Pediatric Exam 1
16.A nurse is caring for a 12-month-old toddler who is hospitalized and confined to a room with contact precautions in place. Which of the following toys should the nurse recommend in order to meet the developmental needs of the client?
!A. Large building blocks B. Hanging crib toys C. Modeling clay D. Crayons and a coloring book
92.A nurse is caring for a 6-month-old infant who has a prescription for clear liquids by mouth after a repair of an intussusception. Which of the following fluids should the nurse select for the infant?
!A. Oral electrolyte solution B. Half-strength infant formula C. Half-strength orange juice D. Sterile water
13.A nurse is caring for a client who is postoperative immediately following a tonsillectomy. Which of the following snacks should the nurse offer the client?
!A. Orange ice pop B. Hot tea C. Ice cream D. Cranberry juice
94.A nurse is reinforcing teaching about diagnostic tests with the parents of a child who has suspected cystic fibrosis. Which of the following diagnostic tests should the nurse include as the most definitive when diagnosing cystic fibrosis?
!A. Sweat chloride test B. Sputum culture C. Stool fat content analysis D. Pulmonary function test
4. A nurse is collecting data from an infant who has otitis media. The nurse should expect which of the following findings?
!A. Tugging on the affected ear lobe B. Bluish-green discharge from the ear canal C. Increase in appetite D. Erythema and edema of the affected auricle
45.A nurse is caring for an infant who is dehydrated and requires IV therapy. The nurse should monitor the infant's response to therapy by performing which of the following actions?
!A. Weighing the infant at the same time every day B. Taking the infant's vital signs every 2 hr C. Measuring the infant's head circumference twice per day D. Counting the number of wet diapers every shift
159.A nurse is caring for a 2-week old infant whose mother requests additional information about sudden infant death syndrome (SIDS). Which of the following responses should the nurse make?
!A. "You should place your baby on her back when sleeping to decrease the risk of SIDS." B. "SIDS is directly correlated to diphtheria, tetanus, and pertussis vaccines." C. "SIDS rates have been rising over the last 10 years." D. "Sleep apnea is the main cause of SIDS."
12.A parent asks a nurse about toys to provide for a 10-month-old infant. Which of the following toys should the nurse suggest?
!A. Push-pull toy B. Crib gym C. Large-piece puzzles D. Coloring book with crayons
138.A nurse is reinforcing teaching to parents of a toddler about temper tantrums. Which of the following statements should the nurse include in the teaching?
A. "You should leave the room while the tantrum is going on." !B. "Temper tantrums are the toddler's attempt to gain control of a situation." C. "You should get a psychological consult for the temper tantrums." D. "Temper tantrums are due to a type of learning disability."
155.A nurse is collecting data from an infant at a well-child visit. The nurse should expect the infant to double his birth weight by which of the following ages?
A. 3 months !B. 6 months C. 9 months D. 12 months
206.A nurse is reinforcing instructions with the parent of a toddler about foods that are included on a clear liquid diet. Which of the following foods suggested by the parent indicates understanding of the instructions?
A. Yogurt B. Pureed fruit !C. Gelatin D. Strained soup
In infants and toddlers, pull the pinna _____ and _____ to visualize the tympanic membrane
down and back
35.A nurse is planning care for a 10-year-old child who will be hospitalized for an extended period of time. Which of the following actions should the nurse include in the plan of care to meet the client's psychosocial needs according to Erikson?
!A. Arrange for a teacher to provide lesson plans. B. Allow the client to select his own food from the menu. C. Discourage visits from the client's friends. D. Provide a daily session with a play therapist.
69.A nurse is assessing the psychosocial development of a toddler. The nurse should recognize that this stage is characterized by which of the following?
A. Imaginary playmates B. Erikson's stage of initiative versus guilt C. Demonstrations of sexual curiosity !D. Negative behaviors characterized by the need for autonomy
88.A nurse is collecting data from a child who is postoperative following a tonsillectomy. Which of the following is a clinical manifestation of a hemorrhage?
A. Increased pain B. Poor fluid intake C. Drooling !D. Continuous swallowing
186.A nurse is collecting data from a 6-month-old infant in the well child clinic. Which of the following findings should the nurse expect?
A. Infant sits well without support. B. Infant's birth weight is tripled. C. Lateral incisors are present. !D. Posterior fontanel is closed.
179.A nurse is monitoring a child who is postoperative following a tonsillectomy for signs of hemorrhage. Which of the following findings is a sign of this postoperative complication?
A. Mouth breathing !B. Frequent swallowing C. Reports of thirst D. Reports of pain
30.A nurse in a PACU is admitting a client who is postoperative following a tonsillectomy. Which of the following actions should the nurse plan to take to prevent aspiration?
A. Place a bedside humidifier at the head of the client's bed. B. Suction the nasopharynx as needed. !C. Withhold fluids until the client demonstrates a gag reflex. D. Perform chest physiotherapy.
57.A nurse is assisting with a parenting class and is approached by a parent of a 2-year-old toddler who asks what to do when the toddler throws a tantrum. Which of the following instructions should the nurse give?
A. Place the child in time-out for 3 min. B. Distract the child by buying a toy. C. Calmly tell the child to stop. !D. Appear to ignore them.
38.A parent of a toddler asks a nurse at a well-child visit how the child's frequent temper tantrums can best be handled. Which of the following actions should the nurse suggest to the parent?
A. Restrain the child physically. !B. Ignore the temper tantrums. C. Tell the child that temper tantrums are not acceptable. D. Distract the child by offering to play a game.
73.A nurse has accepted a position on a pediatric unit and is learning about psychosocial development. Place Erikson's stages of psychosocial development in order from birth to adolescence. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)
2 A. Autonomy vs. shame and doubt 4 B. Industry vs. inferiority 5 C. Identity vs. role confusion 3 D. Initiative vs. guilt 1 E. Trust vs. mistrust
48.A nurse is caring for a child who is on a clear liquid diet. At lunch, the child consumed 1⁄2 cup of juice, 3 oz gelatin, 1 oz of an ice pop, and 20 mL ginger ale. How many mL should the nurse record as the child's fluid intake?
260ml
47.A nurse is reinforcing teaching with the parents of a child who has cystic fibrosis and a prescription for pancrelipase capsules. Which of the following instructions should the nurse include in the teaching?
!A. "Administer the medication with meals and snacks." B. "Tell your child to chew the capsules thoroughly." C. "Discontinue the medication when the child's symptoms resolve." D. "Observe for signs of bleeding."
111.A nurse is assisting with the admission of a 9-year-old child who has acute rheumatic fever. When obtaining the client's history, it is appropriate for the nurse to ask the parent which of the following questions?
!A. "Has your son had a sore throat recently?" B. "Was your son born with this cardiac defect?" C. "Has your child had any injuries recently?" D. "Are you aware that your son will have to be in isolation?"
43.A nurse is collecting data from a 10-year-old child during a well-child visit. Which of the following statements by the child indicates he is meeting the psychosocial development expectations of a school-age child?
!A. "I really want to do well in school." B. "I like to collect rocks." C. "My parents set rules that I need to follow." D. "I can do simple math problems in my head."
113.A nurse is teaching the mother of a 5-year-old child who has cystic fibrosis about pancreatic enzymes. The nurse should understand that further teaching is necessary when the mother makes which of the following statements?
!A. "I will give my son the enzymes between meals." B. "The enzymes probably won't cause many side effects." C. "The enzymes help him digest fat." D. "I will put the enzyme crystals in his applesauce."
A nurse is reinforcing discharge instructions with a parent of a child who has cystic fibrosis. Which of the following statements by the parent indicates an understanding of the teaching?
!A. "I will make sure my child washes her hands before eating." B. "I will restrict the amount of salt in my child's meals." C. "I will put my child in daycare to ensure that she socializes with other children." D. "I will provide low-fat meals for my child."
70.A nurse is reinforcing discharge instructions with a parent of a 6-year-old child who has just had a tonsillectomy. Which of the following statements by the parent indicates an understanding of postoperative care?
!A. "I'll call the doctor if my child is swallowing continuously." B. "It's okay for my child to have plenty of ice cream." C. "I'll help my child gargle with salt water a few times a day." D. "It's okay for my child to ride his bike in a few days."
76.A nurse is caring for a newborn whose mother voices concerns about sudden infant death syndrome (SIDS). The nurse should include which of the following statements in a discussion with the mother?
!A. "Placing your child on her back when sleeping will decrease the risk of SIDS." B. "SIDS is directly correlated with the diphtheria, tetanus, and pertussis vaccines." C. "SIDS rates have been rising over the last 10 years." D. "Sleep apnea is the main cause of SIDS."
12.A nurse is providing discharge teaching about nutrition to the parents of a child who has cystic fibrosis (CF). Which of the following responses by the parents indicates an understanding of the teaching?
!A. "We will give our child pancreatic enzymes with snacks and meals." B. "We will restrict the amount of salt in our child's food." C. "I will limit my child's fluid intake." D. "I will prepare low-fat meals with limited protein for my child."
25.A nurse is caring for an 18-month-old toddler who has been hospitalized for 10 days. After the toddler's mother leaves the room, the nurse observes the toddler sitting quietly in the corner of the crib, sucking her thumb. When the nurse approaches the crib, the toddler turns away from the nurse. The nurse should understand that these behaviors indicate which of the following developmental reactions?
!A. An anxiety reaction B. Regression C. Resentment toward the mother D. Developing autonomy
2. A nurse is assessing a toddler in the well-child clinic. At what point in the physical examination should the nurse examine the tympanic membrane?
!A. At the end B. At the beginning C. Before the head and neck are examined D. Before the chest and abdomen are auscultated
37.A nurse is caring for an 8-year-old child who has acute rheumatic fever. Which of the following assessments is the nurse's priority immediately after admission?
!A. Auscultating the rate and characteristics of the child's heart sounds B. Using a pain-rating tool to determine the severity of the joint pain C. Identifying the degree of parental anxiety related to the diagnosis D. Assessing the client's erythematous rash
17.A nurse in an emergency department is caring for an infant who has a 2-day history of vomiting and an elevated temperature. Which of the following should the nurse recognize as the most reliable indicator of fluid loss?
!A. Body weight B. Skin integrity C. Blood pressure D. Respiratory rate
28.A nurse is assessing a 6-month-old infant at a well-child visit. Which of the following findings should the nurse expect?
!A. Closed posterior fontanel B. Uses thumb and index fingers in a pincer grasp C. Lateral incisors D. Sitting steadily without support
18.A nurse is caring for a child who is 2 hr postoperative following a tonsillectomy. Which of the following fluid items should the nurse offer the child at this time?
!A. Crushed ice B. Orange juice C. Vanilla milkshake D. Cranberry juice
A nurse is caring for a toddler who has laryngotracheobronchitis and is placed in a cool mist tent. Which of the following findings should the nurse expect as a result of the treatment?
!A. Decreased stridor B. Improved hydration C. Barking cough D. Temperature stabilization
142.A nurse is caring for a 6-month-old infant who is postoperative following a myringotomy. Which of the following pain assessment scales should the nurse use to determine the infant's pain level?
!A. FLACC B. Oucher C. FACES D. Visual Analog Scale
202.A nurse is caring for a 6-month-old infant. Which of the following findings should the nurse expect?
!A. Heart rate 130/min B. Respiratory rate 18/min C. Temperature 38.2° C (100.8° F) D. SpO2 92%
232.A nurse is reinforcing teaching with new parents about risk factors for sudden infant death syndrome (SIDS). Which of the following statements by a parent indicates an understanding of the teaching?
A. "Our baby will sleep in my bed because I am breastfeeding." B. "I do not plan to offer my baby a pacifier during naps or at bedtime." !C. "My baby will be placed on her back when sleeping." D. "We will place an antique quilt in our baby's crib."
27.The father of a toddler asks a nurse at a well-child clinic what to do when his child kicks and screams during temper tantrums. Which of the following responses should the nurse make?
A. "Tell your toddler that temper tantrums are not acceptable." B. "You should punish your toddler when the tantrum stops." !C. "You should ignore your toddler's temper tantrums." D. "You should offer your child a reward if he stops the tantrum."
63.A nurse is reinforcing teaching with the parents of a school-age child who has cystic fibrosis. Which of the following statements should the nurse make?
A. "Administer a bronchodilator to the child after chest percussion therapy." B. "A pigeon-shaped chest might become evident as the disease progresses." C. "Bradycardia is an early indicator of a pneumothorax." !D. "Engage the child in daily aerobic exercise."
32.A nurse is caring for a 3-year-old client who has persistent otitis media. To help identify contributing factors, the nurse should ask the parents which of the following questions?
A. "Has your daughter been drinking 6 glasses of water a day?" !B. "Does anyone smoke in the same house as your daughter?" C. "Does your daughter get water in her ears when you bathe her?" D. "Has your daughter had a lot of earwax in her ears over the last month?"
86.A nurse is reinforcing teaching with a parent of a toddler about dealing with temper tantrums. Which of the following statements by the parent indicates an understanding of the teaching?
A. "I should turn on the television as a distractor." B. "I should limit his options until he is older." C. "I should honor his original request." !D. "I should ignore the tantrum behavior."
122.A nurse is reinforcing teaching with the mother of a child who has cystic fibrosis and is to take pancreatic enzymes three times per day. Which of the following statements indicates the mother understands the information?
A. "My child will chew the capsules." B. "My child will take the enzymes to prevent nausea." !C. "My child will take the enzymes to help digest the fat in foods." D. "My child will take the enzymes 2 hours before meals."
236.A nurse is obtaining a 4-month-old infant's vital signs. The infant's heart rate is 190/min, and her temperature is 40° C (104° F). The father asks the nurse, "Why is my baby's heart beating so fast?" Which of the following is an appropriate response by the nurse?
A. "This is within the expected range for your baby." !B. "The fever is causing an increase in your baby's heart rate." C. "As your baby begins to fall asleep, her heart rate will decrease." D. "Your baby's heart is beating fast in an attempt to cool down the body."
91.A nurse is admitting a 6-month-old infant who has dehydration. Which of the following amounts of urinary output should indicate to the nurse that the treatment has corrected the fluid imbalance?
A. 0.5 mL/kg/hr !B. 2 mL/kg/hr C. 7.5 mL/kg/hr D. 15 mL/kg/hr
75.A nurse is collecting data from an infant at a well-child visit. The nurse should understand that birth weight typically doubles by what age?
A. 3 months !B. 6 months C. 9 months D. 12 months
106.A nurse is caring for a child who has rheumatic fever. When obtaining the client's medical history from the parent, the nurse should recognize which of the following findings as significant?
A. A classmate has fifth disease. !B. A sibling had a sore throat 3 weeks ago. C. The father had gastritis 2 weeks ago. D. A neighbor's child has chickenpox.
54.A nurse is selecting a toy for a 7-month-old infant. Which of the following toys should the nurse choose?
A. A set of blocks to build a block tower B. A colorful crib mobile that plays music !C. A soft toy that squeaks or crackles when squeezed D. A wooden farm animal puzzle with large pieces
57.A nurse is preparing to measure an infant's vital signs. The nurse should use which of the following sites to assess a heart rate?
A. Carotid artery !B. Apex of the heart C. Brachial artery D. Radial artery
134.A nurse is assessing the psychosocial development of an 18-month old toddler. The nurse should recognize that this stage is characterized by which of the following behaviors?
A. Creating imaginary playmates B. Exhibiting Erikson's stage of initiative versus guilt C. Demonstrating sexual curiosity !D. Offering negative responses due to the need for autonomy
23.A nurse is caring for a toddler who has laryngotracheobronchitis. For which of the following findings should thenurse monitor to detect airway obstruction?
A. Decreased stridor B. Decreased restlessness !C. Increased heart rate D. Decreased temperature
189.A nurse is assisting with the care of a 3-month-old infant following a surgical procedure. Which of the following pain scales should the nurse use to determine the infant's pain level?
A. FACES B. Oucher !C. FLACC D. Word-Graphic Rating Scale
A nurse is caring for a school-age child who has mild persistent asthma. Which of the following is an expected finding? (Select all that apply.)
A. Symptoms are continuous throughout the day. !B. Daytime symptoms occur more than twice a week. C. Nighttime symptoms occur approximately twice a month. !D. Minor limitations occur with normal activity. !E. Peak expiratory flow (PEF) is greater than or equal to 80% of the predicted value.
53.A nurse is reinforcing teaching with the parents of an adolescent about expected development. Which of the following developmental tasks should the nurse instruct the parents to expect the adolescent to achieve?
A. Trust B. Initiative !C. Identity D. Autonomy
79.A nurse in a clinic is assessing a 7-month-old infant. Which of the following indicates a need for further evaluation?
A. Uses a unidextrous grasp B. Has a fear of strangers C. Shows preferences towards foods !D. Babbles one-syllable sounds
11.A nurse is preparing to perform an abdominal assessment on a child. Identify the sequence the nurse should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)
INSPECTION AUSCULTATION SUPERFICIAL PALPATION DEEP PALPATION