Maternity & Pediatrics - Ricci Chapters 25-36 end of chapter questions

A child's weight is 35lb 7 oz. Convert the weight to kilograms

7oz/16oz (because there are 16 oz in 1lb) = .4375lb 35.4375lb/2.2kg = 16.1kg

The father of a 2 month old girl is expressing concern that his infant may be getting spoiled. What is the nurses best response? a. She just needs love and attention. Don't worry, she's to young to spoil. b. Consistently meeting the infants needs helps promote a sense of trust. c. Infants need to be fed and cleaned; if you are sure those needs are met, just let her cry. d. Consistency in meeting needs is important, but you are right, holding her too much will spoil her.

B. Consistently meeting the infants needs helps promote a sense of trust.

The mother of a 3-month old asks the nurse about starting solid foods. What is the most appropriate response by the nurse? a. It's OK to start pureed solids at this age if fed via the bottle. b. Infants don't require solid food until 12 months of age. c. Solid foods should be delayed until 6 months, when the infant can handle a spoon on his own. d. The tongue extrusion reflex disappears at age 4-6 months, making it a good time to start solid foods.

D. The tongue extrusion reflex disappears at age 4-6 months, making it a good time to start solid foods.

An infant boy is at your facility for his initial health supervision visit. He is 2 weeks old and responds to a bell during his examination. You review all his birth records and find no documentation that a newborn hearing screening was performed. What is the best action by the nurse? a. Do nothing; responding to the bell proves the infant does not have a hearing deficit. b. Schedule the infant immediately for newborn hearing screening. c. Ask the mother to observe for signs that the infant is not hearing well. d. Screen again with the bell at the infant's 2-month health supervision visit.

b. Schedule the infant immediately for newborn hearing screening.

A 10-year-old child on a regular diet refuses to eat the food on her meal tray. She requests chicken nuggets, French fries, and ice cream. What is the best nursing action? a. Ask the child's desired foods be sent up from the kitchen. b. Negotiate with the child to eat at least part of the food on the tray. c. remove a privilege's. d. Offer the child cereal and milk from stock on the nursing unit.

a. Ask the child's desired foods be sent up from the kitchen.

An infant is receiving intermittent gavage feedings via a nasogastric tube ever 6 hours. The feeding tube was inserted w/ a previous feeding and remains in place. The nurse is preparing to administer the next scheduled feeding. Place the events in the proper sequence. a. check the placement of the feeding tube b. position the infant on his right side w/ the head of the bed slightly elevated c. allow the feeding to come to room temp. d. flush the tube with water e. clamp the tube to prevent air from entering the stomach f. poor the solution into the barrel of the syringe.

1 - c - allow the feeding to come to room temp. 2 - a - check the placement of the feeding tube. 3 - f - poor the solution into the barrel of the syringe. 4 - d - flush the tube with water 5 - e - clamp the tube to prevent air form entering the stomach. 6 - b - position the infant on his right side w/ the head of the bed slightly elevated.

A child's height is 41 inches. Convert the height to centimeters.

41in x 2.54cm = 104.14cm

The nurse is caring for an infant who weighs 8.2 kg an dis NPO an receiving IV fluid therapy. What rate does the nurse calculate as meeting the child's daily fluid requirements?

8.2 x 100 = 820 820/24hours = 34.2ml per hour ---> 34ml/hour

The nurse providing home care to a 2-year-old listens to the child's parents talk about how the child and family are adjusting to the child's current illness. Which of the following roles is the nurse participating in? a. Case management. b. Child and family advocacy c. Direct nursing care d. Child and family education.

c. Direct nursing care

When giving parents guidance for the adolescent years, the nurse would advise the parents to: (Choose all that apply.) a. Accept the adolescent as a unique individual b. Provide strict, inflexible rules c. Listen and try to be open to the adolescent's views d. Screen all of his or her friends e. Respect the adolescent's privacy f. Provide unconditional love

a. Accept the adolescent as a unique individual c. Listen and try to be open to the adolescent's views e. Respect the adolescent's privacy f. Provide unconditional love

A child is scheduled for a bone marrow aspiration at 4pm. The nurse would plan to apply EMLA cream to the intended site at which time? a. 1:30pm b. 3:00pm c. 3:30pm d 4:00pm

a. 1:30pm

The mother of a 3 year old is concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response. a. Hesitancy and dysfluency are normal during this period of development. b. Reading to the child will help model appropriate speech. c. Expressive language concerns warrant a developmental evaluation. d. The mother should ask her child's physician for a speech therapy evaluation.

a. Hesitancy and dysfluency are normal during this period of development.

Which statement indicates the best sequence for the nurse to conduct an assessment in a nonemergency situation? a. Introduce yourself, ask about any problems, take a history, and do the physical examination b. Perform the physical examination and then ask the family if there are any problems in the child's life. c. Do the physical examination while at the same time asking about the child's previous illnesses; then talk about the family's concerns. d. Get a complete history of the family's health beliefs and practices, and then assess the child.

a. Introduce yourself, ask about any problems, take a history, and do the physical examination

Which of the following are reasons that stealing occurs in school-age children? (select all that apply) a. To escape punishment. b. High self-esteem c. Low expectations of family/peers d. Lack of sense of property e. Strong desire to own something.

a. To escape punishment. d. Lack of sense of property e. Strong desire to own something.

The parents of a child with a developmental disability ask the nurse for advice about disciplining their child. What is the best response by the nurse? a. You should choose methods that are most congruent with your values about discipline. b. Children like this really can't follow directions, so they may be very hard to discipline. c. Punish your child only for socially unacceptable or offending behaviors. d. Spanking works well for this type of child, as they really don't like pain.

a. You should choose methods that are most congruent with your values about discipline.

What is the best advice about nutrition for the toddler? a. encourage cup drinking and give water between meals and snacks. b. Encourage unlimited milk intake, because toddlers need the protein for growth. c. Avoid sugar-sweetened fruit drinks and allow as much natural fruit juice as desired. d. Allow the toddler unlimited access to the sippy cup to ensure adequate hydration.

a. encourage cup drinking and give water between meals and snacks.

Which facility fulfills the characteristics of a medical home? a. An urgent care center b. A primary care pediatric practice c. A mobile outreach immunization program d. A dermatology practice.

b. A primary care pediatric practice

When working with children and families, which is critical strategy for promoting therapeutic communication? a. Detailed explanations b. Attentive listening c. comforting touch d. closed-ended questions.

b. Attentive listening

A sleeping 5-month-old girl is being held by the mother when the nurse comes in to do a physical examination. What assessment should be done initially? a. Listening to bowel sounds b. Counting the heart rate c. Checking the temperature d. Looking in the ears.

b. Counting the heart rate

A 9-month-old infant's mother is questioning why cow's milk is not recommended in the first year of life as it is cheaper than formula. What rationale does the nurse include in her response? a. It is permissible to substitute cow's milk for formula at this age as he is so close to 1 year old. b. Cow's milk is poor in iron and does not provide the proper balance of nutrients for the infant. c. As long as the mother provides whole milk, rather than skim, she can start cow's milk in infancy. d. If the mother cannot afford the infant formula, she should dilute it to make it last longer.

b. Cow's milk is poor in iron and does not provide the proper balance of nutrients for the infant.

An adolescent who is a competitive swimmer comes to the emergency department complaining of localized aching pain in his shoulder. He states, "I've been practicing really hard and long to get myself ready for my meet this weekend." The area is tender to touch. The nurse determines that the adolescent is most likely experiencing which type of pain? a. Cutaneous pain b. Deep somatic pain c. Visceral pain d. Neuropathic pain

b. Deep somatic pain

In developing a weight-loss plan for an adolescent, which would the nurse include? (select all that apply) a. Have parents make all the meal plans b. Eat slowly and place the fork down between each bite. c. Have the family exercise together. d. Refer to an adolescent weight-loss program. e. Keep a food and exercise diary.

b. Eat slowly and place the fork down between each bite. c. Have the family exercise together. d. Refer to an adolescent weight-loss program. e. Keep a food and exercise diary.

What approach by the nurse would most likely encourage a child to cooperate with an assessment of physical and developmental health? a. Explain to the child what's going to happen when the child asks questions. b. Explain what is going to happen in words the child can understand. c. Force the child to cooperate by having a parent hold him or her down. d. Give the child a sticker before beginning the examination.

b. Explain what is going to happen in words the child can understand.

The nurse is preparing to assess the pain of a 3-year-old child who has had surgery the day before. Which pain assessment method would be most appropriate for the nurse to use? a. FACES pain rating scale and poker chip tool b. FACES pain rating scale, observation of the child, and parent report c. Asking the parents to rate their child's pain using the word-graphic rating scale d. Visual analog scale

b. FACES pain rating scale, observation of the child, and parent report

To gain cooperation from a toddler, what is the best approach by the nurse? a. Immediately pick the toddler up form the mother's lap. b. Kneel in front of the toddler while he or she is on the mother's lap. c. Do the nursing tasks quickly so the toddler can play. d. Ask the toddler if it is OK if you begin the needed task.

b. Kneel in front of the toddler while he or she is on the mother's lap.

A 6-month-old infant requires restraint to prevent removal of his nasogastric tube. What is the priority nursing intervention? a. Tie the restraint loosely to prevent skin breakdown. b. Leave the baby unrestrained when directly observed. c. Position the restrained infant prone to prevent aspiration. d. Place the infant in a room near the nurses' station.

b. Leave the baby unrestrained when directly observed.

The mother of two sons, age 6 and 9, states they want to play on the same baseball team. As the school nurse, what advice would you give the mother? a. Having the boys on the same team will make it more convenient for the mother. b. Levels of coordination and concentration differ, so the boys need to be on different teams. c. Put the boys on the same team because they are both school-age children. d. It is best to avoid putting the boys on the same team to prevent sibling rivalry.

b. Levels of coordination and concentration differ, so the boys need to be on different teams.

The mother of a 4 year old asks for advice on using time-out for discipline with her child. What advice should the nurse give the mother? a. If spanking is not working, then time-out is not likely to be helpful either. b. Place the child in time-out for 4 minutes c. Use time-out only if removing privileges is unsuccessful. d. The child should stay in time-out until crying ceases.

b. Place the child in time-out for 4 minutes

When administering ear drops to a 2-year-old, which action would be most appropriate? a. Tell the child that the drops are to treat his infection b. Pull the pinna of the child's ear down and back c. Have the child turn his head to the opposite side after giving the drops. d. Massage the child's forehead to facilitate absorption of the medication.

b. Pull the pinna of the child's ear down and back

The nurse is caring for a 3-year-old with a gastrostomy tube and tracheostomy who is on supplemental oxygen and multiple medications. The mother is rooming in during this hospitalization. What is the priority nursing action? a. Incorporate the mother's assistance in care when convenient. b. Recognize the mother as the expert on her child's needs and care. c. Recommend that the mother go home to get some rest. d. Provide family-centered care since the mother is there.

b. Recognize the mother as the expert on her child's needs and care.

Which activities will promote weight in an obese school-age child? (select all that apply) a. Unlimited computer and TV time b. Role modeling by family. c. Becoming active in sports. d. Eating unstructured meals. e. Involving child in meal planning and grocery shopping. f. Drinking 3 glasses of water per day.

b. Role modeling by family. c. Becoming active in sports. e. Involving child in meal planning and grocery shopping.

Which assessment finding is considered normal in children? a. Irregular respiratory rate and rhythm. b. Split S2 and sinus arrhythmia c. Decreased heart rate with crying d. Genu varum past the age of 5 years

b. Split S2 and sinus arrhythmia

Which is associated with early adolescence? (select all that apply). a. Uses scientific reasoning to solve problems. b. Still at times wants to be dependent upon parents. c. Incorporates own set of morals and values. d. Is influenced by peers and values memberships in cliques.

b. Still at times wants to be dependent upon parents. d. Is influenced by peers and values memberships in cliques.

Samantha, a 10-year-old girl, is brought into your clinic for a well-child examination. Her mother states "Samantha's friend group seems to be so much more important to her these days." As the nurse caring for her, how would you explain the role of peers in the school-age child? a. This allows her the opportunity to learn conflict management. b. This helps her to shape her concept of self and provides security as she gains independence from her parents. c. This will encourage her to remain dependent on her teachers and family. d. This will help her to work through her fears of body safety.

b. This helps her to shape her concept of self and provides security as she gains independence from her parents.

When caring for children, how does the nurse best incorporate the concept of family-centered care? a. Encourages the family to allow the physician to make health care decisions for the child. b. Uses the concept of respect, family strengths, diversity, and collaboration with the family. c. Advises the family to choose a pediatric provider who is on the child's health care plan. d. Recognizes that families undergoing stress related to the child's illness cannot make good decisions.

b. Uses the concept of respect, family strengths, diversity, and collaboration with the family.

The nurse is caring for a 2-year old in the hospital, and the mother expresses concern that the toddler will be scared. Which response by the nurse would be most appropriate? a. Don't worry; we practice family-centered and atraumatic care here. b. We will do our best to minimize the stress that your child experiences. c. It will probably be upsetting for you as well, so you should stay home. d. Our practice of atraumatic care will eliminate all pain and stress for your child.

b. We will do our best to minimize the stress that your child experiences.

The successful resolution of developmental tasks for the school-age child, according to Erikson, would be identified by: a. learning from repeating tasks. b. developing a sense of worth and competence. c. using fantasy and magical thinking to cope with problems. d. developing a sense of trust.

b. developing a sense of worth and competence.

The nurse is caring for a hospitalized 30 month old who is resistant to care, is angry, and yells "no" all the time. The nurse identifies this toddler's behavior as: a. problematic, as it interferes with needed nursing care. b. normal for this stage of growth and development. c. normal because the child is hospitalized and out of his routine.

b. normal for this stage of growth and development.

During the health interview, the mother of a 4-month-old says, "I'm not sure my baby is doing what he should be." What is the nurse's best response? a. "I'll be able to tell you more after I do his physical." b. "Fill out this developmental screening questionnaire and then I can let you know." c. "Tell me more about your concerns." d. "All mothers worry about their babies. I'm sure he's doing well."

c. "Tell me more about your concerns."

A 4-year-old child is having a vision screening performed. Which screening chart would be best for determining the child's visual acuity? a. Snellen b. Ishihara c. Allen figures d. CVTME

c. Allen figures

The nurse is providing anticipatory guidance to the mother of a 6 month old infant. What is the best instruction by the nurse in relation to the infant's oral health? a. Start brushing her teeth after all the baby teeth come in. b. Use a washcloth with toothpaste to clean her mouth. c. Clean your baby's gums, then new teeth, with a washcloth. d. Rinse your baby's mouth with water after every feeding.

c. Clean your baby's gums, then new teeth, with a washcloth.

The nurse is caring for a child who has received all possible medical care for cancer yet continues to experience relapse and metastasis. It is time to make the transition from curative care attempts to palliative care. What is the most important nursing consideration at this time? a. The health care professional should make the decision about the child's care. b. The family may lose a sense of hope, so cancer treatments should continue. c. Involve the family in the decision-making process about the shift to palliative care. d. Palliative care can take place only at home, so the child should be discharged.

c. Involve the family in the decision-making process about the shift to palliative care.

The mother of a 15-month-old is concerned about a speech delay. She describes her toddler as being able to understand what she says, sometimes following commands, but using only one or two words with any consistency. What is the nurse's best response to this information? a. The toddler should have a developmental evaluation as soon as possible. b. If the mother would read to the child, then speech would develop faster. c. Receptive language normally develops earlier than expressive language. d. The mother should ask her child's physician for a speech therapy evaluation.

c. Receptive language normally develops earlier than expressive language.

Parents of an 8-month-old girl express concern that she cries when left with the babysitter. How does the nurse best explain this behavior? a. Crying when left with the sitter may indicate difficulty with building trust. b. Stranger anxiety should not occur until toddlerhood; this concern should be investigated. c. Separation anxiety is normal at this age; the infant recognizes parents as separate beings. d. Perhaps the sitter doesn't meet the infant's needs; choose a different sitter.

c. Separation anxiety is normal at this age; the infant recognizes parents as separate beings.

The parents of a 5-year-old with special health care needs talk to the parents of a 10-year old with a similar condition for quite a while each day. What is the nurses' interpretation of this behavior? a. The nurse has not provided enough emotional support for the parents. b. This relationship between the children's parent is potentially unhealthy. c. Support between parents of special children is extremely valuable. d. Confidentiality is a pressing issue in this particular situation.

c. Support between parents of special children is extremely valuable.

A 5-year-old boy visits the pediatric office with an upper respiratory infection. Which approach would give the nurse the most information about the child's developmental level? a. Playing a game with the child b. Talking with the child about the teddy bear next to him. c. Using a screening tool during a follow-up office visit. d. Asking the 10-year-old siblings about the child.

c. Using a screening tool during a follow-up office visit.

After teaching a child's parent about the different methods of distraction that can be used for pain management, which statement by the parents indicates a need for additional teaching? a. We'll have her focus on her hand and count each finger slowly b. We'll read some of her favorite stories to her. c. We'll have her imagine that she's at the beach this summer. d. She likes to play video games, so we'll bring in some from home.

c. We'll have her imagine that she's at the beach this summer. -- this is imagery not distraction

A child is to undergo a tympanostomy tube placement in a freestanding outpatient surgery center. What is the major disadvantage associated w/ this location? a. Increased risk for infection b. Increased health care costs. c. need to transferred if overnight stay is required d. Increased disruption of family functioning.

c. need to transferred if overnight stay is required

The nurse is caring for a hospitalized 4 year old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. she then agrees to have the assessment or intervention done to herself. The nurse identifies this preschooler's behavior as: a. problematic; the child is old enough to begin to have a basis in reality. b. normal, because the child is hospitalized and out of her routine. c. normal for this stage of growth and development. d. problematic, as it interferes with needed nursing care.

c. normal for this stage of growth and development.

The nurse is providing teaching about accidental poisoning to the family of a 3-year-old. The nurse understands that a child of this age is at increased risk of accidental ingestion due to which sensory alteration? a. A lack of fully developed hearing. b. A less discriminating sense of touch. c. Visual acuity that has not fully developed. d. A less discriminating sense of taste.

d. A less discriminating sense of taste.

The nurse is preparing a 5-year-old boy for surgery on his lower leg. His mother is helping him into the hospital gown and the boy fights removal of his underwear. What is the most appropriate nursing action? a. Allow the mother to remove the underwear. b. Tell the boy he is acting childishly. c. Notify the OR that the underwear is on. d. Allow the boy to keep his underwear on.

d. Allow the boy to keep his underwear on.

When developing the plan of care for a child in pain, the nurse identifies appropriate strategies aimed at modifying which factors influencing pain? a. Gender b. Cognitive level c. Previous pain experience d. Anticipatory anxiety

d. Anticipatory anxiety

A 5-year-old child is not gaining weight appropriately. Organic problems have been ruled out. What is the priority action by the nurse? a. Allow the child unlimited access to the sippy cup to ensure adequate hydration. b. Encourage sweets for the extra caloric content. c. Teach the mother about nutritional needs of the preschooler. d. Assess the child's usual intake pattern at home.

d. Assess the child's usual intake pattern at home

A 15-month old girl is having her first health supervision visit at your facility. Her mother has not brought a copy of the child's immunization record but believes she is fully immunized: "She had immunizations 3 months ago at the local health department." Which would be the best action by the nurse? a. Ask the mother to bring the records to the 18-month health supervision visit. b. Start to "catch-up" schedule because there are no immunization records. c. Keep the child at the facility while the mother returns home for the records. d. Call the local health department and verify the child's immunization status.

d. Call the local health department and verify the child's immunization status.

A 3-year-old child is to receive a medication that is supplied as an enteric-coated tablet. What is the best nursing action? a. Crush the tablet and mix it with apple sauce. b. Dissolve the medication in the child's milk. c. Place a pill in the posterior part of the pharynx and tell the child to swallow. d. Check with the prescriber to see if an alternative form can be used.

d. Check with the prescriber to see if an alternative form can be used.

The nurse is caring for a child with a developmental disability who is starting kindergarten this year. The mother is tearful and doesn't want the child to go to school. What is the best response by the nurse? a. Do you need some time alone to collect yourself? b. You've known for a while this time would come. c. Can I call your husband or friend for you? d. It is normal to feel stressed or sad at this time.

d. It is normal to feel stressed or sad at this time.

A 2-year-old boy is scheduled to undergo an endoscopic procedure. His parent are asking when they should tell him about it. Based on the nurse's understanding of the child's developmental stage, when would be the most appropriate time to prepare the child for the procedure? a. About 1 week before the scheduled date b. a few days in advance of the scheduled date c. about 1 hour before the procedure is to occur d. Just before the procedure is to be performed.

d. Just before the procedure is to be performed.

A 2-year-old is having a temper tantrum. what advice should the nurse give the mother? a. For safety reasons, the toddler should be restrained during the tantrum. b. Punishment should be initiated, as tantrums should be controlled. c. The mother should promise the toddler a reward if the tantrum stops. d. The tantrum should be ignored as long as the toddler is safe.

d. The tantrum should be ignored as long as the toddler is safe.

When providing atraumatic care to a child, which action would be the most appropriate? a. Applying restraints for any procedure that would be uncomfortable. b. Keeping the lights on in the child's room throughout the day and night. c. Limiting the use of topical anesthetics for painful injections d. allowing parents and children an informed choice about being together.

d. allowing parents and children an informed choice about being together.