EAQ

The nurse is caring for a toddler who has undergone bone marrow transplantation. Which clinical finding would the nurse anticipate if an infection develops? 1 Fever and lethargy 2 Positive blood antibody titers 3 A delay in the growth of bone 4 Neutropenia and lymphocytopenia

1 FEVER & LETHARGY A fever occurs with an infection because pyrogens affect the temperature-regulating center in the hypothalamus; lethargy occurs with an infection because of the related increased basal metabolic rate. Antibody titers indicate exposure to microorganisms, not the presence of an actual infection. Delayed bone growth is not an indication of infection. After a bone marrow transplant, neutropenia and lymphocytopenia are present until the bone marrow is fully repopulated. An altered white blood cell count is not a reliable indicator of infection.

3.The nurse is preparing a diet plan for a child whose body mass index (BMI) is 29. Which instruction would be included in the child's diet plan? Select all that apply. One, some, or all responses may be correct. 1 Provide low-fat milk. 2 Avoid protein-rich foods. 3 Avoid carbonated drinks. 4 Limit the intake of calcium. 5 Increase the intake of leafy greens.

1 Provide low-fat milk. 3 Avoid carbonated drinks. 5 Increase the intake of leafy greens. A BMI greater than 25 indicates that the child is overweight. Fat causes accumulation of cholesterol, thereby causing weight gain. Low-fat milk can be used to prevent weight gain. Carbonated drinks often contain excess amounts of sugar and cause weight gain. Leafy greens contain cellulose, which creates a feeling of fullness in the stomach and limits the intake of food. Proteins are the building blocks of the body. They increase the muscle mass but are not associated with fat levels. Calcium is good for the bones and teeth. Limited intake of calcium will not be beneficial for weight loss but will affect the development of bones and teeth.

Which characteristic related to achieving autonomy would the nurse anticipate when providing care to a toddler? 1 Ritualism 2 Positivity 3 Magical thinking 4 Object permanence

1 Ritualism The nurse expects the toddler to exhibit ritualism during this stage of development to achieve autonomy. The nurse also would expect the toddler to exhibit negativism, not positivity. Magical thinking is a characteristic the nurse anticipates for the preschool-age, not toddler-age, client. Object permanence is a characteristic that the nurse anticipates for the infant, not the toddler.

ow many words would the nurse expect the 3-year-old child to acquire each day? 1 2 to 3 2 5 to 6 3 8 to 10 4 11 to 13

2 5 to 6 The nurse would expect the 3-year-old toddler-age child to acquire five to six new words each day. Two to three new words, 8 to 10 new words, and 11 to 13 new words are not expected parameters for language development.

Which statement is true regarding the physical development of a preschooler? 1 Children gain about 3 lbs (1.36 kg) per year. 2 Preschoolers grow 6.2 to 7.5 cm per year. 3 Preschoolers grow three times their length at around 4 years. 4 The average weight of the child at 4 years is 32 lbs (14.51 kg).

2 Preschoolers grow 6.2 to 7.5 cm per year. Preschoolers grow 6.2 to 7.5 cm per year. Preschoolers gain about 5 lbs (2.26 kg) per year. They also grow double their length at around 4 years old. The average weight of a 4-year-old child is 37 lbs (16.78 kg).

Which would the nurse claim is true regarding play in toddlers? 1 Children have imaginary playmates. 2 Children prefer to play with other children. 3 Children get curious and explore the environment. 4 Children prefer to stay away from parents while playing.

3 Children get curious and explore the environment. During toddlerhood, the child is curious, which is evident in their exploration of the environment. Preschoolers have fantasies and imaginations. Imaginary playmates are a sign of health and allow children to distinguish between reality and fantasy. Children continue to engage in solitary play during toddlerhood but also begin to participate in parallel play. Children prefer playing beside rather than with another child. Toddlers fear separation from their parents and feel safer in their presence.

Which would the nurse anticipate when assessing a preschool-age child, according to Erikson's developmental stages? 1 Being engaged in tasks 2 Questioning sexual identity 3 Having highly imaginative thoughts 4 Wanting to participate in organized activities

3 Having highly imaginative thoughts The nurse would anticipate that a preschool-age child would have highly imaginative thoughts, according to Erikson. Being engaged in tasks and wanting to participate in organized activities is expected for the school-age child. Questioning sexual identity is expected for the adolescent.

Which developmental milestone would the nurse anticipate for a 24-month-old child? 1 Using a straw to drink 2 Drinking well from a cup 3 Beginning to use a fork by holding it in a fist 4 Spilling small amounts of food when using a spoon

1 Using a straw to drink The nurse would anticipate that a 24-month-old toddler can use a straw to drink liquids. The 15-month-old toddler is expected to drink well from a cup. Beginning to use a fork by holding it in the fist and spilling small amounts of food when using a spoon are expectations for a 36-month-old toddler.A toddler seems afraid to select a toy or activity in the clinic playroom. Which age-appropriate play materials would the nurse offer?

According to Piaget's theory, which period describes a child's stage of egocentrism? 1 Sensorimotor 2 Preoperational 3 Formal operations 4 Concrete operations

2 Preoperational During the preoperational period, children learn to think with the use of symbols and mental images. They exhibit egocentrism where they see all objects and persons as their own. The sensorimotor period occurs between birth and 2 years of age. During this period, infants develop an action pattern for dealing with the environment. The formal operations period lasts from 11 years of age into adulthood. During this period, the person is self-conscious and thinks he or she is invulnerable and tends to show risk-taking behaviors. The concrete operations period occurs between 7 to 11 years of age. During this period, children are able to perform mental operations.

A child wants to be on time for a family dinner. According to Kohlberg's theory, which stage of development is the child experiencing? 1 Good boy-nice girl orientation 2 Society-maintaining orientation 3 instrumental relativist orientation 4 Universal ethical principle orientation

3 instrumental relativist orientation When a child wants to be on time for a family dinner, this thought exemplified the instrumental relativist orientation stage. A child at this stage follows his or her parent's rules. During the good boy-nice girl orientation stage, a child wants to win the approval of and maintain the expectations of one's immediate group. During the society-maintaining orientation stage, an individual expands focus from a relationship with others to societal concerns. During the universal ethical principle orientation stage, the concept of "rightness" is defined by self-chosen ethical principles.

Which treatment would the nurse anticipate when providing care for a child who ingested bleach? 1 Gastric lavage 2 Activated charcoal 3 Encourage vomiting 4 Analgesics, per prescription

4 Analgesics, per prescription The nurse would anticipate a prescription for analgesics for a toddler who presents after ingestion of bleach. Gastric lavage, activated charcoal, and vomiting are contraindicated because each can cause more harm to the child.

Which is true about the preoperational period of Piaget's theory? 1 The child develops a scheme for dealing with the environment. 2 The child is able to describe a process without actually doing it. 3 The child has the capacity to reason with respect to possibilities. 4 The child believes that everyone experiences the world exactly as he or she does.

4 The child believes that everyone experiences the world exactly as he or she does. According to Piaget's theory, children believe that everyone experiences the world exactly as they do during the preoperational period. Children develop a scheme for dealing with the environment during the sensorimotor period. Children are able to describe a process without actually doing it during the concrete operations period. Children have the capacity to reason with respect to possibilities during the formal operations period.

Which pain scale would the nurse use when assessing a 4-year-old child? 1 CRIES 2 FLACC 3 Numerical 4 Wong-Baker

4 Wong-Baker The Wong-Baker method is a type of faces pain scale best used in children as young as 3 or 4 years. It contains several faces that a child can use to identify his or her pain level. CRIES and FLACC are pain scales typically used with young infants who are unable to verbalize pain. The numerical pain scales are best used in older children, teens, or adults who can accurately assign a number to represent pain level.

Which would the nurse anticipate when assessing a school-age child according to Erikson's theory of development? Select all that apply. One, some, or all responses may be correct. 1 Being engaged in tasks 2 Questioning sexual identity 3 Having highly imaginative thoughts 4 Wanting to participate in organized activities 5 Struggling with self-control and independence

1 Being engaged in tasks 4 Wanting to participate in organized activities The nurse would anticipate that the school-age child would want to be engaged in tasks and participate in organized activities. Questioning sexual identity is expected for the adolescent.

Which would the nurse state to the mother of a toddler to promote safety? 1 "Throw plastic grocery bags away." 2 "Fill the crib with large, stuffed toys." 3 "Put pacifiers around the neck of the toddler." 4 "Place the toddler to sleep on his or her back."

1 "Throw plastic grocery bags away." The nurse educates the mother of a toddler to remove plastic grocery or other bags from the house to reduce the risk of suffocation. The nurse would instruct the mother not to fill the crib with stuffed toys because there is an increased risk of suffocation. Putting pacifiers around the neck of the child attached with a string also increases the risk of suffocation. The nurse would tell the mother to place a newborn on his or her back to sleep; it reduces the risk of sudden infant death syndrome.

According to Kohlberg's theory of moral development, which statement about conventional reasoning is true? 1 A person wants to fulfill family expectations. 2 A child's thinking is mostly based on likes and pleasures. 3 A child recognizes that there is more than one correct view. 4 An individual moves away from moral decisions based on authority.

1 A person wants to fulfill family expectations. During the "convention reasoning" level, a person wants to fulfill the expectations of his or her family, group, or nation. During the "preconventional reasoning" level, a child's thinking is mostly based on likes and pleasures. During this stage, the child also recognizes that there is more than one correct view. During the "postconventional stage," individuals move away from moral decisions based on authority or conformity to groups to define their own moral values and principles.

Which statement is true about the instrumental relativist orientation stage? 1 An individual recognizes that there is more than 1 correct point of view. 2 An individual finds a balance between societal rules and basic human rights and obligations. 3 An individual response to a moral dilemma is in terms of absolute obedience to authority and rules. 4 An individual sees moral reasoning based on his or her own personal internalization of societal and other's expectations.

1 An individual recognizes that there is more than 1 correct point of view. During the instrumental relativist orientation stage, an individual finds that there is more than 1 correct point of view. During the postconventional reasoning stage, a person finds a balance between societal rules and basic human rights and obligations. During the punishment and obedience orientation stage, a child's response to a moral dilemma is in terms of absolute obedience to authority and rules. During the conventional reasoning stage, the person sees moral reasoning based on his or her own personal internalization of societal and other's expectations.

The nurse assesses a client and determines that she has achieved thelarche. Which clinical finding prompted the nurse's report? 1 Appearance of breast buds 2 Occurrence of gynecomastia 3 Growth of hair on mons pubis 4 Occurrence of menstrual cycle

1 Appearance of breast buds The appearance of breast buds is considered to be an initial indication of puberty and is known as thelarche. A few months after thelarche, growth of pubic hair on the mons pubis occurs. This is known as adrenarche. The occurrence of the first menstrual cycle is known as menarche. Temporary gynecomastia is seen in some boys during mid-puberty.

Which action related to gender is often expected in regards to socialization for school-age girls within the community setting? 1 Expressing feelings openly 2 Being insensitive to others 3 Trying out for the football team at school 4 Taking the most challenging classes in school

1 Expressing feelings openly Health professionals have long been aware that boys and girls are socialized differently by parents and teachers. Girls are encouraged to express their emotions openly. Girls are also expected to be sensitive and responsive to others. Girls are often ostracized if they want to play a sport that is historically associated with the male gender, such as football. Taking the most challenging classes in school is an expectation for males, not females.

A 3-year-old child has been observed in the clinic waiting room taking toys from others, tearing pages out of books, and striking the mother. The nurse takes time when interviewing the mother to ask about television habits because of which reason? 1 Viewing violent programs is positively correlated with the development of aggression. 2 The nurse is interested in how much time the mother spends during interactions with the child. 3 Watching Sesame Street and other children's shows results in slow cognitive development. 4 There is a direct correlation between the number of hours of television viewed and toddler aggression.

1 Viewing violent programs is positively correlated with the development of aggression. Watching violent programs is positively correlated with the development of aggression. Television viewing time does not necessarily have anything to do with interaction time with the mother. Children's shows have not been shown to slow cognitive development. There are no statistics stating specifically that the number of hours of television watched correlates directly with an intensification of aggression.

Which would the nurse teach the parent of an infant who is at risk for infections? 1 "You must avoid placing the infant in bright sunlight." 2 "Breast-feeding will provide protection against bacteria." 3 "Use soy-based infant formulas to help prevent infection." 4 "The infant will be less susceptible to infections later in life."

2 "Breast-feeding will provide protection against bacteria." Breast milk contains immunoglobulin G (IgG) that protects the infant against many bacteria, such as Escherichia coli. The nurse instructs the parent to avoid placing the infant in bright sunlight for a long period of time to prevent burns, but not to prevent infections. Soy-based infant formulas are used only if the infant is allergic to lactose in the breast milk and are not used to prevent the risk for infections. Later, susceptibility would be dependent on multiple factors, including nutrition and exposure to infections.

Which is the recommended size of the urinary catheter that can be used in a 3-year-old child? 1 5 to 6 Fr 2 8 to 10 Fr 3 14 to 16 Fr 4 16 to 18 Fr

2 8 to 10 Fr The recommended size of a urinary catheter that can be used in a 3-year-old child is 8 to 10 Fr. A urinary catheter of 5 to 6 Fr is generally used in infants. A length of 14 to 16 Fr is recommended for most adult clients. A length of 16 to 18 Fr is commonly used in adult males.

he nurse is measuring the blood pressure of toddlers. Which blood pressure finding is the nurse most often to find in the toddlers? 1 85/54 mm Hg 2 95/65 mm Hg 3 105/65 mm Hg 4 110/65 mm Hg

2 95/65 mm Hg The nurse is most likely to find 95/65 mm Hg as a toddler's blood pressure because this is the normal blood pressure of toddlers. The normal blood pressure in infants is 85/54 mm Hg. The optimal blood pressure for children above the age of 6 years is 105/65 mm Hg. Between the ages of 10 and 13 years, normal blood pressure is 110/65 mm Hg.

For which pediatric client would the nurse use the Age and Stages Questionnaire (ASQ) as a developmental screening tool during a health maintenance assessment? 1 A 2-week-old newborn client 2 A 15-month-old toddler client 3 A 6-year-old school-age client 4 A 14-year-old adolescent client

2 A 15-month-old toddler client The ASQ developmental screening tool is appropriate to use for pediatric clients from 1 month to 4.5 years of age. The nurse would use this screening tool for the 15-month-old toddler. The other clients are not within the age range for the use of the ASQ screening tool.

Which gross motor skill would the nurse anticipate when assessing a 15-month-old child during a scheduled health maintenance visit? 1 Using a cup well 2 Creeping up stairs 3 Scribbling spontaneously 4 Building a tower of two blocks

2 Creeping up stairs Creeping up the stairs is a gross motor skill the nurse expects when assessing a 15-month-old toddler-age client during a scheduled health maintenance visit. Using a cup well, scribbling spontaneously, and building a tower with two blocks are all fine, not gross, motor skills the nurse expects when assessing a 15-month-old toddler-age client.

Which psychosocial change does a toddler exhibit? 1 Achieves full independence 2 Engages in temper tantrums 3 Exhibits weak determination 4 Performs very few muscular activities

2 Engages in temper tantrums A 2-year-old child engages in temper tantrums when parents start restricting certain activities to prevent harm. At 2 years of age, a child has a strong will and determination, which may result in negative behavior. The child strives for independence by using the developing muscles to do everything for himself or herself.

A teenager with a diagnosis of osteosarcoma is to have the affected leg amputated. Which should promote psychological adjustment and early function immediately after surgery? 1 Allow the client to change the first dressing. 2 Help the client adjust to the temporary prosthesis. 3 Assign the client to a room with another adolescent. 4 Have the client meet with a member of a cancer survivor organization.

2 Help the client adjust to the temporary prosthesis. A temporary prosthesis attached to a cast with a metal extension can be applied immediately after surgery. This will allow the adolescent to walk within several hours and helps start the adjustment process. The first dressing change is usually done by a member of the surgical team; also, this is too early to expect the adolescent to be ready to look at the surgical site. Assigning the adolescent to a particular room is usually done out of necessity rather than to promote psychologic adjustment. It is too early to have another cancer survivor visit, but this may be done later in the recovery process.

According to Kohlberg's theory of moral development, which stage is a part of conventional reasoning? 1 Social contract orientation 2 Society-maintaining orientation 3 Instrument relativist orientation 4 Universal ethical principle orientation

2 Society-maintaining orientation In Kohlberg's theory, the society-maintaining orientation is stage 4 of conventional reasoning. Social contract orientation is stage 5 of postconventional reasoning. Instrument relativist orientation is stage 2 of preconventional reasoning. Universal ethical principle orientation is stage 6 of postconventional reasoning.

Which developmental skills should a preschooler exhibit? Select all that apply. One, some, or all responses may be correct. 1 Personal identity 2 Specific reasoning 3 Increased curiosity 4 Magical thinking 5 Understanding of others

2 Specific reasoning 3 Increased curiosity 4 Magical thinking Preschoolers begin to engage in specific and become curious. Preschoolers' thinking is often described as magical thinking. Between the ages of 12 and 36 months, toddlers start thinking of the self as separate from the mother. School-age children around the age of 12 years start concentrating on more than 1 aspect of a situation. They also start understanding different points of view.

Which is true about the effect of grief and loss in toddlers? 1 They show resilience after a loss. 2 They express a sense of change in sleeping. 3 They understand the concepts of permanence. 4 They get disrupted in developing an autonomous sense of self.

2 They express a sense of change in sleeping. Toddlers cannot understand loss or death, but often express the sense of absence they feel with changes in eating and sleeping patterns or fussiness. Older adults show resilience after a loss as a result of their prior experiences and developed coping skills. School-age children understand the concepts of permanence and irreversibility but do not always understand the causes of a loss. Illness or death disrupts the young adult's future and the establishment of an autonomous sense of self.

Which is the cause of milk anemia in toddlers? 1 Drinking skim milk 2 Drinking fruit juice 3 Increased milk intake 4 Increased intake of fruits

3 Increased milk intake Toddlers who consume more than 24 ounces of milk daily in place of other foods sometimes develop milk anemia because milk is a poor source of iron. Children are usually not offered low-fat or skim milk until age 2 because they need the fat for satisfactory physical and intellectual growth. Toddlers need to drink whole milk until the age of 2 years to make sure that there is adequate intake of fatty acids necessary for brain and neurological development. Other solid food items are necessary for healthy growth and development in toddlers.

When is administration of activated charcoal indicated after a poisoning? 1 Charcoal is administered after gastric lavage. 2 Charcoal can be administered in any poisoning situation. 3 The charcoal has to be administered within 1 hour after the poisoning. 4 The charcoal can be administered up to 24 hours after the poisoning has occurred.

3 The charcoal has to be administered within 1 hour after the poisoning. Activated charcoal must be administered within 1 hour after the poisoning. Charcoal is not administered after a gastric lavage, in any poisoning situation, or up to 24 hours after a poisoning has occurred.

Which nursing action would be given to an individual in the initiative versus guilt stage of Erikson's theory? 1 The nurse should help the parents cope with the hospitalization of an infant. 2 The nurse should assist physically ill adults in choosing creative ways to foster social development. 3 The nurse should teach parents about a child's impulse control to avoid the risks of altered growth and development. 4 The nurse should help hospitalized adolescents deal with their illness by giving them enough information to make informed decisions about their treatment plans

3 The nurse should teach parents about a child's impulse control to avoid the risks of altered growth and development.

Which activities can a child perform at 3 years of age? Select all that apply. One, some, or all responses may be correct. 1 Jumping rope 2 Drawing triangles 3 Turning doorknobs 4 Holding crayons with fingers 5 Eating with a spoon without rotating it 6 Classifying objects based on size and color

3 Turning doorknobs 4 Holding crayons with fingers 5 Eating with a spoon without rotating it At the age of 3 years, a child can turn the pages of a book one at a time and can easily turn doorknobs. The child can now hold crayons with the fingers. A 3-year-old child can manage to eat with a spoon without rotating it. A preschooler by the age of 5 years is able to jump rope and can easily draw triangles and diamond shapes. By the age of 3 years, a child is able to drink from a cup without spilling it. A preschooler, not a toddler, is able to classify objects according to their size or color.

Which age would the nurse teach the parents of a school-age client to expect mandibular second molars to erupt? 1 7 to 8 years 2 9 to 10 years 3 10 to 12 years 4 11 to 13 years

4 11 to 13 years Mandibular second molars often erupt between 11 and 13 years of age. The maxillary central incisor is expected to erupt between 7 and 8 years of age. The mandibular cuspids are expected to erupt between 9 and 10 years of age. The mandibular second bicuspids are expected to erupt between 11 to 12 years of age.

The nurse is assessing the development of a male child and finds that the child is tall, with deficient secondary sex characteristics, and hypogenitalism. Which chromosomal notation is associated with the child's condition? 1 45,XO 2 47,XXX 3 47,XYY 4 48,XXXY

4 48,XXXY The male child is tall, with deficient secondary sex characteristics and hypogenitalism, indicating Klinefelter syndrome. The chromosomal abnormality present in the child is denoted as 48,XXXY. The chromosomal complement 45,XO is seen in children with Turner syndrome. A child with Turner syndrome will have short stature and a webbed neck. The 47,XXX chromosomal complement indicates that the child has triple X, or superfemale, chromosomal abnormality. This condition is associated with impaired language and mental capacity. A child with the chromosomal complement 47,XYY has Jacobs XYY chromosomal abnormality, which is associated with normal sexual development and aggressive sexual tendencies.

The nurse performs a gross motor skills assessment on an infant. Which age should the infant obtain the ability to crawl? 1 3 months 2 5 months 3 7 months 4 9 months

4 9 months At the age of 9 months, a child starts to crawl along the floor and can pull himself or herself to a standing or sitting position. At the age of 3 months, a child can lift his or her head and chest and is able to sit erect with support. At the age of 5 months, a child can support much of his or her own weight when pulled to stand. At the age of 7 months, a child can sit alone without support, can bear his or her full weight on his or her feet, and can hold on to furniture.

The nurse is explaining to the mother of two teenage children why her daughter's height is comparatively less than her son's height. Which explanation would the nurse provide for lower overall height in girls compared with boys? 1 increase in muscle mass 2 Hypertrophy of the laryngeal mucosa 3 Maturation of structural appendages of the skin 4 Closure of epiphyses because of estrogen secretion

4 Closure of epiphyses because of estrogen secretion The difference in skeletal growth between girls and boys at puberty is because of the influence of hormones. The secretion of high levels of estrogen in girls causes early closure of the epiphyseal ends of the bones. Girls generally have an overall lower height compared with boys. Boys have a longer period of growth before puberty and slower rate of epiphyseal closure. At puberty, boys have an increase in muscle mass both quantitatively and qualitatively. This increased lean mass results in high blood volume in pubertal boys. The hypertrophy of laryngeal mucosa along with elongation of the larynx and vocal cords results in voice changes in both boys and girls at puberty. Hormonal influence during puberty results in maturation of structural appendages of the skin such as sweat glands; this maturation is not related to the height difference between girls and boys.

An 8-year-old child is being prepared for surgery the next day. How would the nurse present preoperative instructions to this child? 1 Be sure to repeat instructions often. 2 Provide time for needle play. 3 Use several abstract examples. 4 Focus on simple anatomical diagrams.

4 Focus on simple anatomical diagrams. According to Piaget, an 8-year-old child's level of development is in the stage of concrete operations; the child will benefit from simple, concrete examples. The preschooler and younger child, not the school-age child, require repetition. Therapeutic needle play is more appropriate if and when the child is to receive an injection. The child who is in the period of concrete operations cannot think in the abstract; the ability to do this develops during adolescence.

A parent asks the nurse what to do when the toddler has temper tantrums. Which play materials would the nurse suggest that the child be offered as another means of expressing anger? 1 Ball and bat 2 Wad of clay 3 Punching bag 4 Pegs and pounding board

4 Pegs and pounding board A pounding board with pegs to hammer into holes is a safe toy for toddlers because it is fairly large, easy to manipulate, and sturdy. It also provides an acceptable way for anger to be expressed. The child's motor and hand-eye coordination are too immature for the child to use a ball and bat. A wad of clay is not as effective for releasing anger as a pounding board. A punching bag is appropriate for an older child with more mature motor coordination to compensate for a moving object.