PEDS 4434 Quiz 1
The parents of a 5-year-old have just found out that their child has head lice. Which statement by the parents would support the nursing diagnosis of deficient knowledge? A) "I can't believe it. We're not unclean, poor people." B) "We'll have to get that special shampoo." C) "Everybody in the house will need to be checked." D) "That explains his complaints of itching on his neck."
A) "I can't believe it. We're not unclean, poor people." Head lice is not an indication of poor hygiene or poverty. Ch 37
A teenager tells the nurse that she is being abused by her boyfriend but she doesn't want her parents to know because they won't let her see him any longer. What is the BEST response by the nurse? A) "I understand your fear, but I am obligated to be sure your parents know you are in danger. Would you like for us to talk to them together?" B) "Ok I won't tell them this time but if it happens again I will have to tell them." C) "It is important to be open with your parents. Are you sure you don't want to tell them?" D) "I don't know why you would want to see an abusive boyfriend but if you don't want to share it with your parents then we won't."
A) "I understand your fear, but I am obligated to be sure your parents know you are in danger. Would you like for us to talk to them together?" The most empathetic & informative response is recognizing the teen's fear. This response establishes trust by letting the client know what the nurse's responsibility is while also offering support by talking to the parents w/ the teen. Responding that the nurse won't inform the parents this time is incorrect b/c the nurse is legally bound to notify the parents if the child is in danger. Ch ?
During a health check-up without his parents, a 17-year-old tells the nurse he is gay. Which of the following approaches should the nurse take? A) "Tell me what makes you think you are gay." B) "This puts you in an at-risk category." C) "We need to talk about safe sex." D) "You're not gay; you're confused."
A) "Tell me what makes you think you are gay." The nurse needs to get more info from the teen (assessment) b/f making any comment & then proceed in a sensitive & caring way. Comments about being at risk or needing to know about safe sex are negative & should be replaced w/ health promotion comments. Denying the statement shows the teen that you are not an ally. Ch 29
The nurse educator is preparing a lecture for a group of students about the possible client indicators of poor health literacy. Which student statements would indicate the teaching was successful? Select all that apply A) "They frequently have missed appointments." B) "They don't ask questions because they don't care." C) "Clients will have difficulty filling out registration forms." D) "They do not hear what they are being told." E) "There is a pattern of lack of follow up with treatments." F) "There is a pattern of history of medication errors."
A) "They frequently have missed appointments." C) "Clients will have difficulty filling out registration forms." E) "There is a pattern of lack of follow up with treatments." F) "There is a pattern of history of medication errors." Ch ?
The school nurse providing school health screenings knows that the 7- to 11-year-old is in Piaget's stage of concrete operational thoughts. Which of the following should this age group accomplish when developing operations? Select all answers that apply. A) Ability to assimilate and coordinate information about the world from different dimensions B) Ability to see things from another person's point of view and think through an action C) Ability to use stored memories of past experiences to evaluate and interpret present situations D) Ability to think about a problem from all points of view, ranking the possible solutions while solving the problem E) Ability to think outside of the present and incorporate into thinking concepts that do exist as well as concepts that might exist F) Ability to understand the principle of conservation—that matter does not change when its form changes
A) Ability to assimilate and coordinate information about the world from different dimensions B) Ability to see things from another person's point of view and think through an action C) Ability to use stored memories of past experiences to evaluate and interpret present situations F) Ability to understand the principle of conservation—that matter does not change when its form changes COME BACK TO THIS Ch 28
The nurse is providing anticipatory guidance to the mother of a 9-month-old girl during a well-baby visit. Which of the following topics would be most appropriate? A) Advising how to create a toddler-safe home B) Warning about small objects left on the floor C) Cautioning about putting the baby in a walker D) Telling about safety procedures during baths
A) Advising how to create a toddler-safe home Advising how to create a toddler-safe home is important bc the child will very soon be pulling herself up to standing & cruising the house. This will give her access to areas yet explored. Warning about small objects left on the floor, telling about safety procedures during baths, & cautioning about using the baby walker would no longer be anticipatory guidance as the child has passed these stages. Ch 25
During a physical assessment of a 5-month-old child, the nurse observes the first tooth has just erupted and uses the opportunity to advise the mother to schedule a dental examination for her baby. Which of the following is the correct time for the dentist visit? A) By the first birthday B) By the second birthday C) By entry into kindergarten D) By entry into first grade
A) By the first birthday The American Academy of Pediatric Dentistry recommends that a dentist examine the infant by his 1st birthday. Besides assessing routine oral health care, establishing a dental contact by the 1st birthday provides a resource for emergency dental care if it is needed. Ch 31
The nurse is caring for a 5-year-old girl post-tonsillectomy. The girl looks out the window and tells the nurse that it is raining and says, "The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process? A) Magical thinking B) Centration C) Transduction D) Animism
A) Magical thinking Magical thinking is a normal part of preschool development. The preschool-age child believes her thoughts to be all-powerful. Transduction is reasoning by viewing one situation as the basis for another situation whether or not they are truly causally linked. Animism is attributing life-like qualities to inanimate objects. Centration is focusing on one aspect of a situation while neglecting others. Ch 27
The nurse is caring for a 7-year-old girl hospitalized in isolation. The nurse notices that she has begun sucking her thumb and changing her speech patterns to those of a toddler. What condition is the girl manifesting? A) Regression B) Suppression C) Repression D) Denial
A) Regression Sucking the thumb & changing speech pattern (baby talk) are signs of regression, a defense mechanism used to deal w/ unpleasant experiences by returning to a previous more comfortable stage. Suppression is a conscious inhibition of idea or desire. Repression is an unconscious inhibition of idea or desire. Denial is exhibited by expressions of resignation instead of true contentment. Ch 33
The school nurse is helping parents choose books for their preschoolers. What literacy skills present in the preschooler would the nurse consider when making choices? Select all answers that apply. A) Preschoolers enjoy books with pictures that tell stories. B) Preschoolers like stories with repeated phrases as they help keep their attention. C) Preschoolers like stories that describe experiences different from their own. D) Preschoolers demonstrate early literacy skills by reciting stories or portions of books. E) Preschoolers may retell the story from the book, pretend to read books, and ask questions about the story. F) Preschoolers do not have enough focus and expanded attention to notice when a page is skipped during reading.
A) Preschoolers enjoy books with pictures that tell stories. B) Preschoolers like stories with repeated phrases as they help keep their attention. D) Preschoolers demonstrate early literacy skills by reciting stories or portions of books. E) Preschoolers may retell the story from the book, pretend to read books, and ask questions about the story. COME BACK TO THIS Ch 27
The nurse is preparing a hospitalized 7-year-old girl for a lumbar puncture. Which of the following actions would help reduce her stress related to the procedure? Select all answers that apply. A) Pretend to perform the procedure on her doll. B) Explain the procedure to her in medical terms. C) Do not allow her to see or touch the equipment. D) Teach her the steps of the procedure. E) Tell her not to pay attention to any sounds she might hear. F) Introduce her to the health care personnel.
A) Pretend to perform the procedure on her doll. D) Teach her the steps of the procedure. F) Introduce her to the health care personnel. Ch 33
A new parent group inquires about the stages through which their children will progress as they grow older. The nurse is discussing Piaget's developmental stages. In what order would you expect the child to progress through Piaget's stages of development? A) Sensorimotor B) Preoperational C) Concrete operational D) Formal operational
A) Sensorimotor B) Preoperational C) Concrete operational D) Formal operational
While in the pediatrician's office for their child's 12-month well-child exam, the parents ask the nurse for advice on age appropriate toys for their child. Based on the child's developmental level, the nurse should suggest which types of toys? Select ALL that apply. A) Soft toys that can be manipulated B) Small toys that can pop apart and go back together C) Jack in the box D) Toys with black and white patterns E) Push and pull toys
A) Soft toys that can be manipulated C) Jack in the box E) Push and pull toys
The school nurse is conducting a seminar for parents of adolescents on how to communicate with teenagers. Which of the following guidelines might the nurse recommend? Select all answers that apply. A) Talk face to face and be aware of body language. B) Ask questions to see why he or she feels that way. C) Do not give praise unless the adolescent deserves it. D) Speak to your child as an authority figure, not an equal. E) Don't admit that you make mistakes. F) Don't pretend you know all the answers.
A) Talk face to face and be aware of body language. B) Ask questions to see why he or she feels that way. F) Don't pretend you know all the answers. COME BACK Ch 29
The nurse knows that the school-age child is in Erikson's stage of industry versus inferiority. Which of the following is the best example of a school-ager working toward accomplishing this developmental task? A) The child signs up for after-school activities. B) The child performs his bedtime preparations autonomously. C) The child becomes aware of the opposite sex. D) The child is developing a conscience.
A) The child signs up for after-school activities. Erickson describes the task of the school-age years to be sense of INDUSTRY vs. INFERIORITY. During this time the child is developing his sense of self-worth by becoming involved in multiple activities at home, school , & in the community, which develops his cognitive & social skills. Achieving independence is a task of the preschooler who also in developing a conscience at that age. Awareness of the opposite sex occurs in, but is not the focus of, the school-age child. Ch 28
A 12-year-old girl is experiencing prepubescence, and tells the school nurse that she feels "very out of place" in her school. What would be acceptable responses by the nurse? Select all that apply. A)"It must be difficult for you. Why don't you sit down and we can talk about it." B)"I would suggest that you talk to your parents about your feelings. This isn't something that I can talk to you about." C)"All of the girls and boys will be going through the same thing as you so that should make you feel a little better." D)"Tell me how this makes you feel. Talking about your feelings may help you feel better about school." E)"I went through the same thing when I was in school. I know it doesn't feel like it now but I promise it will get easier."
A)"It must be difficult for you. Why don't you sit down and we can talk about it." D)"Tell me how this makes you feel. Talking about your feelings may help you feel better about school." Prepubescence typically occurs in the 2 years before the beginning of puberty and is characterized by the development of secondary sexual characteristics, a period of rapid growth for girls, and a period of continued growth for boys. Acknowledging the student's feelings and encouraging her to talk about her feelings will likely help her to feel better about herself. She may not be comfortable with talking about her feelings with her parents at this point, and the nurse discussing this topic with the student is acceptable. Telling her that everyone goes through it and that it will "get easier" does not address the student's feelings and is nontherapeutic communication.
Which of the following would the nurse include when teaching an adolescent about tinea pedis? A) "Keep your feet moist and open to the air as much as possible." B) "Dry the area between your toes really well." C) "Wear nylon or synthetic socks every day." D) "Go barefoot when you are in the locker room at school."
B) "Dry the area between your toes really well." Keeping the feet clean & dry is key for the child w/ tinea pedis. This includes rinsing the feet w/ H2O or H2O & vinegar mixture & drying them, esp. b/t the toes. The adolescent should wear cotton sock & shoes that allow the feet to breathe. Going barefoot at home is allowed, but the adolescent should wear flip-flops around swimming pools & locker rooms. Ch 45
The nurse is teaching the parents of a 12-year-old boy about appropriate approaches when raising an adolescent. Which of the following comments should be included in the discussion? A) "Find out if his friends are worthy of him." B) "Try to be open to his views." C) "Maintain a firm set of rules." D) "Remind him that he is still your little boy."
B) "Try to be open to his views." Being open to his views will encourage the child to consider parental concerns & promote communication. Ch 29
For which of the following children would the nurse conduct an immediate comprehensive health history? A) A child who is brought to the emergency room with lacerations B) A child who is a new client in a pediatric office C) A child who is a routine client and presents with signs of a sinus infection D) A child whose condition is improving
B) A child who is a new client in a pediatric office The purpose of examination will determine how comprehensive the hx must be. Comprehensive hx's needed for new child in pediatric office or hospital, if physician rarely sees child or child is critically ill. Ch 32
The nurse observes an infant interacting with his parents. Which of the following are normal social behavioral developments for this age group? Select all answers that apply. A) Around 5 months the infant may develop stranger anxiety. B) Around 2 months the infant exhibits a first real smile. C) Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. D) Around 3 months the infant will mimic the parent's facial movements, such as sticking out the tongue. E) Around 3 to 6 months of age the infant may enjoy socially interactive games such as patty-cake and peek-a-boo. F) Separation anxiety may also start in the last few months of infancy.
B) Around 2 months the infant exhibits a first real smile. C) Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. D) Around 3 months the infant will mimic the parent's facial movements, such as sticking out the tongue. F) Separation anxiety may also start in the last few months of infancy. Stranger anxiety develops around 8 months. At 6-8 months the infant may enjoy socially interactive games such as patty-cake and peek-a-boo. Ch 25
The nurse is examining a 12-month-old who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with bright red scaly plaques and small papules. Satellite lesions are also present. This is most likely caused by which of the following? A) Impetigo (Staph) B) Candida albicans (yeast) C) Urine and feces D) Infrequent diapering
B) Candida albicans (yeast)
The nurse is teaching the parents of a 2-year-old toddler methods of dealing with their child's "negativism." Based on Erickson's theory of development, which of the following would be an appropriate intervention for this child? A) Discourage solitary play; encourage playing with other children. B) Encourage the child to pick out his own clothes. C) Use "time-outs" whenever the child says "no" inappropriately. D) Encourage the child to take turns when playing games.
B) Encourage the child to pick out his own clothes. Erickson defines the toddler period as time of AUTONOMY vs. SHAME & DOUBT. It is a time of exerting independence. Allowing child to choose own clothing helps him to assert independence. Negativism = always saying no & is normal healthy development as toddler is trying is assert independence & should not be punished w/ "time-outs". Toddler should be encouraged to play alone & w/ other children. Turn-taking in games happens at age 3 yrs. Ch 26
The nurse is preparing for a public health campaign with a focus on current trends with family-centered care. What information would the nurse include in the presentation? Select all that apply
B) Family-centered care promotes greater family decision-making abilities C) Family-centered care requires sensitivity to the client's and family's beliefs E) The client's family is considered in health care to be an expert partnership
The pediatric nurse is aware of the maturation of organ systems in the school-age child. Which of the following accurately describe these changes? Select all answers that apply. A) The brain grows very slowly during the school-age years and growth is complete by the time the child is 12 years of age. B) Respiratory rates decrease, abdominal breathing disappears, and respirations become diaphragmatic in nature. C) The school-age child's blood pressure increases and the pulse rate decreases, and the heart grows more slowly during the middle years. D) The school-age child experiences more gastrointestinal upsets compared with earlier years since the stomach capacity increases. E) Bladder capacity increases, but varies among individual children, and girls generally have a greater bladder capacity than boys. F) Prepubescence typically occurs in the 2 years before the beginning of puberty and is characterized by the development of secondary sexual characteristics.
B) Respiratory rates decrease, abdominal breathing disappears, and respirations become diaphragmatic in nature. C) The school-age child's blood pressure increases and the pulse rate decreases, and the heart grows more slowly during the middle years. E) Bladder capacity increases, but varies among individual children, and girls generally have a greater bladder capacity than boys. F) Prepubescence typically occurs in the 2 years before the beginning of puberty and is characterized by the development of secondary sexual characteristics. COME BACK TO THIS Ch 28
When the nurse is assessing a child's pain, which of the following is most important? A) Obtaining a pain rating from the child with each assessment B) Using the same tool to assess the child's pain each time C) Documenting the child's pain assessment D) Asking the parents about the child's pain tolerance
B) Using the same tool to assess the child's pain each time Although obtaining a pain rating, documenting the assessment, & asking the child's parents about the pain are important , the MOST important aspect of pain assessment is to use the same tool each time so that appropriate comparisons can be made & effective interventions can be planned & implemented. Consistency allows the most accurate assessment of the child's pain. Ch 36
The nurse is collecting information from the parents of a 3-year-old child about her sleeping patterns. Which question by the nurse will best elicit information from the parents? A) "What time does you child go to bed at night?" B) "How are things going at home?" C) "How many hours does your child sleep at night?" D) "Is your child sleeping well?"
C) "How many hours does your child sleep at night?" Asking an open-ended question will provide the most opportunity for data to be collected from parents. Asking how things are going at home is vague & may or may not give the needed information. Asking when the child goes to bed is a broad question that may not provide the needed information about the quality of sleep being achieved by the child each night. Ch ?
When describing the various changes that occur in organ systems during adolescence, which of the following would the nurse include? A) Significant increase in brain size B) Ossification completed later in girls C) Decrease in heart rate D) Decrease in activity of sebaceous glands
C) Decrease in heart rate During adolescence, the heart rate decreases while the systolic blood pressure increases. Brain growth, but size of the brain does not increase significantly. Ossification is more advanced in girls & occurs at an earlier age. Sebaceous gland activity increases during adolescence. Ch 29
Put the following nursing assessments of a toddler in the best order for the nurse to proceed: A) Examination of the eyes, ears, and throat B) Auscultation of chest C) Developmental assessment D) Palpation of abdomen
C) Developmental assessment B) Auscultation of chest D) Palpation of abdomen A) Examination of the eyes, ears, and throat Perform assessment in a head-to-toe manner leaving the most traumatic procedures until last.
The nurse is caring for children in a physician's office where health supervision is practiced. Which of the following is a key focus of health supervision? Select all answers that apply. A) Making referrals for all health care needs B) Monitoring disease incidence C) Optimizing level of functioning D) Monitoring quality of care provided E) Teaching parents to prevent injury F) Providing care developed from national guidelines
C) Optimizing level of functioning E) Teaching parents to prevent injury F) Providing care developed from national guidelines COME BACK Ch 31
The nurse is providing anticipatory guidance to a mother to help promote healthy sleep for her 3-week old baby. Which of the following recommended guidelines might be included in the teaching plan? A) Place the baby on a soft mattress with a firm flat pillow for the head. B) Place the head of the bed near the window to provide fresh air, weather permitting. C) Place the baby on his or her back when sleeping. D) If the baby sleeps through the night, wake him or her up for the night feeding.
C) Place the baby on his or her back when sleeping. COME BACK TO THIS Ch 25
The nurse is performing a physical examination on a 9-year-old boy who has experienced a tick bite on his lower leg and is suspected of having Lyme disease. Which assessment finding would the nurse expect to find? A) Swelling in the neck B) Confusion and anxiety C) Ring-like rash on lower leg D) Hypersalivation
C) Ring-like rash on lower leg A ring-like rash at site of tick bite is characteristic for Lyme disease. Swelling in the neck is a symptom of mumps. Confusion, anxiety, and hypersalivation are symptoms of rabies. Ch 37
The nurse is providing teaching about car safety to the parents of a 5-year-old girl who weighs 45 pounds. What should the nurse instruct the parents to do? A) "Place her in a booster seat with lap and shoulder belts in the front seat." B) "Place her in the back seat with the lap and shoulder belts in place." C) "Place her in a forward-facing car seat with a harness and top tether." D) "Place her in a booster seat with lap and shoulder belts in the back seat."
D) "Place her in a booster seat with lap and shoulder belts in the back seat." A child who weighs between 40-80 lbs. should ride in a booster seat that utilizes both the lap & shoulder belts in the back seat. When a child is large enough to sit up straight w/ knees bent at front edge of seat, then he may sit directly on the seat of car w/ lap/shoulder belt securely & appropriately attached. The back seat of car is safest place for a child to ride. A forward-facing car seat w/ harness & top tether for a preschooler who weighs less than 40 lbs. Ch 27
The nurse is assessing the heart rate of a healthy school-age child. The nurse expects that the child's heart rate will be in which of the following ranges? A) 80 to 150 bpm B) 70 to 120 bpm C) 65 to 110 bpm D) 60 to 100 bpm
D) 60 to 100 bpm School-age = 60-100 bpm Infant = 90-160 bpm Toddler/Preschooler = 80-115 bpm Ch 32
The adolescent continues to develop self-concept and self-esteem. Which of the following is most important to a teen's self-esteem? A) Strong authority figures B) Spirituality C) Morals and values D) Body image
D) Body image COME BACK Ch 29
The nurse is caring for a child who has been admitted for a sickle cell crisis. Which of the following would the nurse do first to provide adequate pain management? A) Administer a nonsteroidal anti-inflammatory drug as ordered. B) Use guided imagery and therapeutic touch. C) Administer meperidine as ordered. D) Initiate pain assessment with a standardized pain scale.
D) Initiate pain assessment with a standardized pain scale. The nurse should first initiate pain assessment w/ a standardized pain scale upon admission & provide frequent evaluations of pain. Administering NSAIDS or meperidine & use of nonpharmacologic pain management techniques are all appropriate. However, the FIRST action is to assess the child's pain to provide a baseline for future comparison. Ch 46
A mother and her 4-week-old infant have arrived for a health maintenance visit. Which of the following activities will the nurse perform? A) Assess the child for an upper respiratory infection B) Take a health history for a minor injury C) Administer a varicella injection D) Plot the child's head circumference on a growth chart
D) Plot the child's head circumference on a growth chart The nurse will plot the head circumference as part of developmental surveillance & screening. Assessing for an infection & taking a health hx for an injury are not part of a HEALTH MAINTENANCE visit. Administering a vaccination for varicella would not occur until 12 months of age. Ch 31
The nurse caring for a child on a pediatric intensive care unit notices that when the parents go to work the child is very angry and cries easily. What does the nurse suspect is occurring with this client? A) Despair phase of separation anxiety B) Detachment phase of separation anxiety C) Normal reaction to separation from parents D) Protest phase of separation anxiety
D) Protest phase of separation anxiety The first phase of separation anxiety, PROTEST, occurs when the child is separated from parents or primary caretaker. This phase may last from a few hrs. to several days & is characterized by crying, expressing agitation, rejecting others who attempt to offer comfort, anger, & inconsolable grief.
The parents of an 8-year-old boy are interested in promoting learning through reading to their son. Which of the following suggestions by the nurse would best promote this goal? A) Have the parents choose what he should read initially. B) Tell the child to read instead of watching TV with his parents. C) Tell the parents that reading is for the child to do by himself. D) Take the child to the library to check out some books.
D) Take the child to the library to check out some books. Ch 28
A nurse is assessing the fontanels of a crying newborn and notes that the posterior fontanel pulsates and briefly bulges. What do these findings indicate? A) Increased intracranial pressure B) Overhydration C) Dehydration D) These are normal findings.
D) These are normal findings. It is common to see the fontanel pulsate or briefly bulge is a baby cries. Overhydration or increased intracranial pressure would cause persistent bulging. Dehydration would cause the fontanel to be sunken. Ch 32
The nurse is performing a physical examination on a sleeping newborn. Which of the following body systems should the nurse examine last? A) Heart B) Abdomen C) Lungs D) Throat
D) Throat If an infant is asleep the nurse should auscultate the heart lungs & abdomen first while the baby is quiet. Perform assessment in a head-to-toe manner leaving the most traumatic procedures until last. Ch 32
