peds exam 1
1. The nurse is conducting a well-child examination of a 5-year-old girl, who was 40 in tall at her last examination at age 4. Which height measurement would be within the normal range of growth expected for a preschooler? A) 41 in B) 43 in C) 45 in D) 47 in
B
The mother of a 5-year-old boy calls the nurse and seeks advice on how to assist the child with the recent death of his paternal grandfather. The boy keeps asking when his grandpa is coming back. How should the nurse respond? A) "It is best to just ignore this and to not respond to his questions." B) "This is normal; children his age do not understand the permanence of death." C) "You have to keep repeating that his grandfather is never coming back."
B
The nurse is assessing a 4-month-old boy during a scheduled visit. Which findings might suggest a developmental problem? A) The child does not babble. B) The child does not vocally respond to voices. C) The child never squeals or yells. D) The child does not say dada or mama.
B
The nurse is caring for a 4-week-old girl and her mother. Which is the most appropriate subject for anticipatory guidance? A) Promoting the digestibility of breast milk B) Telling how and when to introduce rice cereal C) Describing root reflex and latching on D) Advising how to choose a good formula
B
The nurse is teaching good sleep habits for toddlers to the mother of a 3-year-old boy. Which response indicates the mother understands sleep requirements for her son? A) "I'll put him to bed at 7 PM, except Friday and Saturday." B) "He needs 12 hours of sleep per day including his nap." C) "I need to put the side down on the crib so he can get out." D) "His father can give him a horseback ride into his bed."
B
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? A) Discourage solitary play; encourage playing with other children. B) Encourage the child to pick out his own clothes. C) Use "time-outs" whenever the child says "no" inappropriately. D) Encourage the child to take turns when playing games.
B
The parents of a 2-year-old girl are frustrated by the frequent confrontations they have with their child. Which is the best anticipatory guidance the nurse can offer to prevent confrontations? o A) "Respond in a calm but firm manner." B) "You need to adhere to various routines." C) "Put her in time-out when she misbehaves." D) "It's important to toddler-proof your home."
B
The parents of a 4-year-old ask the nurse when their child will be able to differentiate right from wrong and develop morals. What would be the best response of the nurse? A) "The preschooler has no sense of right and wrong." B) "The preschooler is developing a conscience." C) "The preschooler sees morality as internal to self." D) "The preschooler's morals are his or her own, right or wrong."
B
When instructing the parents of a toddler about appropriate nutrition, what would the nurse recommend? A) About 12 to 16 ounces of fruit juice per day B) Approximately 16 to 24 ounces of milk per day C) Fat intake of 30% to 40% of total calories D) An average of 10 to 12 grams of fiber per day
B
Which reflex, if found in a 4-month-old infant, would cause the nurse to be concerned? A) Plantar grasp B) Step C) Babinski D) Neck righting
B
A new mother expresses concern to the nurse that her baby is crying and grunting when passing stool. What is the nurse's best response to this observation? A) "This is normal behavior for infants unless the stool passed is hard and dry." B) "This is normal behavior for infants due to the immaturity of the gastrointestinal system." C) "This indicates a blockage in the intestine and must be reported to the health care provider."
A
The nurse is assessing the developmental milestones of an infant. The infant was born 8 weeks ago and was 4 weeks premature. The nurse anticipates that the infant will be meeting milestones for what age of child? Record your answer in weeks.
4
. The nurse is providing teaching about accidental poisoning to the family of a 3-year-old. The nurse understands that a child of this age is at increased risk of accidental ingestion due to which sensory alteration? A) A less discriminating sense of taste B) A lack of fully developed hearing C) Visual acuity that has not fully developed D) A less discriminating sense of touch
A
After teaching a group of parents about language development in toddlers, what if stated by a member of the group indicates successful teaching? A) "When my 3-year-old asks 'why?' all the time, this is completely normal." B) "A 15-month-old should be able to point to his eyes when asked to do so." C) "At age 2 years, my son should be able to understand things like under or on." D) "An 18-month-old would most likely use words and gestures to communicate."
A
The nurse in a community clinic is caring for a 6-month-old boy and his mother. Which intervention is priority to promote adequate growth? A) Monitoring the child's weight and height B) Encouraging a more frequent feeding schedule C) Assessing the child's current feeding pattern D) Recommending higher-calorie solid foods
A
The nurse is caring for a 5-year-old girl posttonsillectomy. The girl looks out the window and tells the nurse that it is raining and says, "The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process? A) Magical thinking B) Centration C) Transduction D) Animism
A
The nurse is assessing the respiratory system of a newborn. Which anatomic differences place the infant at risk for respiratory compromise? Select all that apply. A) The nasal passages are narrower. B) The trachea and chest wall are less compliant. C) The bronchi and bronchioles are shorter and wider. D) The larynx is more funnel shaped. E) The tongue is smaller. F) There are significantly fewer alveoli.
A, D, F
The nurse is assessing the psychosocial development of a preschooler. What are normal activities characteristic of the preschooler? Select all that apply. A) Plans activities and makes up games. B) Initiates activities with others. C) Acts out roles of other people. D) Engages in parallel play with peers. E) Classifies or groups objects by their common elements. F) Understands relationships among objects.
A, B, C
The RN caring for newborns knows infants exhibit phenomenal increases in their gross motor skills over the first 12 m of life. Which statements describe the typical infant's achievement of these milestones? SATA. A) 1 m, lifts and turns the head to the side in the prone position B) 2 m, rolls from supine to prone to back again. C) 6 m, pulls to stand up D) 7 m, sits alone with some use of hands for support E) 9 m, crawls with the abdomen off the floor F) 12 m, walks independently
A, D, E, F
A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm. How might the nurse respond to this information? A) "This is a primitive reflex known as the plantar grasp." B) "This is a primitive reflex known as the palmar grasp." C) "This is a protective reflex known as rooting." D) "This is a protective reflex known as the Moro reflex."
B
During a health history, the nurse explores the sleeping habits of a 3 YO boy by asking his parents. Which statement from the parents reflects a recommended guideline for promoting healthy sleep in this age group? A) son sleeps through the nite, & we insist that he takes 2 naps a day B) We keep a strict bedtime ritual, includes a bath & bedtime story C) son sleeps in a crib bc we feel it is the safest place for him D) son occasionally experiences night walking so we allow him to stay up later
B
The nurse is teaching a new mother about the drastic growth and developmental changes her infant will experience in the first year of life. Which statement describes a developmental milestone occurring in infancy?
By 6 months of age, the infant's brain weighs half that of the adult brain; at age 12 months, the brain weighs 2.5 times what it did at birth
The nurse observes an infant interacting with his parents. What are normal social behavioral developments for this age. A) 5 m, infant may develop stranger anxiety B) 2 m, infant exhibits first smile C) 3 m, infant smiles widely & gurgles when interacting with parent D) 3 m, infant will mimic the parent's facial movements, like sticking out tongue E) 3 to 6 m, infant enjoys socially interactive games like patty-cake/ peek-a-boo F) Separation anxiety may start in the last few months of infanc
B, C, D, F
The neonatal nurse assesses newborns for iron deficiency anemia. Which newborn is at highest risk for this disorder? A) A postterm newborn B) A term newborn with jaundice C) A newborn born to a diabetic mother D) A premature newborn
D
The RN is teaching parents interventions appropriate to the emotional development of their toddlers. What is a recommended intervention for this age group? A) Remove children's security blankets to help them assert their autonomy B) Distract toddlers from exploring their own body parts, particularly their genitals C) Do not blame toddlers for aggressive behavior; instead, point out the results of their behavior D) Offer toddlers many choices to foster control over their environment
C
The nurse is assessing a 3-year-old boy's development during a well-child visit. Which response by the child indicates the need for further assessment? A) He says a swear word when he hurts himself playing. B) He says "pew" when his sister has soiled her diaper. C) He laughs when his brother cries getting vaccinated. D) He constantly asks "why?" whenever he is told a fact.
C
The nurse is assessing the motor skills of a 5-year-old girl. Which finding would cause the nurse to be concerned? A) Can copy a square on another piece of paper B) Can dress and undress herself without help C) Draws a person with three body parts D) Is beginning to tie her own shoelaces
C
The nurse is examining a 10-month-old boy who was born 10 weeks early. Which finding is cause for concern? A) The child has doubled his birth weight. B) The child exhibits plantar grasp reflex. C) The child's head circumference is 49.53 cm. D) No primary teeth have erupted yet.
C
The nurse is performing a health assessment of a 3-month-old African-American boy. For what condition should this infant be monitored based on his race? A) Jaundice B) Iron deficiency C) Lactose intolerance D) Gastroesophageal reflux disease (GERD)
C
What activity would the nurse expect to find in an 18-month-old? A) Standing on tiptoes B) Pedaling a tricycle C) Climbing stairs with assistance D) Carrying a large toy while walking
C
A 6-month-old girl weighs 14.7 lb during a scheduled check-up. Her birth weight was 8 lb. What is the priority nursing intervention? A) Talking about solid food consumption B) Discouraging daily fruit juice intake C) Increasing the number of breastfeedings D) Discussing the child's feeding patterns
D
The RN is developing a teaching plan for toddler safety to present at a parenting seminar. Which intervention should the nurse address? A) enroll toddlers in swimming classes to avoid the need for constant supervision around water. B) keep pot handles on stoves turned outward to avoid accidental burns. C) smoke only in designated rooms in the house or outside the house. D) use a forward-facing car seat with harness straps and a clip, placed in the back seat of the car.
D
The RN is providing D/C teaching regarding formula preparation for a new mom. Which guideline would the RN include in the teaching? A) Always wash bottles and nipples in hot soapy water and rinse well; do not wash them in the dishwasher B) Store tightly covered ready-to-feed formula can after opening in fridge for up to 24 hr C) Warm bottle of formula by placing bottle in a container of hot water/ microwaving formula D) Do not add cereal to formula in the bottle/ sweeten the formula with honey
D
The mother of a 4-year-old boy tells the nurse that her son occasionally wets his pants during the day. How should the nurse respond? A) "Is there a family history of diabetes?" B) "Suddenly having accidents can be a sign of diabetes." C) "That's normal; don't worry about it." D) "Tell me about the circumstances when this occurs."
D
The nurse emphasizes that a toddler younger than the age of 18 months should never be spanked primarily for which reason? A) Spanking in a child this age predisposes the child to a pro-violence attitude. B) The child will become resentful and angry, leading to more outbursts. C) Spanking demonstrates a poor model for problem-solving skills. D) There is an increased risk for physical injury in this age group.
D
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? A) Completing puzzles with four pieces B) Winding up a mechanical toy C) Playing make-believe with dolls D) Knowing which are his or her toys
D
The nurse is designing a nursing care plan for a toddler with lymphoma, who is hospitalized for treatment. What is a priority intervention that the nurse should include in this child's nursing plan? A) Limiting visitors to scheduled visiting hours B) Planning physical therapy for the child C) Introducing the toddler to other toddlers in the unit D) Monitoring the toddler for developmental delays
D
Which activity would the nurse least likely include as exemplifying the preconceptual phase of Piaget's preoperational stage? A) Displays of animism B) Use of active imaginations C) Understanding of opposites D) Beginning questioning of parents' values
D
The nurse is choosing foods for a toddler's diet that are high in vitamin A. What foods could be added to the menu? Select all that apply. A) Applesauce B) Avocados C) Broccoli D) Sweet potatoes E) Spinach F) Carrots
D, E, F
The nurse is assessing a 2-year-old boy who has missed some developmental milestones. Which finding will point to the cause of motor skill delays? A) The mother is suffering from depression. B) The child is homeless and has no toys. C) The mother describes an inadequate diet. D) The child is unperturbed by a loud noise.
B
The parents of a 4-year-old who is a picky eater ask the nurse what foods to include in their child's diet to provide adequate iron consumption. Which food would the nurse recommend? A) Cooked lentils B) Whole milk C) Oranges D) Sweet potatoes
A
When observing a group of preschoolers at play in the clinic waiting room, which type of play would the nurse be least likely to note? A) Parallel play B) Cooperative play C) Dramatic play D) Fantasy play
A
The nurse is caring for a premature baby in the NICU. The mother reports that the infant's normally happy and outgoing 5-year-old sister is acting sad and withdrawn. The nurse understands that due to her developmental stage, the girl is at risk of what happening? A) Viewing her baby sister's illness as her fault B) Harming the baby C) Experiencing clinical depression D) Creating an imaginary friend to cope with the situation
A
At which age would the nurse expect to find the beginning of object permanence? A) 1 month B) 6 months C) 9 months D) 12 months
B
The nurse is performing a physical assessment of a 10-year-old boy. The nurse notes that during last year's check-up, the child weighed 80 lb. According to average growth for this age group, what would be his expected current weight? A) 81 lb B) 85 lb C) 87 lb D) 89 lb
C
The nurse is watching toddlers at play. Which normal behavior would the nurse observe? A) Toddlers engage in parallel play. B) Toddlers engage in solitary play C) Toddlers engage in cooperative play. D) Toddlers do not engage in play outside the home.
A
The nurse is providing anticipatory guidance to the mother of a 9-month-old girl during a well-baby visit. Which topic would be most appropriate? A) Advising how to create a toddler-safe home B) Warning about small objects left on the floor C) Cautioning about putting the baby in a walker D) Telling about safety procedures during baths
A
The nurse is explaining to parents that the preschooler's developmental task is focused on the development of initiative rather than guilt. What is a priority intervention the nurse might recommend for parents of preschoolers to stimulate initiative? A) Reward the child for initiative in order to build self-esteem. B) Change the routine of the preschooler often to stimulate initiative. C) Do not set limits on the preschooler's behavior as this results in low self-esteem.
A
The nurse is interviewing a 3 YO girl who tells the nurse: "Want go potty." The parents tell the RN that their daughter often speaks in this type of broken speech. What would be RN response to this? A) This is a normal, common speech pattern in the 3 YO & is called telegraphic speech B) This is considered a developmental delay in the 3 YO & we should consult a speech therapist C) This is a condition known as echolalia and can be corrected if you work w your daughter on language skills
A
The parents of a 5-year-old are concerned that their son is too short for his age. The nurse measures the child's height at 40 in (101.6 cm). How should the nurse respond? A) Some kids are short for their age during the preschool years but usually catch up during early childhood. B) Are most of the adults in your family short? It may be hereditary that your kid will be shorter than average. C) The average height for a 5-year-old is 43 in tall, so your son is within the normal range for height
C
The nurse is performing a cognitive assessment of a 2-year-old. Which behavior would alert the nurse to a developmental delay in this area? A) The child cannot say name, age, and gender. B) The child cannot follow a series of two independent commands. C) The child has a vocabulary of 40 to 50 words. D) The child does not point to named body parts
D
The nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl. Which is the most effective anticipatory guidance? A) Substituting cow's milk if breast milk is not available B) Advocating iron supplements with bottle-feeding C) Advising fluid intake per feeding of 5 or 6 ounces D) Discouraging the addition of fruit juice to the diet
D
The nurse is providing teaching about car safety to the parents of a 5-year-old girl who weighs 45 lb. What should the nurse instruct the parents to do? A) "Place her in a booster seat with lap and shoulder belts in the front seat." B) "Place her in the back seat with the lap and shoulder belts in place." C) "Place her in a forward-facing car seat with a harness and top tether." D) "Place her in a booster seat with lap and shoulder belts in the back seat."
D
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? A) The need for separation and control B) The need for love and belonging C) The need for safety and security D) The need for peer approval
A
The parent of a 6-month-old infant asks the nurse for advice about his son's thumb sucking. What would be the nurse's best response to this parent? A) "Thumb sucking is a healthy self-comforting activity." B) "Thumb sucking leads to the need for orthodontic braces." C) "Caregivers should pay special attention to the thumb sucking to stop it." D) "Thumb sucking should be replaced with the use of a pacifier."
A
The parents of a 1-year-old girl, both of whom have perfect teeth, are concerned about their child getting dental caries. Which is the best advice the nurse can provide? A) Tell the parents to limit the child's eating to meal and snack times. B) Urge the parents to take the child to a dentist for a check-up. C) Advise the parents to reduce carbohydrates in the child's diet. D) Advise the parents to use fluoride toothpaste.
A
The nurse is educating a first-time mother who has a 1-week-old boy. Which is the most accurate anticipatory guidance? A) Describing the effect of neonatal teeth on breastfeeding B) Explaining that the stomach holds less than 1 ounce C) Informing that fontanels will close by 6 months D) Telling that the step reflex persists until the child walks
B
The nurse is counseling the mother of a newborn who is concerned about her baby's constant crying. What teaching would be appropriate for this mother? A) Carrying the baby may increase the length of crying. B) Reducing stimulation may decrease the length of crying. C) Using vibration, white noise, or swaddling may increase crying. D) Using a swing or car ride may increase the incidence of crying episodes.
B
The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development? A) The child has trouble undressing himself. B) The child is unable to push a toy lawnmower. C) The child is unable to unscrew a jar lid. D) The child falls when he bends over.
B
The nurse is providing anticipatory guidance for parents of a preschooler regarding sex education. What is a recommended guideline when dealing with this issue? A) Be prepared to thoroughly cover a topic before the child asks about it. B) Before answering questions, find out what the child thinks about the subject. C) Expand upon the topic when answering questions to prevent further confusion. D) Provide a less than honest response to shelter the child from knowledge that is too advanced.
B
The nurse is teaching a new mother about the development of sensory skills in her newborn. What would alert the mother to a sensory deficit in her child? A) The newborn's eyes wander and occasionally are crossed. B) The newborn does not respond to a loud noise. C) The newborn's eyes focus on near objects. D) The newborn becomes more alert with stroking when drowsy.
B
Which food suggestion would be most appropriate for the mother of a preschooler to ensure an adequate intake of calcium? A) Spinach B) White beans C) Enriched bread D) Fortified cereal
B
The nurse is performing a physical assessment of a 3-year-old girl. What finding would be a concern for the nurse? A) The toddler gained 4 lb in weight since last year. B) The toddler gained 3 in in height since last year. C) The toddler's anterior fontanel is not fully closed. D) The circumference of the child's head increased 1 in since last year.
C
The nurse is providing anticipatory guidance to a mother to help promote healthy sleep for her 3-week-old baby. Which recommended guideline might be included in the teaching plan? A) Place the baby on a soft mattress with a firm, flat pillow for the head. B) Place the head of the bed near the window to provide fresh air, weather permitting. C) Place the baby on his or her back when sleeping. D) If the baby sleeps through the night, wake him or her up for the night feeding.
C
The nurse is providing guidance after observing a mother interact with her negative 2-year-old boy. For which interaction will the nurse advise the mother that she is handling the negativism properly? A) Telling the child to stop tearing pages from magazines B) Asking the child if he would please quit throwing toys C) Telling the child firmly that we don't scream in the office D) Saying, "Please come over here and sit in this chair. OK?"
C
The nurse is testing the sensory development of a toddler brought to the clinic for a well visit. What might alert the nurse to a potential problem with the child's sensory development? A) The toddler places the nurse's stethoscope in his mouth. B) The toddler's vision tests at 20/50 in both eyes. C) The toddler does not respond to commands whispered in his ear. D) The toddler's taste discrimination is not at adult levels yet.
C
The pediatric nurse is planning quiet activities for a hospitalized 18-month-old. What would be an appropriate activity for a child of this age group? A) Painting by number B) Putting shapes into appropriate holes C) Stacking blocks D) Using crayons to color in a coloring book
C
