Ch 16 & 17

A 5-month-old boy was born at 6 pounds, 7 ounces. He is being seen in the office for a well-child visit. The nurse would expect him to weigh approximately: a. 10 pounds, 14 ounces b. 11 pounds, 7 ounces c. 12 pounds, 14 ounces d. 13 pounds, 7 ounces

12 pounds, 14 ounces

A woman usually eats an 1800-calorie diet. She is now in the second trimester of her pregnancy. Which of the following best describes the caloric nutritional needs for this woman during the second and third trimester? a. 1800 calories b. 2100 calories c. 2400 calories d. 2700 calories

2100 calories

The mother of an 8-month-old asks what the minimum recommended amount of fat intake is for her 10-kg infant. Which of the following would be the minimum recommended fat intake? a. 18 grams a day b. 28 grams a day c. 38 grams a day d. 48 grams a day

38 grams a day

By what age is an infants retina fully developed? a. Birth b. 2 months c. 4 months d. 6 months

4 months

During which week would pregnancy begin to pose health concerns for the fetus? a. 36 weeks b. 38 weeks c. 40 weeks d. 42 weeks

42 weeks

A pregnant woman who is at the end of 20 weeks of gestation is at a prenatal visit. Which of the following changes in weight from pre-pregnancy would require the nurse to take additional action? a. 6 pound increase b. 11 pound increase c. 14 pound increase d. 20 pound increase

6 pound increase

At 1 minute of age, an infant has a heart rate of 95, a strong cry, some flexion of extremities, a cry reflex, and is completely pink. Which of the following is a correct assessment of the infants Apgar score? a. 4 b. 6 c. 8 d. 10

8

A nurse makes a home visit to a 15-month-old following a hospitalization for a fall. Which finding would be concerning to the nurse? a. Radiator heating system in the home b. The child drinking from a cup c. The child experiencing a temper tantrum d. A decorative bowl filled with colorful marbles on the coffee table

A decorative bowl filled with colorful marbles on the coffee table

Which of the following mothers would be most likely to bond appropriately with their infant? a. A mother who feels unloved will bond appropriately because now the baby will love her. b. A mother who feels great about herself will show love toward the infant and bond appropriately. c. A mother who feels empty by the birth of her child will bond appropriately once she holds the baby. d. A mother who feels ugly will bond appropriately with her child because her child will bring self-esteem.

A mother who feels great about herself will show love toward the infant and bond appropriately.

Which properties must the sperm possess for conception to occur? (select all that apply) a. High motility b. Uniform size c. Ability to secrete enzymes that dissolve the membrane surrounding the egg d. Life span of at least 3 hours

A,B,C

A nurse is using the Denver Developmental Screening Test (DDST) II to assess a 10-month-old infant. Which of the following purposes does this screening serve? (select all that apply) a. Screens apparently healthy infants for developmental problems b. Allows the infants growth patterns to be compared with other infants c. Validates intuitive concerns about an infants development using an objective test d. Monitors high-risk children for developmental problems

A,C,D

A woman who is 30 weeks pregnant tells the nurse that she and her husband are having sexual difficulties. Which of the following actions should the nurse take? a. Tell the woman she should not be sexually active at this point in her pregnancy because it may harm the fetus. b. Ask her to elaborate on the difficulties. c. Tell her that they should modify their positions during intercourse and that will take care of the problem. d. Tell her men like the way pregnant women look.

Ask her to elaborate on the difficulties.

During a prenatal visit, pregnant parents ask the nurse what they can do to prepare their 4-year-old child for the birth of the new baby. Which of the following actions would be most appropriate for the nurse to suggest? a. Discourage any negative comments the child makes about the baby or the pregnancy. b. Do not make any plans regarding the baby in front of the 4-year-old child. c. Provide him with very detailed information about the pregnancy and the birth. d. Ask the 4-year-old boy to help decorate the new babys room.

Ask the 4-year-old boy to help decorate the new babys room.

The mother of a 3-month-old is concerned because her infant usually falls asleep halfway through his bottle. Because of this, the mother is afraid he will not grow well and get sick. Which of the following would be the most therapeutic response by the nurse? a. Ask the mother about the infants feeding schedule. b. Assure the mother that he is growing fine. c. Tell the mother that half a bottle is probably enough for him. d. Tell the mother she should start to add solids to his diet.

Ask the mother about the infants feeding schedule.

A 15-month-old infant has been brought into the office by his Spanish-speaking mother for symptoms of an upper respiratory infection. Which of the following should be the initial action taken by the nurse? a. Ask the mother if she would like an interpreter. b. Ask the mother what home remedies have been used. c. Ask the mother how long the child has had these symptoms. d. Ask the mother about any allergies the child may have.

Ask the mother if she would like an interpreter.

Which of the following is the most common poison ingested by infants? a. Houseplants b. Lead c. Cleaning agents d. Aspirin

Aspirin

A woman who is 23 weeks pregnant is concerned because her baby is moving less than it was a few weeks ago. Which of the following statements would be the most appropriate response by the nurse? a. Your infant is in distress. We should call an ambulance. b. You need to be more active; take a dance class once a week. c. At this point in your pregnancy, the baby moves less frequently because of lack of space in the uterus. d. You probably counted incorrectly.

At this point in your pregnancy, the baby moves less frequently because of lack of space in the uterus.

The mother of a 16-month-old infant asks a nurse her opinion about holiday decorating. Which of the following recommendations should the nurse provide to the mother? a. Avoid hanging a wreath with holly and berries on the front door. b. Avoid hanging decorative pictures of a bearded Santa Claus on the window. c. Avoid placing poinsettia plants around the home. d. Avoid hanging stockings on the fireplace mantle.

Avoid placing poinsettia plants around the home.

A nurse is completing an initial genetic counseling interview with a couple. Which of the following data would be collected during the interview? (select all that apply) a. Paternal age b. Maternal age c. Family history d. Religious affiliation

B,C

A nurse is assessing a woman for positive signs of pregnancy. Which of the following assessment findings would the nurse discover? (select all that apply) a. Positive test for HCG in the maternal urine b. Detection of fetal heart tones c. Enlargement of the uterus d. Palpation of fetal body part

B,D

A new mother has decided to breast-feed her infant after having bottle-fed her other two children. Which of the following information about having a breast-fed infant should the nurse discuss with the mother? a. Breast-fed infants have darker bowel movements than bottle-fed babies. b. Breast-fed infants have smellier bowel movements than bottle-fed babies. c. Breast-fed infants have more frequent bowel movements than bottle-fed babies. d. Breast-fed infants have harder bowel movements than bottle-fed babies.

Breast-fed infants have more frequent bowel movements than bottle-fed babies.

A Mexican American woman comes to the office for a visit. She is found to be 30 weeks pregnant. Which of the following conclusions can the nurse draw from this finding? a. The woman does not value prenatal care. b. Client education may require a different approach because of dissimilar cultural beliefs. c. This culture does not believe in traditional medicine. d. Signs of pregnancy were not recognized by the woman.

Client education may require a different approach because of dissimilar cultural beliefs.

A mother asks a nurse what the best toy would be for her 2-month-old. Based on the growth and development of the infant, which of the following recommendations should be made by the nurse? a. Colorful mobile with music b. Rattle c. Stuffed teddy bear d. Play telephone

Colorful mobile with music

Which of the following best describes an abnormality in structure or function that occurs during fetal development? a. Congenital defect b. Genetic defect c. Embryonic defect d. Chromosomal defect

Congenital defect

A nurse is discussing the harmful effects that chemical agents can have on an unborn child with a woman who is pregnant. Which of the following statements made by the woman indicates a need for further teaching? a. It is safe to eat up to 12 ounces of cooked fish weekly. b. I should avoid using caffeine during pregnancy. c. Consumption of one drink per day will not cause any harm to my unborn baby. d. Use of nicotine during pregnancy may cause my child to be born prematurely.

Consumption of one drink per day will not cause any harm to my unborn baby.

A 2-month-old infant is in for a well-baby visit. Which of the following immunizations should the nurse administer to the infant? a. DTaP-1 b. MMR c. Varicella d. Influenza

DTaP-1

A nurse is working with a family of an infant to improve their health-perception and health management pattern. Which of the following interventions would be most appropriate for the nurse to implement? a. Assess the home for safety hazards. b. Teach parents appropriate coping mechanisms. c. Demonstrate effective parenting skills. d. Encourage appropriate stimulation of the infant.

Demonstrate effective parenting skills.

A nurse is caring for a woman who is in labor. The nurse anticipates that the labor will progress through which of the following sequences? a. Dilation stage, pressure stage, placental stage, recovery stage b. Dilation stage, pushing stage, pain stage, recovery stage c. Dilation stage, pushing stage, placental stage, recovery stage d. Dilation stage, pushing stage, placental stage, refractory stage

Dilation stage, pushing stage, placental stage, recovery stage

A nurse is completing a home visit of a new mother who is breast-feeding her infant. Which of the following instructions should the nurse provide during this visit? a. Consume 500 kcal/day above pre-pregnancy energy intake to avoid excessive weight loss. b. Drink 1 quart of fluids daily to produce sufficient quantity of breast milk. c. Use formula to provide the infant supplementation between feedings. d. Use a pacifier to help the infant to fall asleep so he does not fall asleep when breast-feeding.

Drink 1 quart of fluids daily to produce sufficient quantity of breast milk.

A 9-month-old has mastered the pincer grasp. Which of the following tasks would the nurse anticipate that the infant can do by himself? a. Play with a rattle. b. Eat cheerios off a hard surface. c. Hold a spoon to feed himself. d. Drink from a cup.

Eat cheerios off a hard surface.

During a home visit, the nurse finds a 9-month-old in a playpen with a couple of toys. Which of the following instructions would be most appropriate for the nurse to provide to the parent to encourage growth and development of the child? a. Encourage the addition of a few more toys to the playpen. b. Suggest keeping the infant in the playpen as much as possible to promote safe play. c. Encourage providing the infant with supervised time outside of the playpen. d. Suggest removing all toys from the playpen.

Encourage providing the infant with supervised time outside of the playpen.

Which of the following statements about race and culture in the United States is correct? a. The United States ranks 22nd in the world for infant mortality rate. b. Ethnic minority populations have higher rates of low-birth-weight infants. c. Black infants are more likely to have cleft palates than Native American infants. d. Whites have more fraternal twin pregnancies than non-Whites.

Ethnic minority populations have higher rates of low-birth-weight infants.

During a routine clinic visit, a pregnant woman expresses concern about reflux she is experiencing. Which statement should be made by the nurse when addressing the womans concern? a. Frequent heartburn may be a sign of fetal distress and an ultrasound should be performed immediately. b. Frequent heartburn is caused by high levels of hormones during pregnancy. c. Frequent heartburn is a result of gastrointestinal system changes that occur during pregnancy. d. Frequent heartburn during pregnancy requires immediate consultation with a gastroenterologist.

Frequent heartburn is a result of gastrointestinal system changes that occur during pregnancy.

The nurse performs a home visit for a new mother and infant. The nurse observes that the infant lacks a regular feeding schedule, has diapers that are not changed promptly, and cries for long periods of time before being consoled. Which of the following problems is the infant most at risk for encountering in the future? a. Developing enuresis as a toddler b. Having difficulty forming relationships c. Becoming a picky eater d. Taking longer to toilet train

Having difficulty forming relationships

During the second prenatal visit, the pregnant woman informs the nurse that she has stopped smoking. This finding is based on an assessment of which functional health pattern? a. Cognitive-perceptual pattern b. Self-perceptionself-concept pattern c. Health-perceptionhealth-management pattern d. Values-beliefs pattern

Health-perceptionhealth-management pattern

Where do most accidents occur? a. In the home b. In the car c. At day care d. On the playground

In the home

Which of the following changes is experienced by the urinary system during pregnancy? a. Increased urinary output secondary to total body water increase b. Decreased bladder capacity c. Decreased glomerular filtration rate (GFR) resulting from estrogen and progesterone surge d. Increased renal excretion of acidic drugs

Increased urinary output secondary to total body water increase

A mother asks the nurse when she should start feeding her infant solid foods. Which of the following is the most appropriate response by the nurse? a. It is recommended that solid foods are introduced no earlier than 3 months of age. b. It is recommended that solid foods are introduced no earlier than 6 months of age. c. You should wait until your child is 9 months old to start solid foods. d. You should wait until your child is 1 year old to start solid foods.

It is recommended that solid foods are introduced no earlier than 6 months of age.

A nurse is caring for a client who is 30 weeks pregnant at a prenatal visit. Which of the following statements made by the client would be of concern to the nurse and warrant further explanation and close follow-up? a. I have been feeling more tired lately. b. My husband complains every time I ask him to do something for me. c. Sometimes, the smell of food makes me nauseous. d. I need to get up two times a night to go to the bathroom.

My husband complains every time I ask him to do something for me.

A pregnant woman reports to the nurse that the first day of her last menstrual period was January 22. Using Ngeles rule, which of the following dates would be the most accurate estimated date of delivery? a. September 16 b. September 22 c. October 29 d. October 17

October 29

A nurse is developing an educational program about SIDS for a new mothers support group in the community. Which of the following information would be included in this presentation? a. Parents are encouraged to place their infants in the supine sleeping position. b. SIDS is the leading cause of death among infants age 6 months to 1 year old. c. SIDS is associated with infants who have had difficulty sleeping at night. d. Parents are encouraged to limit the amount of tummy time of their infant.

Parents are encouraged to place their infants in the supine sleeping position.

Which of the following infants is most at risk to experience child abuse? a. Father has experienced paternal engrossment b. Responds to parental touch c. Parents have low-self esteem d. Has been adopted

Parents have low-self esteem

An infant is lying in a crib watching and listening to a colorful mobile. What is the purpose of having a mobile? a. Provides stimulation necessary for continued growth and development for the infant b. Provides too much stimulation for the infant, making it difficult for the infant to focus c. Serves as inadequate stimulation for the infant because it is an inanimate object d. Serves as a distractor for the infant, making it easier to fall asleep

Provides stimulation necessary for continued growth and development for the infant

A new young mother asks the nurse what she should do to play with her 3-month-old infant. Which of the following suggestions should the nurse provide? a. Take the infant for a walk outside. b. Place several toys around the infant when lying on the floor. c. Rock the infant in a rocking chair. d. Search the Internet for toys highly recommended for infants

Rock the infant in a rocking chair.

An infant is going through the toys in his toy box. He looks at each one before dropping it to the floor and picking the next toy out of the box. Using a growth and development perspective, which of the following conclusions can the nurse draw by assessing this behavior? a. The infant is testing his limits. b. The infant is exploring his environment. c. The infant is expressing his emotions. d. The infant is developing fine motor skills.

The infant is exploring his environment.

A nurse assesses that the task of development of affection for and from others has been met or is in the process of being met by an infant. Which of the following observations has the nurse made? a. The infant smiles at mirror images. b. The infant makes cooing noises. c. The infant begins to smile socially. d. The infant likes to be picked up.

The infant likes to be picked up.

A new father is installing a car seat for an infant in the car. Which of the following information should be given to the father by the nurse? a. The infant should be in a rear-facing car seat in the front seat. b. The infant should be in a rear-facing car seat in the back seat. c. The infant should be in a front-facing car seat in the front seat. d. The infant should be in a front-facing car seat in the back seat.

The infant should be in a rear-facing car seat in the back seat.

During a home visit to the home of a 3-month-old infant, which environmental finding requires immediate anticipatory guidance? a. A pool in the backyard without a gate b. The lack of smoke detectors c. The lack of childproof latches on drawers and cupboards d. Two azalea plants in the living room

The lack of smoke detectors

A nurse is assessing the nutritional-metabolic patterns of a pregnant woman. Which of the following findings would be of concern to the nurse? a. The woman drinks about 1 gallon of water a day. b. The woman works out at the gym daily. c. The woman does not like vegetables. d. The woman usually eats three meals a day in addition to two snacks a day.

The woman does not like vegetables.

During a prenatal visit, a pregnant woman informs the nurse that she and her husband have chosen godparents for the baby. This finding is based on an assessment of which functional health pattern? a. Cognitive-perceptual pattern b. Self-perceptionself-concept pattern c. Health-perceptionhealth-management pattern d. Values-beliefs pattern

Values-beliefs pattern

A nurse is completing a well-child assessment of a 6-month-old infant. Which of the following guidelines should be used when assessing the infants height and weight? a. CDC growth charts b. CDC body mass index (BMI) charts c. WHO growth standards d. Denver Developmental Screening height and weight standards

WHO growth standards

A nurse would like to be involved in promoting change in health care policies. Which of the following actions would be most appropriate for the nurse to accomplish this goal? a. Be an active member of a national nursing organization. b. Vote for political leaders in favor of health care reform. c. Enroll in a health policy class. d. Learn about community resources

Be an active member of a national nursing organization.

. A woman is Rh negative and the father of her baby is Rh negative. The woman states that her friend told her that she would need a shot to keep her baby alive. Which of the following statements would be the best response by the nurse? a. Yes, you will need an injection of RhoGAM at 28 weeks gestation and within 72 hours after birth. b. Because the father of the baby is also Rh negative, your baby will not inherit Rh positive blood cells and you will not need the injection. c. Yes, you will need the injection because this is your first pregnancy. You will not need it with subsequent pregnancies. d. No, you will not need the injection because you are White. Rh incompatibility affects only Black women.

Because the father of the baby is also Rh negative, your baby will not inherit Rh positive blood cells and you will not need the injection.

A client who is 36 weeks of gestation is at her prenatal visit. The nurse tells the client that she will be screened for group B Streptococcus during todays visit. Which of the following statements would be made by the nurse when providing client education about this screening test? a. Screening for group B Streptococcus is necessary as this infection can cause complications with pregnancy and to the unborn infant. b. This screening will help us to determine if your unborn infant will be susceptible to respiratory distress when he or she is born. c. Screening for group B Streptococcus will help us identify if you have been exposed to this or any other infections during your pregnancy. d. This screening is necessary to determine if there is any Rh blood group incompatibility between you and your unborn child.

Screening for group B Streptococcus is necessary as this infection can cause complications with pregnancy and to the unborn infant.

A nurse is caring for a woman who is in labor and the fetus descends to the lower birth canal. The woman is in which of the following stages of labor? a. First b. Second c. Third d. Fourth

Second

During the first prenatal visit, the pregnant woman informs the nurse that she cannot wait to start wearing maternity clothes. This finding is based on an assessment of which functional health pattern? a. Cognitive-perceptual pattern b. Self-perceptionself-concept pattern c. Health-perceptionhealth-management pattern d. Values-beliefs pattern

Self-perceptionself-concept pattern

A nurse makes a home visit to monitor the blood pressure of a pregnant woman who is single. Which finding would be of most concern to the nurse? a. The bedroom is located on the second floor. b. She has a pet cat. c. There is an area rug in the living room. d. She has a 1-year-old child.

She has a pet cat.

During a prenatal visit, a nurse discovers that a Black woman has been occasionally craving and eating clay. Which of the following actions should be taken by the nurse? a. Tell the client that many pregnant women crave such nonfood substances, and it is not a problem. b. Ignore the comment because pica is acceptable in some rural Black cultures. c. Encourage the client to eat it with plenty of water because of the risk of constipation. d. Stress the importance of an appropriate diet and avoiding pica in a culturally sensitive way.

Stress the importance of an appropriate diet and avoiding pica in a culturally sensitive way.

A nurse is encouraging parents to immunize their infants. Which of the following strategies would be the best way for the nurse to facilitate this? a. Send a reminder for immunizations to the parents. b. Talk to the parents about immunizations during office visits. c. Track clients who have not been immunized. d. Memorize the CDC immunization schedule.

Talk to the parents about immunizations during office visits.

A nurse is caring for a woman during the fourth stage of labor. Which of the following best describes an action the nurse would take during this stage? a. Providing constant reinforcement and education about the labor process and assisting the woman with pushing b. Explaining unusual interventions such as the use of a fetal heart monitor c. Assisting with labor discomfort by modeling breathing d. Teaching the new mother positioning of the infant to assist with breast-feeding

Teaching the new mother positioning of the infant to assist with breast-feeding

A woman who just found out she is pregnant starts crying. She tells the nurse that over the last 3 days she was not feeling herself, so she took some Tylenol. She states if she knew she was pregnant, she never would have taken the medication. Which of the following actions should be taken by the nurse? a. Tell the client that there is a high probability that her baby will have a birth defect b. Tell the client not to worry because research indicates that in recommended doses Tylenol is safe. c. Tell the client not to worry because she did not know she was pregnant, but in the future, she should use herbal products instead of over-the-counter medication. d. Tell the client that there is a high probability of a stillbirth.

Tell the client not to worry because research indicates that in recommended doses Tylenol is safe.

A nurse is assessing the language development of a 6-month-old infant. Which of the following findings would the nurse anticipate? a. The infant forms two-syllable sounds. b. The infant coos and makes vowel sounds. c. The infant babbles. d. The infant says ma-ma and bye-bye.

The infant babbles.

A nurse is assessing a 4-month-old infant during a well-child visit. Which of the following findings will require the nurse to collect additional information? a. The infants shirt is wet from drooling. b. The infant has gained one pound since her 2-month well-child visit. c. The infant holds his or her head steady when in a sitting position. d. The infant grasps objects with two hands.

The infant has gained one pound since her 2-month well-child visit.

A nurse visits a 3-month-old infant of a single mother for a weight check. She finds two older children running around the home, the infant is crying, the mother yelling at the two children and a half-lit cigarette is in an ashtray. The mother tells the nurse the visit needs to be cut short today because she has to pick up her other children from the bus stop. Which of the following would be the most beneficial intervention this nurse can provide during this visit? a. Leave and tell the mother to call her to reschedule the appointment. b. Weigh the infant and contact the Department of Children and Families. c. Weigh the infant and offer community resources to the mother. d. Offer to go pick up the other children at the bus stop.

Weigh the infant and offer community resources to the mother.

A delivery room nurse senses disappointment when a mother is told she just delivered a baby girl. Which of the following would be the most therapeutic response by the nurse? a. Yes, you just delivered a healthy, beautiful baby girl. b. This is your first baby. You can always try again for a boy. c. Dont worry, many parents often feel the same way you do. d. You are tired. I think you should get some rest.

Yes, you just delivered a healthy, beautiful baby girl.

A nurse is caring for a pregnant woman who has a pre-pregnancy body mass index (BMI) of 27. Which of the following instructions should the nurse provide the woman regarding weight gain during pregnancy? a. You should gain 11 to 20 pounds during your pregnancy. b. You should gain 15 to 25 pounds during your pregnancy. c. You should gain 25 to 35 pounds during your pregnancy. d. You should gain 28 to 40 pounds during your pregnancy.

You should gain 15 to 25 pounds during your pregnancy.

The mother of a 4-month-old infant is concerned about the possibility of SIDS because her neighbors daughter passed away last year as a result of SIDS. The mother reports she is so nervous that she has taken up smoking again. The mother informs you that the 4-month-old sleeps supine and takes a pacifier to help her fall asleep. Which of the following statements would be the best response from the nurse? a. You should place the infant in the bed with you until 6 months of age. b. You should never give the infant a pacifier while she is sleeping. c. You should try to stop smoking. d. You should place the infant on her stomach.

You should try to stop smoking.

A pregnant woman is having a TORCH screening done at todays prenatal visit. She states she is anxious to get the results back because she recently had unprotected sex with someone she just met and is afraid she might have HIV. Which of the following statements would be the best response by the nurse? a. You will know your HIV status in about 1 week when the results come back. b. You will require additional testing for HIV as it is not tested for with the TORCH screen. c. You will need to be tested for HIV after you deliver because pregnancy can produce false HIV results. d. You need to be exposed for at least 6 months before being tested for HIV in order for the results to be accurate.

You will require additional testing for HIV as it is not tested for with the TORCH screen.

The client who is taking prescribed _____ would require preconception management to minimize the potential for drug-related birth defects. a. antiemetics b. antiepileptics c. iron d. non-narcotic analgesics

antiepileptics