N6500 Exam One
What will the nurse view as best maintaining normalcy in the life of a 10-year-old boy who is experiencing a lengthy hospitalization? A) keeping up with his schoolwork B) Choosing the time of his bath or shower C) watching daytime television D) playing board games with the child life specialist
A) keeping up with his schoolwork
The nurse is teaching the parents of a 2-year-old child how to handle the child's temper tantrums. The nurse determines that the teaching was successful if the parents make which statement? A) "We will offer our child a treat to stop having the tantrum." B) "We will attempt to reason with our child to limit tantrums." C) "We will ignore our child while having the tantrum." D) "We will place our child in time-out for 5 minutes after the tantrum."
C) "We will ignore our child while having the tantrum."
The mother of a school-aged child is discussing parenting behaviors with the nurse. She questions the nurse about the best way to provide feedback to her child. What suggestion by the nurse is most appropriate? A) Emphasizing negative behaviors is more important than focusing on positive behaviors. B) Timing of feedback is not of importance. C) Positive reinforcement is more valuable than negative feedback. D) Positive and negative feedback should be equally provided to children.
C) Positive reinforcement is more valuable than negative feedback.
The parents of an 8-year-old girl with a slow-to-warm temperament are concerned about their daughter's reaction when she visits the dentist for the first time after having a cavity filled at the last visit. How should the nurse respond? A) "Remind your daughter of the importance of proper oral hygiene." B) "Tell your daughter that it is just like going to see the pediatrician." C) "Wait to tell her about the visit until just before the appointment." D) "Remind her in simple terms what will happen in the dentist's office."
D) "Remind her in simple terms what will happen in the dentist's office."
A nurse is evaluating a 5-year-old client in the clinic. Which finding would indicate to the nurse that the client is not meeting Erikson's stages of psychosocial development? A) The client can tie shoes. B) The client tells a vivid story. C) The client sleeps 12 hours a day. D) The client asks permission to play.
D) The client asks permission to play.
During a well-child check at the ambulatory clinic, the mother of a 10-year-old boy reports concerns about her son's frequent discussions about death and dying. Based upon knowledge of this age group, the nurse understands that: A) at this age, children are not afraid of death. B) discussing death and dying may hint at a psychological disorder. C) consistent thoughts of death and dying at this age lead to the later development of depression. D) preoccupation with death and dying is common in the school-aged child.
D) preoccupation with death and dying is common in the school-aged child.
A hospitalized 7-year-old is recovering from a head injury. Occupational therapy has been ordered to assist the child in regaining eye/hand coordination. If the child cannot master this skill, what feelings may arise? A) A sense of doubt B) A sense of shame C) A feeling of inferiority D) A sense of mistrust
C) A feeling of inferiority
Which is the best way for parents to aid a toddler in achieving the developmental task? A) Urge the toddler to dress oneself completely alone B) Give the toddler small household chores to do C) Allow the toddler to make simple decisions D) Help the toddler learn to count
C) Allow the toddler to make simple decisions
A nurse is educating the parents on how to help their 10-year-old daughter deal with an extended hospital stay due to surgery, followed by traction. Which response indicates a need for further teaching? A) "She will be sensitive to our concerns." B) "We must prepare her in advance." C) "She will watch our reactions carefully." D) "I should not tell her how long she will be here."
D) "I should not tell her how long she will be here."
The father of a 6-week-old infant voices concerns about his son's stooling. He further shares that his son grunts and cries when having a bowel movement. What response by the nurse is most appropriate? A) "What does his stool look like?" B) "Grunting is normal with infant stool formation." C) "Is he in pain?" D) "We will need to collect a stool specimen for analysis."
A) "What does his stool look like?"
What statement by the mother of a 20-month-old indicates a need for further teaching about nutrition? A) "She drinks three 6-ounce cups of whole milk each day." B) "I give my daughter juice at breakfast and when she is thirsty during the day." C) "When she doesn't eat well at meals we give her nutritious snacks." D) "New foods are offered along with ones she likes."
B) "I give my daughter juice at breakfast and when she is thirsty during the day."
The nurse is educating a group of caregivers of 3-year-old children on behavior. Which statement made by a caregiver concerns the nurse? A) "I have my child apologize when mean to another child." B) "I place my child in time-out for 10 minutes." C) "My child acts out when he does not get his way." D) "My child's behavior declines if her schedule is interrupted."
B) "I place my child in time-out for 10 minutes."
The parents of a 4-year-old girl tell the nurse that their daughter is having frequent nightmares. Which statement indicates that the girl is having night terrors instead of nightmares? A) "She has a hard time going back to sleep." B) "She screams and thrashes when we try to touch her." C) "She comes and wakes us up after she awakens." D) "She is scared after she wakes up."
B) "She screams and thrashes when we try to touch her."
A mother of a 9-month-old 18-pound (8.2 kg) infant asks the nurse about choosing the best car seat. What should the nurse recommend? A) a rear-facing booster seat B) a rear-facing 5-point harness restraint C) a forward-facing convertible booster D) a forward-facing 5-point harness restraint
B) a rear-facing 5-point harness restraint
The developmental task of the school-aged period, according to Erikson, is gaining a sense of: A) identity versus failure. B) industry versus inferiority. C) independence versus dependence. D) autonomy versus shame.
B) industry versus inferiority.
The nurse is caring for a 7-year-old boy in a body cast. He is shy and seems fearful of the numerous personnel moving in and out of his room. How can the nurse help reduce his fear? A) Remind the boy he will be out of the hospital and going home soon. B) Encourage the boy's parents to stay with him at all times to reduce his fears. C) Write the name of his nurse on a board and identify all staff on each shift, every day. D)Tell him not to worry; explain that everyone is here to care for him.
C) Write the name of his nurse on a board and identify all staff on each shift, every day.
The best way for an infant's parent to help the child complete the developmental task of the first year is to: A) expose the infant to many caregivers to help the infant learn variability. B) talk to the infant at a special time each day. C) respond to the infant consistently. D) keep the infant stimulated with many toys.
C) respond to the infant consistently.
The physician has made a notation in the medical record of a 17-year-old that the teen is not demonstrating successful completion of Erikson's stages of development. What behavior would be consistent with this assessment? A) The teen is distrustful of others. B) The teen is anxious to move away from his parent's home. C) The teen is sexually promiscuous. D) The teen is uncertain and frequently unable to make decisions.
D) The teen is uncertain and frequently unable to make decisions.
Following the discharge of a child who has a chronic health condition from the hospital, the nurse case manager follows up with a visit to the home and meets with the family and child. This visit best represents which philosophy of pediatric nursing? A) atraumatic therapeutic care B) evidence-based nursing care C) risk-reduction potential care D) family-centered care
D) family-centered care
The nurse is providing a class to a group of parents about child rearing. One of the participants reports that she regularly uses spanking as a form of discipline for her 5-year-old son. What is the best response by the nurse? A) "Many studies show that spanking can lead to aggression in children." B) "Spanking in children older than age 5 has very limited benefit." C) "I think spanking is wrong." D) "Spanking can be a very useful form of discipline in come families."
A) "Many studies show that spanking can lead to aggression in children."
The parents of a 4-day-old infant report concern about his weight loss. What is the best response by the nurse? A) "With appropriate nutrition weight gain will commence with a return to the birth weight within 10 days of age" B) "Weight loss after birth is normal." C) "Babies may lose up to 10% of their body weight in the first month of life." D)"Babies will begin to rapidly regain weight and will double birth weight around 4 to 6 months of age."
A) "With appropriate nutrition weight gain will commence with a return to the birth weight within 10 days of age"
The nurse enters a room to perform an assessment and finds the 9-month-old client asleep in the father's arms. Which action will the nurse take first? A) Assess the infant's respiratory status. B) Monitor how long the infant sleeps. C) Obtain the infant's temperature. D) Instruct the father to call when the infant wakes
A) Assess the infant's respiratory status.
In 2007 the World Factbook published statistics that showed the United States still lagged behind other industrialized nations in the incidence of infant mortality. What is one reason that the United States has a higher infant mortality rate than other countries? A) Low birth weight B) Early prenatal care C) Low adolescent delivery rates D) Home deliveries
A) Low birth weight
The nurse is conducting a health screening for a 3-year-old boy as required by his new preschool. Which statement by the parents warrants further discussion and intervention? A) "There is a very low student-teacher ratio, and they do a lot of hands-on projects." B) "The school is quite structured and advocates corporal punishment." C)"The school requires processed foods and high sugar foods be avoided." D) "The school has a loose environment, which is a good match for his temperament."
B) "The school is quite structured and advocates corporal punishment."
The infant weighs 6 lb 8 oz (2,950 g) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of 12 months? A) 10 lb 8 oz (4760 g) B) 19 lb 8 oz (8825 g) C) 15 lb 4 oz (6920 g) D) 13 lb (5900 g)
B) 19 lb 8 oz (8825 g)
A 6-year-old child will be hospitalized for a surgical procedure. How can the nurse best ease the stress of hospitalization for this child? A) Tell the parents to bring toys for the child from home. B) Prepare the child for hospitalization by explaining what to expect and showing him or her around the hospital. C) There is no way to adequately prepare a child for an impending hospitalization. D) Have another child talk with the child to be hospitalized.
B) Prepare the child for hospitalization by explaining what to expect and showing him or her around the hospital.
A nurse is caring for a 4-year-old child. The parents indicate that their child often reports that objects in the house are his friends. The parents are concerned because the child says that the grandfather clock in the hallway smiles and sings to him. Which response by the nurse is best? A) "Is there any family history of mental health disorders?" B) "Has your child suffered any type of physical trauma lately?" C) "Attributing lifelike qualities to inanimate objects is quite normal at this age." D) "Your child is demonstrating animism, which is common."
C) "Attributing lifelike qualities to inanimate objects is quite normal at this age."
The nurse is observing several children interacting during a community health event. Which observed behavior would be indicative of a 4-year-old child? A) "I ran the race better than my best friend because he was slow." B) "I told the other child no, when he asked me to cheat at the game." C) "Look! I am a nurse, and I am helping people feel better!" D) "I lost the game because I did not play good, and I am sad."
C) "Look! I am a nurse, and I am helping people feel better!"
The nurse is caring for a 13-year-old girl. As part of a routine health assessment the nurse needs to address areas relating to sexuality and substance use. Which statement or question should the nurse say first to encourage communication? A) Do you smoke cigarettes or marijuana? B) I promise not to tell your mother any of your responses. C) Tell me about some of your current activities at school. D) Are you considering sexual activity?
C) Tell me about some of your current activities at school.
The nurse is providing anticipatory guidance to the parent of a 2-month-old infant in relation to growth and development. Which statement from the parent demonstrates proper understanding? A) "I can expect my infant to become clingy around strangers within the next month." B) "I can expect my infant to laugh out loud within the next month." C) "I can expect my infant to be able to hold a rattle within the next month." D) "I can expect my infant to be able to raise the head up when on the stomach within the next month."
D) "I can expect my infant to be able to raise the head up when on the stomach within the next month."
The nurse is interviewing an adolescent. What should the nurse recognize as an important aspect of interviewing the adolescent? A) Adolescents will not likely share information related to sexual relationships or to use of substances. B) Adolescents should be asked if they would like a peer in the room during the interview. C) Adolescents will talk more openly if their caregiver is in the same room. D) Adolescents will share more about themselves in a private conversation.
D) Adolescents will share more about themselves in a private conversation.
When performing neurological reflexes on the infant, which primitive reflex will be present longest? A) Moro B) Babinski C) Root D) Step
B) Babinski
During a parenting class, the nurse gives examples of extinction as a form of discipline. What would be an example of this technique? A) using verbal reprimand B) spanking a toddler C) praising desired behavior D) ignoring a temper tantrum
D) ignoring a temper tantrum
A teen mom asks the discharge nurse if it is okay to sleep in bed with her baby. She says her mom always did it with her siblings and it seemed okay. How should the nurse respond? A) "Bed sharing is okay, just make sure the infant is between two people." B) "Sure you can, but make sure you use a soft mattress for support." C) "Sure, you can do whatever you want, it is your baby." D) "The baby can sleep in your room in an infant crib, but not in an adult bed."
D) "The baby can sleep in your room in an infant crib, but not in an adult bed."
Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? A) Turning a doorknob B) Building a tower of four cubes C) Walking independently D) Sitting independently
D) Sitting independently
The nurse is preparing to assess the respiratory rate of a crying 15-month-old boy. To get the most accurate assessment, what approach should the nurse take? A) Count the respiratory rate for 30 seconds. B) Count after the child stops crying and is comfortable. C) Count abdominal movements. D) Place a stethoscope to count respirations.
B) Count after the child stops crying and is comfortable.
A school nurse has completed an educational program for parents of preschool children. Which statement by a participant indicates a need for further education? A) "My 5-year-old son still needs me to dress and undress him." B) "I need to work with my 4-year-old; she should be able to cut paper with scissors on her own." C) "My 3-year-old is doing fine, he can hop on one foot already." D) "I'm glad to know that it's okay that my 5-year-old is learning to skate."
A) "My 5-year-old son still needs me to dress and undress him."
The nursing instructor is leading a discussion on school-aged children. The instructor determines the session is successful when the students correctly choose which factor as being a priority for the school-aged child? A) Needs 10 to 12 hours of sleep per night B) Should brush their teeth at bedtime C) Have a routine physical exam every 6 months D) Be screened for scoliosis once a year
A) Needs 10 to 12 hours of sleep per night
A nurse is caring for a hospitalized 10-year-old child. What would be an appropriate activity for this child to meet the developmental tasks of this age group? A) Participating in a craft project B) Playing with a jack-in-the-box C) Playing with blocks D) Writing letters to friends
A) Participating in a craft project
Which activity will the nurse encourage new parents to complete in order to assist their infant in accomplishing Erikson's developmental task for the first year of life? A) Respond promptly when the infant cries. B) Read age-appropriate books to the infant daily. C) Appropriately enunciate words when speaking to the infant. D) Praise the infant when a new milestone is reached.
A) Respond promptly when the infant cries.
Which method of communication is appropriate for the nurse to use when caring for a 7-month-old infant? A) Pronounce words as an infant would, using "baby talk" B) Use a soothing and calming tone when speaking to the infant C) Use puppets to communicate with the infant D) Speak similar to the infant's parents and look in the infant's face when speaking
B) Use a soothing and calming tone when speaking to the infant
A parent asks the nurse if the 2-month-old infant can have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which response? A) "Sure, if you feel your infant is ready to have bananas." B) "When did you feed your other child bananas? C) "You can try bananas 2 or 3 months from now." D) "In 1 month you can try bananas if you think your infant is ready."
C) "You can try bananas 2 or 3 months from now."
While caring for a 16-year-old client expected to be hospitalized for several months, the nurse will perform which action to assist the client in meeting the current stage of psychosocial development? A) Explain medical concepts by providing handouts and brochures. B) Provide video games for the client to play. C) Permit peers to visit during open visitation hours. D) Allow the client to touch equipment before procedures.
C) Permit peers to visit during open visitation hours.
The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. The nurse determines the session is successful when the group correctly chooses which example as best displaying toddlers playing? A) Playing apart from others without being part of a group B) Playing together in an activity without organization C) Playing independently and are side by side D) Playing in an organized group with each other
C) Playing independently and are side by side
The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age? A) 1 to 3 natal teeth B) no teeth C) 1 to 2 lower teeth D) 1 upper tooth
B) no teeth
A parent is disciplining the 5-year-old daughter by putting her in time-out. How long should the child be in time-out? A) 3 min B) 5 min C) 10 min D) 15min
B) 5 min
A student nurse shares an interest in pediatric nursing. When discussing her thoughts about pediatric nursing, which statements are consistent with the philosophies of pediatric nursing care? Select all that apply. A) "I believe the family should be included in all aspects of the plan of care and treatment." B) "I think the parents must be the director of the client's care until adulthood." C) "Since health care can be scary for a child, it's important to make them feel secure." D) "The child should be included as much as possible in the plan of care." E) "Until they are teens, kids should have a limited amount of decision making in their care."
A) "I believe the family should be included in all aspects of the plan of care and treatment." C) "Since health care can be scary for a child, it's important to make them feel secure." D) "The child should be included as much as possible in the plan of care."
An 8-year-old boy who says he wants to be a doctor when he grows up pleads with the nurse to let him put on his own band-aid after receiving an injection. The nurse agrees and watches as the boy very carefully lines the band-aid up with the mark left by the injection and applies it to his skin. Then he asks, "Did I do it right?" and waits eagerly for the nurse's feedback. The nurse recognizes in this situation the boy's attempt to master the primary developmental step of school age. What is that step? A) Industry B) Conservation C) Accommodation D) Perfectionism
A) Industry
The nurse is preparing to measure an infant's temperature with a tympanic thermometer. Which is the correct way to position the device? A) Pull the child's earlobe back and down and point the sensor beam toward the center of the tympanic membrane. B) Pull the child's earlobe back and up, and point the sensor beam toward the center of the tympanic membrane. C) Pull the child's earlobe back and down, and point the sensor beam toward the side of the ear canal. D) Pull the child's earlobe back and up, and point the sensor beam toward the side of the ear canal.
A) Pull the child's earlobe back and down and point the sensor beam toward the center of the tympanic membrane.
The nurse is admitting a 15-year-old adolescent to the hospital pediatric unit. What does the nurse recognize as a priority for this adolescent? A) The adolescent's need for privacy should be respected. B) The adolescent should be encouraged to call friends often. C) The adolescent should be given freedom to participate in unit activities as desired. D) The adolescent's need for parental support should be discussed.
A) The adolescent's need for privacy should be respected.
Parents and their nearly 3-year-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay? A) Uses two-word sentences or phrases B) Talks about a past event C) Half of speech understood by outsider D) Asks "why" often
A) Uses two-word sentences or phrases
The mother of a 15-month-old son is returning to work and wants to place her son in the day care close to work; however, they will only accept potty-trained children. Which response from the nurse will best address this situation in answering the mother's questions of how best to potty train her son? A) "Encourage your son to watch his older siblings use the toilet." B) "Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained." C) "Each time you change his diaper, tell your son how important and fun it is to use the potty chair." D) "Get your son a potty chair and have him sit on it for a few minutes each day."
B) "Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained."
The nurse is caring for an 18-month-old child. The nurse is aware that the child is which stage according to Erikson? A) Initiative versus guilt B) Autonomy versus shame and doubt C) Industry versus inferiority D) Trust versus mistrust
B) Autonomy versus shame and doubt
All infants should have their head circumference measured at health assessment visits. Where should the nurse place the tape measure to obtain this measurement? A) just above the eyebrows through the prominent part of the occiput B) the center of the forehead to the base of the occiput C) the hairline in front to the hairline in back D) the middle of the forehead through the parietal prominences
A) just above the eyebrows through the prominent part of the occiput
The parent of an infant asks the nurse when to begin brushing the infant's teeth. What would be the nurse's best response? A) as soon as the first tooth erupts B) by 12 months of age C) when weaning is complete D) as soon as the infant begins to eat fruit
A) as soon as the first tooth erupts
A preschool child fell off a tricycle and broke an arm that will require surgical repair. The nurse wants to prepare the child for surgery. Which is the best technique the nurse could use to teach the child about what to expect? A) dolls B) games C) coloring D) demonstration
A) dolls
To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups? A) Provide guidance regarding proper nutrition. B) Teach injury prevention and proper safety practices. C) Help integrate exercise practices and programs into the lifestyles of individuals and communities. D) Advocate for more research into control of environmental toxins.
B) Teach injury prevention and proper safety practices.
The nurse is working in a pediatric facility whose mission statement strongly emphasizes providing family-centered care. What nursing intervention best exemplifies this facility's belief? A) The nurse asks the child to describe his relationship with his parents. B) The nurse questions the competency of care provided by a single father to his child. C) The nurse plans a meeting with the parents, child, and case worker to discuss care alternatives for the child. D) The nurse assesses the interaction between a child and his parents when the parents visit.
C) The nurse plans a meeting with the parents, child, and case worker to discuss care alternatives for the child.
A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3750 g) at birth. Weight now is 20 pounds 8 ounces (9300 g). The nurse determines: A) the weight assessment is blatantly inaccurate. B) the child weighs more than expected for age. C) the child weighs less than expected for age. D) the child weighs the expected amount for age.
C) the child weighs less than expected for age.
The parent of a 3-month-old infant is concerned because the infant does not yet sit by oneself. Which statement best reflects average sitting ability? A) Sitting ability and the age of first tooth eruption are correlated. B) Most infants sit steadily at 3 months; this infant is slightly delayed. C) Most infants sit steadily at 4 months; this infant is normal. D) Most infants do not sit steadily until 8 months; this infant is normal.
D) Most infants do not sit steadily until 8 months; this infant is normal.
The nurse is reviewing vital signs taken by the unlicensed assistive personnel on a group of toddlers. Which warrants follow up by the nurse? A) Heart rate 105 beats/min, respiratory rate 25 breaths/min B) Heart rate 120 beats/min, respiratory rate 30 breaths/min C) Heart rate 100 beats/min, respiratory rate 27 breaths/min D) Heart rate 60 beats/min, respiratory rate 40 breaths/min
D) Heart rate 60 beats/min, respiratory rate 40 breaths/min
The nurse is caring for a 8-year-old client scheduled for a computed tomography (CT) scan. The client is anxious about the procedure. Which action by the nurse is appropriate? A) Teach the client about the procedure using dolls and toys. B) Have another child who has had a CT tell the client about the procedure. C) Show the client a video about the procedure. D) Take the child to see the CT equipment and answer any questions.
D) Take the child to see the CT equipment and answer any questions.
When planning how to respond to a 3-year-old child about telling stories ("tall tales"), the nurse would base the statement on the fact that: A) preschoolers have a limited vocabulary. B) a preschooler is in an insecure period. C) a 3-year-old knows the word two but not the concept of two. D) imagination in a 3-year-old is at its peak.
D) imagination in a 3-year-old is at its peak.
