week 6 quiz 5
17. Parents report their 3 year old child appears restless at night and frequently scratches her anal area. What action by the nurse is best? a. Educate parents on the cellophane tape test. b. Review hygiene practices with the parents. c. Suggest the child sleep only in pajama tops. d. Ask parents to bring in a stool sample.
A
A 16 year old girl tells the school nurse that she has not started to menstruate yet. The onset of secondary sexual characteristics occurred in this girl about 3 years ago. The appropriate action by the nurse is to a. refer the adolescent for an evaluation. b. assume that the adolescent is pregnant. c. suggest that the adolescent stop exercising until menarche occurs. d. explain that this is not unusual.
A
A mother tells the nurse that her daughter's favorite toy is a large, empty box in which a stove was packaged. She plays "house" in it with her toddler brother. What information should the nurse tell the mother about this type of play? A. It is an example of creative play that should be encouraged. B. It suggests that there are limited family resources. C. It is suggestive of limited adult supervision. D. This is unsafe play that should be discouraged.
A
A nurse is reviewing pediatric physical assessment techniques. Which statement about performing a pediatric physical assessment is correct? a. Physical examinations proceed systematically from head to toe unless developmental considerations dictate otherwise. b. The physical examination should be done with parents in the examining room for children of any age. c. Measurement of head circumference is done until the child is 5 years old. d. The physical examination is done only when the child is cooperative.
A
A very depressed adolescent tells the school nurse: "I just don't know how I'm going to cope with everything I'm going through—maybe it would be better if I wasn't around anymore." What approach is most important for the nurse to use when working with this student? a. Recognize he is exhibiting warning signs of suicide. b. Recognize that what he is saying is an impulsive act resulting from a temporary crisis. c. Explain that a suicide attempt is an immature way of dealing with stress. d. Ignore what he is saying—he is only trying to get attention.
A
According to Erikson, with which development task is infancy concerned with acquiring? A. Trust B. Separation C. Industry D. Initiative
A
Since the preschoolers' thought process is egocentric and they enjoy learning about their environment, what is the most effective approach for communication with children this age? A. Play B. Drawing C. Speech D. Actions
A
The anterior fontanel appears slightly bulging when a 4 month old cries. What action by the nurse is indicated? a. Document the findings b. Notify the pediatrician c. Check the Moro reflex d. Time how long the infant cries
A
The mother of a child with sickle cell disease calls the pediatrician's office because she thinks her son may have fifth disease. What information should the nurse give the mother? a. "Keep your child comfortable at home, but if you notice a major change in his activity level or behavior, call us immediately." b. "Use cool baths with oatmeal to decrease itching first thing in the morning and before going to bed at night." c. "Increase your son's intake of protein and fluids to help replace the liquid he is losing through his skin." d. "Keep your child away from all of the other members of the household for the next three days."
A
The nurse has a 2 year old boy sit in "tailor" position during palpation for the testes. What is the rationale for this position? a. It prevents cremasteric reflex. b. Undescended testes can be palpated. c. This tests the child for an inguinal hernia. d. The child does not yet have a need for privacy.
A
The nurse is assessing a preschooler's chest as part of a well child exam. What normal findings would the nurse expect to document? a. Movement of the chest wall to be symmetric bilaterally and coordinated with breathing. b. Respiratory movements are primarily thoracic. c. Retraction of the muscles between the ribs on respiratory movement. d. Anteroposterior diameter to be equal to the transverse diameter.
A
The nurse is doing a neurologic assessment on a child whose level of consciousness has been variable since sustaining a cervical neck injury 12 hours ago. Which is the most essential part in this assessment? a. Checking the reactivity of pupils. b. Performing a doll's head maneuver. c. Obtaining an oculovestibular response. d. Performing a fundoscopic examination to identify papilledema.
A
The nurse is obtaining vital signs on a 1 year old child. What is the most appropriate site for assessing the pulse rate? a. Apical b. Radial c. Carotid d. Femoral
A
The nurse observes that a 13 year old male has gynecomastia (breast enlargement). How should the nurse explain this to this adolescent? a. It is a normal occurrence during puberty. b. It is a sign of hormonal imbalance. c. It denotes there is too much body fat. d. It is caused by dietary fat intake.
A
The nurse palpated the anterior fontanel of a 14 month old infant and found that it was closed. What does this finding indicate? a. This is a normal finding. b. This finding indicates premature closure of cranial sutures. c. This is abnormal and the child should have a developmental evaluation. d. This is an abnormal finding and the child should have a neurologic evaluation.
A
The nurse percussing over an empty stomach expects to hear which sound? a. Tympany b. Resonance c. Flatness d. Dullness
A
When the nurse lifts the skin on the abdomen and releases it quickly to check skin turgor, the tissue remains suspended for a few seconds, then slowly falls back on the abdomen. Which evaluation can the nurse correctly determine from the findings? a. The child is dehydrated. b. The child is overly hydrated. c. The tissue shows normal elasticity. d. The child is properly hydrated.
A
Which best describes colic? A. It is paroxysmal abdominal pain or cramping manifested by episodes of loud crying. B. Infants older than 6 months of age experience periods of abdominal pain and crying. C. It is usually the result of poor or inadequate mothering. D. The infant experiences periods of abdominal pain that result in weight loss.
A
Which choice includes the components of a complete pediatric history? a. Statistical information, client profile, health history, family history, review of systems, lifestyle and life patterns b. Vital signs, chief complaint, and list of previous problems c. Chief complaint, including body location, quality, quantity, timeframe, and alleviating and aggravating factors d. Pertinent developmental and family information
A
Which intervention is appropriate for a hospitalized child who has crops of lesions on the trunk that appear as a macular rash and vesicles? a. Place the child in strict isolation; airborne and contact precautions. b. Continue to practice Standard Precautions. c. Pregnant women should avoid contact with the child. d. Screen visitors for immunity to measles.
A
Which intervention lowers the risk of sudden infant death syndrome (SIDS)? A. Putting the infant to sleep in the supine position B. Having the infant sleep with parents instead of alone in a crib C. Making sure the infant is kept very warm while sleeping D. Smoking away from the infant
A
Which is appropriate play for a 6month-old infant? a. Pat a cake, peek a boo b. Ball rolling, hide and seek game c. Bright rattles and tactile toys d. Push and pull toys -
A
Which is most descriptive of the spiritual development of the older adolescent? a. The beliefs become more abstract. b. Emphasis is placed on external manifestations, such as whether a person goes to church. c. Strict observance of religious customs is common. d. Rituals and practices become increasingly important.
A
Which statement best explains the growth and development of children? A The sequence of developmental milestones is predictable. B Development proceeds at a predictable rate. C Rates of growth are consistent among children. D At times of rapid growth, there is also acceleration of development.
A
Which statement made by an adolescent girl indicates an understanding about the prevention of sexually transmitted diseases (STDs)? a. "I know the only way to prevent STDs is to not be sexually active." b. "I practice safe sex because I wash myself right after sex." c. "I won't get any kind of STD because I take the pill." d. "I only have sex if my boyfriend wears a condom."
A
A preschooler is diagnosed with helminthes. The child's mother is very upset and wants to know how her child could have contracted this illness. After obtaining a detailed history, the nurse identifies all possible transmission modes. Select all modes that apply. a. Playing in the backyard sandbox b. Not washing hands before eating c. Placing hands in the mouth and nail biting d. Skin to skin contact with other children e. Scratches from a neighborhood cat
A, B, C
The nurse should provide which information to parents about the prevention of parasitic infections? Select all that apply. a. Perform good handwashing. b. Diaper a child when swimming. c. Avoid cleaning the bathroom facilities with bleach. d. Shoes should be worn outside. e. Fruits and vegetables should be washed before eating.
A, D, E
Which statement about performing a pediatric physical assessment is correct for a school age child? Select all that apply. a. Physical examinations proceed systematically from head to toe. b. The physical examination should be done with parents in the waiting room. c. Measurement of head circumference is obtained. d. The physical examination is done only when the child is cooperative. e. Remove clothing and have the child put on an examination gown.
A, D, E
A mother is concerned about giving her infant the scheduled immunizations. What information should the nurse provide to inform the mother about the risks and benefits of immunizations? (Select all that apply.) A. "If your child is feverish or sick, we will not give any immunizations at that time." B. "Fever and local irritation are rare after administration of the DTaP vaccine." C. "Since live measles vaccine is produced by using chicken eggs, there is a slight chance of hypersensitivity in children with egg allergies." D. "Before a second dose of any vaccine is given, we check if there were any side effects after the previous dose of that vaccine." E. "Immunizations are the primary and safest means of managing preventable infectious diseases." F. "We use the arm muscle for the majority of vaccines in babies."
A,C,D,E
The camp nurse is telling a group of campers and their counselors how to avoid insect and tick bites. What information should the nurse include? (Select all that apply.) a. Try to stay on paths rather than walking through dense areas. b. Ticks should be scraped off the skin. c. A hat is helpful when in wooded and grassy areas. d. Dark, long sleeved shirts should be worn. e. Shirts should be tucked into the pants. f. Apply insect repellent lightly on the hands.
A,C,E
The nurse is preparing to assess the lung sounds of a 3 month old sleeping infant who is being held on her belly by her mother against the mother's upper chest. Which techniques should the nurse use to obtain an accurate assessment? (Select all that apply.) a. Identify the hyperresonance heard as normal because of the thin chest wall. b. Warm the stethoscope head before placing it on the infant's shirt. c. Auscultate the lung sounds through her back. d. Place the infant flat while listening to the lungs. e. Assess the lungs from the apex to the base bilaterally. f. Gently turn the infant on her back prior to beginning the assessment.
A,C,E
The nurse is conducting a water safety program for parents of young children at the pediatrician's office. What water safety information should be included? (Select all that apply.) A. A tub of water used to bathe the dog can be a water hazard. B. Children can drown in as little as 4 inches of water. C. Secure the pool drain with a protective cover. D. Toilets cause little hazard because of the location of the water. E. Constant supervision of the child is the best safety mechanism for water safety. F. Supervise the toddler in the tub regardless of how much water is in the bathtub.
A,C,E,F
A child who has measles and a compromised immune system needs to be watched for secondary infections or complications. Symptoms of which conditions should the nurse teach the parents to report immediately? (Select all that apply.) a. Laryngotracheobronchitis (croup) b. Epiglottitis c. Rheumatic fever d. Bronchopneumonia e. Otitis media f. Myocarditis
A,D,E,F
. In which section of the health history should the nurse record that the parent brought the infant to the clinic today because of frequent diarrhea? a. Review of systems b. Chief complaint c. Lifestyle and life patterns d. Health history
B
A cooperative 6 year old child is being evaluated for a sore throat. Which method should the nurse use to view the tonsils and oropharynx of this child? a. Examine the mouth when the child is crying to prevent the need for a tongue blade. b. Ask the child to open her mouth wide and say, "Ahh." c. Pinch the nostrils closed until the child opens her mouth, and then insert the tongue blade. d. Ask the child to open her mouth wide, and then place the tongue blade on the center back area of the tongue.
B
A nurse is conducting a health education class for a group of school age children. Which statement made by the nurse is correct about the body's first line of defense against infection in the innate immune system? a. Nutritional status b. Skin integrity c. Immunization status d. Proper hygiene practices -
B
A parent tells the nurse, "I am worried about my 13 year old son. He hasn't started puberty, and my daughter did when she was 11 years of age." How can the nurse explain the difference to the parent? a. This is abnormal because the onset of pubescence is usually earlier in boys than it is in girls. b. This is normal because the onset of pubescence is usually earlier in girls than it is in boys. c. This is unusual because the onset of pubescence is usually the same in siblings. d. That this is unusual and requires further evaluation of the son.
B
A school age child is recovering from infectious mononucleosis. What information should the nurse give the mother about activities when he returns to school? a. The child should eat away from the other children in the lunchroom. b. Participation in his physical education class should be limited to non contact sports. c. He will be able to return to school full time when he has his medical release. d. Allow the child to rest until he returns to school without worrying about homework.
B
According to Erikson, the psychosocial task of adolescence is to develop a. Intimacy b. Identity c. Initiative d. Independence
B
For a toddler with sleep problems, what should the nurse suggest? A. Varying the bedtime ritual B. Using a transitional object C. Restricting stimulating activities during the day D. Explaining away fears
B
How should the nurse respond to a parent who asks, "How can I protect my baby from whooping cough?" a. "Don't worry; your baby will have maternal immunity to pertussis that will last until they are approximately 18 months old." b. "Make sure your child gets the pertussis vaccine." c. "See the doctor when the baby gets a respiratory infection." d. "Have your pediatrician prescribe erythromycin."
B
Kimberly is having a checkup before starting kindergarten. The nurse asks her to do the "finger to-nose" test. The nurse is testing for a. Deep tendon reflexes b. Cerebellar function c. Sensory discrimination d. Ability to follow directions -
B
The nurse inspecting the skin of a dark skinned child notices an area that is a dusky red or violet color. This skin coloration is associated with what? a. Cyanosis b. Erythema c. Vitiligo d. Nevi -
B
The nurse is assessing a 4 year old child's visual acuity. He is planning to attend preschool next week. The results indicate a visual acuity of 20/40 in both eyes. The child's father asks the nurse about his son's results. Which response, if made by the nurse, is correct? a. "Your child will need a referral to the ophthalmologist before he can attend preschool next week." b. "Your child's visual acuity is normal for his age." c. "The results of this test indicate your child may be color blind." d. "Your child did not pass the screening test. He will need to return within the next few weeks to be reevaluated."
B
The parents of a 5 month old girl complain to the nurse that they are exhausted because she still wakes up as often as every 1 to 2 hours during the night. When she awakens, they change her diaper, and her mother nurses her back to sleep. What should the nurse suggest to help them deal with this problem? A. Leave her a bottle of formula when put into her crib at night. B. Start putting her to bed while still awake. C. Put her in the parents' bed to cuddle. D. Let her cry herself back to sleep.
B
The school nurse overhears a group of adolescent girls talking about gaining weight and getting fat deposits during puberty. What anticipatory advice would be appropriate for the nurse to give to the girls? a. Encourage a low fat diet to prevent fat deposition. b. Provide reassurance that these changes are normal. c. Recommend increased exercise to control weight gain. d. Suggest dietary measures to control weight gain.
B
What change in boys indicates the onset of puberty? a. An increasing penis size b. Testicular enlargement c. Growth of dark pubic hair d. Voice changes
B
What is the best response to a parent of a 2 month-old infant who asks when the infant should first receive the measles vaccine? a. "Your baby can get the measles vaccine now." b. "The first dose is given any time after the first birthday." c. "She should be vaccinated between 4 and 6 years of age." d. "This vaccine is administered when the child is 11 years old."
B
What should be included in health teaching to prevent Lyme disease? a. Complete the immunization series in early infancy. b. Wear long sleeves and pants tucked into socks while in wooded areas. c. Give low dose antibiotics to the child before exposure. d. Restrict activities that might lead to exposure for the child.
B
What should the nurse expect to observe in the prodromal phase of rubeola? a. Macular rash on the face b. Koplik spots c. Petechiae on the soft palate d. Crops of vesicles on the trunk
B
Which STD should the nurse suspect when an adolescent girl comes to the clinic because she has a vaginal discharge that is white with a fishy smell? a. Human papillomavirus b. Bacterial vaginosis c. Trichomonas d. Chlamydia
B
Which assessment finding is considered a neurologic soft sign in a 7 year old child? a. Plantar reflex b. Poor muscle coordination c. Stereognostic function d. Graphesthesia
B
Which behavior is most characteristic of the concrete operations stage of cognitive development? A Progression from reflex activity to imitative behavior. B. Increasingly logical and coherent thought processes C. Ability to think in abstract terms and draw logical conclusions D Inability to put oneself in another's place
B
Which chart should the nurse use to assess the visual acuity of an 8 year old child? a. Lea chart b. Snellen chart c. HOTV chart d. Tumbling E chart
B
Which statement explains why it can be difficult to assess a child's dietary intake? A. Families usually do not understand much about nutrition. B. Recall of food consumption is frequently unreliable. C. Biochemical analysis for assessing nutrition is very expensive. D. No systematic assessment tool has been developed.
B
Which strategy is not always appropriate for pediatric physical examination? a. Take the history in a quiet, private place. b. Examine the child from head to toe. c. Exhibit sensitivity to cultural needs and differences. d. Perform frightening procedures last.
B
Which strategy is the best approach when initiating the physical examination of a 9 month old male infant? a. Undress the infant and do a head to toe examination. b. Have the parent hold the child on his or her lap. c. Put the infant on the examination table and begin assessments at the head. d. Ask the parent to leave because the infant will be upset.
B
Which tool measures body fat most accurately? a. Stadiometer b. Calipers c. Cloth tape measure d. Paper or metal tape measure
B
While caring for hospitalized adolescents, the nurse observes that sometimes they are skeptical of their parents' religious beliefs/practices. How should the nurse interpret this behavior? a. It is abnormal in spiritual development. b. It is normal in spiritual development. c. It is related to illness and occurs only at times of crisis. d. It is related to the inability of parents to explain adequately their beliefs/practices.
B
A hospitalized child has developed a methicillin resistant Staphylococcus aureus (MRSA) infection. The nurse plans which interventions when caring for this child? Select all that apply. a. Airborne isolation b. Administration of vancomycin (Vancocin) c. Contact isolation d. Administration of mupirocin (Bactroban) ointment to the nares e. Administration of cefotaxime (Cefotetan)
B, C, D
A nurse is planning care for a hospitalized toddler in the preoperational thinking stage. Which characteristics should the nurse expect in this stage? Select all that apply. a. Concrete thinking b. Egocentrism c. Animism d. Magical thought e. Ability to reason
B, C, D
A nurse is performing an assessment on a newborn. Which vital signs indicate a normal finding for this age group? Select all that apply. a. Pulse of 80/125 a minute b. B/P of systolic 65/95 and diastolic 30/60 c. Temperature of 36.5/37.3 Celsius (axillary) d. Temperature of 36.4/37 Celsius (axillary) e. Respirations of 30/60 a minute
B, C, E
A school nurse is screening children for scoliosis. Which assessment findings should the nurse expect to observe for scoliosis? Select all that apply. a. Pain with deep palpation of the spinal column b. Unequal shoulder heights c. The trouser pant leg length appears shorter on one side d. Inability to bend at the waist e. Unequal waist angles
B, C, E
What should the nurse recognize as a possible indicator of child abuse in a 4 year old child being treated for ear pain at the emergency department on a chilly Christmas Day in New York State? Select all that apply. a. The child extends his arms to be hugged by the nurse. b. The child is wearing clean, baggy shorts, sandals, and an oversized Tshirt. c. The child answers all questions in complete sentences, and smiles afterward. d. The child has dirty, broken teeth. e. The child states "I'm so fat" when the nurse tells his mother he weighs 25 lb. -
B, D, E
Several adolescents approach the school nurse with questions about skin enhancement including tanning, body piercing, and tattoos. Which responses by the nurse contain correct information? (Select all that apply.) a. Tattoos made with red and green dyes are the easiest to remove if the person wants them removed. b. Generally, body piercing is harmless, but these procedures must be done under sterile conditions or there can be complications, such as bleeding, infection, keloid formation, and allergies to metal. c. There are risks of bloodborne infections, skin infections, and allergic reactions to dyes used in the tattoo process. d. Since many of the tattoo inks contain metal, such as iron, an adolescent needing magnetic resonance imaging (MRI) must inform the MRI center about the tattoo prior to the procedure. e. Piercing guns are a great way of easy body piercing with minimal infection. f. Skin cancer occurs very ra
B,C,D
18. A parent brings a child to the emergency department and reports fever, foul smell coming from the throat, and a gray covering over the tonsils. What action by the nurse takes priority? a. Place the child on a cardiac monitor. b. Attach a pulse oximeter to the child. c. Assess respiratory status immediately. d. Start an IV and draw blood cultures.
C
19. The nurse in the pediatric clinic is caring for a child and assesses this skin rash. What action by the nurse is best? a. Inform parents the child will be contagious for one week. b. Arrange for immediate hospitalization and IV antibiotics. c. Instruct parents to offer the child a soft, bland diet. d. Advise parents the child can maintain normal activities.
C
A 2 month old child has not received any immunizations. Which immunizations should the nurse give? a. DTaP, Hib, HepB, MCV, varicella b. DTaP, Hib, HepB, HPV, IPV, Rota c. DTaP, Hib, HepB, PCV, Rota d. DTaP, Hib, HepB, PCV, HepA
C
A mother asks the pediatric office nurse why her toddler son needs to be seen by an eye specialist. Which explanation by the nurse to the mother states the importance of detecting and following up strabismus in young children? a. Epicanthal folds may develop in the affected eye. b. Corneal light reflexes may occur symmetrically. c. Muscle imbalance can cause loss of vision. d. Color vision deficit may result.
C
A mother calls the pediatrician's office and states that her 4 year old son looks like "someone slapped his cheeks" and he's running a fever. What would the nurse suspect the child has based on the mother's description? a. Roseola infantum b. Scarlet fever c. Fifth disease d. Rubella
C
A mother tells the nurse that she will visit her 2 year old child tomorrow around noon. During the child's bath in the morning, the child asks for her Mommy. What is the best response by the nurse? A. "Mommy had to go home for a while, but she will be here today." B. "Mommy always comes back to see you." C. "Mommy will be here after lunch." D. "Your Mommy told me yesterday that she would be here today about noon."
C
A parent has a 2 year old in the clinic for a well child checkup. Which statement by the parent would indicate to the nurse that the parent needs more instruction regarding accident prevention? A. "We placed gates at the top and bottom of the basement steps." B. "We turned the thermostat down on our hot water heater." C. "We stopped using the car seat now that my child is older." D. "We locked all the medicines in the bathroom cabinet."
C
According to Erikson, what is the primary psychosocial task of the preschool period? A. Intimacy B. Industry C. Initiative D. Identity
C
According to Piaget, at what stage of development do children typically solve problems through trial and error? A. Preoperational B. Concrete operational C. Sensorimotor D. Formal operational
C
An 8 year old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is to a. Ask her why she wants to know. b. Determine why she is so anxious. c. Explain in simple terms how it works. d. Tell her she will see how it works as it is used.
C
By what age would the nurse expect that most children would be using sentences of six to eight words? A. 18 months B. 3 years C. 5 years D. 24 months
C
During a well child visit, the father of a 4 year old boy tells the nurse that he is not sure whether his son is ready for kindergarten. The child's birthday is close to the cutoff date and child has not attended preschool. Which is the nurse's best recommendation? A. Have the child begin kindergarten. B. Observe a kindergarten class to see if his son would fit in. C. Have the Child get a developmental screening. D. Postpone kindergarten and have the child go to preschool.
C
The mother of a 3 month old breastfed infant asks about giving her baby water because it is summer and very warm. What is the most appropriate recommendation by the nurse? A. Water once or twice a day will make up for losses resulting from environmental temperature. B. Water should be given if the infant seems to nurse longer than usual. C. Fluids in addition to breast milk are not needed. D. Clear juices would be better than water to promote adequate fluid intake.
C
The mother of an infant with multiple anomalies tells the nurse that she had a viral infection in the beginning of her pregnancy. Which viral infection is associated with fetal anomalies? a. Measles b. Roseola c. Rubella d. Herpes simplex virus (HSV)
C
The nurse is assessing a 6 month old infant who smiles, coos, and has a strong head lag. What assessment should the nurse make about this infant's development? a. These are normal findings for an infant this age. b. The parent needs to work with the infant to stop the head lag. c. A developmental/neurologic follow up evaluation is needed. d. The infant could have some cognitive impairment.
C
The nurse is discussing toddler development with a parent. Which intervention will best foster the achievement of autonomy in the toddler? A. Providing opportunities for the toddler to play with other children B. Helping the toddler learn the difference between right and wrong C. Encouraging the toddler to do things for self when capable of doing them D. Helping the toddler complete tasks
C
The nurse is explaining the time interval between early manifestations of disease and the overt clinical syndrome to a parent calling about her sick child. Which word would the nurse use? a. The desquamation period b. The incubation period c. The prodromal period d. The period of communicability
C
The nurse is performing a comprehensive physical examination on a young child in the hospital. At what age can the nurse expect a child's head and chest circumferences to be almost equal? a. Birth b. 6 months c. 1 year d. 3 years
C
The nurse is ready to begin a physical examination of an 8 month old infant who is sitting contentedly on her mother's lap, chewing on a toy. Which assessment should the nurse do first? a. The reflexes b. The head, including the fontanel c. Heart and lungs d. Eyes, ears, and mouth
C
The parent of a 12 month old male infant says to the nurse, "He pushes the teaspoon right out of my hand when I feed him. I can't let him feed himself because he makes too much of a mess." What is the most appropriate response by the nurse? A. "It's important to let make a mess and know it will go away as he gets older." B. "It's important not to give in to this kind of temper tantrum at this age." C. "He's at the stage where he is old enough to begin learning how to feed himself." D. "Maybe you need to try a different type of spoon, one designed for young children."
C
What heart sound is produced by vibrations within the heart chambers or in the major arteries from the back and forth flow of blood? a. S1, S2 b. S3, S4 c. Murmur d. Physiologic splitting
C
What term should be used in the nurse's documentation to describe auscultation of breath sounds that are short, popping, and discontinuous on inspiration? a. Pleural friction rub b. Bronchovesicular sounds c. Crackles d. Wheeze
C
When interviewing the mother of a 3 year old child, the nurse asks about developmental milestones such as the age of walking without assistance. This should be considered a. Unnecessary information, because the child is 3 years old b. An important part of the family history c. An important part of the child's past growth and development d. An important part of the child's review of systems
C
When is the most appropriate time to inspect the genital area during a well child examination of a 14 year old girl? a. It is not necessary to inspect the genital area. b. Examine the genital area first. c. After the abdominal assessment. d. Do the genital inspection last.
C
Which action is appropriate when the nurse is assessing breath sounds of an 18 month old crying child? a. Ask the parent to quiet the child so the nurse can listen. b. Auscultate breath sounds and chart that the child was crying. c. Encourage the child to play with the stethoscope to distract and to calm down before auscultating. d. Document that data are not available because of noncompliance.
C
Which characteristic best describes the fine motor skills of a 5 month old infant? A. Has a strong grasp reflex B. Can build a tower of two cubes C. Is able to grasp object voluntarily D. Has a neat pincer grasp
C
Which children are at greater risk for not receiving immunizations? a. Children who attend licensed daycare programs b. Children entering school c. Children who are home schooled d. Young adults entering college
C
Which statement indicates that a father understands the treatment for his child who has scarlet fever? a. "I can stop the medicine when my child feels better." b. "I will apply antibiotic cream to her rash twice a day." c. "I will give the penicillin for the full 10 days." d. "My child can go back to school when she has been on the antibiotic for a week."
C
Which statement is most characteristic of the motor skills of a 24 month old child? A. A toddler is able to grasp small objects but cannot release them at will. B. A toddler walks alone but falls easily. C. A toddler's activities begin to produce purposeful results. D. A toddler's motor skills are fully developed but occur in isolation from the environment.
C
A 17 month old child is expected to be in what stage according to Piaget? a. Trust b. Preoperations c. Secondary circular reaction d. Sensorimotor period
D
A child taking oral corticosteroids for asthma is exposed to varicella. The child has not had the varicella vaccine and has never had the disease. What intervention should be taken to prevent varicella from developing? a. No intervention is needed unless varicella develops. b. Administer the varicella vaccine as soon as possible. c. The child should begin a course of oral antibiotics. d. The child should be prescribed acyclovir.
D
A child with a depressed immune system due to chemotherapy for cancer has been admitted to the pediatric unit because of possible measles. What would the nurse expect to assess if the child is in the prodrome period of the disease? a. Coordination problems, clubbing, and contractures b. Croup, congestion, and crying c. Confusion, chorea, and conjunctivitis d. Coryza, cough, and conjunctivitis
D
A father tells the nurse that his daughter wants the same plate and cup used at every meal, even if they go to a restaurant. The nurse should explain that this is a. A sign the child is spoiled b. A way to exert unhealthy control c. Regression, common at this age d. Ritualism, common at this age
D
A mother calls the pediatrician's office to find out how to provide comfort for her son who is itching from chickenpox. Information from the nurse is correct if which information is shared with the mother? a. "Encourage frequent warm baths." b. "Give acetaminophen (Tylenol)." c. "Apply a thick coat of Caladryl lotion over open lesions." d. "Give diphenhydramine (Benadryl)."
D
A parent asks the nurse how she will know whether her child has fifth disease. The nurse should advise the parent to be alert for which manifestation? a. Bull's eye rash at the site of a tick bite b. Lesions in various stages of development on the trunk c. Maculopapular rash on the trunk that lasts for 2 days d. Bright red rash on the cheeks that looks like slapped cheeks
D
A parent of an 8 month old infant tells the nurse that the baby cries and screams whenever the infant is left with the grandparents. The nurse's response is based on which observation? A. The infant is most likely spoiled.. B. An infant crying and screaming when left with grandparents is an abnormal reaction for this age. C. The grandparents are not responsive to the infant. D. An infant crying and screaming when left with grandparents is a normal reaction for this age.
D
A sexually active adolescent asks the school nurse about prevention of sexually transmitted diseases (STDs). What is the most appropriate recommendation by the nurse? a. Abstain from sex. b. Any type of contraception method will prevent STDs. c. The withdrawal method of contraception will prevent STDs. d. Use condoms.
D
An infant is expected to be able to say "mama" and "dada" with meaning by what age? A. 14 months B. 4 months C. 6 months D. 10 months
D
During examination of a toddler's extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is a. Abnormal, requiring further investigation b. Abnormal unless it occurs in conjunction with knock knee c. Normal if the condition is unilateral or asymmetric d. Normal, because the lower back and leg muscles are not yet well developed -
D
Examination of the abdomen is performed correctly by the nurse in which order? a. Inspection, palpation, and auscultation b. Palpation, inspection, and auscultation c. Palpation, auscultation, and inspection d. Inspection, auscultation, and palpation
D
Superficial palpation of the abdomen is often perceived by the child as tickling. Which measure by the nurse is most likely to minimize this sensation and promote relaxation? a. Palpate another area simultaneously. b. Ask the child not to laugh or move if it tickles. c. Begin with deeper palpation and gradually progress to superficial palpation. d. Have the child "help" with palpation by placing his or her hand over the palpating hand.
D
The development of a 2 year old child is characterized by? A. tripling the birth weight. B. dressing oneself with supervision. C. having a vocabulary of at least 500 words. D. engaging in parallel play.
D
The nurse is using standard precautions while caring for her patients. Nursing care is correct if which procedures are used to promote infection control? a. Needles are capped immediately after use and disposed of in a special container. b. Masks are used only when caring for patients with airborne infections. c. Gloves are worn any time a patient is touched. d. Gloves are worn to change diapers when there are loose or explosive stools.
D
The office nurse is taking a history on a child's illness from the parents. The nurse notes that the parents treated their 7 year old child appropriately for a fever when they report that they provided what care? a. Gave baby aspirin (ASA) b. Bathed the child in cold water c. Gave alternating dosages of acetaminophen (Tylenol) and ibuprofen (Motrin) d. Gave fluids at frequent intervals
D
The parents of a 4 year old girl are worried because she has an imaginary playmate. What response by the nurse is most appropriate? A. "Imaginary playmates are abnormal after age 2." B. "Keep watching, and if the behavior continues, an evaluation may be needed." C. "I wonder if there is some parent child conflict happening that you're unaware of." D. "Imaginary playmates are normal and useful at this age."
D
What discharge information should the nurse give to the parents of a male adolescent who has been diagnosed with the Epstein Barr virus? a. It is particularly important to protect the adolescent's head during physical activities. b. The teen will feel like himself and be back to his usual routines in a week. c. The treatment of the Epstein Barr virus is prolonged bed rest, usually lasting several months. d. Fatigue may persist, and the adolescent may need to increase school activities gradually.
D
What should be included in the care for a neonate who was diagnosed with pertussis? a. Monitoring hemoglobin level b. Hearing test before discharge c. Serial platelet counts d. Treatment of all close contacts with a prophylactic antibiotic
D
When palpating the child's cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm. What is the best explanation for this? a. Some form of cancer b. Local scalp infection common in children c. Infection or inflammation distal to the site d. Infection or inflammation close to the site
D
Which action is initiated when a child has been scratched by a rabid animal? a. No intervention unless the child becomes symptomatic b. Administration of immune globulin around the wound c. Administration of rabies vaccine on days 3, 7, 14, and 28 d. Administration of both immune globulin and vaccine as soon as possible after exposure
D
Which assessment should the nurse perform last when examining a 5 year old child? a. Heart b. Lungs c. Abdomen d. Throat
D
Which cranial nerve is assessed when the child is asked to imitate the examiner's wrinkled frown, wrinkled forehead, smile, and raised eyebrow? a. Accessory b. Hypoglossal c. Trigeminal d. Facial
D
Which immunizations should be used with caution in children with an allergy to eggs? a. HepB b. DTaP c. Hib d. MMR
D
Which is the most appropriate recommendation for relief of teething pain? A. Rub the infant's gums with aspirin to relieve inflammation. B. Apply diluted hydrogen peroxide to gums to relieve irritation. C. Have the child chew on a warm teething ring to encourage tooth eruption. D. Give the child a frozen teething ring to relieve inflammation.
D
Which measurement is not indicated for a 4 year old well child examination? a. Blood pressure b. Weight c. Height d. Head circumference
D
Which parameter correlates best with measurements of the body's total musclemass to fat ratio? a. Height b. Weight c. Skin-fold thickness d. Mid arm circumference -
D
Which should the nurse recommend to help a toddler cope with the birth of a new sibling? A. Explain to the toddler that a new playmate will soon come home. B. Prepare the toddler for the upcoming changes about 1 to 2 weeks before the birth of the sibling. C. Discourage the toddler from helping with care of the new sibling. D. Give the toddler a doll with which he or she can imitate parenting.
D
Which statement made by a parent indicates incorrect information about intervention for a child's fever? a. "I should keep her covered lightly when she has a fever." b. "I'll give her plenty of liquids to keep her hydrated." c. "I can give her acetaminophen for a fever." d. "I'll look for over the counter preparations that contain aspirin.-"
D
Why are infants particularly vulnerable to acceleration deceleration head injuries? A. The scalp has extensive vascularity. B. The anterior fontanel is not yet closed. C. Nerve tissue is not well developed. D. The musculoskeletal support of the head is insufficient.
D
You are the nurse admitting a toddler to the pediatric infectious disease unit. What is the single most important component of the child's physical examination? a. Assessment of heart and lungs b. Measurement of height and weight c. Documentation of parental concerns d. Obtaining an accurate history
D
Clostridium difficile (C difficile) is a gram positive anaerobic bacteria known to cause diarrhea, abdominal cramps, and fever. The CDC has reported that children are at minimal risks as this infection affects primarily the elderly or patients who are immunocompromised. Is this statement true or false? -
F
The CDC recommends that all health care providers use the World Health Organization (WHO) growth standards to monitor growth for infants and children aged 02 years. For children ages 2 and older the CDC growth chart should be used. These charts are standardized and appropriate for all children. Is this statement true or false? -
F
An important part of the physical exam is the otoscopic examination of the ear. The ear canal should be straightened prior to visualization. If the child is younger than 3, this is accomplished when the nurse pulls the pinna of the ear down and back. Is this the correct procedure?
T
Human cytomegalovirus (CMV) infection is a common cause of congenital infection and is the leading cause of hearing loss and intellectual disability in the United States. The neonate may be infected during the prenatal, perinatal, or postnatal period. Only infections acquired in utero cause permanent infection. Is this statement true or false
T
Adolescent sexuality refers to the thoughts, feelings, and behaviors related to the teen's sexual identity. The most recent research (2009) indicates that 46% of all adolescents have been involved in some kind of sexual activity. The only complete protection from pregnancy and sexually transmitted diseases (STDs) is ____________.
abstinence
The nurse has just assisted in the delivery of a female infant to first time parents. The infant is suctioned, dried, and placed skin-to-skin on her mother's chest. This allows for significant interaction between mother and baby and is known as _____________. -
attachment
It is late winter when a 7 year old child reports to the school nurse with fever, headache, myalgia, and glandular swelling. After assessment the nurse's preliminary diagnosis includes the viral infection most commonly known as ________.
mumps
The parents of a preschool child ask the nurse why their child needs to have her "eyes tested." The nurse explains that although evaluating the visual acuity in a young child can be difficult, the American Academy of Pediatric recommends that visual acuity testing be assessed on all children beginning no later than age _________ years.
three
In terms of fine motor development, what should the 7month-old infant be able to do? a. Transfer objects from one hand to the other. b. Use thumb and index finger in crude pincer grasp. c. Hold crayon and make a mark on paper. d. Release cubes into a cup. -
A
In terms of gross motor development, what would the nurse expect a 5month-old infant to do? a. Roll from abdomen to back. b. Roll from back to abdomen. c. Sit erect without support. d. Move from prone to sitting position. -
A
Which statement, made by a 4year-old child's father, is true about the care of the preschooler's teeth? a. "Because the 'baby teeth' are not permanent, they are not important to the child." b. "My son can be encouraged to brush his teeth after I have thoroughly cleaned his teeth." c. "My son's 'permanent teeth' will begin to come in at 4 to 5 years of age." d. "Fluoride supplements can be discontinued when my son's 'permanent teeth' erupt."
-B
In assessing adolescents using Tanner staging, sexual maturity is rated using _________ distinct stages. (Your answer should appear as a number.)
5
A 14 year old male seems to be always eating, although his weight is appropriate for his height. The best explanation for this is that a. This is normal because of increase in body mass. b. This is abnormal and suggestive of future obesity. c. His caloric intake would have to be excessive. d. He is substituting food for unfilled needs.
A
A 3 month old infant born at 38 weeks of gestation will hold a rattle if it is put in her hands, but she will not voluntarily grasp it. The nurse should interpret this as a. Normal development b. Significant developmental lag c. Slightly delayed development as a result of prematurity d. Suggestive of a neurologic disorder such as cerebral palsy
A
A nurse is teaching adolescent boys about pubertal changes. The first sign of pubertal change seen with boys is a. Testicular enlargement b. Facial hair c. Scrotal enlargement d. Voice deepens
A
According to Piaget, the adolescent is in the fourth stage of cognitive development, or period of what? a. Formal operations b. Concrete operations c. Conventional thought d. Postconventional thought
A
The environment, both physical and psychosocial, is a significant determinate of growth and development outcomes before and after birth. Nurses can assist parents in preventing environmental injury for their 2 year old toddler by teaching them to avoid the most common sources of exposure. This anticipatory guidance includes teaching related to a. Avoiding sun exposure, secondhand smoke, and lead b. Socioeconomic status, primarily poverty c. Maternal smoking and alcohol intake during pregnancy d. The passing of environmental toxins through breast milk
A
The most fatal type of burn in the toddler age group is a. Flame burn from playing with matches b. Scald burn from high temperature tap water c. Hot object burn from cigarettes or irons d. Electric burn from electrical outlets
A
The parent of 16 month old Chris asks, "What is the best way to keep Chris from getting into our medicines at home?" The nurse should advise that a. "All medicines should be locked away securely." b. "The medicines should be placed in high cabinets." c. "Chris just needs to be taught not to touch medicines." d. "Medicines should not be kept in the homes of small children."
A
The theorist who viewed developmental progression as a lifelong series of conflicts that need resolution is a. Erikson b. Freud c. Kohlberg d. Piaget
A
Which statement best describes development in infants and children? a. Development, a predictable and orderly process, occurs at varying rates within normal limits. b. Development is primarily related to the growth in the number and size of cells. c. Development occurs in a proximodistal direction with fine muscle development occurring first. d. Development is more easily and accurately measured than growth.
A
Which toy is the most developmentally appropriate for an 18to 24 month old child? a. A push-and-pull toy b. Nesting blocks c. A bicycle with training wheels d. A computer -
A
The mother of a 14 month old child is concerned because the child's appetite has decreased. The best response for the nurse to make to the mother is a. "It is important for your toddler to eat three meals a day and nothing in between." b. "It is not unusual for toddlers to eat less." c. "Be sure to increase your child's milk consumption, which will improve nutrition." d. "Giving your child a multivitamin supplement daily will increase your toddler's appetite."
B
You are working as the triage nurse in a pediatric emergency room. You receive a telephone call from the mother of an adolescent whose front tooth was completely knocked out of his mouth while he was playing soccer. The mother is seeking advice. Which is the appropriate response? Select all that apply. a. Rinse the tooth in lukewarm tap water. b. Place the tooth in saline, milk, or water. c. Scrub the tooth with a disinfectant, such as mouth wash. d. Bring the child to the emergency room within the next hour for the best prognosis.
A, B
Which play patterns does a 3 year old child typically display? Select all that apply. a. Imaginary play b. Parallel play c. Cooperative play d. Structured play e. Associative play
A, B, C, E
The nurse is assessing parental knowledge of temper tantrums. Which are true statements about temper tantrums? Select all that apply. a. Temper tantrums are a common response to anger and frustration in toddlers. b. Temper tantrums often include screaming, kicking, throwing things, and head banging. c. Parents can effectively manage temper tantrums by giving in to the child's demands. d. Children having temper tantrums should be safely isolated and ignored. e. Parents can learn to anticipate times when tantrums are more likely to occur.
A, B, D, E
Hearing seems to be relatively acute, even at birth, as shown by reflexive generalized reaction to noise. All newborns should undergo hearing screening at birth, before hospital discharge. In addition, assessment for hearing deficits should take place at every well baby visit. Risk factors for hearing loss include (select all that apply) a. Structural abnormalities of the ear b. Family history of hearing loss c. Alcohol or drug use by the mother during pregnancy d. Gestational diabetes e. Trauma -
A, B, E
A nurse has completed a teaching session for parents about "babyproofing" the home. Which statements made by the parents indicate an understanding of the teaching? Select all that apply. a. "We will put plastic fillers in all electrical plugs." b. "We will place poisonous substances in a high cupboard." c. "We will place a gate at the top and bottom of stairways." d. "We will keep our household hot water heater at 130 degrees." e. "We will remove front knobs from the stove."
A, C, E
Motor vehicle injuries are a significant threat to young children. Knowing this, the nurse plans a teaching session with a toddler's parents on car safety. Which will she teach? Select all that apply. a. Secure in a rear facing, upright car safety seat. b. Place the car safety seat in the rear seat, behind the driver's seat. c. Harness safety straps should fit snugly. d. Place the car safety seat in the front passenger seat equipped with an airbag. e. After the age of 2 years, toddlers can be placed in a forward facing car seat. -
A, C, E
Injuries claim many lives during adolescence. Which factors contribute to early adolescents engaging in risk taking behaviors? Select all that apply. a. Peer pressure b. A desire to master their environment c. Engagement in the process of separation from their parents d. A belief that they are invulnerable e. Impulsivity
A, D, E
A 17 year old tells the nurse that he is not having sex because it would make his parents very angry. This response indicates that the adolescent has a developmental lag in which area? a. Cognitive development b. Moral development c. Psychosocial development d. Psychosexual development
B
A mother asks when toilet training is most appropriately initiated. What is the nurse's best response? a. "When your child is 12 to 18 months of age." b. "When your child exhibits signs of physical and psychological readiness." c. "When your child has been walking for 9 months." d. "When your child is able to sit on the 'potty' for 10 to 15 minutes."
B
A mother of a 2 month old infant tells the nurse, "My child doesn't sleep as much as his older brother did at the same age." What is the best response for the nurse? a. "Have you tried to feed the baby more often?" b. "Infant sleep patterns vary widely, with some infants sleeping only 2 to 3 hours at a time." c. "It is helpful to keep a record of your baby's eating, waking, sleeping, and elimination patterns and to come back in a week to discuss them." d. "This infant is difficult. It is important for you to identify what is bothering the baby."
B
A preschool aged child will be receiving immunizations. Which statement identifies an appropriate level of language development for a 4 year old child? a. The child has a vocabulary of 300 words and uses simple sentences. b. The child uses correct grammar in sentences. c. The child is able to pronounce consonants clearly. d. The child uses language to express abstract thought.
B
Approximately how much would a newborn who weighed 7 pounds 6 ounces at birth weigh at 1 year of age? a. 14 3/4 lb b. 22 1/8 lb c. 29 1/2 lb d. Unable to estimate weigh at 1 year
B
Many adolescents decide to follow a vegetarian diet during their teen years. The nurse can advise the adolescent and his or her parents that a. This diet will not meet the nutritional requirements of growing teens. b. A vegetarian diet is healthy for this population. c. An adolescent on a vegetarian diet is less likely to eat highfat or low-nutrient foods. d. A vegetarian diet requires little extra meal planning. -
B
The mother of a 10month-old infant tells the nurse that her infant "really likes cow's milk." What is the nurse's best response to this mother? a. "Milk is good for him." b. "It is best to wait until he is a year old before giving him cow's milk." c. "Limit cow's milk to his bedtime bottle." d. "Mix his cereal with cow's milk and give him formula in a bottle." -
B
The nurse is teaching parents of a toddler about language development. Which statement best identifies the characteristics of language development in a toddler? a. Language development skills slow during the toddler period. b. The toddler understands more than he can express. c. Most of the toddler's speech is not easily understood. d. The toddler's vocabulary contains approximately 600 words.
B
What predisposes the adolescent to feel an increased need for sleep? a. An inadequate diet b. Rapid physical growth c. Decreased activity that contributes to a feeling of fatigue d. The lack of ambition typical of this age group
B
Which behavior suggests appropriate psychosocial development in the adolescent? a. The adolescent seeks validation for socially acceptable behavior from older adults. b. The adolescent is self absorbed and self-centered and has sudden mood swings. c. Adolescents move from peers and enjoy spending time with family members. d. Conformity with the peer group increases in late adolescence. -
B
Which child is most likely to be frightened by hospitalization? a. A 4 month old infant admitted with a diagnosis of bronchiolitis b. A 2 year old toddler admitted for cystic fibrosis c. A 9 year old child hospitalized with a fractured femur d. A 15 year old adolescent admitted for abdominal pain
B
Which developmental assessment instrument is appropriate to assess a 5 year old child? a. Brazelton Behavioral Scale b. Denver Developmental Screening Test II (DDST II) c. Dubowitz Scale d. New Ballard Scale
B
Which expected outcome is developmentally appropriate for a hospitalized 4 year old child? a. The child will be dressed and fed by the parents. b. The child will independently ask for play materials or other personal needs. c. The child will be able to verbalize an understanding of the reason for the hospitalization. d. The child will have a parent stay in the room at all times.
B
Which is assessed with Tanner staging? a. Hormone levels b. Secondary sex characteristics c. Response to growth hormone secretion tests d. Hyperthyroidism
B
Which is the preferred site for administration of the Hib vaccine to an infant? a. Deltoid b. Anterolateral thigh c. Upper, outer aspect of the arm d. Dorsal gluteal region
B
Which statement by a mother indicates that her 5 month old infant is ready for solid food? a. "When I give my baby solid foods, she has difficulty getting it to the back of her throat to swallow." b. "She has just started to sit up without any support." c. "I am surprised that she weighs only 11 pounds. I expected her to have gained some weight." d. "I find that she really has to be encouraged to eat."
B
Which statement by a mother of a toddler indicates a correct understanding of the use of discipline? a. "I always include explanations and morals when I am disciplining my toddler." b. "I always try to be consistent when disciplining the children, and I correct my children at the time they are misbehaving." c. "I believe that discipline should be done by only one family member." d. "My rule of thumb is no more than one spanking a day."
B
Which statement is correct about toilet training? a. Bladder training is usually accomplished before bowel training. b. Wanting to please the parent helps motivate the child to use the toilet. c. Watching older siblings use the toilet confuses the child. d. Children must be forced to sit on the toilet when first learning.
B
Which statement is the most appropriate advice to give parents of a 16year-old who is rebellious? a. "You need to be stricter so that your teen stops trying to test the limits." b. "You need to collaborate with your daughter and set limits that are perceived as being reasonable." c. "Increasing your teen's involvement with her peers will improve her self-esteem." d. "Allow your teenager to choose the type of discipline that is used in your home." -
B
Which statement made by a mother is consistent with a developmental delay? a. "I have noticed that my 9 month old infant responds consistently to the sound of his name." b. "I have noticed that my 12 month old child does not get herself to a sitting position or pull to stand." c. "I am so happy when my 1 1/2 month old infant smiles at me." d. "My 5 month old infant is not rolling over in both directions yet."
B
Tattoos have become increasingly popular among mainstream adolescents. Like clothing and hairstyles, tattoos serve to define one's identity. It is important for nurses to caution adolescents on the health risks of obtaining a tattoo. These include (select all that apply) a. Amateur tattoos are difficult to remove. b. Tattoos pose a risk for bloodborne and skin infections. c. Health care professionals must be notified of the existence of a tattoo before a magnetic resonance imaging (MRI) scan. d. Tattoo dyes may cause allergic reactions. e. Tattoo parlors are well regulated.
B, C, D
The prevalence of obesity in the United States has risen dramatically in both adults and children. The increase in the number of overweight children is addressed in Healthy People 2020. Strategies designed to approach this issue include (select all that apply) a. Decreased calcium and iron intake b. Increased fiber and whole grain intake c. Decreased use of sugar and sodium d. Increase fruit and vegetable intake e. Decrease the use of solid fats
B, C, D, E
Parents of a teenager ask the nurse what signs they should look for if their child is in a gang. The nurse should include which signs when answering? Select all that apply. a. Plans to try out for the debate team at school b. Skipping classes to go to the mall c. Hanging out with friends they have had since childhood d. Unexplained source of money e. Fear of the police
B, D, E
A mother tells the nurse that she is discontinuing breastfeeding her 5month-old infant. The nurse should recommend that the infant be given a. Skim milk b. Whole cow's milk c. Commercial iron-fortified formula d. Commercial formula without iron
C
According to Piaget, the 6month-old infant is in what stage of the sensorimotor phase? a. Use of reflexes b. Primary circular reactions c. Secondary circular reactions d. Coordination of secondary schemata
C
At what age is an infant first expected to locate an object hidden from view? a. 4 months of age b. 6 months of age c. 9 months of age d. 20 months of age
C
Frequent developmental assessments are important for which reason? a. Stable developmental periods during infancy provide an opportunity to identify any delays or deficits. b. Infants need stimulation specific to the stage of development. c. Critical periods of development occur during childhood. d. Child development is unpredictable and needs monitoring.
C
In providing anticipatory guidance to parents whose child will soon be entering kindergarten, which is a critical factor in preparing a child for kindergarten entry? a. The child's ability to sit still b. The child's sense of learned helplessness c. The parent's interactions and responsiveness to the child d. Attending a preschool program
C
The nurse is explaining Tanner staging to an adolescent and her mother. Which statement best describes Tanner staging? a. Predictable stages of puberty that are based on chronologic age b. Staging of puberty based on the initiation of menarche and nocturnal emissions c. Predictable stages of puberty that are based on primary and secondary sexual characteristics d. Staging of puberty based on the initiation of primary sexual characteristics
C
The nurse is planning a teaching session for a young child and her parents. According to Piaget's theory, the period of cognitive development in which the child is able to distinguish between concepts related to fact and fantasy, such as human beings are incapable of flying like birds, is the _______ period of cognitive development. a. Sensorimotor b. Formal operations c. Concrete operations d. Preoperational
C
The parent of 2week-old Sarah asks the nurse whether Sarah needs fluoride supplements, because she is exclusively breastfed. The nurse's best response is a. "She needs to begin taking them now." b. "They are not needed if you drink fluoridated water." c. "She may need to begin taking them at age 6 months." d. "She can have infant cereal mixed with fluoridated water instead of supplements."-
C
The parents of a 14 year old girl are concerned that their adolescent spends too much time looking in the mirror. Which statement is the most appropriate for the nurse to make? a. "Your teenager needs clearer and stricter limits about her behavior." b. "Your teenager needs more responsibility at home." c. "During adolescence this behavior is not unusual." d. "The behavior is abnormal and needs further investigation."
C
The parents of a newborn infant state, "We will probably not have our baby immunized because we are concerned about the risk of our child being injured." What is the nurse's best response? a. "It is your decision." b. "Have you talked with your parents about this? They can probably help you think about this decision." c. "The risks of not immunizing your baby are greater than the risks from the immunizations." d. "You are making a mistake."
C
What does the nurse need to know when observing a chronically ill child at play? a. Play is not important to hospitalized children. b. Children need to have structured play periods. c. Children's play is a form of communication. d. Play is to be discouraged because it tires hospitalized children.
C
What is the primary purpose of a transitional object? a. It helps the parents deal with the guilt they feel when they leave the child. b. It keeps the child quiet at bedtime. c. It is effective in decreasing anxiety in the toddler. d. It decreases negativism and tantrums in the toddler.
C
Which comments indicate that the mother of a toddler needs further teaching about dental care? a. "We use well water so I give my toddler fluoride supplements." b. "My toddler brushes his teeth with my help." c. "My child will not need a dental checkup until his permanent teeth come in." d. "I use a small nylon bristle brush for my toddler's teeth."
C
Which factor has the greatest influence on child growth and development? a. Culture b. Environment c. Genetics d. Nutrition
C
Which is a priority in counseling parents of a 6month-old infant? a. Increased appetite from secondary growth spurt b. Encouraging the infant to smile c. Securing a developmentally safe environment for the infant d. Strategies to teach infants to sit up -
C
Which milestone is developmentally appropriate for a 2 month old infant? a. Pulled to a sitting position, head lag is absent. b. Pulled to a sitting position, the infant is able to support the head when the trunk is lifted. c. The infant can lift his or her head from the prone position and briefly hold the head erect. d. In the prone position, the infant is fully able to support and hold the head in a straight line
C
Which statement by the nurse is most appropriate to a 15 year old whose friend has mentioned suicide? a. "Tell your friend to come to the clinic immediately." b. "You need to gather details about your friend's suicide plan." c. "Your friend's threat needs to be taken seriously, and immediate help for your friend is important." d. "If your friend mentions suicide a second time, you will want to get your friend some help."
C
Why do peer relationships become more important during adolescence? a. Adolescents dislike their parents. b. Adolescents no longer need parental control. c. They provide adolescents with a feeling of belonging. d. They promote a sense of individuality in adolescents.
C
What should the nurse evaluate before administering the Denver Developmental Screening Test II (DDST II)? Select all that apply. a. The child's height and weight b. The parent's ability to comprehend the results c. The child's mood d. The parent child interaction e. The child's chronologic age
C, E
When counseling parents and children about the importance of increased physical activity, the nurse can emphasize a. Anaerobic exercise should comprise a major component of the child's daily exercise. b. All children should be physically active for at least 2 hours per day. c. It is not necessary to participate in physical education classes at school if a student is taking part in other activities. d. Making exercise fun and a habitual activity.
D
A mother asks the nurse, "When should I begin to clean my baby's teeth?" What is the best response for the nurse to make? a. "You can begin when all her baby teeth are in." b. "You can easily begin now. Just put some toothpaste on a gauze pad to clean the teeth." c. "I don't think you have to worry about that until she can handle a toothbrush." d. "You can begin as soon as your child has a tooth. The easiest way is to take cotton swabs or a face cloth and just wipe the teeth. Toothpaste is not necessary."
D
A parent asks the nurse about negativism in toddlers. The most appropriate recommendation is to a. Punish the child b. Provide more attention c. Ask the child to not always say "no" d. Reduce the opportunities for a "no" answer
D
In girls, the initial indication of puberty is a. Menarche b. Growth spurt c. Growth of pubic hair d. Breast development
D
The most common cause of death in the adolescent age group involves a. Drownings b. Firearms c. Drug overdoses d. Motor vehicles
D
The mother of a 10month-old infant asks the nurse about beginning to wean her child from his bottle. Which statement by the mother suggests that the child is not ready to be weaned? a. "My son is frequently throwing his bottle down." b. "The baby takes a few ounces of formula from the bottle." c. "He is constantly chewing on the nipple. It concerns me." d. "He consistently is sucking." -
D
The mother of a 9 month old infant is concerned because the infant cries when approached by an unknown shopper at the grocery store. What is the best response for the nurse to make to the mother? a. "You could consider leaving the infant more often with other people so he can adjust." b. "You might consider taking him to the doctor because he may be ill." c. "Have you noticed whether the baby is teething?" d. "This is a sign of stranger anxiety and demonstrates healthy attachment."
D
The nurse is discussing with a parent group the importance of fluoride for healthy teeth. What should the nurse recommend? a. Use fluoridated mouth rinses in children older than 1 year. b. Brush teeth with fluoridated toothpaste unless fluoride content of water supply is adequate. c. Give fluoride supplements to breastfed infants beginning at age 1 month. d. Determine whether water supply is fluoridated.
D
The parents of a newborn say that their toddler "hates the baby...he suggested that we put him in the trash can so the trash truck could take him away." The nurse's best reply is a. "Let's see if we can figure out why he hates the new baby." b. "That's a strong statement to come from such a small boy." c. "Let's refer him to counseling to work this hatred out. It's not a normal response." d. "That is a normal response to the birth of a sibling. Let's look at ways to deal with this."
D
What do parents of preschool children need to understand about discipline? a. Both parents and the child should agree on the method of discipline. b. Discipline should involve some physical restriction. c. The method of discipline should be consistent with the discipline methods of the child's peers. d. Discipline should include positive reinforcement of desired behaviors.
D
What is helpful to tell a mother who is concerned about preventing sleep problems in her 2year-old child? a. Have the child always sleep in a quiet, darkened room. b. Provide high-carbohydrate snacks before bedtime. c. Communicate with the child's daytime caretaker about eliminating the afternoon nap. d. Use a nightlight in the child's room. -
D
What is the best response a nurse can make to a 15 year old girl who has verbalized a desire to have a baby? a. "Have you talked with your parents about this?" b. "Do you have plans to continue school?" c. "Will you be able to support the baby?" d. "Can you tell me how your life will be if you have an infant?"
D
When planning care for adolescents, the nurse should a. Teach parents first, and they, in turn, will teach the teenager. b. Provide information for their long term health needs because teenagers respond best to longrange planning. c. Maintain the parents' role by providing explanations for treatment and procedures to the parents only. d. Give information privately to adolescents about how they can manage the specific problems that they identify. -
D
Which assessment finding in a preschooler suggests the need for further investigation? a. The child is able to dress independently. b. The child rides a tricycle. c. The child has an imaginary friend. d. The child has a 2lb weight gain in 12 months.
D
Which is the priority concern in developing a teaching plan for the parents of a 15 month old child? a. Toilet training guidelines b. Guidelines for weaning children from bottles c. Instructions on preschool readiness d. Instructions on a home safety assessment
D
Which statement concerning physiologic factors is true? a. The infant has a slower metabolic rate than an adult. b. An infant has an inability to digest protein and lactase. c. Infants have a slower circulatory response than adults do. d. The kidneys of an infant are less efficient in concentrating urine than an adult's kidneys.
D
You are preparing immunizations for a 12 month old child who is immunocompromised. Which immunizations cannot be given? Select all that apply. a. DTaP b. HepA c. IPV d. Varicella e. MMR
D, E
The rate of Sudden Infant Death Syndrome (SIDS), now the third leading cause of death in infants, has increased despite international efforts and the Back to Sleep campaign. Is this statement true or false?
F
Breastfeeding is the ideal method for providing nutrition to the human infant and is recommended by the American Heart Association, the American Academy of Pediatrics, and the World Health Organization. Infants should be exclusively breastfed for a minimum of 4 months and preferably 6 months. Is this statement true or false?
T
Parents are often concerned about their toddler's interest in and curiosity about gender differences. Sex play and masturbation are common among toddlers. Is this statement true or false?
T
The use of electronic or digital media for communication has had a negative effect on the language development of adolescents. Is this statement true or false?
T
A type of play that allows children to act out roles and experiences that may have happened to them, that they fear may happen, or that they have observed in others is known as ______ play.
dramatic
The nurse advises the mother of a 3
month-old exclusively breastfed infant to a. Start giving the infant a vitamin D supplement. b. Start using an infant feeder and add rice cereal to the formula. c. Start feeding the infant rice cereal with a spoon at the evening feeding. d. Continue breastfeeding without any supplements. - A
The nurse is performing a routine assessment on a 14
month-old infant and notes that the anterior fontanel is closed. This should be interpreted as a(n) a. Normal finding b. Questionable finding infant should be rechecked in 1 month c. Abnormal finding indicates need for immediate referral to practitioner d. Abnormal finding indicates need for developmental assessment - A
Adolescents' eyes and ears are fully developed and, with the exception of minor infections, the sensory system remains quite healthy during this period of development. The mother of a 12year-old complains to the nurse that she is concerned that her daughter frequently needs changes to her corrective lenses. This is a condition known as ___________. -
myopia
A disturbance in the flow and time patterning of speech is known as ____________.
stuttering
