Pediatrics Exam 1 - S1

A nurse is attempting to get a 5-year-old child's cooperation when auscultating heart sounds. Which of the following comments is most likely to elicit the child's cooperation?

"Would you like to listen to the sounds your heart makes?"

A 21 month old boy was 21inches long at birth. If they stayed on the same percentile for length, their current height would be <blank1> inches?

35.4 inches or 90 cm

The nurse is preparing to ambulate an 11-year-old child who has had an appendectomy. In addition to pharmacologic pain management, the nurse can use which nonpharmacologic pain management strategy for this client? A pillow to splint the incisional area

A pillow to splint the incisional area

The parents of a 2½-year-old are concerned about their child's finicky eating habits. While counseling the parents, the nurse would accurately make which statements? Select all that apply. A. "The child is experiencing physiologic anorexia which is normal for this age group." B. "Breastfeeding must be discontinued by the second birthday." C. "It is more appropriate to assess a toddler's nutritional demands over a one-week period rather than over a twenty-four hour period." D. Nutritious foods should be made available at all times of the day so that the child is able to 'graze' whenever he is hungry." E. The toddler should drink as much milk as they wish since this is a good source of iron."

A. "The child is experiencing physiologic anorexia which is normal for this age group." C. "It is more appropriate to assess a toddler's nutritional demands over a one-week period rather than over a twenty-four hour period."

The nurse is explaining growth and development to a family who recently adopted a child. Which of the following is an example of development? A. 7 month old pulls to a standing position B. 2 lower teeth appear in an 8 month old infant C. The birth weight of an infant doubles by 6 months of age D. A child uses words instead of crying to communicate needs

A. 7 month old pulls to a standing position

A 4 month old infant is admitted to the nursing unit with moderate dehydration. Which of the following symptoms does the nurse recognize as consistent with this diagnosis? Select all that apply. A. Elevated heart rate B. Urine specific gravity of 1.038 (less than 1.010 normal for infants) C. Weight gain D. Polyuria E. Slow capillary refill

A. Elevated heart rate B. Urine specific gravity of 1.038 (less than 1.010 normal for infants) E. Slow capillary refill

While teaching a 10-year-old child about their impending heart surgery, the nurse should A. Explain the surgery using a model of the heart B. Provide a verbal explanation just prior to the surgery C. Introduce the child to another child who had heart surgery three days ago D. Provide the child with a booklet to read about the surgery

A. Explain the surgery using a model of the heart

The nurse is assessing a four-month-old infant. The nurse would anticipate finding that the infant would be able to A. Hold a rattle B. Bang two blocks C. Move the small toy from one hand to another D. Wave "bye-bye"

A. Hold a rattle

Which is appropriate language development for an 8 month old? This child should be: A. Saying "dada" to father and "mama" to mother B. Saying three other words besides "mama" and "dada" C. Saying "dada" and "mama" nonspecifically D. Saying "ball" when parents point to a ball

A. Saying "dada" to father and "mama" to mother

The nurse is admitting an 8-year-old child who hit a parked car while riding a bike. The child has a fracture of the left radius and femur in addition to a fractured orbit. The child is stoic, won't speak with the nurse, and will not tell his family how much pain he has. The most appropriate action by the nurse is to:

Administer pain medication based on the injuries and understanding the child's demeanor.

After reading the vaccine information sheets, the parent of a 2 month old infant is hesitant to consent to the recommended vaccinations. The nurse should first ask the parent: A. "Did you know that vaccinations are required by law for school entry?" B. "What concerns do you have about vaccinations?" C. "Would you prefer that fewer vaccinations are given at a time?" D. "Can you please sign this vaccine waiver form?"

B. "What concerns do you have about vaccinations?"

The nurse assesses a 6-month old for vaccination readiness. Which finding would most likely indicate the need to delay administering the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine? A. A family history of sudden infant death syndrome (SIDS) B. A fever of 38.5 degrees C (101.3 F) following the 4 month vaccinations C. An acute bilateral ear infection D. Living with a family member who is immunosuppressed.

B. A fever of 38.5 degrees C (101.3 F) following the 4 month vaccinations

The nurse is planning care for an 18 month-old child. Which of the following should be included in the child's care? A. Hold and cuddle the child often B. Encourage the child to feed himself finger food C. Allow the child to walk independently on the nursing unit D. Engage the child in games with other children

B. Encourage the child to feed himself finger food

Which of the following best describes the development of a school-age child. Select all that apply. A. Death has yet no meaning B. Same-sex peers are more important than family C. School-age children are concerned about how they appear to others D. Children enjoys playing board games and sports E. Causes of injuries include bicycle crashes, head injuries, and sprains

B. Same-sex peers are more important than family D. Children enjoys playing board games and sports E. Causes of injuries include bicycle crashes, head injuries, and sprains

A nurse is evaluating the developmental level of a two (2)-year-old. Which of the following does the nurse expect to observe in this child? A. Uses a fork to eat B. Uses a cup to drink C. Uses a knife for cutting food D. Pours own milk into a cup

B. Uses a cup to drink

A clinic nurse assesses the communication patterns of a five (5)-month-old infant. The nurse determines that the infant is demonstrating the highest level of developmental achievement expected if the infant: A. Uses simple words such as "mama" B. Uses monosyllabic babbling C. Links syllables together D. Coos when comforted

B. Uses monosyllabic babbling

The parent of a 6-month old reports starting 2% milk. The nurse should first ask the parent: A. "Do you think your baby will be fine with milk?" B. "Is it possible for you to switch your baby to whole milk?" C. "Can you tell me more about the reason you switched your baby to 2% milk?" D. "You cannot switch to 2% milk right now. Did your pediatrician tell you to do this?"

C. "Can you tell me more about the reason you switched your baby to 2% milk?"

The parents of a 3 week old healthy newborn ask the nurse why their child is intermittently cross-eyed. The nurse's best response is: A. "An eye patch may be necessary for 6 weeks to correct your child's vision" B. "Your child will likely need an ophthalmology consult" C. "It is normal to have eye-crossing in the newborn period" D. "Surgery may be necessary to correct your child's vision"

C. "It is normal to have eye-crossing in the newborn period"

Which statement by a parent reflects the need for further teaching regarding car seat safety? A. "My baby should stay in a rear-facing car seat until he is 1 year old" B. "I should check my old car seat's expiration date before using it for this baby" C. "My older child will need to stay in a booster seat until he is 4 feet 9 inches" D. "My children should ride in the back seat until they are 13 years old"

C. "My older child will need to stay in a booster seat until he is 4 feet 9 inches"

The nurse notes that an infant stares at an object placed in his hand and takes it to his mouth, coos and gurgles when talked to, and sustains part of his own weight when held in a standing position. The nurse correctly interprets these findings as characteristic of an infant at which age? A. 2 months B. 4 months C. 7 months D. 9 months

C. 7 months

The nurse is preparing to care for a toddler who is admitted due to fever, diarrhea, and vomiting. The doctor diagnosed the child with acute gastroenteritis. Which interventions are appropriate for the child? Select all that apply. A. Limit parental presence to promote faster recovery B. Inform the child of his scheduled ultrasound on day 5 of his hospitalization C. Allow to bring his favorite pillow or provide activity e.g., blowing bubbles D. Allow the child to hold the thermometer before getting the temperature E. Provide an option between fruit cups and jellies for dessert.

C. Allow to bring his favorite pillow or provide activity e.g., blowing bubbles D. Allow the child to hold the thermometer before getting the temperature E. Provide an option between fruit cups and jellies for dessert.

While giving nursing care to a hospitalized adolescent, the nurse should be aware that the major threat felt by the hospitalized adolescent is A. Fear of the unknown B. Loss of bodily control C. Altered body image D. Separation from family

C. Altered body image

Kelly, a first-time mother, went to the community clinic and asked the nurse what kind of toy would be most appropriate for her 15th-month-old child? A. Knitting knits B. Board games C. Ball Popper Toys D. Checkers

C. Ball Popper Toys

A parent brings a 4-month old to the clinic for a regular well visit and expresses concern that the infant is not developing appropriately. Which finding in the infant would indicate the need for further developmental screening? A. Has no interest in peekaboo B. Does not turn front to back C. Does not babble D. Sits unsupported

C. Does not babble

To assess the development of a 1 month old, the nurse asks the parent if the infant is able to: A. Smile and laugh out lout B. Roll from back to side C. Hold a rattle briefly D. Lift head from prone position

C. Hold a rattle briefly

The nurse is speaking with the mother of a 13-year-old girl who is concerned because her daughter has gained 10 lbs since she began puberty. The child's mother asks the nurse for advice about what to do about her daughter's weight gain. Which of the following should the nurse do? A. Provide the child's mother with some pamphlets on nutrition and healthy eating. B. Provide the child's mother with information about a new exercise program for teens. C. Inform the child's mother that it is common for teen girls to gain weight during puberty. D. Inform the child's mother that her daughter will likely gain another 5 to 10 lbs in the next year.

C. Inform the child's mother that it is common for teen girls to gain weight during puberty.

The nurse is teaching the parents of an 8 month old about what the child should eat. This nurse should include which information points in the teaching plan? A. Vegetables should be introduced before fruits B. Solid foods should not be introduced until the infant is 10 months old C. Iron-fortified cereals should not be introduced until the infant is 8 months old D. The infant's diet can be changed from formula to whole milk when the infant is 12 months old

C. Iron-fortified cereals should not be introduced until the infant is 8 months old D. The infant's diet can be changed from formula to whole milk when the infant is 12 months old

Which of the following is the most appropriate activity for a 5-year-old child? A. Squeeze toy B. Board games C. Play-Doh D. Computer games

C. Play-Doh

One of the participants attending a parenting class asks the teacher "What is the leading cause of death during the first month of life? A. Bacterial sepsis B. Respiratory distress of newborn C. SIDS D. Neonatal hemorrhage

C. SIDS

The nurse is assessing a six-month-old child. Which developmental skills are normal and should be expected? A. Pulling up to a standing position B. Can feed self with a spoon C. Sits alone D. Speaks in short sentences

C. Sits alone

A 10 month old looks for objects that have been removed from his view. The nurse should instruct the parents that: A. Neuromuscular development enables the child to reach out and grasp objects B. The child's curiosity has increased C. The child understands the permanence of objects even though the child cannot see them D. The child is now able to transfer objects from hand to hand

C. The child understands the permanence of objects even though the child cannot see them

The nurse is observing children playing in the hospital playroom. She would expect to see 5-year-old children playing: A. Building a tower out of blocks B. With their own toys alongside with other children C. Alone with handheld computer games D. Cooperatively with other preschoolers

D. Cooperatively with other preschoolers

The parents of a 9 month old bring the infant to the clinic for a regular checkup. The infant has received no immunizations. Which vaccine if prescribed would the nurse question? A. DTaP B. Haemophilus influenza type B (Hib) C. Measles, mumps and rubella (MMR) D. Inactivated influenza (Flu)

D. Inactivated influenza (Flu)

The nurse should refer the parents of an 8 month old child to a healthcare provider if the child is unable to: A. Stand momentarily without holding onto furniture B. Stand unsupported well for long periods of time C. Stoop to recover an object D. Sit without support for long periods of time

D. Sit without support for long periods of time

The nurse caring for a hospitalized adolescent can best meet the adolescent's developmental needs by:

Explaining procedures and including the adolescent in decision making

The nurse is caring for a 12 year old child who injured his leg in a backyard football game. He is currently complaining of mild pain at the site and has received oral pain medication. What is the most appropriate complementary therapy for pain management for this child?

Teach guided imagery

The nurse is explaining growth and development to a family who recently adopted a child. Which of the following is an example of development? a. A 7 month old pulls to a standing position b. 2 lower teeth appear in an 8 month old infant c. The birth weight of an infant doubles by 6 month of age d. A Child uses words instead of crying to communicate needs

a. A 7 month old pulls to a standing position d. A Child uses words instead of crying to communicate needs

The nurse has a patient assignment that includes patients from a variety of cultures. Which of the following areas may differ from one culture to another? (Select all that apply) a. Hand gestures b. Intelligence c. Use of alternative therapies d. Religious beliefs e. Time orientation f. Nutrition

a. Hand gestures c. Use of alternative therapies d. Religious beliefs e. Time orientation f. Nutrition

The nurse is teaching a mother who plans to discontinue breast-feeding after 5 months. The nurse should advise her to include which of the following to replace the breast milk in her infant's diet? a. Iron fortified formula b. Baby food c. Whole milk d. 2% milk

a. Iron fortified formula

The nurse is providing teaching to a parent regarding car seat safety for their infant. Which of the following instructions should the nurse include in the discussion? a. Place the infant car seat rear facing in the back seat of the car b. Move the car seat to the forward facing position when the child reaches 1 year of age c. Keep the child in a booster seat until the child is at least 12 months of age. d. Tighten the straps of the seat so that only an adult fist fits under the straps.

a. Place the infant car seat rear facing in the back seat of the car

The nurse is planning care for a 4-year-old girl who has sickle cell disease. If the plan is based on the concept of family-centered care, which of the following factors should the nurse consider? Select all that apply. a. The grandparents' interest in homeopathic medicine b. The child's opinions about the process of care delivery c. The child's responsibilities as they relate to care delivery Child can't be responsible for their own care d. Effect of the child's chronic illness on her siblings e. Provisions for 24-hhour parental visiting

a. The grandparents' interest in homeopathic medicine b. The child's opinions about the process of care delivery d. Effect of the child's chronic illness on her siblings e. Provisions for 24-hhour parental visiting

The nurse notes that a 5-month-old has significant head lag when she attempts to pull the infant to a sitting position. What does the nurse recognize based on this assessment of the infant? a. The infant needs further assessment and evaluation. b. The infant has some degree of mental retardation. c. The infant has been neglected by the parents. d. The infant is developing normally.

a. The infant needs further assessment and evaluation.

The nurse is teaching the parents of a young child how to handle poisoning. If the child ingests poison, what should the parents do first? a. Administer syrup of ipecac to induce gastric emptying b. Call 911 c. Call the poison control center d. Punish the child for misbehavior

c. Call the poison control center

The nurse is using family-centered care principles for a family with complex healthcare needs. Which of the following are the most important principles to implement? a. Independence b. Supervision c. Empowerment d. Teaching

c. Empowerment

The nurse is caring for a two year old in isolation. Which of these toys would be appropriate for you to choose from the playroom for this aged child? a. Mobile b. Nesting cups c. Toy vacuum cleaner d. Playhouse

c. Toy vacuum cleaner

The nurse is preparing to care for a 5-year-old who has been placed in traction following a fracture of the femur. The nurse plans care, knowing that which of the following is the most appropriate activity for this child?

crayons and coloring books

Which of the following outcomes of family-centered care is most illustrative of the concept? a. The child is viewed as the most important family member b. All family members enjoy unlimited visiting ours c. Health professionals implement a sensitive plan of care for the child and family d. The nurse and parents mutually develop strategies of care

d. The nurse and parents mutually develop strategies of care

The nurse caring for a 15 month old child is assessing for post op pain. The 15 month old will not cooperate with any subjective pain measures. Which of the following findings is an objective measure that the child is experiencing pain?

increased heart rate

Which structure should be closed by the time the child is 2 months old? Anterior fontanel posterior fontanel

posterior fontanel