Peds 1

A nurse is teaching parents about growth and development in preadolescent girls, and a mother asks at what age her daughter will have her first period. What is the most accurate response by the nurse? 1 Before the pubic hair appears 2 At the end of the growth spurt 3 Near the age when their mothers did 4 Around the time when the breasts develop

2

A nurse is obtaining the health history of a 5-year-old child who has been admitted to the child health unit with acute glomerulonephritis. What does the nurse expect the child's mother to report? 1 The child had a sore throat a few weeks ago. 2 The child has just recovered from the measles. 3 The child's father has a family history of urinary tract infections. 4 The child's immunizations were administered at the start of school.

1

A nurse is assessing a 10-year-old child admitted to the pediatric unit with acute poststreptococcal glomerulonephritis (APSGN). What specific signs and symptoms does the nurse expect? Select all that apply. 1 Anorexia 2 Glycosuria 3 Hypotension 4 Periorbital edema 5 Increased creatinine level

1,4,5

Which roommate should the nurse manager assign to a 4-year-old boy who has been admitted to the pediatric unit with nephrotic syndrome? 1 3-year-old boy with impetigo 2 2-year-old boy with pneumonia 3 5-year-old girl with thalassemia 4 4-year-old girl with conjunctivitis

3

A 4-year-old child with nephrotic syndrome has repeated relapses. As the child gets older, what is the most important attribute for the child to develop? 1 A positive body image 2 The ability to test urine 3 Fine muscle coordination 4 Acceptance of possible sterility

1

Severe hypertension develops in a child with acute glomerulonephritis. What medication does the nurse anticipate that the healthcare provider will prescribe? 1 Digoxin 2 Diazepam 3 Captopril 4 Phenytoin

3

A nurse is caring for a child with the diagnosis of lead poisoning. For which problem should the nurse assess the child initially? 1 Constipation resulting from the excretion of lead 2 Neurologic injury caused by the ingestion of lead 3 Delayed development resulting from parental neglect 4 Inadequate nutrition resulting from decreased iron intake

2

Which should the nurse teach to a preschool-age client to avoid the risk of altered growth and development? 1 Trust 2 Empathy 3 Impulse control 4 Problem solving

3

A nurse is assessing a 3-year-old child with a tentative diagnosis of lead poisoning. What clinical finding supports this diagnosis? 1 Epistaxis 2 Clumsiness 3 Excessive salivation 4 Decreased pulse rate

2

A nurse is assessing the condition of a school-aged child with acute glomerulonephritis. What clinical finding does the nurse anticipate? 1 Ketonuria 2 Periorbital edema 3 Increased appetite 4 Decreased blood pressure

2

A nurse is teaching a class about child abuse. What defense mechanism most often used by the physically abusive individual should the nurse include? 1 Repression 2 Manipulation 3 Transference 4 Displacement

4

A parent brings a 2-month-old infant with Down syndrome to the pediatric clinic for a physical and administration of immunizations. Which clinical finding should prompt the nurse to perform further assessment? 1. Flat occiput 2 Small, low-set ears 3 Circumoral cyanosis 4 Protruding furrowed tongue

3

A 4-year-old child with nephrotic syndrome is being treated with corticosteroid therapy. While evaluating lab values and the intake and output results, the nurse expects to note a decrease in what? 1 Polyuria 2 Hematuria 3 Glycosuria 4 Proteinuria

4

A nurse on the pediatric unit is admitting an adolescent child with acute glomerulonephritis (AGN). What is the priority nursing intervention? 1 Assessing the child for dysuria 2 Inspecting the child for jaundice 3 Monitoring the child for hypertension 4 Testing the child's vomitus for occult blood

3

Hypertension develops in a school-aged child with acute glomerulonephritis. What medication does the nurse anticipate that the healthcare provider will prescribe? 1 Digoxin 2 Furosemide 3 Diazepam 4 Phenytoin

2

Monitoring vital signs, particularly the blood pressure and the rate and quality of the pulse, is essential in detecting physiologic adaptations in a preschool child with nephrotic syndrome. Which clinical manifestation should the nurse be able to detect from these vital signs? 1 Heart failure 2 Hypovolemia 3 Pulmonary embolus 4 Increased serum potassium

2

A 12-year-old boy with nephrotic syndrome is in remission for several months. One day the mother calls the clinic to report that for the past week her child's skin has a pale, muddy appearance; his appetite is poor; and he has been unusually tired after school. In light of the mother's description, what does the nurse suspect? 1 Impending renal failure 2 Excessive activity at school 3 Development of a viral infection 4 Nonadherence to the medication protocol

1

Which teratogens affecting fetal growth and development should the nurse include in a teaching session for pregnant clients? Select all that apply. 1 Rubella 2 Varicella 3 Swordfish 4 Phenytoin 5 Acetaminophen

1,2,3,4

When teaching the parents of a toddler-age client about normal growth and development, which statements should the nurse include in the teaching session regarding learning through the senses? Select all that apply. 1 "The toddler often puts new objects in the mouth." 2 "The toddler may inspect a new toy by turning it over." 3 "The toddler will touch a new object only once during exploration." 4 "The toddler will shake a new toy when it is first introduced to the play area." 5 "The toddler rarely uses the sense of smell to learn about something new introduced within the environment."

1,2,4

Which are clinical manifestations the nurse would anticipate when providing care to a toddler-age client who is diagnosed with acute lead poisoning? Select all that apply. 1 Emesis 2 Nausea 3 Diarrhea 4 Anorexia 5 Hypophosphatemia

1,2,4,5

A nurse is working with children who have been sexually abused by a family member. What overwhelming feelings do these children usually express? Select all that apply. 1 Guilt 2 Anger 3 Revenge 4 Disbelief 5 Self-blame

1,2,5

A 3-year-old child with nephrotic syndrome has been receiving prednisone for 1 week. The nurse reviews the child's progress record and determines that the medication has been effective. What information supports this conclusion? Select all that apply. 1 Weight loss 2 Lower blood pH 3 Decreased lethargy 4 Increased urine output 5 Decreased blood pressure

1,3,4

A 6-year-old child is hospitalized with nephrotic syndrome. The mother asks the nurse what she may bring for her child to play with during the hospitalization. In light of the child's age, what should the nurse suggest? Select all that apply. 1 Checkers 2 Wooden puzzles 3 Paper and crayons 4 Simple card games 5 CDs and a CD player

1,3,4

Which nursing interventions are appropriate while caring for a preschooler exposed to lead poisoning? Select all that apply. 1 Administering the local anesthetic procaine 2 Educating parents to use hot water for cooking 3 Preventing further exposure of the child to lead 4 Identifying the sources of lead in the environment 5 Administering chelating agents into a small muscle mass

1,3,4

Arrange in order the events that occur when a nurse provides emergency treatment to a preschooler who is a victim of poisoning. 1. Assesses the victim 2. Identifies the poison 3. Prevents poison absorption 4. Terminates poison exposure

1,4,2,3

The nurse is caring for a child diagnosed with acute aspirin poisoning. Which statements does the nurse know to be true regarding aspirin poisoning? Select all that apply. 1 Chronic aspirin poisoning is often mistaken for viral illness. 2 Acute ingestion of aspirin is always more serious than chronic ingestion. 3 Peritoneal dialysis is used in the treatment of severe cases of aspirin poisoning. 4 Acute ingestion of aspirin causes severe toxicity when the dosage is 200 to 250 mg/kg 5 Chronic ingestion of aspirin occurs when an amount greater than 100 mg/kg per day is ingested for more than 2 days.

1,5

Which is the priority nursing action to facilitate growth and development when providing care to a pediatric client who is diagnosed with a chronic illness? 1Monitoring growth patterns and plotting on the growth chart 2Teaching the client and family how the illness affects physical growth 3Assessing stage of development frequently and documenting it in the medical record 4Planning activities to promote progression from one stage of development to the next

4

A nurse reviews with the parents of a young infant the principles of growth and development. Place the milestones in the order of their usual achievement. 1. Waves bye-bye and sits alone Incorrect 2. Climbs stairs and drinks from a cup Incorrect 3. Draws a vertical line and walks on tiptoe Incorrect 4. Walks alone and builds a tower of two blocks Incorrect 5. Sits momentarily without support and rolls over

5,1,4,2,3

When assessing the growth and development of children, the nurse uses a specific sequence of gross motor milestones. Place these milestones in order, from the one first performed at the youngest age to the one that is performed last at the oldest age. 1. Balancing on one foot 2.Hopping 3.Skipping 4.Jumping 5.Running

5,4,1,2,3

A child says, "My doll is tired after playing for a long time, and she is resting now." Which characteristic is the child demonstrating? 1 Animism 2 Seriation 3 Egocentrism 4 Object permanence

1

A 4-year-old abused child, after being hospitalized for severe injuries, is placed in temporary foster care. The foster family comes to the hospital to meet the child. What action should the nurse take to facilitate their first meeting? 1 Decorating the child's room with "Welcome" signs 2 Providing the child and foster family with a private room 3 Encouraging the child to draw a picture of the foster family 4 Answering the child's questions and adding details before the meeting

2

A mother takes her 4-year-old child to the playground. The child becomes aggressive and refuses to play or interact with other children. What is the temperament of the child according to the longitudinal study of psychiatrists Stella Chess and Alexander Thomas? 1 The easy child 2 The difficult child 3 The hyperactive child 4 The slow to warm-up child

2

The nurse is providing care to a toddler-age client who is admitted to the medical unit with symptoms of lead poisoning. Which assessment question will help the nurse determine the source of the lead? 1 What year was your home built?" 2 "Do you have plants in your home?" 3 Does your child consume fish in the diet?" 4 Where do you store your cleaning solutions?"

1

Which theory helps pediatric nurses to design appropriate therapeutic play interventions for ill toddlers? 1 Grand theories 2 Peplau's theory 3 Descriptive theories 4 Interdisciplinary theory

4

Which type of play should the nurse encourage when providing age-appropriate care to a preschool-age child who is hospitalized? 1 Team 2 Parallel 3 Solitary 4 Associative

4

A nurse is teaching a class on immunizations to members of a grammar school's Parent-Teacher Association. Which childhood disease does the nurse describe as a viral disease that starts with malaise and a highly pruritic rash that begins on the abdomen and spreads to the face and proximal extremities and can result in grave complications? 1. Rubella 2. Rubeola 3. Chickenpox 4. Scarlet fever

3

A 6-year-old child treated for acute glomerulonephritis has improved and is soon to be discharged. What should the nurse plan to offer the parents in preparation for the discharge? 1 Samples of no-salt-added diets for the child to continue at home 2 Suggestions about activities to keep the child mobile for longer periods 3 Instructions about when the child should return for a workup for a kidney transplant 4 Phone numbers to reach the nurse on the unit so the parents may call if there are any questions

1

The nurse is preparing to conduct a growth and developmental assessment for an infant. What is the correct order of steps the nurse should use during the assessment process? 1.Auscultation 2.Palpation 3.Inspect the mouth 4. Elicit the Moro reflex

1,2,3,4

A child with nephrotic syndrome visits the clinic for follow-up. During the visit the parent states that the child is always tired and has no appetite. The nurse notes that the child has a muddy, pale complexion. What problem does the nurse suspect? 1 Impending renal failure 2 Being too active in school 3 A developing viral infection 4 Refusal of the prescribed medications

1

Which are general growth parameters for an adolescent client that the nurse will monitor during a growth and development assessment during a health maintenance visit? Select all that apply. 1 Height 2 Weight 3 Body mass 4 Blood pressure 5 Head circumference

1,2,3

A nurse is assessing a school-aged child with a tentative diagnosis of nephrotic syndrome. What clinical finding supports this diagnosis versus a diagnosis of acute glomerulonephritis? 1 Lethargy 2 Anasarca 3 Proteinuria 4 Hypertension

2

A nurse is assessing a toddler with the diagnosis of lead poisoning. What is the most harmful adverse effect that the nurse anticipates? 1 Inadequate nutrition 2 Delayed development 3 Anemia and constipation 4 Renal and skeletal damage

2

Which nursing action should be included in the plan of care for a child with acute poststreptococcal glomerulonephritis? 1 Encouraging fluids 2 Monitoring for seizures 3 Measuring abdominal girth 4 Checking for pupillary reactions

2

Which of these age groups has the highest incidence of lead poisoning? 1 Adult 2 Toddler 3 Adolescent 4 School-age child

2

Which age group does the nurse observe engaging in parallel play? 1 Infants 2 Toddlers 3 Adolescents 4 Preschoolers

2

A 3-year-old child is hospitalized with nephrotic syndrome. The child has oliguria and generalized edema. What factor does the nurse identify that will have the greatest effect on the child's adjustment to hospitalization? 1 Lack of parental visits 2 Inability to select a variety of foods 3 Response of peers to the edematous appearance 4 Willingness to participate in cooperative play activities

1

The nursing student accompanies a group of registered nurses in a campaign that promotes the participation of parents to get their children immunized. After the campaign's completion, the group prepares a report that counts the number of immunizations and compares it to last year's report. Which type of research does the nursing student think that the group is doing? 1. Evaluation research 2. Descriptive research 3. Experimental research 4. Correlational research

1

What action should the nurse take if abuse of a 10-year-old child is suspected? 1 Report the suspicion to local authorities. 2 Elicit more information from the parents. 3 Refer the parents to a group therapy meeting. 4 Notify the healthcare provider of the suspicion

1

Which fears related to growth and development should the nurse plan for when providing care to a hospitalized pediatric client? Select all that apply. 1 Having limited independence 2 Being separated from family 3 Falling behind on school work 4 Receiving investigational treatment 5 Being in an unfamiliar environment

1,2,4,5

Which information related to school-age play should the nurse include in a teaching session for parents of children in this stage of development? Select all that apply. 1 Team play 2 Card games 3 Parallel play 4 Board games 5 Club membership

1,2,4,5

Which growth and developmental assessments should the nurse include when conducting a health maintenance visit for a 15-month-old toddler? Select all that apply. 1 Weight 2 Heart rate 3 Blood pressure 4 Head circumference 5 Developmental screening

1,4

A nurse discusses dietary instructions with the parents of a toddler with acute glomerulonephritis. What nutrients does the nurse list that are restricted? Select all that apply. 1 Fats 2 Sodium 3 Glucose 4 Potassium 5 Lipids

2,4

A 4-year-old child is receiving prednisone. Which immunizations are safe for the child to receive? Select all that apply. 1. Rubeola 2 Pertussis 3 Varicella 4 Inactivated poliovirus 5 Tetanus immune globulin

2,4,5

A 10-year-old child with acute glomerulonephritis (AGN) is selecting foods for dinner from a menu. Which foods should the nurse encourage? 1 Baked potato, meatloaf, banana, and pretzels 2 Baked ham, bread and butter, peaches, and milk 3 Corn on the cob, baked chicken, rice, apple, and milk 4 Hot dog on a bun, potato chips, dill pickle slices, and brownie

3

A nurse is assessing a toddler with plumbism (lead poisoning). Which organ system is of most concern because of the condition's irreversible effects? 1 Urinary 2 Skeletal 3 Nervous 4 Hematologic

3

A nurse is caring for a child with a tentative diagnosis of acute poststreptococcal glomerulonephritis (APSGN). What test does the nurse expect to be used to confirm the diagnosis? 1 Renal biopsy 2 Pharyngeal culture 3 Antistreptolysin O titer 4 Urinary tract sonogram

3

A nurse is caring for a school-aged child with nephrotic syndrome who has massive edema. The nurse teaches the parents about the low-sodium diet that has been ordered. Which food group has the lowest level of sodium compared with the other food groups? 1 Meat 2 Dairy 3 Fresh fruit 4 Fresh vegetables

3

A 2-year-old child is admitted with multiple fractures and bruises, and abuse is suspected. Which nursing assessment findings support this suspicion? Select all that apply. 1 Bedwetting 2 Thumb-sucking 3 Difficulty consoling 4 Underdevelopment for age 5 Demands for physical closeness

3,4

A nurse is caring for an 8-year-old child with acute poststreptococcal glomerulonephritis (APSGN). What medications does the nurse expect the practitioner to prescribe? Select all that apply. 1 Penicillin 2 Morphine 3 Furosemide 4 Labetalol 5 Phenobarbital

3,4

What does the nurse explain are the effects of lead poisoning in a preschooler? Select all that apply. 1 Amblyopia 2 Strabismus 3 Brain damage 4 Hepatic steatosis 5 Growth retardation

3,5

The parents of a child with acute poststreptococcal glomerulonephritis tell the nurse that they are concerned about activity restrictions after discharge. How should the nurse respond? 1 Activity must be limited for 1 month. 2 The child should not play active games. 3 The child must remain in bed for 2 weeks. 4 Activity does not affect the course of the illness

4

The nurse assesses the growth and development of a 12-month-old infant and compares the results with the previous assessment findings. Which finding indicates an abnormality in the neonate? 1 Height 2 Weight 3 Head circumference 4 Chest circumference

4 42 to 43

Which combination of foods should the nurse encourage a child with glomerulonephritis to choose for a meal? 1 Corn, roast chicken, peach 2 Tuna salad, cheese melt, milk 3 Hamburger, baked potato, banana 4 Bologna sandwich, salad, vanilla malted

1

A 1-year-old infant is brought to the well-baby clinic. Which toys should the nurse select from the play area for this infant's growth and developmental level? Select all that apply. 1 Push-pull toy 2 Nested boxes 3 Rocking horse 4 Four-piece puzzle 5 Squeaking plastic toy

1,2,5

A 6-year-old child is in the acute phase of nephrotic syndrome. The mother asks the nurse about play activities for her child. What should the nurse suggest? Select all that apply. 1 Hula hoop 2 Video games 3 Large puzzles 4 Stuffed animal 5 Children's books

2,5

What is the most important nursing intervention for a 3-year-old child with a diagnosis of nephrotic syndrome? 1 Regulating diet 2 Encouraging fluids 3 Preventing infection 4 Maintaining bed rest

3

Which description by the nurse is true about the play of preschoolers? Select all that apply. 1 Preschoolers hinder play of other children. 2 Preschoolers follow set rules while playing. 3 Preschoolers pretend to play different roles. 4 Preschoolers get engaged in associative play. 5 Preschoolers need a temporary leader to play.

3,4,5

The primary nurse calls the pediatric nurse practitioner to examine the genital area of a 5-year-old girl in whom sexual abuse by her father is suspected. How can the primary nurse be most supportive to the child? 1 By describing the procedure and staying with the child during the examination 2 By explaining that the nurse wants to see if there is "anything wrong down there" 3 By asking whether she prefers the nurse or the mother to stay with her during the examination 4 By helping the mother explain the examination and the findings in terms that the child will

1

The urinary output of a 9-year-old child with acute glomerulonephritis decreases to 250 mL/24 hr. A diet low in sodium and potassium is prescribed. What should the nurse encourage the child to have for lunch? 1 Baked chicken, green beans, and lemonade 2 Cream of tomato soup, salami sandwich, and cola 3 Grilled cheese sandwich, sliced tomatoes, and milk 4 Peanut butter and jelly sandwich, celery, and orangeade

1

What does the nurse identify as an early sign of chronic lead poisoning (plumbism) in school-aged children? 1 Anemia 2 Seizures 3 Cognitive impairment (CI) 4 Renal calcium dysfunction

1

What should a nurse include in the plan of care for a 9-year-old child with nephrotic syndrome? 1 Providing meticulous skin care 2 Restricting fluids to 4 oz (120 mL) each shift 3 Offering a diet low in carbohydrates and protein 4 Sending blood to the laboratory for typing and crossmatching

1

A nurse prepares a chart listing the methods of treatment of different types of poisoning in preschool children. Which preschooler's entry needs to be corrected? 1 Preschooler A 2 Preschooler B 3 Preschooler C 4 D

1 Denture cleaners/ Activated Charcoal

A nurse in the pediatric clinic is teaching the parents of a toddler how to prevent accidental poisoning. What should the nurse emphasize? 1 Importance of setting limits 2 Child's need for exploration 3 Child's need for parental approval 4 Importance of labeling medications

2

An injured child is brought to the emergency department by the parents. While interviewing the parents, the nurse begins to suspect child abuse. Which parental behaviors might support this conclusion? Select all that apply. 1 Demonstrating concern for the injured child 2 Focusing on the child's role in sustaining the injury 3 Changing the story of how the child sustained the injury 4 Asking questions about the injury and the child's prognosis 5 Giving an explanation of how the injury occurred that is not consistent with the injury

2,3,5

Which school-age developmental characteristics increases the client's risk for poisoning? Select all that apply. 1 Trying new things 2 Adhering to group rules 3 Increasing independence 4 Being easily influenced by peers 5 Having a strong allegiance to friends

2,4,5

What is the most appropriate assessment with which to detect the development of complications associated with acute glomerulonephritis (AGN) in a school-aged child? 1 Assessing the joints for stiffness daily 2 Measuring the pH of each urine specimen 3 Checking the blood pressure every 4 hours 4 Testing the urine from each voiding for glucose

3

What is the priority nursing intervention for a school-aged child with lead poisoning who is undergoing chelation therapy? 1 Scrupulous skin care 2 Provision of a high-protein diet 3 Careful monitoring of intake and output 4 Daily blood sampling for liver function tests

3

What should the nurse encourage the parents of a child with plumbism (lead poisoning) to do? 1 Discourage the child's pica by providing nutritious snacks. 2 Move the family away from areas that are next to gas stations. 3 Assess the family's home environment for lead sources and have them removed. 4 Have the child take repeat x-rays of the wrist and forearm for signs of a lead line

3

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

3

When planning nursing care for a 5-year-old child with acute poststreptococcal glomerulonephritis, what should the nurse emphasize that the child and family must maintain? 1 A bland diet high in protein 2 Bed rest lasting at least 4 weeks 3 Isolation from children with infections 4 A daily intramuscular dose of penicillin

3

A 3-year-old preschooler has been hospitalized with nephrotic syndrome. What is the best way for the nurse to evaluate fluid retention or loss? 1 Measuring the abdominal girth daily 2 Having the child urinate in a bedpan 3 Testing the child's urine for proteinuria 4 Weighing the child at the same time each day

4

A 5-year-old child is admitted to the pediatric unit with a diagnosis of acute poststreptococcal glomerulonephritis. What assessment data lead the nurse to conclude that the child has a fluid volume excess? 1 Dysuria, rash, pruritus 2 Diarrhea, polyuria, weight loss 3 Hypotension, tachycardia, proteinuria 4 Periorbital edema, smoky urine, headaches

4

A child with acute poststreptococcal glomerulonephritis requests a snack. Which is the most therapeutic selection of food the nurse can provide? 1 Peanuts 2 Pretzels 3 Bananas 4 Applesauce

4

A nurse is reviewing the immunization schedule of a 5-month-old infant. What immunizations does the nurse expect the infant to have already received? 1 Rubella, polio, tuberculosis, rotavirus, varicella, pertussis 2 Pertussis, tetanus, polio, rotavirus, pneumococcal, measles 3 Measles, mumps, rubella, rotavirus, pertussis, tuberculosis 4 Rotavirus, DTaP, Haemophilus influenzae, polio, pneumococca

4

A nurse is determining whether a 5-year-old child is displaying appropriate behaviors for this age. What developmental findings does the nurse expect? Select all that apply. 1 Enjoys imitative play 2 Engages in ritualistic games 3 Makes up rules for a new game 4 Asks for a pacifier when uncomfortable 5 Plays near others quietly but not with them

1,3

A nurse is teaching a parent about the different temperaments that a child may display. What temperament would an easy child display? Select all that apply. 1 An easy child is open and adaptable to change. 2 An easy child requires a more structured environment. 3 An easy child is regular and predictable in his or her habits. 4 An easy child displays a mild-to-moderately intense mood that is typically positive. 5 An easy child responds with mild but passive resistance to novelty or changes in routine.

1,3,4

Which warning signals should the nurse observe in a child suspected to be a victim of abuse? Select all that apply. 1 The child doesn't want to be touched by anyone. 2 The child sleeps for an average of 15 hours a day. 3 The child frequently visits the emergency department. 4 The child suffers from fever and tenderness in the abdomen. 5 The child looks at the caregiver before answering any question

1,3,5

A mother whose school-aged son has acute glomerulonephritis (AGN) is fearful that her other children may contract the disorder. What should the nurse tell the mother about the origin of acute glomerulonephritis? 1 "The disorder is difficult to prevent because the cause is unknown." 2 "It is a result of an autoimmune response after a streptococcal infection." 3 "It is transmitted through a sex-linked chromosome that occurs only in males." 4 "The disorder is caused by clot formation in the kidney tubules as a response to an infection."

2

A nurse is teaching dietary management to the parents of a toddler who is undergoing chelation therapy to treat lead poisoning. What will be included in the discussion of the dietary plan? 1 Maintaining a low-salt diet 2 Ensuring adequate fluid intake 3 Avoiding refined sugar and flour 4 Offering high-calorie, low-protein foods

2

A nurse notices that a child is playing with a doll and is practicing hygiene by brushing its hair and teeth. In which stage of Piaget's theory of cognitive development should the nurse expect this child to be considered? 1 Sensorimotor stage 2 Preoperational stage 3 Formal operations stage 4 Concrete operations stage

2

A nurse on the pediatric unit is planning recreational activities for a 4-year-old with an exacerbation of nephrotic syndrome. What are the most appropriate activities in light of the child's developmental level and physical status? 1 Riding a tricycle and playing with large blocks 2 Watching cartoon videos and listening to stories 3 Reading animal stories and playing video games 4 Leading a pull toy and playing with a map puzzle

2

A preschooler who is recently admitted to a school shows aggressive behavior towards his or her teacher. The child resists playing and interacting with other children. What is the temperament of the child according to Stella Chess and Alexander Thomas's longitudinal study? 1 The easy child 2 The difficult child 3 The hyperactive child 4 The slow to warm-up child

2

A toddler with a puncture wound to the sole is brought to the emergency department. Because of a language barrier the caregiver cannot provide a clear history of previous tetanus immunizations. Tetanus immunoglobulin (TIG) is prescribed by the healthcare provider. The nurse explains to the caregiver that this medication is given because it has what action? 1. Produces lifelong passive immunity to tetanus 2. Confers short-term passive defense against tetanus 3. Induces long-lasting active protection from tetanus 4. Stimulates the production of antibodies to fight tetanus

2

During a well-baby clinic visit the nurse assesses an 18-month-old's growth and development. What observation indicates that the toddler is within the expected range? 1 Pedals a tricycle easily 2 Climbs up several stairs 3 Says 150 different words 4 Builds a tower of eight blocks

2

The nurse is planning a presentation related to growth and development for the parents of school-age children. Which topic is most appropriate related to the topic of sexual maturation? 1 Methods to prevent pregnancy 2 Typical questions and learning needs 3 Safer sex practices to prevent infection 4 Information relayed by one parent to the child

2

The parents of a 6-year-old child tell a nurse at the pediatric clinic that their child is weak and lethargic, has headaches, has no appetite, and has dark, cloudy urine. The nurse suspects acute poststreptococcal glomerulonephritis (APSGN). What should the nurse ask the mother? 1 "Has your child lost weight recently?" 2 "Did your child have a sore throat during the past 3 weeks?" 3 "Does your child have migratory pains in the shoulders and knees?" 4 Has your child had a rash on the palms and soles in the past 2 weeks?"

2

Which statement is true regarding the importance of play for children? 1 Pretend play hampers the cognitive development of children. 2 Playing is important because it helps children to release frustration. 3 Children should be introduced to reality if they have imaginary playmates. 4 Children should completely avoid television, electronic games, and computer programs.

2

Which statement made by a pregnant client to a nurse indicates that the client does not understand the teaching regarding fetal growth and development? 1 The baby is smaller if the mother smokes." 2 The baby gets food from the amniotic fluid." 3 "The baby's oxygen is provided by the mother." 4 "The baby's umbilical cord has two arteries and one vein."

2

Which type of immunity will clients acquire through immunizations with live or killed vaccines? 1.Natural active immunity 2.Artificial active immunity 3.Natural passive immunity 4.Artificial passive immunity

2

A client with acute glomerulonephritis reports thirst. Which is the most appropriate choice that the nurse can offer to relieve the client's thirst? 1 Ginger ale 2 Milkshake 3 Hard candy 4 Cup of broth

3

At which stage of development should the nurse anticipate that pediatric clients will begin to show differences in play activities that are related to gender? 1 Preschool 2 Adolescence 3 Late school-age 4 Early school-age

3

Before discharging a 9-year-old child who is being treated for acute poststreptococcal glomerulonephritis (APSGN), what information should the nurse plan to give the parents? 1 How to obtain the vital signs daily 2 Date on which to return to prepare for renal dialysis 3 instructions about which high-sodium foods to avoid 4 List of activities that will encourage the child to remain active

3

A 6-year-old child with glomerulonephritis has a fluid restriction of 600 mL/24 hr. How can the nurse help the child cope with this limitation? 1 By withholding fluids from 7 pm to 7 am 2 By dividing fluids equally among the shifts 3 By allowing fluids as desired until the limit is reached 4 By offering fluids in medicine cups throughout the child's waking hours

4

A client has glomerulonephritis. To prevent future attacks of glomerulonephritis, the nurse planning discharge teaching includes which instruction? 1 "Restrict fluid intake." 2 Take showers instead of bubble baths." 3 Avoid situations that involve physical activity." 4 "Seek early treatment for respiratory infections."

4

A client who is suspected of having tetanus asks a nurse about immunizations against tetanus. Before responding, what should the nurse consider about the benefits of tetanus antitoxin? 1 It stimulates plasma cells directly. 2 A delayed titer of antibodies is generated. 3 It provides immediate active immunity. 4 A passive immunity is produced.

4

A father takes his two-year-old to another child's birthday party. The child resists entering into the party hall and refuses to play with the other kids. The child prefers to sit on the father's lap and watch the other children. What is the temperament of the child according to Stella Chess and Alexander Thomas's longitudinal study? 1 The easy child 2 The difficult child 3 The hyperactive child 4 The slow to warm-up child

4

A nurse in the daycare center is teaching a group of assistants why toddlers are prone to lead poisoning. What factor primarily contributes to their risk for lead poisoning? 1 Lead is easily available to children. 2 Their vascular system is very fragile. 3 Motor vehicle pollution has increased. 4 They have a high level of oral activity

4

The parents of a toddler tell the nurse the family has been living in a very old building. The nurse should carefully assess the child for the irreversible effects of possible lead poisoning by focusing on the what? 1 Urinary system 2 Skeletal system 3 Hematologic system 4 Central nervous system

4

What would the nurse describe as a similarity between the growth and development of preschoolers and that of toddlers? 1 Both need an equal amount of calories. 2 Both prefer to play with other children. 3 Both need at least 12 hours of sleep each night. 4 Both gain 5 to 7 (2.26 to 3.17 kg) pounds per year.

4

Which assessment data would cause the nurse to suspect that a toddler-age client is experiencing physical abuse? 1 Abdominal distention 2 Bloody underclothing 3 Recurrent urinary tract infections 4 Bruises in various stages of healing

4

Which is a later symptom of acute aspirin poisoning seen in children? 1 Nausea 2 Tinnitus 3 Vomiting 4 Confusion

4

Which is an inborn error of metabolism that affects growth and development? 1 Cystic fibrosis 2 Achondroplasia 3 Turner syndrome 4 Hunter syndrome

4

While discussing immunizations with the nurse, the parent of a 7-month-old boy states, "You know, my son doesn't sit up by himself yet. Shouldn't he be able to do this by now?" How should the nurse respond? 1 "He may need a little encouragement. How have you tried to help him sit up?" 2 "Most babies do sit up by this time. Have you discussed this with the pediatrician?" 3 "Don't worry that he's not sitting up yet. Some babies take longer to develop this skill." 4 "Many babies don't sit up until they're 8 months old. Let's watch what he does when I sit him up."

4

A nurse is educating the parents of a preschooler about the importance of play in the development of their child. Which statements made by a parent indicates the need for further teaching? Select all that apply. 1 "Playing helps the child to socialize with others." 2 "Pretend play helps children learn to understand others." 3 "Playing is important because it helps the child to release frustration." 4 "We should eliminate all television, electronic games, and computer programs." 5 "If the child fantasizes about imaginary playmates, we should bring him or her back to reality."

4,5

Which physical change noted by the nurse during a growth and developmental assessment for a 7-year-old client would necessitate further action? 1 Pubescent changes 2 Weight 30 kg (66 lb) 3 Eruption of central incisors 4 Height 129.5 cm (51 inches)

1

Which stage of Piaget's theory of growth and development does an infant develops an action pattern to deal with the environment? 1Sensorimotor 2Preoperational 3Formal operations 4Concrete operations

1

A child presents with symptoms of aspirin poisoning with altered mental status. Which are the appropriate treatment methods in this scenario? Select all that apply. 1 Hemodialysis is used in severe cases. 2 External cooling is used for hyperpyrexia. 3 Activated charcoal is always given as soon as possible. 4 Lavage is performed to remove concretions of acetylsalicylic acid (ASA). 5 Potassium bicarbonate transfusions are used to correct metabolic acidosis

1,2

A child presents with symptoms of iron poisoning from having ingested several chewable mineral supplement pills containing iron. Which symptoms are most likely to indicate that the poisoning has progressed to stage IV? Select all that apply. 1 Jaundice 2 Hypoglycemia 3 Hematochezia 4 Pyloric stenosis 5 Metabolic acidosis

1,2

What should a nurse incorporate into the plan of care for a school-aged child hospitalized with acute glomerulonephritis (AGN)? Select all that apply. 1 Weighing daily 2 Restricting fluids 3 Monitoring intravenous therapy 4 Instituting isolation precautions 5 Checking the blood pressure hourly

1,2

Which of the following clinical findings should the nurse expect to find during the assessment of a child with acute glomerulonephritis (AGN)? Select all that apply. 1 Flank pain 2 Periorbital edema 3 Intermittent fever 4 Increased urine volume 5 Decreased joint mobility

1,2

A nurse is reviewing the health history and laboratory report of a child with lead poisoning. What complications does the nurse expect in relation to lead toxicity? Select all that apply. 1 Anemia 2 Proteinuria 3 Heart failure 4 Encephalopathy 5 Gastrointestinal bleeding

1,2,4

According to Freud, which is a source of pleasure for a toddler-age client that the nurse should educate parents about in regards to normal growth and development? 1 Mouth 2 Anal zone 3 Sexual urges 4 Genital organs

2

In addition to hepatitis B, pneumococcal, H. influenza type B, and varicella vaccines, what should the nurse expect a 20-month-old child who has been receiving immunizations on schedule to have had? 1. Two DTaPs, two IPVs, and one MMR 2. Four DTaPs, three IPVs, and one MMR 3. Three DTaPs, two IPVs, and two MMRs 4. Three DTaPs, three IPVs, and three MMRs

2

A 2.5-year-old child is admitted for treatment of injuries supposedly sustained in a fall down a flight of stairs. Child abuse is suspected. What statements might the nurse expect from a parent who engages in child abuse? Select all that apply. 1 "Kids have to learn to be careful on the stairs." 2 "Every time I turn around the kid is falling over something." 3 "This child tends to be adventurous and doesn't understand about getting hurt on the stairs." 4 "I can't understand it. This child didn't have a problem using the stairs without my help before this." 5 "I try to keep an eye on my child, but little kids are always on the go and I just can't keep running after the kid."

2,4

Which statements should the nurse include in a teaching session for pregnant couples regarding fetal growth and development? Select all that apply. 1 "All major organs are developed and function prior to birth." 2 "Development occurs in a head-to-toe and central-to-peripheral pattern." 3 "The fetal stage of development is most vulnerable to teratogenic influences." 4 "Pregnancy includes the preembryonic, embryonic, and fetal stages of development." 5 "During pregnancy the embryo grows from a single cell to a complex physiologic being."

2,4,5

A 13-year-old girl is brought to the emergency department by her mother, who tells the nurse that she just found out that her daughter has been sexually abused by her grandfather for almost 2 years. What is the nurse's priority intervention? 1 Keeping the family unit intact 2 Validating the truth of the child's accusations 3 Providing a safe, nonjudgmental environment 4 Securing psychiatric treatment for the grandfather

3

A nurse is assessing a school-aged child who has been admitted to the pediatric unit with a diagnosis of acute glomerulonephritis. What clinical finding does the nurse expect? 1 Polyuria 2 Dehydration 3 Periorbital edema 4 Decreased blood pressure

3

A nurse is teaching staff members about the legal terminology used in child abuse. What definition of battery should the nurse include in the teaching? 1 Maligning a person's character while threatening to do bodily harm 2 A legal wrong committed by one person against property of another 3 The application of force to another person without lawful justification

3

A senior high school student, whose immunization status is current, asks the school nurse which immunizations will be included in the precollege physical. Which vaccine should the nurse tell the student to expect to receive? 1 Hepatitis C (HepC) 2 Influenza type B (HIB) 3 Measles, mumps, rubella (MMR) 4 Diphtheria, tetanus, pertussis (DTaP)

3

A young child in whom sexual abuse is suspected asks the nurse, "Did I do something bad?" What is the most therapeutic response by the nurse? 1 "Do you think you did something bad?" 2 "Who said that you did something bad?" 3 "What do you mean by something bad?" 4 "Are you worried that I think you did something bad?"

3

An 18-month-old child has received all required immunizations. What immunization should the nurse explain to a parent will be one of the vaccines required between 4 and 6 years of age? 1. Rotavirus 2. Hepatitis B 3. Inactivated poliovirus 4 Haemophilus influenzae type b

3

A child is brought in to the emergency department with acute aspirin poisoning. Which clinical manifestations indicate that the child exhibits early symptoms of aspirin poisoning? Select all that apply. 1 Hyperactivity 2 Seizures 3 Tinnitus 4 Hyperventilation 5 Respiratory failure

3,4

An 8-year-old child is admitted to the pediatric unit with nephrotic syndrome. What measures should the nurse expect to include in the plan of care for this child? Select all that apply. 1 Maintaining bed rest 2 Administering antibiotics 3 Providing symptomatic care 4 Eliminating high-sodium foods 5 Monitoring response to steroids

3,4,5

Which should the nurse anticipate for a 5-year-old client related to play? Select all that apply. 1 Solitary play 2 Parallel play 3 Dress-up play 4 Team sport play 5 Cooperative play

3,5

An 18-month-old toddler who has received the appropriate immunizations on time is visiting the pediatric clinic for the next scheduled immunization. What vaccine should the nurse administer? 1. Second hepatitis B (Hep B) vaccine 2. Fifth inactivated polio vaccine (IPV) 3. First pneumococcal vaccine (PCV) and influenza vaccine (Hib) 4. Fourth diphtheria toxoid, tetanus toxoid, and acellular pertussis (DTaP) vaccine

4

The nurse is caring for a client who has been diagnosed with glomerulonephritis. Which initial urinary finding supports this diagnosis? 1 Anuria 2 Dysuria 3 Polyuria 4 Proteinuria

4

A 5-year-old child is brought into the clinic with lethargy, abdominal ascites, and peripheral and periorbital edema. The history indicates ongoing diarrhea and decreased urine output. The child is found to have nephrotic syndrome and started on corticosteroid therapy. What does the nurse inform the parents that they can expect the child to exhibit after a week or two of medication therapy? 1 Diuresis 2 Formed stools 3 No signs of infection 4 Enhanced physical growth

1

A nurse determines that the information about falling down the stairs given by a parent suspected of child abuse contradicts the information given by the child. What should the nurse say to the parent? 1 "Tell me again how your child fell down the stairs." 2 "Your child says the stairs did not cause this injury." 3 "Did you do anything to cause this injury to your child?" 4 "Why don't you tell me what really happened to your child?"

1

A nurse is advising a parent to teach the child impulse control and cooperative behaviors to avoid the risks of altered growth and development. In which stage does the nurse teach the parent about this, according to Erikson's theory of psychosocial development? 1 Initiative versus Guilt 2 Intimacy versus Isolation 3 Autonomy versus Sense of Shame and Doubt 4 Generativity versus Self-Absorption and Stagnation

1

A nurse is caring for a preschool-aged child with a history of physical and sexual abuse. What type of therapy will be the most advantageous for this child? 1 Play 2 Group 3 Family 4 Psychodrama

1

A nurse is caring for a toddler with the diagnosis of nephrotic syndrome. What is the best indicator of kidney function in this toddler? 1 Urine output 2 Daily weights 3 Abdominal girth 4 Improved appetite

1

A nurse is reviewing the laboratory report of an adolescent child with nephrotic syndrome. What does the nurse expect analysis of the child's urine to reveal? 1 High protein level 2 Low specific gravity 3 Numerous red blood cells 4 Several crystalline particles

1

The parents of a child with acute poststreptococcal glomerulonephritis ask a nurse why their child is being weighed every morning. What is the best response by the nurse? 1 "It's the best way to measure your child's fluid balance." 2 "It provides a measure of how much protein is being lost." 3 "The disease process is usually over when weight loss stops." 4 "Plans for the daily caloric intake are made according to the daily weight change.

1

What would the nurse describe as a similarity between the growth and development of toddlers and preschoolers? 1 Both gain 5 to 7 pounds per year. 2 Both need an equal amount of calories. 3Both grow about 2.5 inches in height per year. 4 Both need at least 12 hours of sleep every night.

1

When the pediatric nurse practitioner examines the genital area of a 5-year-old child in whom sexual abuse is suspected, what is the most therapeutic action by the primary nurse? 1 Explaining the procedure and remaining with the child during the examination 2 Asking whether the child prefers the nurse or the mother to be present during the examination 3 Telling the child that the nurse practitioner wants to see whether there is "anything wrong down there" 4 Requesting that the mother explain the examination and the findings in terms that the child will understand

1

A 6-year-old child is waiting with a family member in the pediatric clinic for a well-child visit. What are the most appropriate play activities for the office nurse to offer the child? Select all that apply. 1 Coloring book 2 Small metal cars 3 Simple card game 4 Large jigsaw puzzle 5 Children's magazines

1,2,3

A nurse is caring for an 8-year-old child who has been admitted to the pediatric unit with a tentative diagnosis of acute poststreptococcal glomerulonephritis (APSGN). Diagnostic tests are ordered. Which tests will help confirm the diagnosis? Select all that apply. 1 ASO titer 2 Urinalysis 3 Blood chemistry 4 Intravenous pyelogram 5 Chest x-ray examination

1,2,3

A nurse is educating the parents of a preschooler about the importance of play in the development of their child. Which statements should the nurse include for adequate teaching? Select all that apply. 1 "Playing helps the child to socialize with others." 2 "Pretend play allows children to learn to understand others." 3 "Playing helps the child to release frustration." 4 "If the child fantasizes about imaginary playmates, introduce him or her to reality." 5 "The child should completely avoid television, video games, and computer programs."

1,2,3

A nurse is teaching a parent about the different temperaments that a child may display. What personality aspects would a difficult child display? Select all that apply. 1 A difficult child is highly active, irritable, and irregular in habits. 2 A difficult child displays an intense and primarily a negative mood. 3 A difficult child adapts slowly to new routines, people, or situations. 4 A difficult child displays a mild-to-moderately intense mood that is typically positive. 5 A difficult child responds with mild but passive resistance to novelty or changes in routine

1,2,3

Which activities should the nurse expect to see exhibited by a healthy 6-month-old infant during an evaluation of the infant's growth and development? Select all that apply. 1 Playing peek-a-boo 2 Turning completely over 3 Reaching to be picked up 4 Pulling up to a standing position 5 Sitting for a short time without support

1,2,3,5

Before administering the first series of immunizations to a 2-month-old infant, the nurse tells the parent that reactions may occur. What are the characteristics of these reactions? 1. Local or systemic and usually mild 2. Often serious, possibly requiring hospitalization 3. Sometimes causing ulceration at the injection site 4. May be responsible for permanent neurological damage

1

A nurse is providing dietary instructions to a client who is being treated with continuous ambulatory peritoneal dialysis (CAPD) for chronic glomerulonephritis. Which should the nurse include when discussing what the client needs? 1 Low-calorie foods 2 High-quality protein 3 Increased fluid intake 4 Foods rich in potassium

2

What should nursing care for a child admitted with acute glomerulonephritis be directed toward? 1 Enforcing bed rest 2 Promoting diuresis 3 Encouraging fluids 4 Removing dietary salt

2

A nurse is assessing the growth and development of a 3-year-old child. What does the nurse expect the child to be able to do? 1 Hop on one foot. 2 Button a sweater. 3 Cup the hands to catch a ball. 4 Go upstairs while alternating the feet.

4

A nurse who is caring for a 7-year-old child with acute glomerulonephritis assesses the child for cerebral complications. What signs and symptoms indicate cerebral involvement? 1 Headache, drowsiness, and vomiting 2 Generalized edema, anorexia, and restlessness 3 Anuria, temperature higher than 103° F (39.4° C), and confusion 4 Cardiac decompensation, heart rate of 114 beats/min, and vomiting

1

A school-aged child with acute glomerulonephritis has fluid intake restricted to the previous day's output plus 40 mL. The child's output over the past 24 hours was 140 mL. From 3:00 PM to 11:00 PM the child is to receive one-third of the total daily fluid permitted. How much fluid should the nurse provide for the evening intake? 1 60 mL 2 70 mL 3 80 mL 4 90mL

1

Which are sources of lead the nurse should assess for when providing care to a toddler-age client who is admitted with lead poisoning? Select all that apply. 1 Water 2 Pottery 3 Stained glass 4 Collectable toys 5 Vinyl miniblinds

1,2,4,5

A nurse is caring for a 6-year-old child who is admitted to the pediatric unit with recently diagnosed nephrotic syndrome. The parents ask the nurse why their child is retaining so much fluid. What should the nurse consider before telling the parents about the changes in body fluid distribution in language that they can understand? 1 Loss of sodium and water through an impaired basement membrane of the glomerulus results in hypovolemia. 2 Loss of body protein reduces oncotic pressure, and fluid moves from the intravascular to the interstitial space. 3 Hyperproteinemia results in increased oncotic pressure, and fluid moves from the intravascular to interstitial space. 4 Basement membranes of the glomeruli become selectively impermeable to water, and fluid is retained in the tissues.

2

A nurse is teaching a group of parents whose school-aged children have cystic fibrosis about ways to help their children achieve optimal growth and development. The nurse encourages a high-calorie diet. What other important detail of the diet should be included in the teaching? 1 Low protein 2 Moderate fat 3 High calcium 4 High potassium

2

What toys should a nurse suggest to the parent of a 4-month-old infant to help promote the child's growth and development? 1 Push-pull toys 2 Soft squeeze toys 3 Nesting blocks and cups 4 Wooden hammer and pegboard

2

A 3.5-year-old child hospitalized with nephrotic syndrome. The child has been toilet trained for longer than one year but has been incontinent while in the hospital. The child's parents express concern over this behavior. What is the most therapeutic response by the nurse? 1 "Your child is wetting the bed to get attention. Set limits when this occurs." 2 "The incontinence is caused by the renal disease. It will stop with physical improvement." 3 "This is an expected response to hospitalization. Ignore the regressive behavior and be supportive." 4 "Your child is using this regressive behavior to help cope with hospitalization; just use diapers and say nothing."

3

A 6-year-old child is admitted to the pediatric unit with a diagnosis of nephrotic syndrome. What should the plan of care include during the acute phase? 1 Offering a low-protein diet 2 Encouraging fluids every hour 3 Promoting frequent position changes 4 Providing time for active play periods

3

A father worries about the effects that an imaginary playmate will have over his 5-year-old child. What should the nurse inform the father? Select all that apply. 1 "Your child will achieve what the imaginary playmate attempts." 2 Your child will have an inferiority complex because of imaginary playmates." 3 "Imaginary playmates will confuse your child's grasp of reality." 4 "Imaginary playmates will experience what your child wants to remember." 5 "Your child's imagination of a playmate means that your child is healthy.

4,5

A child is admitted with a diagnosis of acute poststreptococcal glomerulonephritis. While performing a physical assessment and reviewing the child's laboratory reports, what clinical findings does the nurse expect? Select all that apply. 1 Hematuria 2 Proteinuria 3 Periorbital edema 4 Increased specific gravity 5 Mildly elevated blood pressure

all of them

What is true about a preschooler's imaginary playmates? 1 Imaginary playmates make the preschooler feel inferior to them. 2 Imaginary playmates attempt to achieve what the child accomplishes. 3 Imaginary playmates cause a child to confuse reality and fantasy. 4 Imaginary playmates experience what a preschooler wants to remember

4

An 8-year-old boy with asthma is being taught breathing exercises. The nurse uses several techniques in a play situation, and the child performs a repeat demonstration for the nurse. Which technique indicates that the child needs further teaching? 1 Moving a cotton ball when inhaling 2 Singing songs containing long phrases 3 Puffing through a straw to move small items 4 Blowing through a plastic pipe to make soap bubbles

1

A 9-year-old child is admitted to the pediatric unit with a diagnosis of acute glomerulonephritis. What does the nurse expect the admission urinalysis to reveal? 1 Polyuria 2 Ketonuria 3 Hematuria 4 Bacteriuria

3

A nurse educates the mother of a four-year-old child about sexual abuse. What behavioral finding explained by the nurse signifies that the child may be a victim of child abuse? 1 The child may attempt suicide. 2 The child may be verbally aggressive. 3 The child may have stress-related concerns. 4 The child may show fear of certain people or places

4

An infant has missed several well-baby visits and therefore is behind on immunizations. The parent brings the child to the clinic, asking that the child be immunized. Before administering the immunization, the nurse assesses the child and reviews the child's history and agency policy. What is the nurse's next action? 1 Administer the second in the series of three vaccines. 2 Ask the parents to come back in 24 hours for the vaccine. 3 Restart the entire immunization series with the first vaccine. 4 Avoid administering the vaccine because of the child's illness, and plan to administer the vaccine at the next scheduled visit (at 8 months of age).

1

Which growth and developmental assessments should the nurse include when conducting a health maintenance visit for a 15-month-old toddler? Select all that apply. 1 Length 2 Weight 3 Body mass index 4 Head circumference 5 Developmental screening

1,2,4

A 5-year-old-child is undergoing chemotherapy. The mother tells the nurse that the child is not up to date on the required immunizations for school. What is the best response by the nurse? 1. "By this time your child has developed sufficient antibodies to provide immunity." 2. "Maintaining current immunizations is critical. Make sure the series is completed." 3. "This isn't the best time to finish the immunizations, because your child's immune system is suppressed." 4. "It's important to complete the immunizations because your child needs to be protected from childhood diseases that could be fatal."

3

A 6-year-old child is admitted to the pediatric unit with a tentative diagnosis of acute glomerulonephritis. What does the nurse expect the laboratory report to reveal? 1 Low sedimentation rate 2 Increased serum complement 3 Increased antistreptolysin O titer 4 Decreased blood urea nitrogen level

3

The nurse instructs a pregnant client regarding fetal growth and development. Which statement indicates that the client requires further teaching? 1 "The fetus keeps growing throughout pregnancy." 2 "The fetus may be underweight if it's exposed to smoke." 3 "The fetus gets nutrients from the amniotic fluid." 4 "The fetus gets oxygen from blood in the placenta."

3

A school nurse is teaching a group of teachers' aides about the play characteristics of 5-year-old kindergartners. In what type of play do these children engage? 1 Parallel 2 Ritualistic 3 Aggressive 4 Cooperative

4

The parents of a 7-year-old child who has acute glomerulonephritis (AGN) are fearful that their other child may contract the illness. What should the nurse explain to them about the disorder? 1 The cause of acute glomerulonephritis is unknown, so it is difficult to know how to prevent it. 2 Acute glomerulonephritis is inherited as a sex-linked recessive trait that usually occurs only in males. 3 The cause of acute glomerulonephritis is the formation of a clot in the renal tubules resulting from a systemic infection. 4 Acute glomerulonephritis is caused by an antigen-antibody response that is usually associated with Streptococcus infection.

4

A 4-year-old child with nephrotic syndrome is admitted to the pediatric unit. What clinical finding does the nurse expect when assessing this child? 1 Severe lethargy 2 Dark, frothy urine 3 Chronic hypertension 4 Flushed, ruddy complexion

2

Which growth and developmental changes indicate increased maturity during the school-age stage of development? Select all that apply. 1 An increase in leg length in relation to height. 2 A decrease in head circumference in relation to standing height. 3 The face grows faster in relation to the remainder of the cranium. 4 A decrease in waist circumference in relation to standing height. 5 Little increase is seen in the size of the skull and the brain, which grow very slowly.

1,2,4

A nurse is assessing growth and development in a 6-month-old infant. What behaviors does the nurse expect the infant to demonstrate? 1 Sitting alone, displaying pincer grasp, and waving bye-bye 2 Pulling up to a standing position, releasing a toy by choice, and playing peek-a-boo 3 Crawling, transferring a toy from one hand to the other, and displaying fear of strangers 4 Turning over completely, sitting momentarily without support, and reaching to be picked up

4

A school-aged child is admitted to the pediatric unit with hypertensive acute glomerulonephritis. In addition to hydralazine, what medication does the nurse anticipate will be prescribed initially? 1 Digoxin 2 Furosemide 3 Alprazolam 4 Phenytoin

2

After reading that nutrition during pregnancy is important for optimal growth and development of the baby, a pregnant woman asks the nurse what foods she should be eating. The nurse begins the teaching/learning process by doing what? 1 Asking the client what she usually eats at each meal 2 Explaining to the client why spicy foods should be avoided 3 Instructing the client to add calories while continuing to eat a healthy diet 4 Providing the client with a list of foods for reference when planning meals

1

For which clients should the nurse measure head circumference during the growth and development assessment? Select all that apply. 1 A 2-month-old infant 2 A 3-year-old preschooler 3 A 14-year-old adolescent 4 An 18-month-old toddler 5 A 6-year-old school-age child

1,2,4

A client develops acute glomerulonephritis after a recent streptococcal infection. The nurse should expect to find which clinical manifestation during the health history and physical examination? 1 Nocturia 2 Periorbital edema 3 Increased appetite 4 Recent weight loss

2

The nurse is teaching growth and development activities to the parents of a 3-month-old infant. Which statements does the nurse include in the teaching plan? Select all that apply. 1 Your child should be able to show the grasp reflex." 2 "Your child should be able to coo, babble, and chuckle." 3 "Your child should be able to pull at blankets or clothes." 4 "Your child should be able to put the feet into the mouth when supine." 5 Your child's head can come up to a 45- to 90-degree angle from the table."

2,3,5

A nurse is teaching parents how to facilitate their 10-week-old infant's optimal growth and development. What type of age-appropriate activity should the nurse encourage? 1 Playing pat-a-cake 2 Pulling push-pull toys 3 Placing the baby in an infant seat 4 Positioning the baby in a carriage with the family

3

The nurse is teaching the Hispanic parents of a preschool child about the prevention of lead poisoning. Which statement by the parents indicates a need for further teaching? 1 "We'll use cold water to cook and drink." 2 "We know to not store food in open cans." 3 "We can use orange powders for diarrhea." 4 "We'll start planning healthy midmorning and afternoon snacks."

3

Which clinical findings indicate to the nurse that a 6-year-old child has nephrotic syndrome (NS) rather than acute glomerulonephritis (AGN)? Select all that apply. 1 Lethargic and appears unwell 2 Gross hematuria 3 Generalized edema 4 Massive proteinuria 5 Unchanged blood pressure

3,4,5

An adolescent child is admitted to a pediatric unit with the tentative diagnosis of acute poststreptococcal glomerulonephritis (APSGN). What diagnostic tests does the nurse expect will be performed to confirm this diagnosis? 1 Electrocardiogram (ECG) and heterophil antibody titer 2 Chest x-ray and blood glucose level 3 Upper gastrointestinal series and liver function tests 4 Serum complement (C3) activity level and urinalysis

4

The parent of a child who has received all of the primary immunizations asks the nurse which ones the child should receive before starting kindergarten. What immunizations does the nurse tell the parent that her child should receive? 1. IPV, HepB, Td 2. DTaP, HepB, Td 3. MMR, DTaP, Hib 4. DTaP, IPV, MMR

4

What toy should a nurse offer two 6-year-old children in the playroom? 1 Clay 2 Checkers 3 Board game 4 Building set

4

A preschooler is admitted with a diagnosis of acute glomerulonephritis. The child's history reveals a 5-lb (2.3 kg) weight gain in 1 week and periorbital edema. How can the nurse obtain the most accurate information on the status of the child's edema? 1 Weighing daily 2 Observing body changes 3 Measuring intake and output 4 Monitoring electrolyte values

1

A healthcare provider prescribes steroid therapy for a 4-year-old child who has nephrotic syndrome. What goal of this treatment does the nurse explain to the child's parents? 1 Prevents infection 2 Stimulates diuresis 3 Provides hemopoiesis 4 Reduces blood pressure

2

How should the nurse expect the urine of a child with acute glomerulonephritis with hematuria to appear? 1 Cola-colored 2 Orange 3 Bright red 4 Straw-colored

1

The mother of a preschooler with acute glomerulonephritis (AGN) asks the nurse whether her child will have to stay in bed. What does the nurse say about the need for bed rest? 1 No longer a necessary part of the treatment plan 2 Limited to 72 hours after the start of antihypertensive therapy 3 Required for 3 weeks and does not depend on the response to therapy 4 Needed until the blood pressure decreases and the hematuria has lessened

1

A 5-year-old child who is HIV positive is taken to the health department for immunizations before the start of school. The CD4 count shows severe immunosuppression. What immunizations can the child be given safely at this time? Select all that apply. 1. Varicella 2. Hepatitis A 3. Polio vaccine (IPV) 4. Measles, mumps, rubella (MMR) 5. Diphtheria, tetanus, pertussis (DTaP

2,3,5

A 5-year-old child is brought to the child health clinic for a routine visit, and the nurse observes the child interacting with other children. What type of play does the nurse expect of the child? 1 Team 2 Parallel 3 Initiative 4 Cooperative

4

A mother complains to a nurse that her three-year-old child refuses to go to play school. The child rarely interacts and avoids playing with other children. What statement should the nurse tell the mother? 1 "Do not be concerned because all toddlers behave this way." 2 "Ask the teacher to push the child to speak up and open up to the other kids." 3 "Set boundaries and supervise the child closely." 4 "Give your child time to get acquainted and warm up to the new environment."

4

A nurse explains to the parents of a toddler why 2-year-old children are at risk for lead poisoning. What major risk factor does the nurse include in the discussion? 1 Lead is readily available to them. 2 Their vascular systems are underdeveloped. 3 Motor vehicle use and pollution have increased. 4 They explore the environment by touching and tasting.

4

A school nurse is teaching high school girls regarding the importance of immunizations. Which newborn anomaly can occur if rubella is contracted during the first trimester of pregnancy? 1. Limb abnormalities 2. Hydrocephalus 3. Down syndrome 4. Cardiac anomalies

4

A 4-year-old child is being treated for nephrotic syndrome. What assessment finding indicates that the child's condition is improving? 1 The child gains weight. 2 Urine output decreases. 3 Urine specific gravity decreases. 4 The child's hemoglobin and hematocrit increase.

3

A nurse administers the first series of immunizations to a 2-month-old infant. The nurse tells the mother that if the site becomes inflamed, she should give the prescribed acetaminophen (Tylenol). What else should the nurse instruct the mother to do? 1 Place a warm compress on the area. 2 Put a witch hazel compress on the site. 3 Give a cool sponge bath for 15 minutes. 4 Apply an ice pack to the area for 2 minutes.

1

A nurse is teaching a group of parents about child abuse. What definition of assault should the nurse include in the teaching plan? 1 Assault is a threat to do bodily harm to another person. 2 Assault is a legal wrong committed by one person against the property of another. 3 Assault is a legal wrong committed against the public that is punishable by federal law. 4 Assault is the application of force to another person without lawful justification.

1

A nurse is working with a child who was physically abused by a parent. What is the most important goal for this family? 1 The child will live in a safe environment. 2 The parents will use verbal discipline effectively. 3 The family will feel comfortable in its relationship with the counselor. 4 The parents will gain an understanding of their abusive behavior patterns.

1

The 8-year-old son of migrant farm workers is brought to the county health clinic. He has no history of immunizations. After measles is diagnosed, the public health nurse goes to the migrant camp to search for people with a greater-than-average chance of contracting the disease. What is the name of this variable? 1. Risk factor 2. Frequency rate 3. Probability rate 4. Causative factor

1

The nurse is caring for a young child diagnosed with lead poisoning. Which finding indicates that the client has suffered from high-dose exposure to lead? 1 Blindness 2 Hyperactivity 3 Hearing impairment 4 Mild intellectual deficit

1

The student nurse is preparing a chart on the clinical manifestations associated with different types of poisoning in children. Which chart entry made by the student nurse indicates adequate knowledge regarding the clinical manifestations of poisoning? 1 Client A 2 Client B 3 Client C 4 Client D

1

What is the nurse's priority responsibility when abuse of an 8-year-old child is suspected? 1 Treating the child's traumatic injuries 2 Protecting the child from future abuse 3 Confirming the child's suspected abuse 4 Having the child examined by the healthcare provider

2

A 6-month-old infant is to receive scheduled immunizations. The parents ask why two influenza vaccines are given: Haemophilus influenzae type B (Hib) and pneumococcal conjugate vaccine (PCV). How should the nurse respond? 1. PCV prevents influenza. 2. Hib is given to prevent pneumonia. 3. Hib and PCV prevent different bacterial diseases. 4. PCV and Hib are given together to protect against viral and bacterial diseases

3

A nurse in the emergency department is assessing a young child with a head injury. The child is accompanied by a parent. Which observation should prompt the nurse to assess the child for abuse? 1 The child has Mongolian spots on the back. 2 The child belongs to a single-parent family. 3 The child has received care for injuries twice earlier. 4 The child and parent narrate the same story about the injury.

3

A nurse is caring for a 5-year-old child who is a victim of physical abuse. Which interventions are appropriate while talking to the child to help reveal the abuse? Select all that apply. 1 Asking about the family's social or legal problems, if any 2 Discussing the body parts using words the child will understand 3 Telling the child that it is not the child's fault and no one is going to blame the child 4 Telling the child that reporting the abuse to the nurse is the right thing to do 5 Allowing the child to talk in the presence of the family members to minimize fear

2,3,4

When a diagnosis of child abuse is established, what is the priority of nursing care? 1 Promoting bonding with the child 2 Staying with the parents while they visit 3 Protecting the total well-being of the child 4 Teaching methods of discipline to the parents

3

A nurse advises the father of a toddler to encourage pretend play in the child. What are the reasons behind this advice? Select all that apply. 1 To help improve sleeping habits 2 To help develop fine muscle skills 3 To help the child become more creative 4 To help the child develop social problem-solving skills 5 To help the child learn to understand other points of view

3,4,5

A toddler who was physically abused is admitted to the pediatric unit. What behavior does the nurse expect when approaching the child? 1 Smiling readily when anyone enters the room 2 Exhibiting fear of physical contact initiated by anyone 3 Beginning to cry when anyone approaches the bedside 4 Paying little attention to anyone standing at the bedside

2

What interventions are needed to help prevent accidental poisoning of children? Select all that apply. 1 Medicines should be referred to as candy. 2 Potent poisons should be kept out of reach of children. 3 Containers of the poisonous substances should be tightly closed. 4 Old unused and unnecessary medications should be safely disposed. 5 Medications should be transferred from their original containers to alternate ones.

2,3,4

A nurse is giving discharge instructions to the parents of an adolescent boy with nephrotic syndrome. What statement by one of the parents about the child's care indicates that more instruction is needed? 1 "Any gain in weight is expected." 2 "We'll give him prednisone with meals." 3 We'll be sure to test his urine for albumin." 4 We'll be sure to check his eyelids every morning."

1

A nurse who is teaching a growth and development class to a group of parents at the daycare center explains that the toddler strives for a sense of what? 1 Trust 2 Industry 3 Initiative 4 Autonomy

4

A 9-year-old child is found to have acute glomerulonephritis after a recent infection. What microorganism should the nurse suspect as the cause of the child's current health problem? 1 Haemophilus 2 Streptococcus 3 Pseudomonas 4 Staphylococcus

2

A nurse is teaching growth and development to a group of parents. When discussing puberty, one parent asks at what age a girl will get her first period. What is the best response by the nurse? 1 Before the pubic hair appears 2 At the end of the prepubertal growth spurt 3 Around the same time at which the breasts develop 4 Near the age at which the mother had her first period

2

A nursing instructor asks a nursing student to explain the importance of play in toddlers. Which statement by the student indicates adequate teaching? Select all that apply. 1 Toddlers have imaginations and fantasies. 2 Toddlers prefer to play beside other children. 3 Toddlers like to pretend and play different roles. 4 Toddlers prefer to stay close to parents while playing. 5 Toddlers should watch television to expand their vocabulary

2,4

A 3-year-old child is admitted to the pediatric unit with a diagnosis of nephrotic syndrome. The child has ascites, oliguria, respirations of 40 breaths/min, and a recent weight gain of 10 lb (4.5 kg). What nursing intervention may help ease the child's respiratory difficulty? 1 Providing six small meals daily 2 Maintaining a well-ventilated room 3 Ensuring bed rest in the low Fowler position 4 Administering oxygen at 2 L/min by way of nasal cannula

3

A 6-year-old boy is hospitalized with an exacerbation of nephrotic syndrome. The mother asks the nurse what she should bring for her son to play with during the hospitalization. What should the nurse suggest? 1 Plastic bat, cloth ball, and a hula hoop 2 Stuffed animals, large puzzles, and blocks 3 Checkers, simple card games, and crayons 4 Children's magazines, a model plane kit, and laptop computer

3

A 7-year-old child is brought to the emergency department with a puncture wound on the sole. It is determined that the child's history of immunizations is uncertain, and tetanus immune globulin and tetanus vaccine are prescribed and administered. What is the priority reason for using tetanus immune human globulin instead of tetanus antitoxin? 1. It is as effective as the antitoxin. 2. It is safe to give to everyone who needs it. 3. The risk for an anaphylactic reaction is less. 4. Skin tests are not needed with the human globulin.

3

A nurse needs to educate a parent about the playing behavior of preschoolers. What information should the nurse provide to the parent? 1 "Your child will avoid playing different roles." 2 "Your child will dislike having a leader for any activity." 3 "Your child will cooperate while playing with another child." 4 "Your child will often like to play with a group of 7-9 children."

3

The mother of an 8-year-old child with the diagnosis of acute poststreptococcal glomerulonephritis (APSGN) is concerned that a 4-year-old sibling may also have the disorder. What does the nurse recall when preparing to explain the cause of the disease process? 1 A systemic infection causing clots in the small renal tubules 2 A factor that is unknown and therefore is difficult to prevent 3 An immune complex disorder occurring after a group A β-hemolytic Streptococcus infection 4 An autosomal recessive trait, meaning that there is an increased probability that a sibling will also have the disease

3

The nurse is preparing a presentation related to normal growth and development at a local community center. Which statement should the nurse include in the presentation? 1 "Physical growth slows during infancy." 2 "Toddlers will begin to participate in collaborative play activities." 3 "The loss of deciduous teeth occurs during the school-age stage of development." 4 "Adolescence is known as the ugly duckling stage due to the changes associated with pubert

3

The student nurse is learning about the pathophysiology of lead poisoning in children. Where in the body does lead ultimately settle, remaining inert and in storage? 1 Liver 2 Blood 3 Bones 4 Soft tissues

3

A nurse is assessing the growth and development of a 6-month-old infant. What behavior indicates that the infant has reached the expected level of development? 1 Says "mama" 2 Crawls forward 3 Turns pages in a book 4 Holds a bottle without help

4

A nurse is caring for a 6-year-old child with a diagnosis of glomerulonephritis. The child's urine output decreases to less than 100 mL/24 hr, the creatinine clearance is 60 mL/min, and there is an irregular apical pulse. A diagnosis of acute renal failure is made. Blood is drawn for testing. Which serum level requires immediate intervention? 1 Sodium 126 mEq/L (126 mmol/L) 2 Bilirubin 0.3 mg/dL (5.1 mcmol/L) 3 Creatinine 1.3 mg/dL (114.4 mcmol/L) 4 Potassium 6.1 mEq/L (6.1 mmol/L)

4

A school nurse is teaching the parents of school-aged children about the importance of immunizations for the childhood communicable diseases. What preventable disease may have the complication of encephalitis? 1. Varicella 2. Scarlet fever 3. Poliomyelitis 4. Whooping cough

1

The nurse is providing care to a preschool-age client who is admitted to the medical unit with symptoms of lead poisoning. Which assessment question will help the nurse determine the source of the lead? 1 What year was your home built?" 2 Do you have plants in your home?" 3 "Does your child consume fish in the diet?" 4 "Where do you store your cleaning solutions?"

1

A nurse on the pediatric unit is assigned to care for a 2-year-old child with a history of physical abuse. What does the nurse expect the child to do? 1 Smile readily at anyone who enters the room. 2 Be wary of physical contact initiated by anyone. 3 Beginto scream when the nurse nears the bedside. 4 Pay little attention to the nurse standing at the bedside

2

A nurse is assessing a toddler and the dynamics of the child's family, in which abuse is suspected. What behaviors are expected? Select all that apply. 1 The child cringes when approached. 2 The parents cannot explain previously healed injuries. 3 The parents are overly affectionate toward the child. 4 The child lies still while surveying the environment. 5 The parents give detailed accounts of the child's injuries.

1,2,4

The parents of an infant ask a nurse why their baby is not receiving the measles, mumps, and rubella (MMR) vaccine at the same time that other immunizations are being given. What explanation should the nurse give about why the MMR vaccine is administered at 12 to 15 months of age? 1. There is an increased risk of side effects in infants. 2. Maternal antibodies provide immunity for about 1 year. 3. It interferes with the effectiveness of vaccines given during infancy. 4. There are rare instances of these infections occurring during the first year of life

2

A nurse counsels a child's mother about preventive measures associated with accidental poisoning. Which statement of the mother indicates effective learning? Select all that apply. 1 "I should refer to medicines as candy." 2 "I should keep potential poisons out of reach." 3 "I should not transfer the drug's contents to another container." 4 "I should not dispose of all unused and unneeded medications." 5 "I should securely seal all containers and keep them in a safe place."

2,3,5

A nurse is educating the parents of preschool-aged children about emergency treatments of poisoning. Which statement made by a parent indicates a need for further education? 1 "I will wait for expert advice to minimize the adverse effects of poisoning." 2 "I will immediately call the poison control center (PCC) in case of poisoning." 3 "I will immediately start treatment at home by using gastrointestinal decontamination." 4 "I will take my child to a healthcare facility with pediatric emergency treatment services if the type of ingested toxin is unknown."

3

If a 5½-month-old infant's immunizations are on schedule, which immunizations does the nurse expect the infant to have had already? 1 Measles, mumps, and rubella vaccine 2 Booster dose of inactivated polio vaccine 3 Two doses of diphtheria, tetanus, and pertussis vaccine 4 First booster dose of diphtheria, tetanus, and pertussis vaccine

3

The nurse is providing care to a toddler-age client who is admitted to the medical unit with symptoms of mercury poisoning. Which assessment question will help the nurse determine the source of the mercury? 1 "What year was your home built?" 2 "Do you have plants in your home?" 3 "Does your child consume fish in the diet?" 4 "Where do you store your cleaning solutions?"

3

A nurse in the pediatric clinic is caring for a child with lead poisoning (plumbism). For which associated complications should the nurse assess the child? Select all that apply. 1 Malnutrition 2 Hallucinations 3 Marked anemia 4 Kidney damage 5 Encephalopathy

3,4,5

What is the best room assignment for a 5-year-old child admitted with injuries that may be related to abuse? 1 In an isolation room 2 With a friendly older child 3 With a child of the same age 4 in a room near the nurses' desk

4

A chelating agent is prescribed for a child with lead poisoning. Because chelating agents may cause hypocalcemia, the nurse encourages the child to eat foods that are high in calcium. Which meals are good sources of calcium? Select all that apply. 1 Beef broth, glazed ham, green beans, and cookies 2 Chicken noodle soup, liver and onions, and fruit salad 3 Vegetable soup, roast beef, baked potato, and apple juice 4 Cream of mushroom soup, macaroni and cheese, broccoli, and milk 5 Pea soup, roast chicken breast, mashed potatoes, creamed spinach, and orange juice

4,5

A nurse suspects sexual child abuse in a preschooler who has come for a routine check-up. What physical findings lead to the nurse's suspicion? Select all that apply. 1 The nurse finds signs of immersion burns. 2 The nurse finds hematomas and bruises at various stages of resolution. 3 The nurse finds injuries and trauma inconsistent with reported cause. 4 The nurse finds that the preschooler has difficulty walking and sitting. 5 The nurse finds that the child has pain, itching, or unusual odor in genital area.

4,5

Two 3-year-old clients are playing together in a hospital playroom. One is working on a puzzle, and the other is stacking blocks. Which type of play are these children participating in based on this scenario? 1 Solitary play 2 Parallel play 3 Associative play 4 Cooperative play

2

Which age group would the nurse state engages in associative play? 1 Infants 2 Toddlers 3 Adolescents 4 Preschoolers

4

The nurse educates the parents of a toddler-age client regarding play and toys appropriate for this stage of development. Which parental responses indicate correct understanding of the information presented? Select all that apply. 1 "We should expect our child to participate in parallel play." 2 "We should provide our child with finger paints to foster creativity." 3 "We should allow our child to watch as much television as she wants." 4 "We should provide our child with toys that foster her imagination, such as a doll." 5 "We should provide our child with toys so that we are able to finish household chores."

1,2,4

A school nurse is teaching a group of teachers' aides about the cause of lead poisoning in children. What should be considered in terms of prevention? 1 Lead poisoning is known to be caused by the ingestion of foods that are high in fat. 2 Lead poisoning is attributed to an indigent and passive parent who fails to supervise the children. 3 Environmental factors are involved because lead is available for ingestion and inhalation. 4 Increasing milk intake will counteract the adverse effects of lead ingestion

3