a bottle of milk or juice
When children are not able to communicate pain verbally, the nurse can use a behavioral assessment. The nurse knows that this assessment will least likely include which of the following?
=sleep patterns
The nurse at an elementary school is explaining the concept of industry versus inferiority to a group of nursing students. What is part of this stage of Erikson's theory?
A sense of competence, mastery, and worth
The nurse is interviewing an adolescent. What should the nurse recognize as an important aspect of interviewing the adolescent?
Adolescents will share more about themselves in a private conversation.
A chronically ill adolescent is readmitted to the hospital with an infected wound requiring long-term dressing changes. What is the best way the nurse can encourage independence for this client?
Allow the adolescent to choose the time for the dressing change.
The nurse is caring for a 5-year-old who has been hospitalized after an episode of asthma. As the nurse prepares to teach the child how to use the nebulizer, which action should the nurse prioritize?
Allow the child to touch and play with the nebulizer for a few minutes before the treatment.
A nurse is caring for an infant with hyponatremia. What intervention would be most appropriate?
Educating about not overdiluting the infant formula
What advice should the nurse provide the parent of a toddler, regarding how to handle temper tantrums?
Appear to ignore the toddler
The nurse is inspecting the genitals of a prepubescent girl. What is a normal sign of the onset of puberty?
Appearance of pubic hair around 11 to 13 years old
When instructing the parents of a toddler about appropriate nutrition, what would the nurse recommend?
Approximately 16 to 24 ounces of milk per day
The nurse is collecting data on a 9-year-old child being admitted to the pediatric unit. What is the most appropriate way to gather information from the child's caregiver?
Ask the caregiver questions and document the answers.
The nurse is preparing to remove an IV device from the arm of a 6-year-old girl. Which approach is best for minimizing fear and anxiety?
Ask the child if they would like to help remove the tape from the IV.
The nurse is assessing a 2-year-old boy during a well child visit. The nurse correctly identifies the child's current stage of Erickson's growth and development as:
Autonomy versus shame and doubt
A 16-year-old girl with acne has been prescribed tretinoin (Retin-A cream). Which of the following instructions should the nurse give this girl related to prevention of a common side effect of this medication?
Avoid prolonged sun exposure
An adolescent is prescribed tretinoin (Retin-A cream) as therapy for acne. What should the nurse instruct the client about this medication?
Avoid unprotected sun exposure.
When assessing the vision of a 2-month-old, what would the nurse use?
Black-and-white checkerboard
During a health promotion seminar with community members, the nurse provides information to support the 2020 National Health Goal to prevent and reduce the incidence of infectious disease in children. What information did the nurse most likely provide?
Importance of maintaining appropriate immunizations
The nurse is talking to the parents of an 2-month-old infant who has been admitted to the hospital with sepsis. The parents report being confused since their older children also had the flu but they recovered without incident. What information can the nurse provide to the parents?
Children this young do not have mature immune systems to fight infection.
Parents bring a toddler age 19 months to the clinic for a regular checkup. When palpating the toddler's fontanels (fontanelles), what should the nurse expect to find?
Closed anterior and posterior fontanels
Which behavior by a 3 year-old child does not validate Erikson's developmental task for preschoolers?
Compares his soccer abilities with his peers.
Which scenario does the nurse anticipate for the life of an adolescent with a chronic condition who has deteriorating function?
Decline in involvement with peer activities
While awaiting an appointment at the doctor's office for his 20-month-old daughter, a young father is astonished to see his daughter assume a proper stance and swing a toy golf club in the play area of the waiting room. A nurse also observes the behavior, and the father recalls that his daughter saw him practicing his golf swing in their back yard a few days ago. The nurse explains that this is an instance of which of the following?
Deferred imitation
Nursing students reviewing information about discipline demonstrate a need for additional education when they identify what information as correct?
Discipline and punishment are interchangeable.
The nurse is teaching the parents of a 2-year-old toddler methods of dealing with their child's "negativism." Based on Erikson's theory of development, what would be an appropriate intervention for this child?
Encourage the child to pick out his own clothes.
A school-aged child goes to the school nurse with a headache and stomachache. The child has normal physical exam findings. The nurse questions the child further, and the child confides experiences of being bullied by another child in the class. What is the best action made by the nurse?
Encourage the child to seek help from the teacher.
The nurse is caring for a family with a chronically ill adolescent. The parents are frustrated that the adolescent will not complete the treatment plan during the school day. Which approach by the nurse will be most appropriate?
Explaining to the parents that the adolescent may be struggling to fit in with his peers
A nurse is assessing a Babinski reflex in a 2-day-old newborn. Which finding by the nurse would indicate a positive finding?
Fanning of the infant's toes
The mother of a toddler is frustrated because the toddler insists on brushing his own teeth and being left alone in the bathtub. What advice should the nurse provide to the mother about these expectations?
Helping with teeth brushing encourages autonomy.
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?
Imagination
An 8-year-old 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 caring for a toddler who is in Piaget's sensorimotor stage of cognitive development. Which task would the nurse expect the toddler to be able to perform?
Knowing which are his or her toys
The nurse is performing an assessment of the reproductive system of a 17-year-old girl. What would alert the nurse to a developmental delay in this girl?
Lack of occurrence of first menstrual period
A nursing instructor is leading a class discussion exploring the various aspects of Erikson's theories of the developmental tasks of toddlers. The instructor determines the session is successful when the students correctly choose which task as a priority for toddlers?
Learning to act on one's own
What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds?
Menarche should follow in about 2 years.
The school nurse is teaching parents risk factors for suicide in adolescents. What would the nurse discuss? Select all that apply.
Mental health changes History of previous suicide attempt Family disorganization Substance use disorder
The nurse is caring for a 6-year-old child with burns on both hands. When assessing this child's pain, which technique would be most appropriate for the nurse to use?
Obtaining a self-report
The nurse caring for a 3-year-old patient is having a very difficult time persuading the child to take an oral medication. The child yells "Yucky" every time the nurse approaches with the medication. Which of the following would be the best approach for the nurse?
Offer the child an ice pop to numb the mouth and decrease the bad taste of the medicine.
The nurse is promoting learning and school attendance for a 13-year-old girl. Which factor will affect the child's attitude most?
Peer group behaviors and attitudes
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?
Peer relationships
The nurse is conducting a well-child assessment of a 4-year-old. Which assessment finding warrants further investigation?
Presence of 10 deciduous teeth
When caring for pediatric clients, which distraction technique is age-appropriate for the nurse to use?
Provide action-oriented video games to a 15-year-old client
What behavioral responses to pain would a nurse observe from an infant younger than age 1?
Reflex withdrawal to stimulus and facial grimacing
Which gross motor developmental milestone is least likely for a 2-year-old?
Rides a tricycle
The father of a toddler reports his son says "no" every time he attempt to correct him. What is the best advice can the nurse offer to the parent?
Saying no is your son's way of trying to exert his independence and is expected.
A 16-year-old client has been hospitalized 100 miles from home for 1 week to repair a fractured patella suffered in a skateboarding accident. She was cheerful and chatty when she first arrived, but the nurse notes in recent days she has become increasingly quiet and seems lonely. Which nursing intervention should the nurse prioritize for this client?
Take her to the teen lounge so she can meet other teens, use a phone, and check her email.
To obtain an accurate heart rate in an infant, what would be most important for the nurse to do?
Take the apical pulse.
The parents of a 6-year-old client are interested in promoting learning through reading to their child. Which suggestion by the nurse will best promote this goal?
Take the child to the library to check out books
The 18-month-old toddler has most likely attained which gross motor skill?
The ability to walk independently.
The nurse observing toddlers in a day care center notes that they may be happy and pleasant one moment and overreact to limit setting the next minute by throwing a tantrum. What is the focus of the toddler's developmental task that is driving this behavior?
The need for separation and control
Parents and their nearly 3-year-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay?
Uses two-word sentences or phrases
The nurse is assessing the gross motor skills of an 8-year-old boy. Which interview question would facilitate this assessment?
"Do you participate in any sports?"
The parent of a 16-year-old female states, "I know she's pregnant because she missed her period for the second time." What is the best response by the nurse?
"I hear your concerns about pregnancy. There may be some other causes we need to explore."
The nurse is teaching good sleep habits for toddlers to the parent of a 3-year-old client. Which response indicates the parent understands sleep requirements for the client?
"My child needs 12 hours of sleep per day including a nap."
A 14-year-old boy has come to his primary care physician's office for a routine well-child visit with his parent. Which statement by the parent should the nurse prioritize for further investigation after noting the father has a history of alcohol use disorder?
"Our next door neighbor is older than my son, and he drinks when they hang out together."
The mother of a 2-year-old child tells the nurse that she is constantly scolding the child for having wet pants. The child was toilet trained at 12 months, but since walking, the child wets all of the time. Which nursing diagnosis should the nurse use to guide instruction for the mother?
Deficient parental knowledge related to inappropriate method for toilet training
The parent of a 2-year-old toddler tells the nurse she needs to constantly scold the toddler for having wet pants. The parent says the toddler was potty trained at 12 months, but since starting to walk, the toddler wets the pants all the time. Which nursing diagnosis would be most applicable?
Deficient parental knowledge related to inappropriate method for toilet training
Mark is a 2-month-old infant who is receiving formula. He has inconsolable crying, is gassy, and constantly draws his legs up. It has been determined that Mark has colic. Which of the following would be most appropriate?
Encourage the use of a different formula to assess for sensitivity.
Infectious mononucleosis ("mono") is caused by which of the following?
Epstein-Barr virus
A group of nursing students are reviewing information about bullying and children who are bullied. The students demonstrate a need for additional review when they identify which of the following as characteristic?
Having numerous friends
The parents of a 16-year-old male are worried about recent changes in his behavior, ignoring his schoolwork and sports, and spending almost all of his free time interacting with his girlfriend. Which suggestion should the nurse point out would best address this situation?
He has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with, or talk to, his girlfriend as long as he has completed his schoolwork for the day.
The nurse is teaching a nutritional class to a group of adolescents who are lactose-intolerant. Which food should the nurse point out will help these adolescents consume the calcium they need for proper nutrition?
Soybean curd
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?
The adolescent's need for privacy should be respected.
The nurse is examining a 3-year-old girl during a regular visit. Which finding would disclose a developmental delay in this child?
The child demonstrates separation anxiety.
The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development?
The child is unable to push a toy lawnmower.
The nurse teaches a preschooler to use a FACES pain rating scale prior to surgery. At that time, the preschooler points to the smiling face. Following surgery when the nurse suspects the child has pain, the preschooler points again to the smiling face. How would the nurse interpret this response?
The child is using the scale to predict what he or she would like, not what the child has.
A mother is concerned that a 7-year-old child has taken money from a sibling's dresser several times. What should the nurse advise the mother about this behavior?
The child needs to be reminded of property rights.
An infant who is 4 months old continues to be seen at doctor visits for illness prevention. What would be the next scheduled appointment that this infant should attend to be evaluated?
The next visit would be at 6 months.
The nurse has brought a 3-year-old's oral medications into the room for administration. Upon approaching the child, the nurse said, "I have your medication. Would you rather have me hand it to you or Mommy?" In critiquing the nurse's actions, which is most accurate?
The nurse's behavior is correct. The nurse provided the child a choice between two acceptable options with the outcome of taking the medication.
When administering medications to an infant, what information would be most important for the nurse to consider?
The oral medication should be directed toward the posterior side of the mouth when using a syringe or dropper.
Parents say they have been using measures to lessen the struggle of getting their preschooler to bed at night and to sleep. Which practice will the nurse suggest they discontinue?
Allowing the preschooler to fall asleep wherever and whenever the child is tired enough
A 14-year-old female has been brought to the pediatric ambulatory care clinic for a "sports physical" by her mother. The teen tells the nurse she does not want to have her mother present during the examination. What action by the nurse is most appropriate?
Ask the teen's mother to wait in a separate area nearby until the physical examination has been completed.
The English-speaking nurse is assessing a 12-month-old child with an English-speaking father and a Spanish-speaking mother. The child does not use words like "drink" "dog" or "ball." What is the nurse's priority intervention?
Asking the mother if the child uses Spanish words for those items
The nurse wants to find out how much time a preschooler spends in various activities throughout the day. What should the nurse do to learn this information?
Ask the parents to complete a day history.
The student nurse is assessing a 9-year-old's cardiovascular system. Which assessment technique should the nurse further discuss with the student?
The student auscultates the heart at the third to fourth intercostal space just medial of the child's left midclavicular line.
A parent tells the nurse that no matter what is asked of the toddler, the toddler says, "No." What suggestion might the nurse make to help the parent handle this situation?
give the toddler secondary, not primary, choices
A 6-month-old has fanning of the toes and dorsiflexion of the big toe seen on physical exam. Based on this finding the nurse should:
document as a normal finding.
The parents of a 2-year-old girl are concerned with her behavior. For which behavior would the nurse share their concern?
Frequently babbles to herself when playing
The nurse is observing a 3-year-old boy in a day care center. Which behavior might suggest an emotional problem?
Has persistent separation anxiety
The nurse has completed an examination of a 32-month-old girl with normal gross and fine motor skills. Which observation would suggest the child is experiencing a problem with language development?
Her vocabulary is between 10 and 15 words.
The nurse is visiting a mother who has a 3-month-old infant. Which anticipatory guidance information should the nurse provide to the mother at this time?
The child should be able to turn over onto the back at age 4 months.
The nurse is assessing a 3-year-old child. The nurse notes the child is able to understand that objects hidden from sight still exist. The nurse correctly documents the child is displaying:
=object permanence
The nurse is teaching the parents of a 9-month-old infant about proper dental care. Which statement by the parents most concerns the nurse?
=our infant goes to sleep at night with bottle of milk or juice
A mother calls the clinic nurse asking for recommendations on comfort measures for her infant who is teething. What recommendation should the nurse make? Select all that apply.
=teething rings =acetaminophen
The nurse is interacting with several families with children during their health visits. Which child would the nurse prioritize to receive a hearing screening?
=the 3-wk old infant who was discharged without ahearing screening
The nurse is identifying outcomes for care provided to a new mother whose infant continues to spit up after feedings. Which outcome would be the most appropriate?
=the baby will have less episodes spitting up aftr sitting upright after a feeding
The nurse is teaching the parents of an infant about bathing. The nurse will inform the parents to set the home hot water heater to which temperature?
=100 F (37.8C)
During an extended stay in a hospital the nurse has observed a 5-year-old having several temper tantrums. How should the nurse address this behavior with the parents?
"Is it common for your child to throw temper tantrums at home? We have observed this behavior several times here."
A mother is concerned about her infant's spitting up. Which suggestion would be most appropriate?
"Keep the baby sitting up for about 30 minutes afterward."
The nurse is preparing to assess the internal ear structures of a 3-year-old. The child is resistant to the otoscope. How should the nurse respond?
"Let's see if I can find some puppies or kittens."
A nurse is interviewing a parent regarding the 2-year-old child's recent illness. The nurse would like the parent to elaborate about any symptoms of the illness noticed. Which would be the most effective question for the nurse to ask the parent in this situation?
"What symptoms has your child exhibited?"
After teaching a group of parents about language development in toddlers, which statement by a member of the group indicates successful teaching?
"When my 3-year-old asks 'Why?' all the time, this is completely normal."
A nurse is administering a liquid oral medication to a 5-month-old. Which nursing action provides the correct dosage? Select all that apply.
-Using a medicine dropper -Gently restraining the child's arms and head -Administering the medicine such that it flows slowly into the child's mouth
A mother shares with the health care provider that her 2-year-old toddler seems to have temper tantrums on a daily basis. Which would be considered good advice to give to this parent? Select all that apply.
=If the child has a tantrum when asked to perform a task, consider if the task is not appropriate for this age group. =If the parent gives in and gives the child a treat like candy, this is actually encouraging the child to have more tantrums so they can get more rewards. =When the child is frustrated and throws a tantrum, role play for the child the proper way to show frustration.
The nursing instructor has just completed a discussion about immunization. Which statement by a student would indicate a need for further instruction?
=an example of active immunity would be when immunoglobins are passed from a mother to her infant by colostrum
The nurse is assessing for pain in a 2-month-old infant. Which behavior indicates that this baby is experiencing pain?
=continued cryig after diaper change and being fed
Behavioral cues must be used to assess for the presence of pain in infants. Which of the following behaviors suggests pain in a 2-month-old infant?
=continued crying diaper change and being fed
The nurse is completing an infant history on a 5-month-old and documents the following symptoms. Which will the nurse attribute to teething? Select all that apply.
=drooling and biting =increased sucking on hands =irritability and awakening from sleep =refusing to eat
A nurse is assessing a Babinski reflex in a 2-day-old newborn. Which finding by the nurse would indicate a positive finding?
=fanning of the infants toes
A mother calls a clinic nurse to ask if her infant born prematurely should receive the seasonal influenza vaccine. The nurse's next question should be:
=how old is your baby
The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify?
=increased biting and sucking
The nurse is examining an infant who is 4 days old. The nurse puts the infant in a semiupright position and lets the head fall back (with immediate support). The nurse is assessing which newborn reflex?
=moro
A single mother with three young children is reluctant to leave her crying and upset 16-month-old daughter overnight in the hospital but needs to go home to care for the other children. Which suggestion from the nurse will best address the fears and concerns of both the child and mother?
Encourage the mother to give the child a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return, such as "when breakfast comes in the morning."
The nurse is caring for a 3-year-old with an exacerbation of a chronic condition that was diagnosed at birth. The nurse assesses that the caregiver is a single parent and she appears frustrated and angry with the nursing staff. She states that she has other children at home that she had to get the neighbor to watch. What is an appropriate nursing diagnosis to include in the plan of care for this patient?
Risk for caregiver role strain related to no other caregivers
The nurse is caring for a 2-year-old child who has been hospitalized after being injured in an automobile accident. During the assessment the child is quiet and watchful of all the nurse's actions. When considering the level of pain being experienced by the child what inference can be made?
The child's nonverbal behaviors may indicate the presence of discomfort.
The nurse is caring for a 2-year-old postoperative PET client. Which consideration is the most appropriate for this child's developmental stage?
Uses words for pain such as owie, boo-boo, or hurt
The nurse is visiting a mother who has a 3-month-old infant. Which anticipatory guidance information should the nurse provide to the mother at this time?
=the child should be able to turn over onto the back at age at 4 months
The nurse is administering otic medication to a 22-month-old with a diagnosis of otitis media. Which nursing action ensures that the medication is distributed appropriately?
Pull the pinna down and back
