PEDS Final

A parent asks the nurse if there is anything that can be done to reduce the pain that his 3-year-old experiences each morning when blood is drawn for lab studies. The most appropriate method the nurse can suggest to relieve pain associated with the venipuncture is (pp. 326-328 [new], 362-363 [old]) A. Intravenous sedation 15 minutes prior to the procedure. B. EMLA cream (lidocaine 2.5% and prilocaine 2.5%) applied to skin at least one hour prior to the procedure. C. Use of guided imagery during the procedure. D. Use of muscle-relaxation techniques.

B. EMLA cream (lidocaine 2.5% and prilocaine 2.5%) applied to skin at least one hour prior to the procedure.

Applications of the principle of atraumatic care in the pediatric setting include which of the following? (Select all that apply) (pp. 222-229; 232-236 [new], 249-256; 259-261 [old]) A. Use of "white lies" to minimize stress B. Encouraging the family to room in with child C. Identifying child/ family stressors D. Effectively managing pain E. Working independently of the parents

B. Encouraging the family to room in with child C. Identifying child/ family stressors D. Effectively managing pain

The home health nurse practices anticipatory guidance for a family with a 12-month-old child by giving information and brochures about: (pp. 145; 85-86 [new], 163; 97-98 [old]) A. Methods to decrease teething discomfort B. Methods to introduce solid food C. Advantages of breastfeeding D. Accident-proofing their home

D. Accident-proofing their home

Which of the following developmental delays are seen in children with Down syndrome? (pp. 814-815 [new], 885 [old]) A. Expressive and receptive language delays B. Cognitive impairments C. Fine and gross motor delays D. All of the above

D. All of the above

The nurse must perform a procedure on a toddler. The technique most appropriate when performing the procedure is to (pp. 223-224, 234-236 [new], 252; 260; 261-263 [old]) A. Ask the mother to restrain the child during the procedure. B. Ask the child if it is okay to start the procedure. C. Perform the procedure in the child's hospital bed. D. Allow the child to cry or scream.

D. Allow the child to cry or scream.

A 5-year-old is in the playroom when the respiratory therapist arrives on the pediatric unit to give the child a scheduled breathing treatment. The nurse should (pp. 238-240, 89-91, 263-264, 793 [new], 265-268; 101-102; 862 [old]) A. Reschedule the treatment for a later time. B. Show the respiratory therapist to the playroom so the treatment may be performed. C. Escort the child to his room and ask the child-life specialist to bring toys to the bedside. D. Assist the child back to his room for the treatment but reassure the child that he may return when the procedure is completed.

D. Assist the child back to his room for the treatment but reassure the child that he may return when the procedure is completed.

The following question stems from this scenario: Monique walks into the ED carrying her crying 18-month old daughter. She tells the nurse her daughter crawled into the leg of the ironing board. The hot iron tumbled off the board and the child touched it before she could interfere. But the burn is on the edge of the child's palm and on her wrist, not her fingers. "This isn't the first time she's touched the iron," Monique says. "You would think she'd learn." When the nurse examines the child, the mother complains that there is nothing wrong with her other than the burn on her hand. During her assessment, the nurse notes scars on the child's back and buttocks shaped like the tip of an iron. (pp. 388-394 [new], 426-432 [old]) The nurse's initial interventions are aimed at: A. Confronting Monique. B. Getting Monique to talk about the suspected abuse C. Providing psychosocial support to Monique D. Attending to the child's physical injuries

D. Attending to the child's physical injuries

Parents of a newborn are confused when their child is diagnosed with a genetic disorder because neither of them has a defect. Testing is done and it is determined that both parents are carriers of the disorder even though they are asymptomatic. Understanding the principles of the Mendelian Pattern of Inheritance, the nurse determines what condition is the likely reason for this genetic disorder? (pp. 51-55 [new], 52-62 [old]) A. X-linked dominant condition B. Autosomal dominant condition C. X-linked recessive condition D. Autosomal recessive condition

D. Autosomal recessive condition

A 10-year-old has been receiving morphine every two hours for postoperative pain as ordered. The medication relieves the pain for approximately 90 minutes, and then the pain returns. The nurse should (pp. 323-324 [new], 359-360 [old]) A. Tell the child that pain medication cannot be administered more frequently than every two hours. B. Reposition the child and quietly leave the room. C. Inform the parents that the child is dependent on the medication. D. Call the family nurse practitioner to see if the child's orders for pain medication can be changed.

D. Call the family nurse practitioner to see if the child's orders for pain medication can be changed.

While teaching a 10 year-old child about his impending heart surgery, the nurse should: (pp. 70-72 [new], 80-83 [old]) A. Provide a verbal explanation just prior to the surgery B. Provide the child with a booklet to read about the surgery C. Introduce the child to another child who had heart surgery three days ago D. Explain the surgery using a model of the heart

D. Explain the surgery using a model of the heart

According to Piaget, this is the fourth stage of cognitive development. This stage is characterized by the ability to think logically about abstract principles and hypothetical situations. (pp. 70-72 [new], 80-83 [old]) Which Piaget stage? A. Sensorimotor B. Preoperational C. Concrete operational D. Formal operational

D. Formal operational

1. Which role would the pediatric nurse be serving when reading and analyzing new research findings and applying those findings to practice? (pp. 2-4) A. Advocate. B. Case manager. C. Educator. D. Researcher.

D. Researcher.

What types of disorders are abnormalities that result from an abnormal sex chromosome? (pp. 53-54 [new], 60 [old]) A. Autosomal dominant B. Autosomal recessive C. Multifactorial D. X-linked

D. X-linked

If respiratory depression occurs with opioid use, the pediatric nurse should use which reversal agent when oxygen and stimulation of the child are ineffective? (Slide # 72, PowerPoint lecture) A. Atropine sulfate B. Dexamethasone C. Epinephrine D. Methylprednisolone E. Nalaxone hydrochloride F. Sodium bicarbonate G. Dextroamphetamine H. Midazolam hydrochloride

E. Nalaxone hydrochloride

Overarching goals of Healthy People 2020 include: (Select all that apply.) (p. 7 [new], 8 [old]) A. Promotion of oral health and reduction of tooth decay B. High-quality, longer lives free of preventable disease, disability, injury and premature death C. Create social and physical environment that promote good health for all D. Health equity, eliminate disparities, improve the health of all groups E. Elimination of addictive habits such as smoking, drinking and abuse of substances

B. High-quality, longer lives free of preventable disease, disability, injury and premature death C. Create social and physical environment that promote good health for all D. Health equity, eliminate disparities, improve the health of all groups

The nurse is aware that the prevalence of chronic health conditions in children is: (pp. 7, 246-248 [new], 9, 274-276 [old]) A. Decreasing as a result of advances in health care and treatment B. Increasing as a result of advances in health care and treatment C. Increasing as a result of increased incidence of childhood injury D. Decreasing as a result of decreased incidence of childhood injury

B. Increasing as a result of advances in health care and treatment

A 5-year-old is being discharged from the outpatient surgical center. Which statement by the parent would indicate the need for further teaching? (pp. 323-324 [new], 359-360 [old]) A. "I can expect my child to have some pain for the next few days." B. "I will plan to give my child pain medicine around the clock for the next day or so." C. "Since my child just had surgery today, I can expect the pain level to be higher tomorrow." D. "I will call the office tomorrow if the pain medicine is not relieving the pain."

C. "Since my child just had surgery today, I can expect the pain level to be higher tomorrow."

A mother complains that her 13-year-old has started to grow rapidly, and asks the nurse if this is normal and how long it will last. The best nursing response is: (pp. 94-96 [new], 105-106 [old]) A. "This is unusual at this age, and a physician should be contacted." B. "This is normal, but will only last a few months." C. "This is normal and can last until about age 20." D. "This is normal, but growth should be completed by about age 15 or 16."

C. "This is normal and can last until about age 20."

Baby Smith weighs 14 pounds. What is his hourly fluid needs? (p. 415 [new], 454 [old]; p. 14 Clinical Guidebook) A. 5.8 mL/hour B. 14 mL/hour C. 26.5 mL/hr D. 128.3 mL/hour

C. 26.5 mL/hr

Tina is 33 inches tall at 24 months. The nurse anticipates that Tina will be how many inches tall when fully grown? (pp. 85 [new], 92-94 [old]) A. 48 inches B. 60 inches C. 66 inches D. 72 inches

C. 66 inches

A mother visits her primary care provider for the child's 12-month visit. The child weighed 2,800 grams at birth. Which of the following weights is most consistent with the expected weight for this child? A. 7,500 grams B. 8,000 grams C. 8,500 grams D. 9,000 grams

C. 8,500 grams

The nurse is caring for a child who has been sedated for a painful procedure. The priority nursing activity for this child should be (pp. 314-316 [new], 353-355 [old]) A. Allow parents to stay with the child. B. Monitor pulse oximetry. C. Assess the child's respiratory effort. D. Place the child on a cardiac monitor.

C. Assess the child's respiratory effort.

Breastmilk is preferred over formula because: (pp. 282-283 [new], 314-316 [old]) A. Breastfed infants gain more weight B. Breastmilk has more calories C. Breastmilk contains antibodies D. Formula is nutritionally inadequate

C. Breastmilk contains antibodies

According to Piaget, this is the third stage of cognitive development that is characterized by the ability to think logically about concrete objects and situations. (pp. 70-72 [new], 80-83 [old]) Which Piaget stage? A. Sensorimotor B. Preoperational C. Concrete operational D. Formal operational

C. Concrete operational

According to Piaget, the 7- to 11-year-old-child is at which of the following stages of cognitive development? (pp. 70-72 [new], 80-83 [old]) A. Sensorimotor B. Formal operations C. Concrete operations D. Preoperational

C. Concrete operations

The nurse needs to administer a medication to a 4-year-old child. The medication is only available in tablet form. The nurse should: (p. 233 [new], 259 [old]) A. Place the tablet on the child's tongue and give the child a drink of water. B. Break the tablet in small pieces and ask the child to swallow the pieces one by one. C. Crush the tablet and mix it in a teaspoon of applesauce. D. Crush the table and mix it in a cup of juice.

C. Crush the tablet and mix it in a teaspoon of applesauce.

The 20-month-old child appears to be happy and content with multiple caregivers and other children. She also ignores her parents when they reappear on the unit. The pediatric nurse determines that the child is experiencing which stage of separation anxiety? (pp. 224-225 [new], 250-251 [old]) A. Contentment B. Despair C. Detachment D. Protest

C. Detachment

A 2-year-old child recently diagnosed with a seizure disorder will be discharged home on an oral anticonvulsant medication. Which of the following actions by the mother best demonstrates understanding of how to give the medication? The mother (p. 233 [new], 259 [old]) A. Verbalizes how to give the medication. B. Acknowledges understanding of written instructions. C. Draws up the medication correctly in an oral syringe and administers it to the child. D. Observes the nurse draw up the medication and administer it to the child.

C. Draws up the medication correctly in an oral syringe and administers it to the child.

A 3-year-old is hospitalized following surgery for a ruptured appendix. During assessment of the child, the nurse notes that the child is sleeping. Vital signs are as follows: temperature 97.8 degrees F axillary, pulse 90, respirations 12, and blood pressure 100/60. Based on this assessment, the nurse concludes that the child is: (pp. 318-321 [new], 353-354 [old]) A. Comfortable and the pain is controlled. B. In shock secondary to blood loss during surgery. C. Experiencing respiratory depression secondary to opioid administration for postoperative pain. D. Sleeping to avoid pain associated with surgery.

C. Experiencing respiratory depression secondary to opioid administration for postoperative pain.

The following question stems from this scenario: Monique walks into the ED carrying her crying 18-month old daughter. She tells the nurse her daughter crawled into the leg of the ironing board. The hot iron tumbled off the board and the child touched it before she could interfere. But the burn is on the edge of the child's palm and on her wrist, not her fingers. "This isn't the first time she's touched the iron," Monique says. "You would think she'd learn." When the nurse examines the child, the mother complains that there is nothing wrong with her other than the burn on her hand. During her assessment, the nurse notes scars on the child's back and buttocks shaped like the tip of an iron. (pp. 388-394 [new], 426-432 [old]) Monique's explanation of how the child was injured is: A. Not really important. B. Not pertinent information for the nurse to chart. C. Inconsistent with the injury. D. The only reason the nurse suspects abuse.

C. Inconsistent with the injury.

A 10-year-old fifth-grader enjoys having his artwork displayed on the family refrigerator. This behavior is indicative of which developmental stage as described by Erikson? (pp. 70-71 [new], 80 [old]) A. Initiative versus guilt B. Intimacy versus isolation C. Industry versus inferiority D. Identity versus role confusion

C. Industry versus inferiority

A child is 5 years old and has been recently admitted into the hospital. According to Erikson, in which of the following stages is this child? (pp. 70-71 [new], 80 [old]) A. Trust vs. mistrust B. Autonomy vs. shame C. Initiative vs. guilt D. Intimacy vs. isolation

C. Initiative vs. guilt

Which of the following features is NOT commonly seen in children with Down syndrome? (pp. 814-815 [new], 885 [old]) A. Epicanthal folds in the eyes B. Low muscle tone C. Muscle spasticity D. Flattened mid-face E. Low-set ears

C. Muscle spasticity

The nurse conducts developmental screenings at a community center for infants and young children. The nurse explains that the purpose of these screenings is to: (pp. 103-105 [new], 118-120 [old]) A. Reverse degenerative processes that have occurred. B. Recognize early infection in order to prevent spread to individuals in close contact with the child. C. See if there's cause to suspect that a baby or toddler has a disability or developmental delay. D. Measure intelligence and readiness for school. E. Diagnose a developmental impairment in physical, learning, language, or behavior areas.

C. See if there's cause to suspect that a baby or toddler has a disability or developmental delay.

The pediatric nurse is formulating a disaster preparedness plan for disadvantaged children in a rural community. This plan includes allocation of supplies and equipment, sheltering-in-place, and roles/ assignments for healthcare personnel. This meticulous planning demonstrates which level of preventive health maintenance? (pp. 145, 213-219 [new],164, 238-245 [old]) A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Quaternary prevention

C. Tertiary prevention

The following question stems from this scenario: Monique walks into the ED carrying her crying 18-month old daughter. She tells the nurse her daughter crawled into the leg of the ironing board. The hot iron tumbled off the board and the child touched it before she could interfere. But the burn is on the edge of the child's palm and on her wrist, not her fingers. "This isn't the first time she's touched the iron," Monique says. "You would think she'd learn." When the nurse examines the child, the mother complains that there is nothing wrong with her other than the burn on her hand. During her assessment, the nurse notes scars on the child's back and buttocks shaped like the tip of an iron. (pp. 388-394 [new], 426-432 [old]) The nurse documents: A. Patient is a victim of child abuse. B. Abuse suspected by the mother. C. The location, shape, color and size of the burn D. Patient brought in due to accidental causes.

C. The location, shape, color and size of the burn

Which of the following are examples of primary prevention activities or strategies? (pp. 145-146, 151-152 [new],163-164; 170-171 [old]) A. Using medication to treat conditions such as high blood pressure or high cholesterol, screening for sexually transmitted infections or utilizing nicotine patches to reduce smoking frequency B. For a child with juvenile arthritis, doing exercises, participating in physical therapy, and taking medication to control inflammation and pain C. Vaccination, behavioral counseling for smoking cessation, physical activity, and nutrition D. For a child with a disabling injury, intensive, long-term physical therapy to regain use of limbs or develop alternate means for independent functioning

C. Vaccination, behavioral counseling for smoking cessation, physical activity, and nutrition

A 4-year-old is seen in the clinic for a sore throat. In the child's mind, the most likely causative agent is that the child (pp. 70, 89, 223 [new], 83,101, 252 [old]) A. Was exposed to someone else with a sore throat. B. Did not eat the right foods. C. Yelled at his brother. D. Did not take his vitamins.

C. Yelled at his brother.

A client and her husband are positive for the sickle cell trait. The client asks the nurse about chances of her children having sickle cell disease. Which of the following is an appropriate response by the nurse? (pp. 52-53 [new], 58-59 [old]) A. one of her children will have sickle cell disease B. only the male children will be affected C. each pregnancy carries a 25% chance of the child being affected D. if she had four children, one of them would have the disease

C. each pregnancy carries a 25% chance of the child being affected

Match the color-coded category of the Pediatric Early Warning Score with the correct numerical score. Each choice will be used only once. (Slides # 102-103, Lecture PowerPoint) Green Yellow Orange Red A. 0-2 B. 3 C. 4 D. ≥ 5

A. 0-2 B. 3 C. 4 D. ≥ 5

A nurse admits a three-month-old infant to the pediatric floor for observation, with a medical diagnosis of Brief Resolved Unexplained Event (BRUE) (formerly Apparent Life-Threatening Event [ALTE]). A brief examination reveals that the child is alert, has an even and unlabored respiratory rate and effort, warm and pink skin, an instant capillary refill, oxygen saturation of 99%, and the pulse rate is regular at 124. An excerpt from the History of Present Illness is as follows: "The mother says she was holding the infant in her arms when the child stopped breathing. She had just had a bowel movement in her diaper. The mother yelled for her husband, who came, grabbed the infant and blew in her face. The mother states the child had 'turned a blue color' and didn't breathe until the husband blew in her face. She remained limp, moving little, and never cried. After approximately three minutes, the child returned to her normal active state." According to Gordon's Functional Health Patterns, which focus is priority for the nurse to assess? (pp. 481-482 [new],527-528 [old]) A. Activity Exercise Pattern B. Elimination Pattern C. Nutritional-Metabolic Pattern D. Sleep-Rest Pattern

A. Activity Exercise Pattern

A 3-year-old child with a history of strabismus has an eye-patch over her eye. This is likely due to: (p. 447 [new], 490 [old]) A. Amblyopia B. Astigmatism C. Conjunctivitis D. Myopia E. Ptosis F. Uveitis

A. Amblyopia

Which assessment finding by the nurse would be least suggestive of respiratory distress syndrome (RDS) in an infant? (pp. 836-837, Lowdermilk) A. Bloating or swelling of the belly (abdominal distention) B. Breathing that stops and starts (apnea) C. Chest retractions (pulling in at the ribs and sternum during breathing) D. Tachypnea (rapid breathing)

A. Bloating or swelling of the belly (abdominal distention)

A characteristic sign of necrotizing enterocolitis (NEC) in the newborn is: (Lowdermilk, pp. 839-840) A. Bloody diarrhea B. Necrosis of the abdomen C. Projectile vomiting D. High fever

A. Bloody diarrhea

The pediatric nurse is performing a developmental screen on a 15-month-old child. This child should typically be able to: (See: "Toddler Developmental Grid" in the Course Packet) A. Build a 3-block tower. B. Speak with a vocabulary of 10 words. C. Throw a ball without falling. D. Turn the pages of a book.

A. Build a 3-block tower.

Preterm infants are at risk for cold stress. Which signs should alert the nurse that the preterm infant may be hypothermic? (p. 818, Lowdermilk) (Select all that apply) A. Cyanosis B. Hypoglycemia C. Irritability D. Periodic breathing pattern E. Bradycardia F. Abdominal distention

A. Cyanosis B. Hypoglycemia C. Irritability E. Bradycardia

Clinical manifestations of prematurity include: (p. 554, Lowdermilk) A. Disproportionately large head B. Fine hair (lanugo) covering much of the body C. Abundant scalp hair D. Lack of fat stores E. Sunken fontanels F. Thin, translucent skin G. Dry, loose, peeling skin H. Visible creases on palms and soles of feet

A. Disproportionately large head B. Fine hair (lanugo) covering much of the body D. Lack of fat stores F. Thin, translucent skin

The actual time that the fetus remains in the uterus is termed: (Lowdermilk, pp. 554, 817) A. Gestational age B. Intrauterine growth rate C. Neurological age D. Level of maturation

A. Gestational age

An infant weighed 2.9 kg (6.4 lbs) at birth. Now, at her 6-month well-child checkup, she weighs 5.8 kg (12.75 lbs). How should you describe her weight gain? (Choose the one best answer.) (p. 79 [new], 91 [old]) A. Normal for age B. Small for age C. Large for age D. Excessive for age

A. Normal for age

A mother questions the nurse regarding car seat safety for her infant. Which of the following information should the nurse include in the discussion? A. Place the infant seat rear facing in the back seat of the car. B. Move the car seat to the forward-facing position when the child reaches 1 year of age. C. Keep the child in a bucket seat until the child is at least 12 months of age. D. Tighten the straps of the seat so that only an adult fist fits under the straps.

A. Place the infant seat rear facing in the back seat of the car.

A ten-month-old infant is seen in the well-child clinic. Which of the following behaviors should the nurse expect to see? (See "Infant Growth & Development Document" in the Course Packet; pp. 80-81; 84 (new), 92-93; 95 (old) in the textbook) Select all that apply. A. Plays peek-a-boo and patty cake B. Walks independently C. Feeds self with a spoon D. Stacks two blocks into a tower E. Transfers objects from hand to hand

A. Plays peek-a-boo and patty cake E. Transfers objects from hand to hand

Match each of the following four terms with the phrase that most closely describes it. Each answer may be used only once. (Lowdermilk, p. 817) Length of time spent in the uterus Less than 38 weeks gestation More than 42 weeks of gestation 38 to 42 weeks of gestation

A. Postterm gestation B. Term gestation C. Preterm gestation D. Gestational age

According to Piaget, this is the first stage of cognitive development. This is the period where the infant explores the environment and acquires knowledge through sensing and manipulation of objects. (pp. 70-72 [new], 80-83 [old]) Which Piaget stage? A. Sensorimotor B. Preoperational C. Concrete operational D. Formal operational

A. Sensorimotor

The nurse correctly recognizes that a shared goal of early intervention for both maple syrup urine disease (MUSD) and phenylketonuria (PKU) is avoidance of which complication? (pp. 893-896 [new], 970 [old]) A. Severe neurologic impairment B. Secondary liver disease C. Obesity D. Heart disease

A. Severe neurologic impairment

The stage that occurs between birth and one year of age is concerned with: (pp. 70-71 [new], 80 [old]) A. Trust vs. Mistrust B. Autonomy vs. Shame and Doubt C. Initiative vs. Guilt D. Identity vs. Role Confusion

A. Trust vs. Mistrust

Which of the following strategies should be employed to reduce pediatric medication errors? (Select all that apply) (pp. 11-12) A. Use capital letters to distinguish between medications B. Open all medications at the nurses station, for accuracy and ease of administration C. Include the child's weight, age, and calculated dose D. Use bar code medication scanning in place of the six rights of medication administration E. Weigh the child in pounds and ounces

A. Use capital letters to distinguish between medications C. Include the child's weight, age, and calculated dose

Which of the following are true concerning the Babinski reflex? (Select all that apply.) (Lowdermilk, p. 548) A. With a positive Babinksi response, the infant's smaller toes fan out and the big toe dorsiflexes slowly. B. Indicates equilibrium and cerebellar function. C. Usually disappears by 1 year of age. D. Abnormal in a child > 2 years of age (indicates central nervous system dysfunction). E. To elicit the Babinski response, the lateral side of the sole of the foot is rubbed with a blunt instrument or device so as not to cause pain, discomfort, or injury to the skin; the instrument is run from the heel along a curve to the toes. F. A positive Babinski response occurs in infancy because the corticospinal pathways that run from the brain down the spinal cord are not fully myelinated.

A. With a positive Babinksi response, the infant's smaller toes fan out and the big toe dorsiflexes slowly. C. Usually disappears by 1 year of age. D. Abnormal in a child > 2 years of age (indicates central nervous system dysfunction). E. To elicit the Babinski response, the lateral side of the sole of the foot is rubbed with a blunt instrument or device so as not to cause pain, discomfort, or injury to the skin; the instrument is run from the heel along a curve to the toes. F. A positive Babinski response occurs in infancy because the corticospinal pathways that run from the brain down the spinal cord are not fully myelinated.

Copy of Please match the infant reflex with the correct descriptor. Only one descriptor corresponds with each item. (Lowdermilk, pp. 546-549) Babinski Moro (startle) Palmar grasp Stepping. Rooting. Sucking. Tonic neck (fencing).

A. With stimulation (stroking) the cheek, the neonate turns toward the stimulus. B. When a finger is placed in the neonate's palm, the fingers grasp tightly. C. When the head is turned to one side, the arm and leg on that side extend (stretch out to fullest length) and the opposite arm and leg flex (curl upward). D. Immediate sucking when something placed in the mouth. E. When there is a loud noise, or when lifted above the crib and lowered quickly, there is symmetrical abduction and extension of the arms with the fingers extended to form a 'C'. F. When held in an upright position with the feet in contact with a hard surface, the infant will alternatively raise feet as if stepping or dancing. G. When the side of the foot on the side of the little toe is stroked, the infant's toes fan upward.

When a preterm infant who is being gavage fed has a bloody stool, the nurse should: (pp. 839-840, Lowdermilk) A. assess for abdominal distention. B. decrease the amount of the next feeding. C. institute enteric precautions. D. get a culture of the next stool.

A. assess for abdominal distention.

When using an infant seat, the 5-point harness straps should be located: (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. at or slightly below the infant's shoulders B. at or slightly above the infant's shoulders C. above the infant's shoulders D. an infant seat doesn't need harness straps

A. at or slightly below the infant's shoulders

Harness straps should fit (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. snug and tight without any slack B. loosely so the child can get out of the car easily C. below the child's shoulders in a forward facing seat D. snug, but with one finger-width of slack

A. snug and tight without any slack

The nurse understands that primary dentition is usually completed by age: (p. 118 [new], 133 [old]) A. 18 months B. 3 years C. 4 years D. 6 years

B. 3 years

The pediatric nurse understands that the rooting reflex typically disappears at which age? (Choose the correct answer.) (Please refer to Lowdermilk, pp. 541-544; See also "Normal Infant Reflexes" section in the Infant & Toddler PowerPoint.) A. 1-2 months B. 3-4 months C. 5-6 months D. 7-8 months

B. 3-4 months

The nurse should teach a parent to introduce solid foods to an infant at what age? (p. 284 [new], 317 [old]) A. 3 months B. 6 months C. 8 months D. 10 months

B. 6 months

Where should a harness chest clip be positioned? (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. Near the child's neck B. At the level of his armpits C. Over his belly D. Near his waist

B. At the level of his armpits

The pediatric nurse is conducting an examination of a nine-month-old baby. During the examination, the nurse should be able to elicit which reflex? (See pp. 139 [new],156-158 [old]; Lowdermilk, p. 546) A. Moro B. Babinski C. Stepping D. Palmar grasp E. Plantar grasp

B. Babinski

A six-month-old child received the following play things as a gift from a relative. The nurse should advise the parents that which of the following items is potentially dangerous for the child to play with? (pp. 72, 82 [new], 83,97 [old]; slides 56, 66 Infant & Toddler PowerPoint) A. Stuffed animal B. Balloon C. Toy cell phone D. Shape sorter

B. Balloon

The nurse is teaching parents of an infant about introduction of solid food to their baby. What is the first food they can add to the diet? (p. 284 [new], 317 [old]) A. Vegetables B. Cereal C. Fruit D. Meats

B. Cereal

The neonatal nurse understands that factors contributing to the development of bronchopulmonary dysplasia (BPD) include which of the following? (Select all that apply) (pp. 837-838, Lowdermilk) A. Concentrated enteral formula B. Extra oxygen for breathing C. Low amounts of surfactant D. Overnutrition E. Prematurity F. Radiant warmers G. Steroids H. Use of a mechanical ventilator

B. Extra oxygen for breathing C. Low amounts of surfactant E. Prematurity H. Use of a mechanical ventilator

The nurse is caring for a preterm infant who is at risk for an intraventricular hemorrhage (IVH). Which daily assessment is most critical for this infant? (pp. 838-839, Lowdermilk) A. Blood pressure B. Head circumference C. Intake and output D. Pupillary light reflex

B. Head circumference

When caring for a preterm infant at 30 weeks of gestation, the nurse should recognize that the newborn's priority nursing diagnosis is: (pp. 820-822, Lowdermilk) A. Risk for Infection related to decreased immune response B. Ineffective Breathing Pattern related to surfactant deficiency and weak respiratory muscle effort C. Ineffective Thermoregulation related to immature thermoregulation center D. Imbalanced Nutrition Less than Body Requirements related to ineffective suck and swallow

B. Ineffective Breathing Pattern related to surfactant deficiency and weak respiratory muscle effort

Infections in the newborn require prompt intervention because: (Lowdermilk, p.843) A. They spread more quickly. B. Infections that are relatively harmless to an adult can be fatal to the newborn. C. The portals of entry and exit are more numerous. D. The newborn has no defense against infection.

B. Infections that are relatively harmless to an adult can be fatal to the newborn.

For an eight-month-old infant, which toy promotes cognitive development? (pp. 72, 82 [new], 83, 97 [old]) A. Finger paint B. Jack-in-the-box C. A small rubber ball D. A play gym strung across the crib

B. Jack-in-the-box

A child with nystagmus should demonstrate: (p. 442 [new], 484 [old]) A. One eye gazing in a different direction during the cover/uncover test. B. Jerky eye movements during the 6 Cardinal Positions of Gaze test. C. Droopy eyelids that partially or completely cover the pupil. D. Nicking of the retinal blood vessels during the internal eye examination.

B. Jerky eye movements during the 6 Cardinal Positions of Gaze test.

The nurse is assessing a six-month-old child. Which developmental skills are normal and should be expected? (See "Infant Growth & Development Document" in the Course Packet; pp. 80-81; 84 (new), 92-93; 95 (old) in the textbook) A. Speaks in short sentences. B. Sits alone in tripod position. C. Can feed self with a spoon. D. Pulling up to a standing position.

B. Sits alone in tripod position

A day care nurse is observing a 2-year old child and suspects that the child may have strabismus. Which observation made by the nurse might indicate this condition? (p. 447 [new], 490 [old]) A. The child has involuntary, shaking, "to and fro" movement in the eyes. B. The child consistently tilts the head to see. C. The child consistently turns the head to see. D. The child does not respond when spoken to.

B. The child consistently tilts the head to see.

The infant weighs 1300 grams (2 pounds, 14 ounces) at birth. The neonatal nurse correctly classifies this infant as: (p. 817, Lowdermilk) A. Low-birth-weight (LBW) infant B. Very low-birth-weight (VLBW) infant C. Extremely low-birth-weight (ELBW) infant D. Small-for-gestational age (SGA) infant

B. Very low-birth-weight (VLBW) infant

When using a forward facing convertible seat, the harness straps should be located: (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. at or slightly below the child's shoulders B. at or slightly above the child's shoulders using the top set of harness slots C. below the child's shoulders D. at or below the child's feet, using the bottom set of harness slots

B. at or slightly above the child's shoulders using the top set of harness slots

The nurse explains that an infant born at 31 weeks of gestation may need to be fed by gavage during the first few weeks of life because the infant: (p. 829, Lowdermilk) A. is unable to digest food properly. B. has weak coordination of sucking and swallowing. C. refuses to take the breast by mouth. D. needs a larger quantity of formula at each feeding.

B. has weak coordination of sucking and swallowing.

Where should a 25 pound 9 month old ride in the car? (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. in a front-facing car seat in the back seat B. in a rear-facing car seat in the middle of the back seat C. in a rear-facing car seat in the front seat, as long as there is an air bag D. in a booster seat in the back seat

B. in a rear-facing car seat in the middle of the back seat

An infant weighted 7 lbs, 11 oz. at birth. What should the nurse expect this infant to weigh at 12 months of age? (pp. 80-83 [new], 92-94 [old]) A. 15 lbs. B. 20 lbs. C. 23 lbs. D. 25 lbs.

C. 23 lbs.

A child should be able to pull off her shoes by which age? (p. 85 [new], 97 [old]) A. 13 months B. 18 months C. 24 months D. 36 months

C. 24 months

Most children are ready to begin the process of toilet training by which age? (pp. 85-86, 173 [new]; 97-98; 194 [old]) A. 18 months B. 24 months C. 27 months D. 32 months

C. 27 months

An infant seat should recline at an angle of: (p. 161-162, 176-177, 194 [new],183 [old]) A. 180 degrees B. 90 degrees C. 45 degrees D. 25 degrees

C. 45 degrees

Which of the following developmental markers should the nurse expect to see in caring for an infant who is four months old? (Choose the correct answer.) ( See "Infant Growth & Development Document" in the Course Packet; pp. 80-81; 84 (new), 92-93; 95 (old) in the textbook) A. Begins to feed self finger foods; sits alone steadily without support. B. Begins forming words out of previous sounds ("mama"); crawls and creeps. C. Begins to use consonant sounds; no head lag when pulled to sitting position. D. Uses pincer grasp to pick up small objects; turns from back to abdomen. E. Mimics sounds and facial expressions; understands words such as "no" and "cracker."

C. Begins to use consonant sounds; no head lag when pulled to sitting position.

The nurse is providing anticipatory guidance to the parents of a young child on how to handle a suspected poisoning. If their child ingests poison, what should the parents do first? A. Administer ipecac syrup B. Call 911 to summon an ambulance immediately C. Call the nationwide poison control center at 1-800-222-1222 D. Punish the child for bad behavior

C. Call the nationwide poison control center at 1-800-222-1222

A common cause of food allergy in young children is: (p. 285 [new], 318 [old]) A. Breast milk B. Apples C. Cow's milk D. Rice

C. Cow's milk

According to the CDC schedule, which immunizations are expected for a child at 6 months of age? (pp. 160 [new], 195; 372-373 [old]) A. DTaP Rotavirus Meningococcal Hib Inactivated Polio Virus (IPV) PCV Influenza B. DTap Rotavirus Hib HPV PCV C. DTap Rotavirus Hep B Hib IPV PCV Influenza D. Hib Varicella PCV MMR DTap

C. DTap Rotavirus Hep B Hib IPV PCV Influenza

The mother of a one-month-old infant states that she is curious as to whether her child is developing normally. Which of the following developmental milestones should the nurse inform the mother that the infant is expected to perform at this age? (See "Infant Growth & Development Document" in the Course Packet; pp. 80-81; 84 (new), 92-93; 95 (old) in the textbook) A. Rolling from side to back B. Laughing and squealing C. Lifting head briefly D. Holding a rattle placed in hand

C. Lifting head briefly

A 2-week-old premature infant is experiencing periods of apnea, temperature instability, vomiting, and diarrhea. What is the best explanation for these clinical manifestations? (pp. 836-840, Lowdermilk) A. Respiratory distress syndrome B. Bronchopulmonary dysplasia C. Necrotizing enterocolitis D. Hydrocephalus secondary to intraventricular hemorrhage

C. Necrotizing enterocolitis

Providing high oxygen concentrations to a preterm newborn may cause:(Lowdermilk, pp. 837-838) A. Oral-tactile hypersensitivity (oral aversion) B. Acrocyanosis C. Retinopathy of prematurity D. Primary atelectasis

C. Retinopathy of prematurity

An infant, 6 weeks old, is brought to the Washington County Health Department clinic for a well-baby visit. To assess the fontanels, how should the public health nurse position the infant? (pp. 108-109 [new], 122-124 [old]) A. Supine B. Prone C. Seated upright D. Left lateral position

C. Seated upright

1. The nurse conducts developmental screenings at a community center for infants and young children. The nurse explains that the purpose of these screenings is to: (pp. 103-105 [new], 118-120 [old]) A. Reverse degenerative processes that have occurred. B. Recognize early infection in order to prevent spread to individuals in close contact with the child. C. See if there's cause to suspect that a baby or toddler has a disability or developmental delay. D. Measure intelligence and readiness for school. E. Diagnose a developmental impairment in physical, learning, language, or behavior areas.

C. See if there's cause to suspect that a baby or toddler has a disability or developmental delay.

An intramuscular injection has been prescribed for an 8-month-old child. The pediatric nurse determines which of the following anatomic sites as most appropriate for this child? (Slide # 114-117, Lecture PowerPoint) A. Deltoid B. Dorsogluteal C. Vastus lateralis D. Ventrogluteal

C. Vastus lateralis

At 30 months of age, the toddler should be expected to: (Refer to Toddler Developmental Grid) A. Copy a circle. B. Ride a tricycle. C. Walk on tiptoes. D. Walk up and down stairs.

C. Walk on tiptoes.

A 4-year-old is seen in the clinic for a sore throat. In the child's mind, the most likely causative agent is that the child (pp. 72 [new], 83, 101, 252 [old]) A. Was exposed to someone else with a sore throat. B. Did not eat the right foods. C. Yelled at his brother. D. Did not take his vitamins.

C. Yelled at his brother.

Where is the safest place for a 55 pound 6 year old to sit in the car? (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. in the front seat, as long as there is an air bag B. in seat belts in the back seat C. in a booster seat in the back seat D. in the front seat, as long as there is not an air bag

C. in a booster seat in the back seat

Where should most children ride in the car? (pp. 161-162, 176-177, 194 [new],195-196; 213; 757 [old]) A. in the back seat until they are 8 years old B. in the back seat until they are 10 years old C. in the back seat until they are 13 years old D. in the front seat no matter how old they are, as long as there is an air bag

C. in the back seat until they are 13 years old

The nurse clarifies that a preterm infant born at 34 weeks of gestation is placed in an incubator because: (pp. 528-529; 823, Lowdermilk) A. the infant has a small body surface-to-weight ratio. B. heat increases the flow of oxygen to the extremities. C. the infant's temperature control mechanism is immature. D. heat within the incubator facilitates drainage of mucus.

C. the infant's temperature control mechanism is immature.

Most children are able to feed themselves using a spoon by age: (p. 88 [new],100 [old]) A. 1 year B. 2 year C. 3 year D. 4 years

D. 4 years

Normal heart rate (HR) and respiratory rate (RR) for an adolescent is: (choose the best response) (pp. 122, 125 [new], 137, 140 [old]) A. 100-150 HR, 33-55 RR B. 80-120 HR, 25-40 RR C. 65-110 HR, 14-22 RR D. 60-100 HR, 12-20 RR

D. 60-100 HR, 12-20 RR

The nurse is working in a pediatric surgical unit. In discussing patient-controlled analgesia in a preop parental meeting, the nurse should explain that PCA is most appropriate for the (p. 321 [new], 356 [old]) A. A 16-year-old who is developmentally delayed and postop from bone surgery. B. A 5-year-old, postop from tonsillectomy. C. A 10-year-old who has a fractured femur and concussion from a bike accident. D. A 12-year-old, postop from spinal fusion for scoliosis.

D. A 12-year-old, postop from spinal fusion for scoliosis.

Which seat is best for a 35 pound 4 year old? (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. A booster seat with a shield B. He is old enough for seat belts without a car seat. C. A belt-positioning booster seat with lap/shoulder belts D. A forward-facing car seat with harness straps

D. A forward-facing car seat with harness straps

The nurse cautions a group of parents that the leading cause of childhood mortality (after the first year of life) is: (pp. 6-7) A. Chronic disease B. Homicide C. Suicide D. Accidents

D. Accidents

Symptoms of a food intolerance can include: (pp. 284-285 [new], 318 [old]) A. Bloating B. Diarrhea C. Gas D. All of the above

D. All of the above

Gestational age is best determined with: (Lowdermilk, p. 554) A. Weight of the infant at birth B. Stability of the blood glucose level C. The age at which the infant reaches developmental milestones D. Assessment of physical and neurological characteristics

D. Assessment of physical and neurological characteristics

A very low birthweight infant has just been diagnosed with a Grade 4 intraventricular hemorrhage (IVH). The nurse should interpret this as which of the following? (pp. 838-839, Lowdermilk) A. Bleeding occurs just in a small area of the ventricles. B. Bleeding also occurs inside the ventricles. C. Ventricles are enlarged by the blood. D. Bleeding into the brain tissues around the ventricles.

D. Bleeding into the brain tissues around the ventricles.

The charge nurse is concerned with reducing the stressors of hospitalization. The nursing intervention that is most helpful in decreasing the stressors for the toddler is to (pp. 223-225 [new], 250-252 [old]) A. Assign the same nurse to the toddler as much as possible. B. Let the child listen to an audiotape of the mother's voice. C. Place a picture of the family at the bedside. D. Encourage a parent to stay with the child.

D. Encourage a parent to stay with the child.

What is the best intervention a nurse can utilize to promote parental attachment with their preterm infant? (pp. 833-836, Lowdermilk) A. Allow for privacy. B. Contact support families who have been through the same diagnosis with their own child and allow time to discuss the situation. C. Provide an extensive handbook with information related to the preterm newborn. D. Encourage hands-on participation with infant care.

D. Encourage hands-on participation with infant care.

After 6 months of age, which of the following mineral stores becomes depleted in infants? (pp. 283-286 [new], 316-319 [old]) A. Calcium B. Phosphorus C. Fluoride D. Iron

D. Iron

A group of children on one hospital unit are all suffering separation anxiety. When determining the stages of separation anxiety, the nurse recognizes that the child in the "despair" phase is the child who (pp. 224-225 [new], 250-251 [old]) A. Does not cry if parents return and leave again. B. Screams and cries when parents leave. C. Appears to be happy and content with staff. D. Lies quietly in bed.

D. Lies quietly in bed.

Moral development theory differs from cognitive development theory in what way? (pp. 70-73 [new], 80-84 [old]) A. Cognitive development theory deals with the formation of personality. B. Moral development theory predicts how a person will react in any situation. C. Cognitive development theory describes physical changes that take place in stages. D. Moral development theory characterizes the value system of people and their respect for others.

D. Moral development theory characterizes the value system of people and their respect for others.

Currently, the greatest source of lead poisoning in children is from: (pp. 399-400 [new], 437-438 [old]) A. Soil and dust B. Air C. Food and water D. Paint

D. Paint

Which of the following hereditary disorders is transmitted by autosomal recessive inheritance? (pp. 52-55 [new], 59; 61 [old]) A. Cleft lip B. Marfan syndrome C. Osteogenesis imperfecta D. Phenylketonuria

D. Phenylketonuria

To promote drainage of lung secretions in the preterm infant, the nurse should (p. 820, Lowdermilk) A. Position the infant with the face up B. Place a small roll under the buttocks to straighten the spine C. Position flat on the back with the feet higher than the head D. Position the infant's body lying face down

D. Position the infant's body lying face down

The newborn has a heelstick for studies. Which of the following is incorrect technique? (Lowdermilk, pp. 576-577) A. Dampen a diaper with warm water and fasten it over the heel for a few minutes. B. Clean the area with alcohol and dry with sterile gauze or allow to air dry. C. Wipe away the first drop of blood with gauze. D. Puncture the center of the heel with a lancet to a depth of less than 2 mm.

D. Puncture the center of the heel with a lancet to a depth of less than 2 mm.

A mother of a 2-year-old tells a clinic nurse that the child is rebelling constantly and having temper tantrums. The nurse most appropriately tells the mother to: (p. 172 [new], 193 [old]) A. Punish the child every time the child says "no", to change the behavior. B. Allow the behavior because this is normal and expected at this age period. C. Ignore him by walking away to another room, leaving him alone to cry it out. D. Remove him from the source of stimulation by taking him to a quiet, safe place to calm down.

D. Remove him from the source of stimulation by taking him to a quiet, safe place to calm down.

The nurse carefully assesses the preterm infant for respiratory distress syndrome (RDS) because of a deficiency of which substance? (pp. 836-837, Lowdermilk) A. Protein B. Estrogen C. Hyaline D. Surfactant

D. Surfactant

The nurse is teaching the parents about dental care for their toddler. Which of the following information is appropriate for the nurse to include? (pp. 171-172; 283 [new], 192; 316 [old]) A. Allow only a teaspoon-size amount of toothpaste per day B. Flossing is not necessary, due to the negativity and resistance to care of the toddler years C. The child should not take a bottle to bed, but may have a tippy cup D. Teeth should be brushed with a soft bristle nylon brush or washcloth

D. Teeth should be brushed with a soft bristle nylon brush or washcloth

The nurse assessing a preterm infant understands that the infant's level of maturation refers to: (p. 554, Lowdermilk) A. actual time the baby remained in the uterus. B. age on the New Ballard scoring system. C. infant's weight as compared to the gestational age. D. ability of the organs to function outside of the uterus.

D. ability of the organs to function outside of the uterus.

A first-time mother asks you about the reasons for breastfeeding. You should state that: (pp. 157, 169; 282-283 [new], 178, 190; 315-316 [old]) A. breastfed infants do not have SIDS. B. breast milk hinders maturation of the GI tract. C. breastfed infants have a high incidence of allergies. D. breast milk contains antibodies that can protect against infections.

D. breast milk contains antibodies that can protect against infections.

When are most children ready for regular seat belts? http://www.buckleupnc.org/occupant-restraint-laws/child-passenger-safety-law-faqs/ A. when they are 5 years old B. when they are 6 years old C. when they are 7 years old D. it depends on the child's height and how the seat belts fit

D. it depends on the child's height and how the seat belts fit

The best position for an infant to sleep is: (pp. 159, 483-484 [new], 180; 528-529 [old]) A. on the abdomen B. in an infant seat C. with the caregiver D. on the back E. lateral recumbent F. on the side

D. on the back

Children in the preoperational stage lack the ability to understand the principle of conservation. The principle of conservation states that two equal quantities remain equal even though the form or appearance is rearranged, as long as nothing is added and subtracted. The lack of understanding of conservation can be reflected in centration and irreversibility. (pp. 70-72 [new], 80-83 [old]) True or false? True False

True

For the infant, slowly instill liquid medication by dropper along the side of his tongue and the young child, crush pills and mix them with 1/2 teaspoon of baby food or any sweet-tasting substance. True or False? (Slides # 111, 113 Lecture PowerPoint) True False

True

Munchausen syndrome by proxy (factitious disorder) is usually difficult to diagnose. (pp. 393-394 [new], 432 [old]) True or False? True False

True

The core concepts of Family Centered Care on the inpatient hospital unit are: 1. Dignity and Respect-To Listen to and honor patient and family ideas and choices and to use patient and family knowledge, values, beliefs and cultural backgrounds to improve care planning and delivery. 2. Information Sharing-To communicate and share complete and unbiased information with patients and families in useful ways. Patients and families receive timely, complete and accurate details so they can take part in care and decision making. 3. Involvement-To encourage and support patients and families in care and decision making at the level they choose. 4. Collaboration-To invite patients and family members to work together with health care staff to develop and evaluate policies and programs. True or False? (pp. 6, 18-19, 226-228 [new], 6, 20-23, 254 [old]) True False

True

The purpose of adult-directed play in the hospital setting is to increase a young patient's sense of predictability regarding pending medical procedures and health care experiences, increase a sense of self-control, reduce stress from unrealistic fantasies about medical procedures, increase effective coping skills, and to clear up confusions and misconceptions. True or False? (pp. 238-241 [new], 265-268 [old]) True False

True

Which of the following are accurate statements concerning avoidant-restrictive food intake disorder (ARFID)? (ARFID was formerly known as failure to thrive.) Select all that apply: (pp. 299-300 [new], 332-333 [old]) A. ARFID is defined as a weight that falls below the 5th percentile on a growth chart, and weight-for-length that is less than 80%. B. The cause of ARFID can be organic or nonorganic. C. Most cases of ARFID are organic, such as inborn errors of metabolism, congenital heart defect, or neurologic disease. D. Most cases of ARFID involve inadequate caloric intake caused by behavioral or psychosocial issues. E. A multidisciplinary approach to treatment, including home nursing visits and nutritional counseling, has been shown to improve weight gain, parent-child relationships, and cognitive development. F. Nursing care centers on performing a thorough history and physical assessment, documenting accurate weight and height, observing parent-child interactions during feeding times, and providing teaching to enable parents to respond appropriately to their child's needs. G. ARFID accounts for 25% of pediatric hospitalizations in children under 1 year of age.

A. ARFID is defined as a weight that falls below the 5th percentile on a growth chart, and weight-for-length that is less than 80%. B. The cause of ARFID can be organic or nonorganic. D. Most cases of ARFID involve inadequate caloric intake caused by behavioral or psychosocial issues. E. A multidisciplinary approach to treatment, including home nursing visits and nutritional counseling, has been shown to improve weight gain, parent-child relationships, and cognitive development. F. Nursing care centers on performing a thorough history and physical assessment, documenting accurate weight and height, observing parent-child interactions during feeding times, and providing teaching to enable parents to respond appropriately to their child's needs.

Obese children are vulnerable to a number of health problems, including: (Select all that apply) (pp. 293-295 [new], 325-326 [old]) A. Abnormal acceleration of growth in childhood B. Early onset of puberty in girls and abnormalities in sexual development in boys C. Hypotension D. Type 2 diabetes E. Dyslipidemia F. Coronary heart disease G. Gallbladder disease H. Osteoarthritis

A. Abnormal acceleration of growth in childhood B. Early onset of puberty in girls and abnormalities in sexual development in boys D. Type 2 diabetes E. Dyslipidemia F. Coronary heart disease G. Gallbladder disease H. Osteoarthritis

During the nurse's initial assessment of a school-age child, the child reports a pain level of 6 out of 10. The child is lying quietly in bed watching television. The nurse should (pp. 318-327 [new], 353-361 [old]) A. Administer prescribed analgesic. B. Ask the child's parents if they think the child is hurting. C. Reassess the child in 15 minutes to see if the pain rating has changed. D. Do nothing, since the child appears to be resting.

A. Administer prescribed analgesic.

Which stage of development is most unstable and challenging regarding development of personal identity? (pp. 70-71 [new], 80 [old]) A. Adolescence B. Preschool age C. School age D. Toddler

A. Adolescence

The nurse is working with a school-age child who is hospitalized. In planning care that will promote a sense of industry in this child, the nurse should (pp. 226 [new], 252-253 [old]) A. Allow the child to assist with her care. B. Encourage parents to participate in the child's care. C. Give the child a detailed scientific explanation of the illness. D. Speak to the child in a high-pitched voice.

A. Allow the child to assist with her care.

Huntington's disease, neurofibromatosis-1, achondroplasia, and Marfan syndrome are examples of genetic conditions transmitted by which pattern of inheritance? (p. 52 [new], 59 [old]) A. Autosomal dominant B. Autosomal recessive C. X-linked recessive D. Multifactorial

A. Autosomal dominant

If a disorder is (fill in the blank), it means the affected person only needs to get the abnormal gene from one parent to inherit the disease. One of the parents has to have the disorder. These disorders involve altered genes on autosomes rather than the sex chromosomes X and Y. Both males and females have an equal chance of being affected. There is a 50% chance of an affected child. (pp. 51-52 [new], 58 [old]) A. Autosomal dominant B. Autosomal recessive C. X-linked recessive D. Multifactorial

A. Autosomal dominant

The Pediatric Early Warning Score (PEWS) has been found to be a reliable tool for use by the bedside nurse to identify early patient instability. This score is generated from an assessment of which three parameters? (Slide # 103, Lecture PowerPoint) Select all that apply: A. Behavior B. Blood pressure C. Cardiovascular D. Level of consciousness E. Communicative skills F. Respiratory G. Skin status H. Vital signs

A. Behavior C. Cardiovascular F. Respiratory

Neonatal abstinence syndrome (also called NAS) is a group of conditions a newborn can have if he's exposed to addictive street or prescription drugs in the womb before birth. A baby can get addicted to these drugs and then go through drug withdrawal after birth. Which of the following are signs and symptoms of NAS? (p. 770 [new], 837 [old]) Select all that apply: A. Body shakes B. Excessive crying C. Poor feeding D. Respiratory depression E. Excessive sleepiness F. Stuffy nose G. High-pitched cry

A. Body shakes B. Excessive crying C. Poor feeding F. Stuffy nose G. High-pitched cry

A child must be able to sit before he can walk. This is an example of which directional pattern of development? (pp. 66-67 [new], 77-78 [old]) A. Cephalocaudal B. Proportional C. Proximodistal D. Linear

A. Cephalocaudal

The pediatric nurse takes into consideration that the primary cause of infant mortality is: (pp. 6-7) A. Congenital deformities B. Low birth weight C. Sudden infant death syndrome D. Systemic infection

A. Congenital deformities

A maternity nurse is providing instruction to a new mother regarding the psychosocial development of the newborn infant. Using Erikson's psychosocial development theory, the nurse should instruct the mother to: (Choose the one best answer.) (pp. 70-71 [new], 80 [old]) A. Consistently meet the infant's needs, when the newborn signals a need. B. Anticipate all of the needs of the newborn infant. C. Avoid the newborn infant during the first 10 minutes of crying. D. Attend to the newborn infant immediately when crying.

A. Consistently meet the infant's needs, when the newborn signals a need.

Please match the Erikson stage with the correct descriptor. Only one descriptor will be used with each item. (pp. 70-71 [new], 80 [old]) Trust vs. mistrust D Autonomy vs. shame and doubt B Initiative vs. guilt E Industry vs. inferiority C Identity vs. role confusion A

A. Consumed with looks and viewpoints of others. B. During this stage, toddlers learn to achieve self-control and willpower. Learns to control bodily functions. C. During this stage, children develop a sense of competency. Learns to socialize. D. The first stage, during which children develop faith and optimism. Develops mistrust if the needs are not adequately met. E. During this stage which occurs from ages 3 to 6 years, children develop direction and purpose. Teaching impulse control and cooperative behaviors during this stage help the child to avoid risks of altered growth and development. Develops conscience.

Which of the following are accurate statements concerning anticipatory guidance? (Select all that apply.) (pp. 145-146 [new], 163-164 [old]) A. Examples of anticipatory guidance are informing parents of newborns about physical changes in their infant (e.g., teething), and anticipating concerns in parents of adolescents due to alcohol and drug abuse. B. Anticipatory guidance is key to achieving a primary goal of pediatric nursing care, which is health promotion. C. Anticipatory guidance, when implemented correctly and consistently, prevents all accidents and injuries from occurring in young children. D. This is guidance provided by the pediatric nurse to parents, in anticipating likely upcoming concerns with the child. E. A thorough knowledge of the principles of growth and development is not always necessary. F. Anticipatory guidance is challenging because of the range and complexity of appropriate issues, the enormous individual differences among normal children and their families, and the limited time in health supervision visits.

A. Examples of anticipatory guidance are informing parents of newborns about physical changes in their infant (e.g., teething), and anticipating concerns in parents of adolescents due to alcohol and drug abuse. B. Anticipatory guidance is key to achieving a primary goal of pediatric nursing care, which is health promotion. D. This is guidance provided by the pediatric nurse to parents, in anticipating likely upcoming concerns with the child. F. Anticipatory guidance is challenging because of the range and complexity of appropriate issues, the enormous individual differences among normal children and their families, and the limited time in health supervision visits.

A 5-year-old is hospitalized with a fractured femur. Which of the following assessment tools are appropriate for this age child? Select all that apply. (pp. 315-317 [new], 350-353 [old]) A. FACES pain scale. B. Numeric Rating Scale. C. Visual Analog Scale. D. Oucher Scale. E. PAT Tool. F. FLACC Scale.

A. FACES pain scale. D. Oucher Scale. F. FLACC Scale.

Eight-year old Steven has a difficult time making friends at school. He has trouble completing his schoolwork accurately and on time, and as a result, receives little positive feedback from his teacher and parents. According to Erikson's theory, failure at this stage of development results in _____________? (pp. 70-71 [new], 80 [old]) A. Feelings of inferiority B. A sense of guilt C. A poor sense of self D. Mistrust

A. Feelings of inferiority

The following question stems from this scenario: Monique walks into the ED carrying her crying 18-month old daughter. She tells the nurse her daughter crawled into the leg of the ironing board. The hot iron tumbled off the board and the child touched it before she could interfere. But the burn is on the edge of the child's palm and on her wrist, not her fingers. "This isn't the first time she's touched the iron," Monique says. "You would think she'd learn." When the nurse examines the child, the mother complains that there is nothing wrong with her other than the burn on her hand. During her assessment, the nurse notes scars on the child's back and buttocks shaped like the tip of an iron. (pp. 388-394 [new], 426-432 [old]) When child abuse is suspected, the nurse's initial assessment should include: A. Gathering information from many sources to determine how the injury occurred. B. Talking with the parents only about the injury. C. Looking for risk factors of abuse to confirm suspicions. D. Making sure the parents are aware that abuse is suspected.

A. Gathering information from many sources to determine how the injury occurred.

Factors that contribute to childhood morbidity are: (Select all that apply.) (pp. 7-8) A. General health B. Ethnicity C. Psychosocial factors D. Climate E. Socioeconomic factors

A. General health C. Psychosocial factors E. Socioeconomic factors

The nurse is working with an adolescent who will be admitted to the hospital in two days. The appropriate nursing approach to prepare the adolescent for hospitalization is (pp. 226-227; 234 [new], 253; 260 [old]) A. Have teens who have had similar experiences talk to the adolescent about hospitalization. B. Provide an opportunity for the child to talk with an adult who has had a similar experience. C. Teach parents what to expect so the information can be shared with the adolescent. D. Provide an opportunity for the teen to try on surgical attire.

A. Have teens who have had similar experiences talk to the adolescent about hospitalization.

Nurses should make which of the following recommendations to parents, to prevent childhood obesity? (Select all that apply) (pp. 293-295 [new], 325-326 [old]) A. If possible, breast-feed children rather than bottle feeding them. B. Insist that the child finish every feeding or meal. C. Put the child on a low-carbohydrate diet. D. Limit the high-calorie and sugary foods kept in the house. E. Provide a nutritious diet with ample fiber from fruits and vegetables, with no more than 30 percent of calories derived from fat. F. Do not use food as a reward or bribe a child to finish a meal by offering sweets. G. Limit the child's television viewing or video games to no more than two hours per day.

A. If possible, breast-feed children rather than bottle feeding them. D. Limit the high-calorie and sugary foods kept in the house. E. Provide a nutritious diet with ample fiber from fruits and vegetables, with no more than 30 percent of calories derived from fat. F. Do not use food as a reward or bribe a child to finish a meal by offering sweets. G. Limit the child's television viewing or video games to no more than two hours per day.

Which of the following are accurate statements concerning multifactorial inheritance? (pp. 55-56 [new], 59-62 [old]) (Select all that apply) A. Most common genetic malfunction. B. Fathers do not pass these disorders to their daughters or sons. C. Combination of environmental and genetic factors. D. Often occurs in people with no history of the disorder in their family. E. Examples are cleft palate and neural tube defects. F. Examples are Duchenne muscular dystrophy and hemophilia-A. G. These disorders do not have a clear-cut pattern of inheritance. H. These conditions tend to run in families.

A. Most common genetic malfunction. C. Combination of environmental and genetic factors. E. Examples are cleft palate and neural tube defects. G. These disorders do not have a clear-cut pattern of inheritance. H. These conditions tend to run in families.

Risk factors for child abuse and neglect include which of the following (select all that apply): (pp. 388-394 [new], 427 [old]) A. Parents who were abused as children B. Female gender C. Low socioeconomic status D. Chinese ethnicity E. Age 5 through 15 F. Substance abuse and violence in the family

A. Parents who were abused as children B. Female gender C. Low socioeconomic status F. Substance abuse and violence in the family

A 2-year-old is hospitalized with a fractured femur. In addition to pain medication, which of the following will best provide pain relief for this child? (p. 326 [new], 362 [old]) A. Parents' presence at the bedside. B. Age-appropriate toys. C. Deep-breathing exercises. D. Videos for the child to watch.

A. Parents' presence at the bedside.

A nurse is preparing to care for a 5-year-old who has been placed in traction following a fracture of the femur. The nurse plans care, knowing that the child is in which stage of Kohlberg's Theory of Moral Development? (pp. 72-73 [new], 83-84 [old]) A. Preconventional Moral Reasoning B. Conventional Reasoning C. Postconventional Moral Reasoning D. Universal Principles Moral Reasoning

A. Preconventional Moral Reasoning

The nurse is working with a hospitalized preschool-age child. The nurse is planning activities to reduce anxiety in this child. The most appropriate action by the nurse is to (pp. 225-226 [new], 265-268 [old]) A. Provide the child with a doll and safe medical equipment. B. Read a story to the child. C. Use an anatomically correct doll to teach the child about the illness. D. Talk to the child about the hospitalization.

A. Provide the child with a doll and safe medical equipment.

Match the behavior that is typical of a child in the preoperational stage of cognitive development with its descriptor. (pp. 70-72 [new], 80-83 [old] Object permanence B Egocentrism C Irreversibility E Centration A Symbolic thinking D

A. This is the tendency to focus or center on one aspect of the situation and ignore other important aspects of the situation. B. An object continues to exist even when it can no longer be seen. C. This does not mean selfishness or conceit as social psychologists use the word. This means that children lack the ability to consider another person's point of view or perspective. D. They start to use words, images, and symbols to represent their world. Such behaviors are characterized by: •the use of language (the word "fly" represents an annoying, buzzing creature), and •use of fantasy and imagination (remember when you built a fort out of the couch cushions?). E. They cannot reverse a sequence or logical operations. A child displaying irreversibility says 2 x 4 is different from 4 x 2. Likewise a child may be able to perform multiplication, but can't divide.

The nurse is admitting a 9-year-old child who hit a parked car while riding a bike. The child has a fracture of the left radius and femur in addition to a fractured orbit. The child is alert and oriented. An appropriate action by the nurse is which of the following? Select all that apply. (pp. 315-317 [new], 350-353 [old]) A. Use the Numeric Rating Scale to determine the child's pain level. B. Tell the child to ring the call bell if the leg starts hurting. C. Administer pain medication as ordered and as needed per provider specification. D. Ask the child's parents to push the PCA button if the child complains of pain.

A. Use the Numeric Rating Scale to determine the child's pain level. B. Tell the child to ring the call bell if the leg starts hurting. C. Administer pain medication as ordered and as needed per provider specification.

1. The nurse is aware that emancipated minors and those who qualify under the mature minor doctrine may sign consents for their own medical treatment without parent approval. Persons not needing parent approval for medical care would be: (Select all that apply.) (pp. 11-12 [new],13-14 [old]) A. a 14-year-old girl married to a 16-year-old boy B. a 17-year-old serving in the U.S. Navy C. a 17-year-old college freshman living in a school dormitory D. a 17-year-old seeking medical care for a sexually transmitted disease E. a 15-year-old seeking an abortion

A. a 14-year-old girl married to a 16-year-old boy B. a 17-year-old serving in the U.S. Navy D. a 17-year-old seeking medical care for a sexually transmitted disease

The nurse explains that the statistics of infant mortality are expressed in number of infant deaths per: (pp. 6-7) A. 100 live births B. 1000 live births C. 10,000 live births D. 100,000 live births

B. 1000 live births

The charge nurse on a hospital unit is developing plans of care related to separation anxiety. The charge nurse recognizes that the hospitalized child at highest risk to experience separation anxiety when parents cannot stay is the (pp. 224-225 [new], 250-252 [old]) A. 6-month-old. B. 18-month-old. C. 3-year-old. D. 4-year-old.

B. 18-month-old.

The parents of a critically injured child wish to stay in the room while the child is receiving emergency care. The nurse should (pp. 228, 230-232, 260-269 [new], 254; 257; 290-298 [old]) A. Escort the parents to the waiting room and assure them that they can see their child soon. B. Allow the parents to stay with the child. C. Ask the physician if the parents can stay with the child. D. Tell the parents that they do not need to stay with the child.

B. Allow the parents to stay with the child.

Jane, who is 32-months, insists on dressing herself each morning, even though she generally selects mismatching outfits, misses buttons, and wears her shoes on the wrong feet. When her mother tries to dress Jane or fix her outfit, Jane brushes her mother off and insists on doing it herself. What stage of psychosocial development best describes Jane's behavior? (pp. 70-71 [new], 80 [old]) A. Trust vs. Mistrust B. Autonomy vs. Shame and Doubt C. Initiative vs. Guilt D. Industry vs. Inferiority

B. Autonomy vs. Shame and Doubt

Beta-thalassemia, cystic fibrosis, Guacher disease, phenylketonuria, sickle cell disease, and Tay-Sachs disease are examples of genetic conditions transmitted by which pattern of inheritance? (p. 52 [new], 59 [old]) A. Autosomal dominant B. Autosomal recessive C. X-linked recessive D. Multifactorial

B. Autosomal recessive

Childhood obesity is defined as: (pp. 293 [new], 325-326 [old]) A. BMI between the 85th and 94th percentile B. BMI at or above the 95th percentile C. Weight between the 85th and 94th percentile D. Weight at or above the 95th percentile

B. BMI at or above the 95th percentile

Which role would the pediatric nurse be serving when providing support and assisting with resources and referrals? (pp. 2-4) A. Advocate. B. Case manager. C. Educator. D. Researcher.

B. Case manager.

As an advocate for the child undergoing bone-marrow aspiration, the nurse should most appropriately suggest (pp. 329-330 [new], 364-365[old]) A. General anesthesia. B. Conscious sedation. C. Intravenous narcotics ten minutes before the procedure. D. Oral pain medication for discomfort after the procedure.

B. Conscious sedation.

School-age children engage in a type of play that is goal-oriented (in other words, the children play in an organized manner toward a common goal). The children plan, assign roles, and play together with established rules. (p. 92 [new], 104 [old]) This type of play is known as: A. Associative play B. Cooperative play C. Goal-oriented play D. Social recreation play

B. Cooperative play

The pediatric nurse understands that the infant mortality rate is important because: (pp. 6-8) A. It demonstrates the benefits of healthy eating in preventing coronary heart disease, boosting the immune system, and helping maintain a healthy lifestyle, in the overall health of a nation or people group. B. It represents or describes the overall state of health of a country, region, ethnic group, and/or community. C. It emphasizes the importance of avoiding potential hazards that the infant may encounter during the first year of life. D. It highlights the importance of primary, secondary, and tertiary prevention care strategies to prevent or slow the progression of disease.

B. It represents or describes the overall state of health of a country, region, ethnic group, and/or community.

An inborn error of metabolism that makes it impossible for the body to use the amino acid valine is: (pp. 893-896 [new], 969-972 [old]) A. Galactosemia B. Maple syrup urine disease C. Phenylketonuria D. Sickle cell disease

B. Maple syrup urine disease

A 28-month old child, 30-month old child, and 33-month old child are playing with blocks, dolls, and musical instruments in the hospital playroom. Closer observation reveals they are playing alongside one another, rather than interacting with each other. The nurse is observing: (p. 86 [new], 96 [old]) A. Solitary play B. Parallel play C. Associative play D. Cooperative play

B. Parallel play

Which of the following statements concerning Down syndrome is FALSE? (pp. 48-49, 59, 110. 814-815 [new], 885 [old]) A. Down syndrome is also known as Trisomy 21, which is the presence of a third copy of chromosome 21 B. People with Down syndrome have profound intellectual disability and cannot function meaningfully in society C. Down syndrome is the most common chromosomal abnormality D. Children with Down syndrome are at higher risk for congenital heart disease, gastrointestinal abnormalities, and hearing loss

B. People with Down syndrome have profound intellectual disability and cannot function meaningfully in society

According to Piaget, the second stage of cognitive development that is characterized by the increased use of symbols and prelogic thought processes. When Piaget uses the word "operational", "operations", etc., he refers to logical, mental activities. (pp. 70-72 [new], 80-83 [old]) Which Piaget stage? A. Sensorimotor B. Preoperational C. Concrete operational D. Formal operational

B. Preoperational

Which of the following does NOT demonstrate atraumatic care for the hospitalized child? (pp. 223-229, 233-234 [new], 249-256; 259-261 [old]) A. Use numbing medication (EMLA cream) on the skin before venipuncture. B. Restrain the child, holding him down firmly during procedures to prevent injury. C. Avoid use of irritating chemicals (such as alcohol) on the skin. D. Never use needles and instruments which cause unnecessary pain.

B. Restrain the child, holding him down firmly during procedures to prevent injury.

With phenylketonuria: (pp. 893-894 [new], 970 [old]) A. Transmission is by autosomal dominance B. The child typically has lighter skin, hair, and eyes C. The child is unable to metabolize galactose D. The child is unable to metabolite leucine

B. The child typically has lighter skin, hair, and eyes

When taking the health history of a suspected victim of Munchausen syndrome by proxy, the nurse or other healthcare professional should pay close attention to: (pp. 393-394 [new], 432 [old]) A. The gender of the child B. Whether the perpetrator is always present when the child has symptoms C. Whether the mother is single D. Whether the child victim has any siblings

B. Whether the perpetrator is always present when the child has symptoms

Which of the following is the best example of appropriate communication with a young child in the hospital setting? (pp. 78-81, 234 [new], 99; 260 [old]; Powerpoint slides # 83-86) A. "I'm going to take your pulse now." B. "I'm going to give you a little stick in the arm." C. "I'm going to count how fast your heart beats." D. "I will give you a shot in the arm." E. "This will hurt or burn."

C. "I'm going to count how fast your heart beats."