Peds Exam 2 - Ch 6, 12, 13, 14, 16, 17, 18, 32; ATI Ch 4,5,6,7

Molestation

"Indecent liberties," such as touching or fondling

The toddler years cover the period from _________ to _________ months of age.

12 to 36

2. The average annual weight gain during the preschool years is ____ to ______ kg, or _______ to ________ lb.

2 to 3 kg, 4.5 to 6.5 lb

13. The average child can be expected to have a vocabulary of more than ________ words by the age of 6 years.

2100

1. The approximate age range for the preschool period begins at age ___ years and ends at age ____ years.

3, 5

4. By _____ years of age, the child skips on alternate feet, jumps rope, and begins to skate and swim.

5

Secondary amenorrhea

6-months or more irregular menses in a previous menstruating female

44. In 2014, NHTSA made a recommendation to use the lap-shoulder seat restraint instead of the LATCH system if the child's and restraint seat's combined weight is more than _________

65 lb

Conjugate vaccine

A carrier protein with proven immunologic potential combined with a less antigenic polysaccharide antigen to enhance the type and magnitude of the immune response; Hib

1. A nurse is providing teaching about expected changes during puberty to a group of guardians of early adolescent girls. Which of the following statements by one of the guardians indicates an understanding of the teaching? A. "Girls usually stop growing about 2 years after menarche." B. "Girls are expected to gain about 65 pounds during puberty." C. "Girls experience menstruation prior to breast development." D. "Girls typically grow more than 10 inches during puberty."

A. "Girls usually stop growing about 2 years after menarche."

3. A nurse is providing education about age-appropriate activities for the caregivers of a 6-year-old child. Which of the following activities should the nurse include in teaching? A. Jumping rope B. Playing card games C. Solving jigsaw puzzles D. Joining competitive sports

A. Jumping rope

Paresthesia

Abnormal sensation such as burning or prickling

Dysfunctional uterine bleeding

Abnormal vaginal bleeding that does not have a pathogenic cause

Anesthesia

Absence of sensation

Laceration

Accidental cut, with either torn or jagged edges

Munchausen syndrome by proxy

An illness that one person fabricates or induces on behalf of the child

Benzoyl peroxide

Antibacterial agent that inhibits growth of P. acnes

Incest

Any physical sexual activity between family members

Primary dysmenorrhea

Associated with ovulatory cycles; arises from the release of prostaglandins with menses

3. A nurse is preparing an education program for a group of caregivers of preschool-age children about promoting optimum nutrition. Which of the following information should the nurse include in the teaching? A. Saturated fats should equal 20% of total daily caloric intake. B. Average calorie intake should be 1,800 calories per day. C. Daily intake of fruits and vegetables should total 2 servings. D. Healthy diets include a total of 8 g protein each day.

B. Average calorie intake should be 1,800 calories per day.

4. A nurse is teaching a course about safety during the school-age. Which of the following information should the nurse include in the course? (Select all that apply) A. Gating stairs at the top and bottom B. Wearing helmets when riding bicycles or skateboarding C. Riding safely in bed of pickup trucks D. Implementing firearm safety E. Wearing seat belts

B. Wearing helmets when riding bicycles or skateboarding D. Implementing firearm safety E. Wearing seat belts

Parasuicide

Behaviors range from gestures to attempts to kill oneself

Puberty

Biologic changes of adolescence

Open comedone

Blackhead

Universal Precautions

Blood and body fluid precautions designed to reduce the risk of transmission of bloodborne pathogens

Gynecomastia

Breast enlargement that occurs during puberty, Benign and temporary disease that occurs in about 70% of adolescent boys

Secondary lesion

Changes resulting from alteration of lesion (e.g., rubbing, scratching)

Syphilis

Characterized by a primary lesion, the chancre, which appears 14 to 21 days after infection

Prader-Willi syndrome

Characterized by hypogonadism; slow intellectual development; short stature; they lack the internal mechanism that regulates food satiety and as a result go to great lengths to obtain food

Leukorrhea

Clear to cloudy vaginal discharge

Endometriosis

Condition that may be caused by the presence of endometrial tissue outside the uterine cavity

Egocentric speech

Consists of repeating words and sounds for the pleasure of hearing oneself and is not intended to communicate

Pertussis

Cough occurs at night, and inspirations sound like crowing.

Suicide

Deliberate act of self-injury with death as a result

Suicide attempt

Deliberate but unsuccessful act of self-injury

Physical abuse

Deliberate infliction of physical injury on a child

Physical neglect

Deprivation of necessities such as food and clothing

Airborne Precautions

Designed to reduce the transmission of infectious agents that remain suspended in air or by dust particles containing the infectious agent

Thelarche

Development of breast tissue

Pubarche

Development of pubic hair

Dyscalculia

Difficulty with calculation

Dysgraphia

Difficulty with writing

Hypesthesia

Diminished sensation

Rubella

Discrete pinkish red maculopapular rash appears on face and then spreads downward to neck, arms, trunk, and legs; greatest danger is teratogenic effect on fetus.

Penetrating

Disruption of the skin that extends into the underlying tissue or into a body cavity

Incision

Division of the skin made with a sharp object

Chronic wound

Does not heal in the expected time frame and can be associated with complications

Hyperesthesia

Excessive sensitivity

Emotional neglect

Failure to meet the child's needs for affection

Child neglect

Failure to provide for the child's basic needs and adequate level of care

Avulsion

Forcible pulling out or extraction of tissue

Comedogenesis

Formation of comedones

Pubertal growth spurt

General increase in growth of the skeleton, muscles, and internal organs; reaches a peak of about 12 years of age in girls and 14 years of age in boys

Acute wound

Heals uneventfully within 2 to 3 weeks

Domestic mimicry

Imitation of household activity

Active immunity

Immune bodies are actively formed against specific antigens by having had the disease or by introducing the antigen into the individual

Preoperational thinking

Implies that children think primarily based on their own perception of an event; phase in which problem solving is based on what children see or hear directly, rather than on what they recall about objects and events

Obesity

Increase in body weight resulting from excessive accumulation of body fat relative to lean body mass

Exhibitionism

Indecent exposure

Pelvic inflammatory disease (PID)

Infection of the upper genital tract (endometrium, fallopian tubes, and ovaries), most commonly caused by sexually transmitted bacteria, such as Neisseria gonorrhoeae, Chlamydia trachomatis, and a variety of other anaerobic bacteria

Natural immunity

Innate resistance to infection

Child maltreatment

Intentional physical abuse or neglect, emotional abuse or neglect, and sexual abuse of children

Retin-A

Interrupts abnormal follicular keratinization that produces microcomedones

Standard Precautions

Interventions that synthesize the major features of Universal (blood and body fluid) Precautions and body substance isolation; involve the use of barrier protection; designed for the care of all patients to reduce the risk for transmission of microorganism from both recognized and unrecognized sources of infection

Indirect contact transmission

Involves contact of a susceptible host with a contaminated intermediate object, usually an inanimate object in the patient's environment

Direct contact transmission

Involves skin-to-skin contact and physical transfer of microorganisms to a susceptible host from an infected or colonized person

Pruritus

Itching

Gynecomastia

Male breast enlargement and tenderness

Testicular torsion

Marked by the testis hanging free from its vascular structure; results in partial or complete venous occlusion, Manifested by scrotum that is swollen, painful, red, and warm; pain radiating to groin, accompanied by nausea, vomiting, and abdominal pain; typically, an absence of fever and urinary symptoms; immediate surgery required to treat

Toxoid

Modified bacterial toxin that has been made nontoxic but retains its ability to stimulate the formation of antitoxin

Genetic endowment

Most important determinant of the onset, rate, and duration of pubertal growth

42. _________________ injuries cause a significant number of accidental deaths in all pediatric age-groups

Motor vehicle

Combination vaccine

Multiple vaccines into one parenteral form

Physiologic leukorrhea

Normal vaginal discharge

Acquired immunity

Occurs from exposure to the invading agent

Pubertal delay

Occurs when girls fail to develop breasts by age 13

Socialized speech

One of the two types of speech used by children in the toddler years; used for communication; egocentric in that children communicate about themselves to others

Menarche

Onset of menstrual periods

Dysmenorrhea

Pain during or shortly before menstruation

Dyspareunia

Painful sexual intercourse

Distribution pattern

Pattern of lesion distribution

Poliomyelitis

Permanent paralysis may occur.

Contagion suicide

Phenomenon resulting from excessive media coverage after an adolescent suicide

Parallel play

Playing alongside, not with, other children

When administering vaccines, a(n) ____________ is a condition in a person that might increase the risk for a serious adverse reaction or that might compromise the ability of the vaccine to produce immunity

Precaution

Pedophilia

Preference for a prepubertal child by an adult as a means of achieving sexual excitement

Suicidal ideation

Preoccupation with thoughts about committing suicide

Orexigenic

Produce signals that increase appetite

Anorexigenic

Produce signals that promote cessation of appetite

Priapism

Prolonged penile erection

Regeneration

Rapid replacement by similar cells

Rubeola

Rash appears 3 to 4 days after onset and maculopapular eruption on face with gradual spread downward; Koplik spots are present before the rash

Fifth disease

Rash appears in three stages; stage I is erythema on face, chiefly on cheeks.

Roseola

Rash composed of rose-pink macules or maculopapules, appearing first on trunk, then spreading to neck, face, and extremities; rash is nonpruritic.

Dyslexia

Reading letters in reverse

Erythema

Reddened area

Overweight

Refers to state of weighing more than average for height and body build

Ovulation

Release of an ovum by a follicle

Abrasion

Removal of the superficial layers of skin by scraping

Penile fracture

Rupture of the corpus cavernosum as a result of trauma to the erect penis

Trichomonas vaginitis

STI caused by an anaerobic parasitic protozoa

Allodynia

Sensation of pain from normally nonpainful stimuli

Configuration and arrangement

Size, shape, and arrangement of lesion or groups of lesions

Primary lesion

Skin changes caused by causative factor

Preoperational phase

Spans ages 2 to 7 years; characterized by egocentrism, transductive reasoning, magical thinking, and inability to conserve

Cocooning

Strategy of protecting infants from pertussis by vaccinating all persons who come in close contact with the infant

Bacterial vaginosis

Symptoms that include thin, malodorous, "fishy" vaginal discharge; diagnosis confirmed by clue cells on microscopic examination

Passive immunity

Temporary immunity obtained by transfusing immunoglobulin or antitoxins from a person or animal that has been actively immunized against the antigen

Primary amenorrhea

The absence of menses by 15 years, regardless of normal growth and development

Amenorrhea

The absence of menstrual flow

Separation

The child's emergence from a symbiotic fusion with the mother

Autonomy versus doubt and shame

The developmental task of the toddler years

Tertiary circular reactions

The fifth stage of the sensorimotor phase of development, when the child uses active experimentation to achieve previously unattainable goals

Inventions of new means through mental combinations

The final sensorimotor stage that occurs during ages 19 to 24 months

Egocentrism

The inability to envision situations from perspectives other than one's own

Acne vulgaris

The most common skin problem during adolescence

Negativism

The persistent negative response to requests; characteristic of the toddler's behavior

Ritualism

The toddler's need to maintain sameness and reliability; provides a sense of comfort

Sexual abuse

The use, persuasion, or coercion of any child to engage in sexually explicit conduct

Varicella

This condition has a rash that begins as macules, rapidly progressing to papules and then to vesicles, eventually breaking and forming crusts.

Mumps

This condition results in earache that is aggravated by chewing.

Individuation

Those achievements that mark children's assumption of their individual characteristics in the environment

Paraphimosis

Tight foreskin of the penis that cannot be retracted

Attenuate

To reduce the virulence of a pathogenic microorganism by treating it or cultivating it on a certain medium

Topical antibacterial agent

Used to prevent new inflammatory lesions

Systemic antibiotic therapy

Used with moderate to severe acne

Abnormal uterine bleeding

Uterine bleeding that is irregular in amount, duration, or timing and is not related to regular menstrual bleeding

Abusive head trauma

Violent shaking of infant that can cause traumatic brain injury

Precocious puberty

When boys or girls develop secondary sexual characteristics before the age of 8 years

Closed comedone

Whitehead

Varicocele

Wormlike mass that is palpated above the testicle and becomes smaller when the adolescent lies down, The most common treatable cause of male-related impaired fertility

Puncture

Wound with an opening that is small compared with its depth

Which of the following does a nurse include in the educational plan when instructing parents about the use of tropical steroids? A. Don't use this cream on a fungal infection. B, apply a thick layer of cream and rub it into the skin well, C don't use for longer than three days in chronic conditions. D, all of the above.

a Don't use this cream on a fungal infection.

Which of the following is the most common symptom of atopic dermatitis (eczema)? A Pruritis B Lichenified Plaques C Hyperpigmentation D Vascular Lesions.

a Pruritis

typical treatment of poison ivy contact dermatitis to the arm does not include which of the following? a. oral corticosteriods b. calamine lotion c. aveeno baths d. topical corticosteriod gel

a oral corticosteriods

Management of brown recluse spider bites includes A possible skin graft B administration of antivenin C. applying lemon juice mixed with baking soda directly to the bite. D administering epinephrine and corticosteroids for impending shock.

a possible skin graft

14. Barbara has been diagnosed with attention deficit/hyperactivity disorder and placed on methylphenidate by her primary care provider. Which of the following statements, made by the nurse to Barbara's parents, is correct? a. "Barbara's appetite may decrease with this drug." b. "Dosage is usually unchanged until adolescence." c. "This medication takes 2 to 3 weeks to achieve an effect." d. "Barbara's appetite will be increased with this drug."

a. "Barbara's appetite may decrease with this drug."

Cindy is 12 years old and is brought to the clinic because of a bald spot developing on her head. Cindy wears her hair tightly braided with beads. Which of the following should the nurse suspect? a. Alopecia from trauma b. Tinea capitis c. Psoriasis d. Urticaria

a. Alopecia from trauma

34. Which of the following is least appropriate when developing an outpatient contract between the patient with an eating disorder and the therapist? a. Begin the psychotherapy immediately before the contract is developed and before weight gain. b. Develop the contract so that the patient's feeling of control and responsibility toward recovery is established. c. Specify in the contract the weight at which tube feedings will be implemented. d. Specify in the contract when rewards for achievement will be implemented.

a. Begin the psychotherapy immediately before the contract is developed and before weight gain.

Clinical manifestations differentiate bacterial conjunctivitis from viral conjunctivitis. Which of the following is present with bacterial conjunctivitis but not usually found with viral conjunctivitis? a. Child awakens with crusting eyelids b. Child has increase in watery drainage from eyes c. Child has inflamed conjunctiva d. Child has swollen eyelids

a. Child awakens with crusting eyelids

5. When initiating a treatment plan for an obese child, the nurse should do which of the following? a. Defer treatment until the family is ready to begin. b. Proceed with the plan regardless of the family's readiness if the child is ready. c. Understand that the child cannot take personal responsibility for dietary habits and physical activity. d. Understand that children who are forced by their parents to seek help can easily become motivated.

a. Defer treatment until the family is ready to begin.

38. Which of the following would be an inappropriate method to help a toddler adjust to the initial dental checkup? a. Explain to the child that a checkup will not hurt. b. Have the child observe his or her sibling's examination. c. Have the child perform a checkup on a doll. d. Ask the dentist to reserve a thorough examination for another visit.

a. Explain to the child that a checkup will not hurt.

11. Which of the following actions taken by the nurse is least likely to prevent recurrence of poisonings? a. In the emergency department, begin a discussion of ways to injury-proof the home. b. Do a home visit to assess safety before the child is discharged. c. Administer questionnaire for poison prevention to the parents when the child is discharged. d. Advise parents to kneel down to the child's level when determining what products need to be placed out of reach

a. In the emergency department, begin a discussion of ways to injury-proof the home.

37. Which of the following adolescents does the nurse recognize as least likely to begin smoking? a. Johnny, age 16 years, whose father quit smoking 2 years ago b. Karen, age 15 years, whose older sister smokes c. Ted, age 17 years, who smoked a cigarette at home in front of his parents d. Lilly, age 12, who feels uncomfortable with her early-maturing body

a. Johnny, age 16 years, whose father quit smoking 2 years ago

17. Of the following techniques, which is the best to use when toilet training a toddler? a. Limit sessions to 5 to 8 minutes of practice. b. Remove child from the bathroom to flush the toilet. c. Ensure the toddler's privacy during the sessions. d. Place potty chair near a television to help distract the child during the sessions.

a. Limit sessions to 5 to 8 minutes of practice.

25. Which one of the following statements is false? a. Most reporting of abuse has been from the middle socioeconomic population. b. One child is usually the victim in an abusive family; removal of this child often places the other sibling(s) at risk. c. The abusive family environment is often one of chronic stress, including problems of divorce, poverty, unemploy-ment, and poor housing. d. Child abuse is a problem of all socioeconomic groups

a. Most reporting of abuse has been from the middle socioeconomic population.

37. Which of the following is not considered a complementary and alternative medicine therapy? a. Multivitamin b. St. John's wort (herb) c. Massage therapy d. Probiotic

a. Multivitamin

7. Tommy is brought in by his father for his yearly physical. On examination, the nurse notes that since last year Tommy has developed pubic hair, testicular enlargement, and related scrotal changes. In planning anticipatory guidance, the nurse recognizes that which of the following subjects would best be discussed with Tommy as soon as possible? a. Nocturnal emission b. Sexually transmitted infection prevention c. Pregnancy prevention d. Hygiene needs

a. Nocturnal emission

2. The adolescent with testicular torsion is most likely to be initially seen with which of the following signs and symptoms? a. Tender, painful swelling of the testes b. A mass in the posterior aspect of the scrotum that can be transilluminated c. A heavy, hard, painless mass palpable on the anterior or lateral surface of the testicle d. An asymptomatic scrotal mass that aches, especially after exercise or penile erection

a. Tender, painful swelling of the testes

21. Changes in family structure and parent employment have resulted in: a. adolescents having more time unsupervised by adults. b. adolescents having more time for communication and intimacy with parents. c. adolescents having less time to spend with peers. d. adolescents requiring more supervision by outside family members.

a. adolescents having more time unsupervised by adults.

20. The best way for parents to respond to a child's questions about sexuality is to give the child: a. an honest answer and find out what the child thinks. b. one or two sentences that answer specific questions only. c. an honest, short, and to-the-point answer, d. an honest answer but a little less information than the child expects.

a. an honest answer and find out what the child thinks.

12. Therapeutic management for chlamydia includes: a. doxycycline. b. intramuscular injection of ceftriaxone (Rocephin). c. intramuscular injection of penicillin. d. clarithromycin.

a. doxycycline.

A drug used to treat children diagnosed with giardiasis is: a. metronidazole (Flagyl) b. Amoxicillin c. Erythromycin d. Tetracycline

a. metronidazole (Flagyl)

23. Identified characteristics of parents who are at higher risk for abusing their children do not include: a. older parents who waited until their mid-30s before having their first child. b. isolated parents with few supportive relationships. c. parents who grew up with poor role models. d. single-parent family.

a. older parents who waited until their mid-30s before having their first child.

8. Piaget's theory of cognitive development depicts the toddler as a child who: a. repeatedly explores the same object each time it appears in a new place. b. is able to transfer information from one situation to another. c. has a persistent negative response to any request. d. has the rudimentary beginning of a superego.

a. repeatedly explores the same object each time it appears in a new place.

15. As the child moves through the toddler period, there is a decrease in the frequency of: a. solitary play. b. imitative play. c. tactile play. d. parallel play.

a. solitary play.

Erythema migrans is associated with which of the following conditions? A contact dermatitis B Lyme's disease C cat scratch disease. D Stevens-Johnson syndrome.

b Lyme's disease

The nurse is assisting Billy, aged 10 years, in applying an all purpose insect Repellent that contains that active ingredient DEET, which of the following should be included in the nurses discussion with Billy? A. DEET is effective against most insects and archnids, but not ticks. B. after returning indoors, treated skin needs to be washed off with soap and water before he goes to bed tonight. C. DEET should be applied to the whole body, including the face and hands for better protection. D. DEET should be heavily applied and frequent reapplication is necessary.

b after returning indoors, treated skin needs to be washed off with soap and water before he goes to bed tonight.

11. Adolescent egocentrism may lead to a pattern of personal fable. An example of a personal fable is: a. "Everyone is coming to the play just to see me." b. "Mary Sue got pregnant, but it won't happen to me." c. "I hate taking my clothes off for gym class because everyone stares at me." d. "Mary is very envious of how I dress."

b. "Mary Sue got pregnant, but it won't happen to me."

What antiviral agent is used to treat varicella infections in children at increased risk for complications associated with varicella? a. Varicella-zoster immune globulin b. Acyclovir c. Salicylates d. Steroids

b. Acyclovir

25. Which of the following statements is true in regard to nutritional changes from the infant to the toddler years? a. Growth rate increases. b. Caloric requirements decrease. c. Protein requirements are minimal. d. Fluid requirements increase.

b. Caloric requirements decrease.

42. Which of the following is the most common method of successful suicide among adolescents? a. Overdose of drugs b. Firearms c. Self-inflicted lacerations d. Hanging

b. Firearms

51. The nurse, in working with special groups of adolescents, recognizes which of the following statements is true? a. Effective health promotion programs for minority adolescents must contain culturally competent information and must be provided by health care professionals with the same cultural background as the adolescent. b. Gay and lesbian adolescents are at much greater risk for suicidal behaviors. c. Nurses should encourage all gay and lesbian adolescents to disclose their sexual orientation to their families immediately to help eliminate the stress of keeping "the secret." d. Rural adolescents' access to health care is the same as for urban areas because of the advantages of Medicaid and incentives offered to physicians to work in these areas.

b. Gay and lesbian adolescents are at much greater risk for suicidal behaviors.

8. Which of the following statements about pattern of growth during adolescence is true? a. Knowing the correct sequence of the growth pattern is useful only when assessing abnormal growth patterns versus normal growth patterns. b. Girls usually begin puberty and reach maturity about 2 years earlier than boys do. c. Girls and boys experience an increase of muscle mass that begins during early puberty and lasts throughout adolescence. d. Girls and boys experience an increase in linear growth that begins for both during midpuberty.

b. Girls usually begin puberty and reach maturity about 2 years earlier than boys do.

1. Which of the following is associated with 75% of all penile neoplasias? a. Human papillomavirus (HPV) types 6 and 11 b. HPV type 16 c. Uncircumcised males d. Paraphimosis

b. HPV type 16

10. Which of the following statements about ipecac use for poisonous substance ingestion is true? a. Ipecac helps absorb the toxin. b. Ipecac is no longer recommended for routine home treatment of poisoning. c. Ipecac is useful when a corrosive substance has been ingested. d. Ipecac is useful when an overdose of a calcium channel blocker has been ingested.

b. Ipecac is no longer recommended for routine home treatment of poisoning.

11. Which of the following describes the onset of secondary enuresis? a. Occurs following established stool continence b. Occurs after a period of established urinary continence c. Occurs following a gastrointestinal illness d. Occurs as a result of behavioral acting out

b. Occurs after a period of established urinary continence

3. Which of the following statements about the preschooler's physical proportions is true? a. Preschoolers have a squat and potbellied frame. b. Preschoolers have a slender but sturdy frame. c. The muscle and bones of the preschooler have matured. d. Sexual characteristics can be differentiated in the preschooler.

b. Preschoolers have a slender but sturdy frame.

35. Effective health education and health care for adolescents does not include which of the following? a. Recognizes that adolescents, as they progress through adolescence, can assume additional responsibility for their own health b. Recognizes that the need to maintain privacy and confidentiality decreases as the adolescent ages c. Should meet the physical and emotional needs of the adolescent d. Recognizes that parents need to respect their teenagers' independence and move more toward the role of health consultant

b. Recognizes that the need to maintain privacy and confidentiality decreases as the adolescent ages

23. Which of the following dysfunctional speech patterns is a normal characteristic of the language development of a preschooler? a. Lisp b. Stuttering c. Nystagmus d. Echolalia

b. Stuttering

26. Which of the following statements about adolescents and school is true? a. Transition from elementary school to middle school has no negative effects on adolescents. b. Teenagers whose grades fall below average spend more time in perceived negative environments and feel alienated from school. c. Students who repeat one or more grades are more likely to bring weapons to school. d. Students with above-average grades have been identified as more likely to engage in suicide attempts.

b. Teenagers whose grades fall below average spend more time in perceived negative environments and feel alienated from school.

12. The nurse expects to assist with administration of a specific antidote for poisoning in which one of the following pediatric patients? a. The 8-month-old child admitted to the emergency department after eating 8 or 10 holly berries b. The 13-year-old girl who ingested an overdose of diazepam (Valium) c. The 8-year-old child who ingested three of his mother's birth control pills d. The 6-year-old child who ingested an overdose of an unidentified corrosive substance

b. The 13-year-old girl who ingested an overdose of diazepam (Valium)

17. In regard to the development of temperament in the preschool years, which of the following statements is true? a. Temperamental characteristics change considerably during the preschool years. b. The effect of temperament on adjustment in a group becomes important during the preschool years. c. Children need to be treated the same regardless of differences in temperament. d. There really is no tool that will adequately identify temperamental characteristics during the preschool years.

b. The effect of temperament on adjustment in a group becomes important during the preschool years.

Bedbugs, although once considered to be practically nonexistent, have remerged within the past decade as troublesome. Which of the following does the nurse recognize as incorrect information about bedbugs? a. They tend to inhabit warm, dark areas such as furniture and emerge at night to feed. b. They act as vectors for disease transmission. c. The treatment of bedbugs should focus on proper identification, treatment of symptoms, and eradication. d. Their bites are often misdiagnosed as scabies, spider bites, or mosquito bites.

b. They act as vectors for disease transmission.

12. Adolescents develop the social cognition change of mutual role-taking. Which of the following is the best description of this ability? a. Heightened sense of self-consciousness b. Understanding the perspectives of others and that actions can influence others c. Beliefs that are more abstract and rooted in ideologic principles d. Realization that others have thoughts and feelings

b. Understanding the perspectives of others and that actions can influence others

The nurse knows, regarding pertussis, that: a. the incidence has decreased in infants younger than 6 months of age. b. a booster vaccine (Tdap) is now recommended for all children 11 to 12 years of age. c. treatment should begin as soon as exposure is confirmed and includes the antibiotic amoxicillin. d. the disease is not contagious, so close household members do not need treatment.

b. a booster vaccine (Tdap) is now recommended for all children 11 to 12 years of age.

When administering the pertussis vaccine, the nurse recognizes which of the following as incorrect? a. can be given any time during pregnancy b. cannot be given to the postpartum mother who is breastfeeding c. the acellular pertussis vaccine, from the same manufacturer, is recommended for the first 3 immunizations and is given along with diphtheria and tetanus at 2, 4, and 6 months of age d. is recommended for health care workers having close contact with infants under the age of 12 months

b. cannot be given to the postpartum mother who is breastfeeding

22. Childhood depression: a. is easily detected because children tend to act out their problems and feelings. b. has characteristics that are determined by parallel developments in symbolism, language, and cognitive development. c. does not interrupt normal growth and development. d. treatment consists of antidepressants that must be at a therapeutic level for at least 6 to 8 weeks to achieve beneficial effect.

b. has characteristics that are determined by parallel developments in symbolism, language, and cognitive development.

24. A child who unintentionally contributes to an abusive situation most likely: a. fits into the "easy-child pattern." b. has demands, both physical and emotional, that contribute to caregiver fatigue. c. has low self-esteem. d. comes from a low socioeconomic background.

b. has demands, both physical and emotional, that contribute to caregiver fatigue.

Neurofibromatosis: i. is an autosomal dominant genetic disorder ii. is suspected cafe-au-lait spots iii. is suspected when the infant develops axillary or inguinal freckling iv. is associated with learning disabilities v. has the risk of being transmitted to 100% of the offspring vi. therapy is limited to excision of tumors that produce pain or impair function and symptomatic management of symptoms a. i, ii, iii, iv, and v b. i, ii, iii, iv, and vi c. i, iii, v, vi d. ii, iii, iv, v, vi

b. i, ii, iii, iv, and vi

skin in the infant and small child as compared with skin in older children and adults: a. is tightly bound to the dermis b. is less likely to have blister formation from an inflammatory process c. is more likely to react to a sensitizing allergen than to a primary irritant d. is more susceptible to superficial bacterial infection

b. is less likely to have blister formation from an inflammatory process

Mumps immunization: a. is recommended for children ages 4 years or older b. is typically given in combination with measles and rubella c. Can be administered to infants as young as 6 months of age d. all the above

b. is typically given in combination with measles and rubella

7. During middle childhood: a. children are less susceptible to development of dental caries. b. plasticized sealant, applied to deep fissures and grooves of healthy teeth, can prevent cavity formation. c. periodontal disease contributes to childhood tooth loss. d. regular administration of fluoride dental varnish is no longer recommended.

b. plasticized sealant, applied to deep fissures and grooves of healthy teeth, can prevent cavity formation.

36. Children on strict vegetarian and macrobiotic diets should be evaluated for: a. constipation and heart disease. b. rickets and iron-deficiency anemia c. Scurvy. d. severe acute malnutrition.

b. rickets and iron-deficiency anemia

46. Burn injuries in the toddler age-group are most often the result of: a. flame burns from playing with matches. b. scald burn from hot liquids. c. hot object burns from cigarettes or irons. d. electric burns from electrical outlets.

b. scald burn from hot liquids.

Epidermal necrosis and erythema multi four are associated with which of the following conditions? A neurofibromatosis. B alopecia areata C Stephen Johnson syndrome. D. Inertrigo .

c Stevens Johnson syndrome.

The HBsAg negative mother of Daniella, a premature infant weighing 4 lbs and born 6 hrs ago, asks, "Have you already given Daniella her HepB vaccine?" What is your correct response? a. "Don't worry, we'll give it before she leaves the hospital" b. "Daniella is sleeping rn. I will give it as soon as she wakes up" c. "Because Daniella only weighs 4 lbs, she will not receive her vaccine until she is 1 month of age" d. "Because Daniella is premature and weighs only 4 lbs, she will be given one vaccine dose now and then she will need another in 2 months"

c. "Because Daniella only weighs 4 lbs, she will not receive her vaccine until she is 1 month of age"

13. The typical number of words acquired by the age of 2 years is: a. 50. b. 100 c. 300. d. 500.

c. 300.

Anne, and 8 year old, has been diagnosed with giardiasis. The nurse would expect Anne to most likely been seen initially with which of the following signs and symptoms? a. Diarrhea with blood in the stools b. Nausea and vomiting with a mild fever c. Abdominal cramps with intermittent loose stools d. Weight loss of 5 lb in the past month

c. Abdominal cramps with intermittent loose stools

14. Elements of principled moral reasoning emerge during adolescence. Which of the following is the best description of this moral development? a. Moral guidelines are seen to emanate from authority figures. b. Moral standards are seen as objective and not to be questioned. c. Absolutes and rules are questioned and subject to disagreement. d. A personal value system is developed.

c. Absolutes and rules are questioned and subject to disagreement.

43. Which of the following statements as it relates to use of tobacco, alcohol, and cannabis among adolescents is true? a. Substance abuse decreases with age, and adolescents between 14 and 15 years of age have the highest use pattern. b. The prevalence of binge drinking and tobacco use among high school students is increasing. c. Adolescents may use tobacco, alcohol, and marijuana because these substances provide an opportunity to challenge authority, demonstrate autonomy, gain entry into a peer group, or simply relieve the stress of growing up d. Adolescents who begin smoking at a later age are at greater risk for becoming a life-long smoker.

c. Adolescents may use tobacco, alcohol, and marijuana because these substances provide an opportunity to challenge authority, demonstrate autonomy, gain entry into a peer group, or simply relieve the stress of growing up

40. When is a screening hemoglobin or hematocrit recommended for adolescents? a. At the first health provider encounter with an adolescent b. At the end of pubertal development c. At both of the above visits d. At neither of the above visits

c. At both of the above visits

15. Spiritual development during adolescent years can best be described by which of the following? a. Places less emphasis on what a person believes b. Places more emphasis on whether a person attends religious services c. Becomes more focused on spiritual and ideologic matters and less on observing religious customs d. Becomes more focused on observing religious customs and less on ideologic matters

c. Becomes more focused on spiritual and ideologic matters and less on observing religious customs

15. The nurse, while conducting a home visit, finds that the mother of 4-year-old Nathan is using a mercury thermometer to take his axillary temperature. Which of the following is the best intervention for the nurse at this time? a. Tell the mother to stop using mercury thermometers because if the mercury is ingested, it can cause mercury toxicity. b. Explain to the mother that mercury poisoning can cause acrodynia. c. Explain to the mother that mercury thermometers are no longer recommended and that if broken, the inhaled vapors can cause toxicity. d. Reassure the mother that as long as the mercury thermometer is not broken, it is okay to continue to use it.

c. Explain to the mother that mercury thermometers are no longer recommended and that if broken, the inhaled vapors can cause toxicity.

31. Adolescents with anorexia nervosa are at risk for refeeding syndrome. Which of the following best describes refeeding syndrome? a. It reduces the risk for osteoporosis and returns the menses to normal. b. The risk for heart failure is greatest during the first 2 days of treatment. c. It occurs because of shifts in phosphate from extracellular to intracellular spaces in persons with total body phosphorus depletion. d. It causes mitral valve prolapse and significant electrolyte imbalance.

c. It occurs because of shifts in phosphate from extracellular to intracellular spaces in persons with total body phosphorus depletion.

24. Which of the following sources of stress is typical of a 3-year-old? a. Insecurity b. Masturbation c. Jealousy d. Sexuality

c. Jealousy

26. Which nutritional requirement may be difficult to meet in the toddler years? a. Calories b. Proteins c. Minerals d. Fluids

c. Minerals

37. During the adolescent health screening interview, the nurse focuses on which of the following to best address injury prevention? a. Drownings b. Burns c. Motor vehicle crashes d. Drug use

c. Motor vehicle crashes

19. Of the following strategies, which is most appropriate for parents to use to prepare a toddler for the birth of a sibling? a. Explain the upcoming birth as early in the pregnancy as possible. b. Move the toddler to his or her own new room. c. Provide a doll for the toddler to imitate parenting. d. Tell the toddler that a new playmate will come home soon.

c. Provide a doll for the toddler to imitate parenting.

Skin disorder assessment includes the objective data collected by inspection and palpation. Which of the following is not an example of objective data? a. The lesion has an increased erythematous margin edge b. The rash appears as macules and papules c. The lesion is painful and itches d. The lesion is moist

c. The lesion is painful and itches

33. Cindy has been diagnosed with anorexia nervosa. Her therapeutic management plan includes dietary interventions combined with family psychotherapy. When of the following would the nurse recognize as appropriate? a. Weight gain is a sign that the patient is not relapsing from the plan. b. The patient is only allowed to participate in setting up a food plan as a reward for weight gain. c. The plan needs to be firm but flexible. d. A reasonable goal for weight gain is about 4 lb/week.

c. The plan needs to be firm but flexible.

6. Which of the following statements is most characteristic of a 24-month-old child in regard to motor development? a. Motor skills are fully developed but occur in isolation from the environment. b. The toddler walks alone but falls easily. c. The toddler's activities begin to produce purposeful results. d. The toddler is able to grasp small objects but cannot release them at will.

c. The toddler's activities begin to produce purposeful results.

5. Julie, 12 years old, is brought to the primary care providers office by her mother. Julie has started to develop breast tissue and some pubic hair. Both the mother and daughter are concerned because Julie has been having increased vaginal discharge. Julie tells the nurse, "I wash my private area every day, but I still have fluid that comes out." What is the nurse's best response? a. "It sounds like you have an infection. We'll have the provider check you to see what is causing this discharge." b. "Have you been using soap when you wash?" c. This sounds like a normal discharge that happens to all girls as they start to mature. It is a sign that your body is preparing for your periods to begin." d. "This is probably not related to hygiene. Are you concerned that this discharge might be causing an odor?"

c. This sounds like a normal discharge that happens to all girls as they start to mature. It is a sign that your body is preparing for your periods to begin."

9. Which of the following best describes the formal operational thinking that occurs between the ages of 11 and 14 years? a. Thought process includes thinking in concrete terms. b. Thought process includes information obtained from the environment and peers. c. Thought process includes thinking in abstract terms, possibilities, and hypotheses. d. Thought process is limited to what is observed.

c. Thought process includes thinking in abstract terms, possibilities, and hypotheses.

The nurse is conducting an educational session for the parents of a child diagnosed with varicella. Which one of the following is not an appropriate comfort measure to include in this session? a. promote skin care including daily bathing and changing clothes b. use Caladryl lotion on rash to decrease itching c. Use hot bath water to promote skin rash healing d. Keep nails short and smooth to decrease chances of infection from scratching

c. Use hot bath water to promote skin rash healing

16. On routine physical examination, 2-year-old Zach is found to have an elevated blood lead level. The most likely cause for this finding is: a. Zach is allowed to play in the local sandbox at the park. b. Zach lives in a house built after 1980. c. Zach is fed from pottery that the family makes themselves. e. Zach's father is an artist and works at home.

c. Zach is fed from pottery that the family makes themselves.

19. Infants of adolescents are at risk because: a. teenage mothers often neglect their infants, leaving them for long periods with grandparents. b. teenage mothers supply excessive amounts of cognitive stimulation to their infants. c. adolescents often lack knowledge about normal infant growth and development. d. adolescents are less likely to treat their infant as love objects or playthings.

c. adolescents often lack knowledge about normal infant growth and development.

16. Therapeutic management for a child with a tic disorder primarily consists of. a. behavioral modification to teach the child to suppress the tic disorder. b. administration of haloperidol to suppress the tic disorder. c. education and support for the child and family with reassurance about the prognosis. d. genetic counseling for the parents.

c. education and support for the child and family with reassurance about the prognosis.

11. The preschooler's body image has developed to include: a. a well-defined body boundary. b. knowledge about his or her internal anatomy. c. fear of intrusive experiences. d. anxiety and fear of separation.

c. fear of intrusive experiences.

Human Papillomavirus (HPV) vaccine is recommended for all of the following populations except: a. female adolescents to prevent HPV-related cervical cancer b. boys and men (9 to 26 years) to reduce the likelihood of genital warts c. female preadolescents ages 6 to 8 years d. female adolescents who are not sexually active

c. female preadolescents ages 6 to 8 years

7. A treatment of choice for adolescents with dysmenorrhea is: a. acetaminophen. b. oral contraceptives. c. nonsteroidal anti-inflammatory drugs. d. estrogen-suppression drugs.

c. nonsteroidal anti-inflammatory drugs.

Epithelial wound healing: a. begins 72 hrs after the wound is incurred b. occurs by autolysis of epithelial cells from the wound center toward the wound margins c. occurs more rapidly when the wound is moist and crust-free d. occurs more rapidly when the skin is allowed to dry and to form an eschar, or scab

c. occurs more rapidly when the wound is moist and crust-free

29. One way to decrease total fat intake in the preschooler is to: a. drink less milk. b. eat fewer quantities of dairy products. c. substitute for low-fat food sources. d. consume more fruit juice.

c. substitute for low-fat food sources.

9. Magical thinking, according to Piaget, is the belief that: a. events have cause and effect. b. God is an imaginary friend. c. thoughts are all-powerful. d. if the skin is broken, the child's insides will come out.

c. thoughts are all-powerful.

Wound care instructions to parents should include which of the following? a. Use betadine, alcohol, and hydrogen peroxide to prevent infection. b. Use hydrocolloid dressing that just covers the wound with little overlap. c. Formation of yellow gel with a fruity odor under hydrocolloid dressings is a sign of infection. d. Apply topical antibiotics after washing with mild soap and water.

d Apply topical antibiotics after washing with mild soap and water.

27. While Jenny, age 16, is in for her routine checkup, her mother tells the nurse that Jenny wants to get a job at a local fast-food restaurant, where she would work 30 hours a week to earn extra money for clothes. The mother wonders whether this is a good idea. Which of the following is the nurse's best response? a. "Jenny is healthy, and there is no reason she could not take the job." b. "All adolescents are preoccupied with clothes, so let her go ahead.?" c. "That sounds like a dead-end job. Why would Jenny want to work there?" d. "Working 30 hours a week may take time away from her studies and extracurricular activities and increase fatigue. Looking together at Jenny's future career goals may help identify alternatives."

d. "Working 30 hours a week may take time away from her studies and extracurricular activities and increase fatigue. Looking together at Jenny's future career goals may help identify alternatives."

22. Which of the following factors influences aggressive behavior? a. Frustration b. Modeling c. Gender d. All of the above

d. All of the above

25. Rape victims display a variety of manifestations. Which of the following might the nurse see in 16-year-old Sally as she arrives at the emergency department for treatment after being raped? a. Hysterical crying or giggling b. Calm and controlled behavior c. Anger and rage alternating with helplessness and agitation d. All of the above

d. All of the above

Measles immunization includes which of the following? a. Given at 12-15 months of age with a second dose given at age 4-6 years of age and revaccination at 11-12 years b. Child vaccinated before 12 months of age should receive 2 additional doses beginning at 12-15 months and separated by at least 4 weeks c. Revaccination of all individuals born after 1956 who have not received 2 doses of measles vaccine after 12 months of age d. All the above

d. All the above

Certain groups of children are at risk for serious complications from communicable diseases. These children do not include which of the following groups? a. Children with an immunodeficiency or immunologic disorder b. Children receiving steroid therapy c. Children with leukemia d. Children who have recently undergone a surgical procedure

d. Children who have recently undergone a surgical procedure

Assessment of which of the following is not helpful in identifying potentially communicable diseases? a. Prodromal symptoms b. Immunization history c. Past medical history d. Family history

d. Family history

9. Which of the following statements about children with orthodontic braces is true? a. There is pain when the child has the braces applied or adjusted, which lasts about 30 minutes. b. The bands and brackets offer protection and prevent plaque. c. If an arch wire breaks, cover the broken wire with dental wax and keep the regularly scheduled appointment with the orthodontist. d. Forbidden foods during orthodontic treatment include chewing gum, ice, nuts, uncut apples, corn on the cob, hard candy, hard taco shells, nachos, and popcorn.

d. Forbidden foods during orthodontic treatment include chewing gum, ice, nuts, uncut apples, corn on the cob, hard candy, hard taco shells, nachos, and popcorn.

2. In the female adolescent who has reached puberty, the luteinizing hormone initiates which of the following actions? a. Production of estrogen b. Growth of ovarian follicles c. Production of gonadotropin-releasing hormone d. Ovulation

d. Ovulation

16. Which of the following statements about social development of the preschooler is false? a. Imaginary playmates are a normal part of the preschooler's play. b. Preschoolers have overcome much of their anxiety regarding strangers. c. Preschoolers use telegraphic speech between the ages of 3 and 4 years. d. Preschoolers particularly enjoy parallel play.

d. Preschoolers particularly enjoy parallel play.

13. The nurse is assisting the family of a child with a history of encopresis. Which of the following should be included in the nurse's discussion with this family? a. Instructing the parents to sit the child on the toilet at two daily routine intervals b. Instructing the parents that the child will probably need to have daily enemas for the next year c. Suggesting the use of stimulant cathartics weekly d. Reassuring the family that most problems resolve successfully, with some relapses during periods of stress

d. Reassuring the family that most problems resolve successfully, with some relapses during periods of stress

23. Which of the following statements about stress in toddlers is true? a. Toddlers are rarely exposed to stress or the results of stress. b. Any stress is destructive because toddlers have a limited ability to cope. c. Most children are exposed to a stress-free environment. d. Small amounts of stress help toddlers develop effective coping skills.

d. Small amounts of stress help toddlers develop effective coping skills.

3. The nurse has conducted an assessment of the sleep patterns of Janie and found that Janie delays going to bed each night. Which of the following interventions does the nurse recognize as least helpful? a. Consistent bedtime ritual, like reading a book before bedtime b. Not allowing the child to stay up past a reasonable hour c. Keeping a light on in the room d. Taking the child into the parents' bed

d. Taking the child into the parents' bed

Joey, a 14-year-old adolescent, has recently relocated from Mexico to the United States. While helping his dad do farm work, Joey suffered a laceration in the horse barn. Review of Joey's immunization record from Mexico shows that Joey has had two previous tetanus and diphtheria vaccine immunization shots, the last one being at the age of 6 years. Which of the following would the nurse in the emergency department expect to give at this time? a. Tdap b. DTaP c. Td booster d. Tetanus immunoglobulin (TIG) human and Tdap

d. Tetanus immunoglobulin (TIG) human and Tdap

Which of the following is not an influenza vaccine recommendation? a. the vaccine is administered in early fall before the flu season begins and is repeated yearly b. Trivalent inactivated influenza vaccine is approved for vaccine use in children ages 6 months and older c. Children with severe egg allergy history shouldn't routinely receive the influenza vaccine d. The live attenuated influenza vaccine (LAIV) form is recommended for children 2 to 4 years of age with a history of wheezing or asthma

d. The live attenuated influenza vaccine (LAIV) form is recommended for children 2 to 4 years of age with a history of wheezing or asthma

When instructing the parents caring for an infant with conjunctivitis, the nurse will include which of the following in the plan? a. Accumulated secretions are removed by wiping from outer canthus inward b. Hydrogen peroxide placed on cotton swabs is helpful in removing crusts from eyelids c. Compresses of warm tap water are kept in place on the eye to prevent crusting. d. Washcloth and towel used by the infant are kept separate and not used by others

d. Washcloth and towel used by the infant are kept separate and not used by others

10. The moral development of the preschooler is characterized by: a. concern for why something is wrong. b. actions that are directed toward satisfying the needs of others. c. thoughts of loyalty and gratitude. d. a very concrete sense of justice.

d. a very concrete sense of justice.

standard precautions involve the use of barrier protection to prevent contamination from: a. blood b. body fluids c. mucous membranes d. all of the above

d. all of the above

27. Physiologic anorexia in toddlers is characterized by: a. strong taste preferences. b. extreme changes in appetite from day to day. c. heightened awareness of social aspects of meals. d. all of the above.

d. all of the above.

27. When educating the preschool child about injury prevention, the parents' emphasis should be on: a. setting a good example. b. helping children establish basic safety habits. c. protection and education for injury prevention. d. doing all of the above.

d. doing all of the above.

5. Reduction of poisonings in children and infants can be accomplished by: a. use of child-resistant containers. b. educating parents and grandparents to place products out of reach of small children. c. educating parents to relocate plants out of reach of infants, toddlers, and small children. d. doing all of the above.

d. doing all of the above.

39. Flossing is necessary: a. to remove plaque from below the gum margin. b. to remove debris from between the teeth. c. to reach areas where brushing is ineffective. d. for all of the above.

d. for all of the above.

10. According to Kohlberg, the best way to discipline children is to: a. use a punishment and obedience orientation. b. withhold privileges. c. use power to control behavior. d. give explanations and help the child change.

d. give explanations and help the child change.

2. Increased obesity among children is related to: a. high birth weight. b. underlying disease. c. enzyme abnormalities and metabolic defects. d. overeating.

d. overeating.

21. The best approach to stop a toddler's attention-seeking behavior of a temper tantrum with head banging is to: a. ignore the behavior. b. provide time-out. c. offer a toy to calm the child. d. protect the child from injury.

d. protect the child from injury.

35. In treating eating disorders: a. weight gain is a reliable sign of positive progress. b. when a therapeutic environment is removed, relapses seldom occur. c. antianxiety or antidepressant drug use has not been proven effective. d. psychotherapy is aimed at resolving adolescent identity crises and distorted body image.

d. psychotherapy is aimed at resolving adolescent identity crises and distorted body image.

10. Emergency care for tooth avulsion includes: a. replanting the tooth after bleeding has stopped. b. storing the tooth in tap water until it and the child can be transported to the dentist. c. holding the tooth by the root. d. rinsing the dirty tooth gently under running water before replanting.

d. rinsing the dirty tooth gently under running water before replanting.

In scheduling immunizations, the nurse knows which of the following is correct? a. the beginning primary immunization for infants begins at 2 months of age b. children who are born preterm receive only half the normal dose of each vaccine followed by the second half of the vaccine 2 weeks later c. children who begin primary immunization at the recommended age but fail to receive all the doses by the suggested age need to begin the series again. d. when there is doubt that the child will return for follow-up immunizations according to the optimum schedule, HBV vaccine (HepB), DTaP, IPV (poliovirus vaccine), MMR, varicella, and Hib vaccines can be administered simultaneously at separate injection sites

d. when there is doubt that the child will return for follow-up immunizations according to the optimum schedule, HBV vaccine (HepB), DTaP, IPV (poliovirus vaccine), MMR, varicella, and Hib vaccines can be administered simultaneously at separate injection sites

5. According to Erikson, the chief psychosocial task of the preschool period is acquiring a sense of _______________.

initiative

14. Potential causes of heavy metal poisoning in children include:

lead, mercury, and iron

34. The main source of calcium and phosphorous in a toddler is _______ which should optimally average ____________ oz per day.

milk, 24 to 30

31. the toddler's decreased nutritional requirements are manifested in a phenomenon known as _______

physiological anorexia

Sleep Terrors

A partial arousal from very deep REM sleep Usually occurs 1 to 4 hours after falling asleep Return to sleep is usually rapid, often difficult to keep child awake Initially may sit up, thrash, or run in bizarre manner, scream, talk, show anger or obvious confusion, which disappears when child is fully awake

Regression

A retreat from a present pattern of functioning to past levels of behavior; usually occurs in instances of stress, when the child attempts to cope by reverting to patterns of behavior that were successful in earlier stages of development; common in toddlers

Nightmares

A scary dream taking place during REM (rapid-eye-movement) sleep Crying in younger children and fright in all children; behaviors persistent when child is awake Return to sleep may be considerably delayed because of persistent fear

Antitoxin

A solution of antibodies derived from the serum of animals immunized with specific antigens and used to confer passive immunity

Immunoglobulin

A sterile solution containing antibodies from large pools of human blood plasma

3. A nurse is providing teaching about age-appropriate activities to the guardian of a 2 year old. Which of the following statements by the guardian indicates an understanding of the teaching? A. "I will send my child's favorite stuffed animal when napping away from home will occur." B. "My child should be able to stand on one foot for a second." C. "The soccer team my child will be playing on starts practicing next week." D. "I should expect my child to be able to draw circles."

A. "I will send my child's favorite stuffed animal when napping away from home will occur."

2. A nurse is providing anticipatory guidance to the caregiver of a 13-year-old adolescent. Which of the following screenings should the nurse recommend for the adolescent? (Select all that apply.) A. Body mass index B. Blood lead level C. 24-hr dietary recall D. Weight E. Scoliosis

A. Body mass index D. Weight E. Scoliosis

4. A nurse is providing anticipatory guidance to the caregivers of a toddler. Which of the following should the nurse include? (Select all that apply.) A. Develop food habits that will prevent dental caries. B. Meeting caloric needs results in an increased appetite. C. Expression of bedtime fears is common. D. Expect behaviors associated with negativism and ritualism. E. Annual screenings for phenylketonuria are important.

A. Develop food habits that will prevent dental caries. C. Expression of bedtime fears is common. D. Expect behaviors associated with negativism and ritualism.

2. A nurse is conducting a well-child visit with a 5-year-old child. Which of the following immunizations should the nurse plan to administer to the child? (Select all that apply.) A. Diphtheria, tetanus, pertussis (DTaP) B. Inactivated poliovirus (IPV) C. Measles, mumps, rubella (MMR) D. Pneumococcal (PCV) E. Haemophilus influenzae type B (Hib)

A. Diphtheria, tetanus, pertussis (DTaP) B. Inactivated poliovirus (IPV) C. Measles, mumps, rubella (MMR)

4. A nurse is performing a developmental screening on a 3-year-old child. Which of the following skills should the nurse expect the child to perform? A. Ride a tricycle B. Hop on one foot C. Jump rope D. Throw a ball overhead

A. Ride a tricycle

2. A nurse is conducting a well-child visit with a child who is scheduled to receive the recommended immunizations for 11- to 12-year-olds. Which of the following immunizations should the nurse administer? (Select all that apply.) A. Trivalent inactivated influenza (TIV) B. Pneumococcal (PCV) C. Meningococcal (MCV4) D. Tetanus and diphtheria toxoids and pertussis (Tap) E. Rotavirus (RV)

A. Trivalent inactivated influenza (TIV) C. Meningococcal (MCV4) D. Tetanus and diphtheria toxoids and pertussis (Tap)

1. A nurse is assessing a 2½-year-old toddler at a well-child visit. Which of the following findings Should the nurse report to the provider? A. Height increased by 7.5 cm (3 in) in the past year. B. Head circumference exceeds chest circumference. C. Anterior and posterior fontanels are closed. D. Current weight equals four times the birth weight.

B. Head circumference exceeds chest circumference.

3. A nurse is caring for an adolescent whose guardian expresses concerns about the child sleeping such long hours. Which of the following conditions should the nurse inform the guardian as requiring additional sleep during adolescence? A. Sleep terrors B. Rapid growth C. Elevated zinc levels D. Slowed metabolism

B. Rapid growth

2. A nurse is performing a developmental screening on an 18 month old. Which of the following skills should the toddler be able to perform? (Select all that apply.) A. Build a tower with six blocks B. Throw a ball overhand C. Walk up and down stairs D. Stand on one foot for a few seconds E. Use a spoon without rotation

B. Throw a ball overhand E. Use a spoon without rotation

5. A nurse is caring for a preschool-age child who expresses the need to leave because their doll is scared to be at home alone. Which of the following characteristics of preoperational thought is the child exhibiting? A. Egocentrism B. Centration C. Animism D. Magical thinking

C. Animism

1. A nurse is discussing prepubescence and preadolescence with a group of guardians of school-age children. Which of the following information should the nurse include in the discussion? A. Initial physiologic changes appear during early childhood. B. Changes in height and weight occur slowly during this period. C. Growth differences between boys and girls become evident. D. Sexual maturation becomes highly visible in boys.

C. Growth differences between boys and girls become evident.

4. A nurse is teaching a class about puberty in boys. Which of the following should the nurse include as the first manifestation of sexual maturation? A. Pubic hair growth B. Vocal changes C. Testicular enlargement D. Facial hair growth

C. Testicular enlargement

Premenstrual syndrome

Condition that has more than 150 associated physical, psycho-logic, and behavioral symptoms that start with ovulation and then reoccur during the luteal phase of the menstrual cycle

Vulvovaginal candidiasis

Condition that may manifest with vaginal pruritus and dysuria and is not a sexually transmitted infection (STI); treated with over-the counter topical antifungal creams; characterized by "cottage cheese-like" discharge

20. The best approach toward temper tantrums requires ______________ and developmentally appropriate expectations and rewards.

Consistency

When administering vaccines, a(n) _____________________ is considered a condition in a person that does increase the risk for a serious adverse reaction (e.g., not administering a live virus vaccine to a severely immi compromised child).

Contraindication

1. A nurse is providing teaching to the guardian of a preschool-age child about methods to promote sleep. Which of the following statements by the parent indicates an understanding of the teaching? A. "I will sleep in the bed with my child if she wakes up during the night." B. "I will let my child stay up an additional 2 hours on weekend nights." C. "I will let my child watch television for 30 minutes just before bedtime each night." D. "I will keep a dim lamp on in my child's room during the night."

D. "I will keep a dim lamp on in my child's room during the night."

Emotional abuse

Deliberate attempt to destroy a child's self-esteem

Transmission-Based Precautions

Designed for patients documented or suspected to be infected or colonized with highly transmissible or epidemiologically important pathogens for which interventions beyond Standard Precautions are needed to interrupt transmission in hospitals

Droplet Precautions

Designed to reduce the risk for transmission of infectious agents that are spread when large particles generated during coughing, sneezing, or talking come into contact with the conjunctiva or the mucous membrane of the nose or mouth of a susceptible person; suctioning or bronchoscopy generates these particles

Contact Precautions

Designed to reduce the risk for transmission of microorganisms transmitted by direct or indirect contact

Body substance isolation

Designed to reduce the risk of transmission of pathogens from moist body substances

Monovalent vaccine

Designed to vaccinate against a single antigen or organism

Polyvalent vaccine

Designed to vaccinate against multiple antigens or organisms; meningococcal polysaccharide vaccine

Hospital-acquired infection (HIA)

Infections occur when there is interaction among patients, health care personnel, equipment, and bacteria

Epididymitis

Inflammation that is a result of infection, local trauma, or chemical irritant, Characterized by unilateral scrotal pain, redness, and swelling; may include urethral discharge, dysuria, fever, and pyuria; treated with antibiotics

Ecchymoses

Localized red or purple discolorations

Herd immunity

The majority of the population is vaccinated and the spread of disease stopped without the rest of the population getting vaccinated

Sibling rivalry

The natural jealousy and resentment of children to a new child in the family

Diphtheria

Tonsillar pharyngeal areas are covered with white or gray membrane; complications include myocarditis and neuritis.

Scarlet fever

Tonsils are enlarged, edematous, reddened, and covered with patches of exudate; rash is absent on face; desquamation occurs.

the practitioner has prescribed tretinoin cream (Retin-A) for Nancy's acne. Nancy has been nursing the cream for 2 weeks and is concerned she is not improving. Nancy tells the nurse that she has done everything that she was told to do and ask Why is my ance no better? The nurse's best reply is A. Its normal for it to take weeks to months to see improvement with Ance medication B You must not be using the medication right. Show me how you apply it to your face. C. Ance is caused by dirt or oil on the surface of the skin. You will need to increase the number of times you wash these areas each day D. You will probably need to ask the practitioner about changing your medicine as soon as possible

a Its normal for it to take weeks to months to see improvement with Ance medication

which of the following is a fungal infection that lives on the skin? a. tinea corporis b. herpes simplex type 1 c. scabies d. warts

a tinea corporis

Which of the following is not recommended in the treatment of scabies? A treat only household members who are symptomatic B the drug of choice in children and infants over two months is permethrin 5% cream. C. All persons in close contact with affected children should be treated. D. Ivermectin is indicated for those who don't respond well to scabicide.

a treat only household members who are symptomatic

The most effective method for tick removal in a child is to A use tweezers and grasp close to the point of attachment, then pull straight out using steady even pressure. B apply mineral oil to the back of the tick and wait for it to back out. C use fingers to pull the tick out with straight, steady, even pressure. D place a hot match on the back of the tick and pick it up with gloved hands when the tick falls off.

a use tweezers and grasp close to the point of attachment, then pull straight out using steady even pressure.

18. Which of the following statements is false in regard to toilet training? a. Bowel training is usually accomplished after bladder training. b. Nighttime bladder training is usually accomplished after bowel training. c. The toddler who is impatient with soiled diapers is demonstrating readiness for toilet training. d. Fewer wet diapers signal that the toddler is physically ready for toilet training.

a. Bowel training is usually accomplished after bladder training.

14. Lesley is a sexually active adolescent. She comes to the clinic with abdominal pain and vaginal bleeding. The nurse recognizes that which of the following must be ruled out immediately? a. Ectopic pregnancy b. Ovarian cyst c. STIs d. Endometriosis

a. Ectopic pregnancy

In hospitals, which of the following is the most significant source of methicillin-resistant Staph aureus (MRSA) and the major mode of transport? a. Patient to patient via the hands of the health care provider b. patients coming in direct contact with other patients c. failure of hospital personnel to wear face masks when working with patients in an airborne infection isolation room d. indirect contact transmission from hospital equipment

a. Patient to patient via the hands of the health care provider

30. Which of the following physical exam findings is suggestive of self-induced vomiting? a. Presence of distinctive lesions on the hands (Russell sign) b. Hypertension, weakness, and cool skin c. Elevated potassium, magnesium, and erythrocyte sedimentation rate d. A heart murmur diagnosed as mitral valve prolapse

a. Presence of distinctive lesions on the hands (Russell sign)

Which of the following statements about rotavirus disease or immunization against rotavirus is correct? a. Rotavirus is one of the leading causes of diarrhea in infants and young children b. Rotavirus is one of the leading causes of otitis media in young children. c. One vaccine for rotavirus is RotaTeq, which is approved for children 32 weeks of age or older d. Rotavirus vaccine usually causes only mild reaction, redness, and soreness at the site of injection

a. Rotavirus is one of the leading causes of diarrhea in infants and young children

Meningococcal conjugate vaccines (MCV4) are not recommended for which of the following populations? a. Routinely for children ages 9 months to 10 years b. Children aged 2 years to 18 years who travel or reside in countries where N. meningitidis is hyperendemic or epidemic c. Children and adolescents 11 and 12 years of age d. College freshmen living in dormitories

a. Routinely for children ages 9 months to 10 years

Which of the following techniques is recommended to provide atraumatic care for immunization administration to infants? a. Select a 1 inch needle to deposit vaccine deep into the vastus lateralis b. Use an air bubble to clear the needle before injection c. Use the deltoid muscle d. Use the EMLA patch before administration

a. Select a 1 inch needle to deposit vaccine deep into the vastus lateralis

4. Which of the following characteristics most likely predisposes toddlers to frequent infections? a. Short straight internal ear canal and enlarged lymph tissue b. Slower pulse and respiratory rate and higher blood pressure c. Abdominal respirations d. Less efficient defense mechanisms

a. Short straight internal ear canal and enlarged lymph tissue

29. To best effect adolescent health promotion activity, the nurse should incorporate which of the following in the plan? a. The adolescent's definition of health b. The adolescent's past health promotion activities c. A complete assessment of the adolescent's past medical treatment d. A complete physical examination

a. The adolescent's definition of health

22. A drug approved for medical abortion is mifepristone. Which of the following statements about this drug is true? a. The drug binds progesterone receptors and blocks the action of progesterone. b. The drug acts directly on the cervix to soften and dilate and on the uterine muscle to stimulate contractions. c. The abortion completion rate is 100% in pregnancies if used correctly. d. The drug is administered intramuscularly up to 49 days after the last menstrual period.

a. The drug binds progesterone receptors and blocks the action of progesterone.

8. Gastric lavage for pediatric poison ingestions: a. can be associated with serious complications of gastrointestinal perforation, hypoxia, and aspiration. b. is recommended in the emergency department for all cases of ingestion. c. has been proven to decrease morbidity. d. is most useful when the child comes to the emergency department within 3 hours of ingestion of the toxin.

a. can be associated with serious complications of gastrointestinal perforation, hypoxia, and aspiration.

21. Discharge planning for children with lead poisoning includes: a. confirmation that the child will be discharged to a home without lead hazards. b. immediate referral for development and speech therapy. c. visiting nurse care for continuation of intravenous treatment at home. d. explanation that there is little need for follow-up, because lead levels have returned to normal.

a. confirmation that the child will be discharged to a home without lead hazards.

34. Factors that best promote adolescent health and well-being include: a. connections with adults outside the family, with the school, or other supportive groups. b. the ability of the adolescent to have universal access to the Internet. c. interventions that focus the responsibility for adolescent health to one person or setting d. health promotion efforts aimed at identification of adolescent needs.

a. connections with adults outside the family, with the school, or other supportive groups.

3. The hormone in the female that causes growth and development of the vagina, uterus, fallopian tubes, and breasts is: a. estrogen. b. progesterone. c. follicle-stimulating hormone (FSH). d. luteinizing hormone (LH).

a. estrogen.

During wound healing, immature connective tissue cells migrate to the healing site and begin to secrete collagen into the meshwork spaces. What is this phase called? a. fibroplasia b. scar contracture c. inflammation d. scar maturation

a. fibroplasia

24. Internet chatrooms and social networking: a. have allowed adolescents a more public arena for developing interpersonal skills. b. have decreased the amount of bullying in the school setting. c. have increased the development of multitasking and longer attention spans in the adolescent. d. have decreased adolescents' risk-taking behaviors.

a. have allowed adolescents a more public arena for developing interpersonal skills.

40. Mark, age 14 years, has been rushed to the emergency department because of illegal drug ingestion at a party. Which of the following are most important for the nurse to collect to assist in the emergency treatment plan? i. The type and amount of drug taken ii. The time the drug was taken and mode of administration iii. Number of times Mark has previously overdosed iv. Why the drug was taken a. i and ii b. i, ii, and iii c. i only d. i, ii, iii, and iv

a. i and ii

The American Academy of Pediatrics has recommended vitamin A supplements for certain pediatric patients with measles. Correct dosage of vitamin A and instructions to parents of these children include: i. single oral dose of 200,000 international units in children 1 year old ii. single oral dose of 100,000 international units in children 6 to 12 months old iii. dosage may be associated with vomiting and headache for a few hours iv. safe storage of the drug to prevent accidental overdose

a. i, ii, iii, iv

For which of the following populations is pertussis vaccine currently recommended? i. all children from 6 weeks to the 7th birthday ii. children ages 11 to 12 years who have completed the DTaP/DTP childhood series iii. a 2nd booster for previously immunized adolescents and adults iv. children ages 7 through 10 years who are not fully vaccinated for pertussis (i.e., did not receive 5 doses of DTaP, or who received 4 doses of DTaP with the 4th dose being administered on or after the 4th birthday) v. pregnant adolescents b/t 27 and 36 weeks' gestation, if not previously protected

a. i, ii, iv, and v

35. Studies in adults, which presumably may apply to children as well, indicate that benefits of an adequate intake of dietary fiber: i. decrease constipation. ii. increase body weight. iii. decrease body weight. iv. prevent type 2 diabetes mellitus. v. prevent type 1 diabetes mellitus. a. i, iii, and iv b. i, iii, and iv c. ii and iv d. iii, iv, and v

a. i, iii, and iv

7. The resolution of the Oedipus/Electra complex occurs when the child: a. identifies with the same-sex parent. b. realizes that the same-sex parent is more powerful. c. wishes that the same-sex parent were dead. d. notices physical sexual differences

a. identifies with the same-sex parent.

44. Susan, age 15 years, comes to the school-based clinic and complains to the provider about a vaginal discharge. After the nurse has established a trusting and confidential relationship, Susan confides that she has been sexually active with three different partners within the past 6 months. She thinks they used condoms every time, but she is not sure. Susan's last period was 4 weeks ago, and she has never had a Pap test. What tests would the nurse assisting the provider expect to prepare for? i. Pap test ii. Gonorrhea test iii. Chlamydia test iv. Human immunodeficiency virus test v. Pregnancy test vi. Syphilis test a. ii, iii, iv, v, and vi b. i, ii, ii, iv, v, and vi c. ii, iii, iv, and vi d. i and v

a. ii, iii, iv, v, and vi

Primary intervention of communicable disease is best accomplished by: a. immunization b. control of the disease spread c. adequate water supply d. implementing good hand-washing practices among hospital personnel

a. immunization

14. Language during the preschool years: a. includes telegraphic speech b. is simple and concrete c. uses phrases, not sentences. d. includes the ability to follow complex commands.

a. includes telegraphic speech

21. Conversion reaction: a. is a psychophysiologic disorder associated with sudden onset. b. is more common in girls during childhood and adolescence c. has an organic cause. d. is diagnosed on the basis of seizures and abnormal electroencephalogram.

a. is a psychophysiologic disorder associated with sudden onset.

Rubella vaccine administration: a. is given as protection for the unborn child rather than for the recipient of the immunization b. is recommended for all children beginning at 4 to 6 years of age c. is given to all pregnant women if not previously immunized d. is not given to children whose mother is currently pregnant

a. is given as protection for the unborn child rather than for the recipient of the immunization

32. The goal of the physical assessment for child physical abuse: a. is to identify all injuries. b. always begins with rapid assessment of airway, breathing, circulation, and neurologic systems. c. should recognize that all forms of physical abuse have obvious signs d. should occur only after legal authorities have been notified.

a. is to identify all injuries.

19. Diagnostic evaluations for lead poisoning include: a. lead concentration from a venous blood specimen to confirm diagnosis. b. recommended universal screening for all children, with those ages 6 years or older given priority. c. identifying children at high risk for anemia, since these children will most likely have higher lead levels. d. understanding that a blood level for lead in the 3 to 5 mcg/dl range is normal and the child should be rescreened in 1 year unless exposure status changes.

a. lead concentration from a venous blood specimen to confirm diagnosis.

25. Compared with childhood peer groups, adolescent peer groups are: a. more likely to include peers from the opposite sex. b. less autonomous. c. less likely to influence members' socialization roles. d. more likely to require parental supervision.

a. more likely to include peers from the opposite sex.

26. The primary goal of nursing care for the adolescent rape victim is: a. not to inflict further stress on the victim. b. obtaining a complete history of the incident. c. assisting in the physical examination. d. notifying the police and the parents of the victim before proceeding with assessment.

a. not to inflict further stress on the victim.

Children with pinworm infections are seen with the principal symptom of: a. perianal itching b. diarrhea with blood c. evidence of small, ricelike worms in their stool and urine d. abdominal pain

a. perianal itching

4. The best approach to the management of obesity in children and adolescents is: a. prevention. b. pharmacologic agents sibutramine and orlistat. c. bariatric surgery. d. behavior modification.

a. prevention.

Mary, age 7, fell and sustained a laceration to her chin. She was taken to the ED, where the laceration was sutured with the edges well approximated. THe nurse expects the repair healing to take place by: a. primary intention b. secondary intention c. tertiary intention

a. primary intention

14. One recommended method to foster language development in the toddler is to: a. read books together. b. watch an educational program on the television. c. increase the toddler's exposure to a large number of adults and older children. d. encourage the toddler to watch at least 2 hours of children's television shows per day.

a. read books together.

16. According to Erikson, a key to identity achievement in adolescence is: a. related to the adolescent's interactions with others and serves as a mirror reflecting information back to the adolescent. b. linked to the role the adolescent plays within the family. c. related to the adolescent's acceptance of parental guidelines. d. related to the adolescent's ability to complete his or her plans for future accomplishments.

a. related to the adolescent's interactions with others and serves as a mirror reflecting information back to the adolescent.

48. The adolescent with body art: a. seeks body art as an expression of personal identity and style and to mark significant life events. b. is at lower risk for scarring if the piercing was done on the ear or nose because of the poor blood supply. c. should be advised to have the professional use a piercing gun for all piercings. d. should be advised that complications of piercing include infection and bleeding, but rarely keloid formation, which occurs most often with tattoos.

a. seeks body art as an expression of personal identity and style and to mark significant life events.

46. Cindy, age 16 years, reports that she has been sexually abused by her uncle. The nurse knows that the adolescent who has been a victim of sexual abuse: a. should be informed about the steps in the reporting process before information is disclosed to local authorities. b. is more likely to become a runaway. c. is more likely to remain in school and form ties with less-threatening families. d. will usually attempt suicide within 1 month of reporting the incident.

a. should be informed about the steps in the reporting process before information is disclosed to local authorities.

Which of the following statements about Haemophilus influenzae type b (Hib) vaccine is true? a. the vaccine protects against a number of infections including bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis b. the vaccine protects against the virus that produces influenza c. only 2 doses of Hib vaccine should be given to children 15 months of age or older who have not been previously vaccinated d. Hiberix is a conjugate vaccine licensed for use in infants over the age of 2 months

a. the vaccine protects against a number of infections including bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis

1. Growth and development during middle adolescence includes which of the following? a.Characterized by a transition to a dominant peer orientation b. Characterized by the changes of puberty and the responses to those changes c. Characterized by the taking on of adult roles d. Characterized by excellent conflict resolution over parental control

a.Characterized by a transition to a dominant peer orientation

Billy has been stung by a bee. A small reaction has occurred at the site. What is the most appropriate action at this time? a. Wait until Billy is at home to completely remove the stinger with forceps. b. Remove the stinger as soon as possible by scraping it off the skin. c. Wash the area with hot water and soap. d. Arrange for Billy to undergo skin testing.

b Remove the stinger as soon as possible by scraping it off the skin.

Nora has been brought to the emergency department by her father after having been bitten by a family dog. Examination reveals three puncture wounds on the hand. Expected therapeutic management for these wounds include a suturing the wounds b administering prophylactic antibiotics. c irrigating with hydrogen peroxide e administering a tetanus toxoid booster since Nora's last booster was given 13 months ago.

b administering prophylactic antibiotics.

Which of the following is true about topical therapy for acute treatment of dermatological problems? A application of heat to the area will relieve itching, B apply topical application in a systematic manner following the contour of the body surface. C chemicals that are non irritating to intact skin will be non irritating to inflammed skin. D. Emollient action of soaks, baths, or lotions increase skin irritation.

b apply topical application in a systematic manner following the contour of the body surface.

Johnny's mother is calling the clinic because Johnny has developed a rash over his entire body. Two days ago he was prescribed amoxicillin for an ear infection, and now his mother tells the nurse she thinks Johnny may have gotten a small rash with this medication when he took it before. Which of the following would be the best intervention by the nurse at this time? A. question than mother about other symptoms Johnny may have developed B continue the medication and have Johnny come in tomorrow to see the practitioner. C stop the medication and inform the practitioner. D tell the mother to only give half the prescribed dose of the medication until Johnny can return to the clinic to see the practitioner.

b continue the medication and have Johnny come in tomorrow to see the practitioner.

Dog bites in children occur most often: a. On the upper extremities in young children B from dogs owned by a family or neighbor. c from stray dogs D in school yards and neighborhood parks.

b from dogs owned by a family or neighbor.

Stephen Johnson syndrome, A is rare and occurs most often in females. B is a hypersensitivity reaction to certain drugs. C begins with localized rash over the entire body, except for palms, souls and extensor services. D is caused by a bite from a flea

b is a hypersensitivity reaction to certain drugs.

the nurse knows that with drug reaction rashes, which of the following is true? a. it is usually localized b. it may be delayed or immediate c. it is more common with oral drugs d. it usually has no associated symptoms

b it may be delayed or immediate

During the physical exam of 8 year old Kevin, the nurses of rash at the unpolicus and surrounding area. Kevin tells the nurse that the rash comes and goes, but does itch. The nurse recognizes the rash as contact dermatitis. Which of the following is most likely the cause of this rush? A insect bite B nickel used in Kevin's belt C laundry detergent used to clean Kevin's clothes D a food allergy

b nickel used in Kevin's belt

major aims of skin treatment include all of the following except a. eliminate the cause b. obtain an accurate account of child's symptoms c. effective treatment and symptom relief d. prevent complications

b obtain an accurate account of child's symptoms

the major goal of contact dermatitis is: a. reverse the associated immunologic changes b. prevent further exposure to offending substance c. educate on management of symptoms d. prevent transmission

b prevent further exposure to offending substance

Jimmy, age 9, has fallen and scraped his knee at school. He is brought to the school nurse for treatment. Which of the following does the nurse recognizes as being least likely to promote healing? a. changing the dressing when it becomes loose or soiled b. washing the injury with hydrogen peroxide and applying a dry gauze dressing c. applying an occlusive dressing d. washing the area with mild soap and water and applying a topical antibiotic with a nonadherent dressing

b washing the injury with hydrogen peroxide and applying a dry gauze dressing

Bryan, age 6 months, is starting daycare as his mother is returning to work. Bryan has had no immunizations. Which of the following statements provided by the nurse to the mother is the most appropriate at this time? a. "Since Bryan has not started his immunizations for streptococcal pneumococci yet, it is best to wait until after he gets established at daycare before beginning his injections." b. "Streptococcal pneumococci are responsible for a number of bacterial infections that are especially problematic for children under 2 years of age who attend daycare. Bryan should start his series of pneumococcal vaccine right away." c. "Why has Bryan not received any immunizations? He is past due. Don't you care about his health?" d. "Pneumococcal vaccine (PCV13) is the only vaccine recommended for Bryan at this time."

b. "Streptococcal pneumococci are responsible for a number of bacterial infections that are especially problematic for children under 2 years of age who attend daycare. Bryan should start his series of pneumococcal vaccine right away."

13. The development of a personal value system or value autonomy during adolescence usually occurs by what age? a. 14 to 16 ears b. 18 to 20 years c. 13 to 14 years d. 16 to 18 years

b. 18 to 20 years

20. When caring for the child diagnosed with functional abdominal pain (FAP), the nurse recognizes which of the following as correct? a. Children with FAP have imagined pain usually located in the periumbilical and/or epigastric region of the abdomen. b. Children at high risk for FAP are those with high expectations and extensive personal goals or whose parents have unusually high expectations for them. c. Diagnosis is based on physical, laboratory, and radiographic findings. d. Initial efforts for therapeutic management include dietary modifications and cognitive-behavioral therapy and biofeedback.

b. Children at high risk for FAP are those with high expectations and extensive personal goals or whose parents have unusually high expectations for them.

12. Which of the following skills is not necessary for the toddler to acquire before separation and individuation can be achieved? a. Object permanence b. Lack of concern about parental whereabouts c. Delayed gratification d. Ability to tolerate a moderate amount of frustration

b. Lack of concern about parental whereabouts

18. The nurse is to give an injection of the chelation drug calcium disodium edentate. Which of the following does the nurse recognize as most appropriate? a. Keeping the child NPO for 24 hours after administration of the drug b. Mixing the drug with procaine to lessen the pain associated with the injection c. Maintaining seizure precautions at the bedside d. Making certain the patient has no peanut allergy before injection

b. Mixing the drug with procaine to lessen the pain associated with the injection

38. The most appropriate way to prevent firearm injury among adolescents is: a. teaching the adolescent proper use of firearms. b. counseling the adolescent on nonviolent ways to resolve conflict. c. passing laws to prevent parents from having guns. d. telling parents to keep guns and ammunition in separate locations within the house.

b. counseling the adolescent on nonviolent ways to resolve conflict.

15. Human papillomavirus (HPV): a. has 10 serotypes associated with causing genital warts. b. has lesions that typically resolve on their own without treatment. c. has lesions that decrease in size or disappear during pregnancy. d. has lesions always visible to the naked eye on the cervix.

b. has lesions that typically resolve on their own without treatment.

9. The principal characteristics of Piaget's preoperational phase are: i. dependence on perception in problem solving. ii. egocentric use of language. iii. the ability to manipulate objects in relation to one another in a logical manner. iv. the ability to problem solve based on what is recalled about objects and events. a. i, ii, and iii b. i and ii c. ii and ini d. ii, iii, and iv

b. i and ii

When educating the public about diphtheria vaccine, the nurse recognizes which of the following as correct? i. Diphtheria vaccine is commonly administered in combination with tetanus and pertussis vaccines (DTaP) or DTaP and Hib vaccines for children under 7 years of age ii. Diphtheria vaccine is administered with tetanus and acellular pertussin (TDaP) for children 11 years and older iii. Diphtheria vaccine produces absolute immunity after three doses iv. Several vaccines contain diphtheria toxoid (Hib, meningococcal, pneumococcal), which confers immunity to the disease.

b. i and ii

6. Ingestion of injurious agents by children: a. occurs most frequently at grandparents' or a friend's home. b. occurs because infants and toddlers explore their environment through oral experimentation. c. has increased despite the use of child-resistant containers. d. can be avoided by teaching preschoolers which substances are dangerous.

b. occurs because infants and toddlers explore their environment through oral experimentation.

28. Healthy ways of serving food to toddlers include: a. establishing a pattern of sitting at a table for meals. b. permitting nutritious snacks in lieu of meals. c. discouraging between-meal snacking. d. allowing the toddler to choose preferred foods at every meal.

b. permitting nutritious snacks in lieu of meals.

43. Studies indicate that toddlers up to 24 months of age are safest when they are: a. placed in a car restraint seat in the front seat of the car. b. placed in a car restraint seat facing the rear in the back seat. c. placed in a front passenger seat with a deactivated airbag. d. allowed to stand in the back seat holding on to a shoulder belt.

b. placed in a car restraint seat facing the rear in the back seat.

8. Because of the preschooler's egocentric thought, the best approach for effective communication is through: a. speech. b. play. c. drawing. d. actions.

b. play.

41. Routine nutrition screening for all adolescents should include: a. a complete laboratory evaluation. b. questions about meal patterns and consumption of foods. c. a complete physical examination d. a complete family history.

b. questions about meal patterns and consumption of foods.

12. The major nursing consideration in assisting the family of a child with nocturnal enuresis is to prevent the child from developing alterations in: a. body image. b. self-esteem. c. autonomy. d. peer acceptance

b. self-esteem.

20. Intimate relationships are not necessarily characterized by: a. concern for each other's well-being. b. sharing of sexual intimacy. c. a willingness to disclose private, sensitive topics. d. sharing of common interests and activities.

b. sharing of sexual intimacy.

28. In comparison to toddlers, preschoolers eat: a. slightly less. b. slightly more. c. remain the same.

b. slightly more.

47. Accidental poisonings in toddlers can be best prevented by: a. consistently using safety caps. b. storing poisonous substances in a locked cabinet. c. keeping ipecac syrup in the home. d. storing poisonous substances out of reach.

b. storing poisonous substances in a locked cabinet.

45. One of the best ways to prevent drowning in the toddler group is for parents to: a. learn cardiopulmonary resuscitation (CPR). b. supervise children within arm's reach whenever they are near any source of water. c. enroll the toddler in a swimming program. d. not allow the child to swim.

b. supervise children within arm's reach whenever they are near any source of water.

6. The first pubescent change in boys is: a. appearance of pubic hair. b. testicular enlargement with thinning, reddening, and increased looseness of the scrotum. c. penile enlargement. d. temporary breast enlargement and tenderness.

b. testicular enlargement with thinning, reddening, and increased looseness of the scrotum.

in caring for the child with frostbite, the nurse remembers that: a. slow thawing is associated with less tissue necrosis b. the frostbitten part appears white or blanched, feels solid, and is without sensation c. rewarming produces a small return of sensation with a small amount of pain d. rewarming is accomplished by rubbing the injured tissue

b. the frostbitten part appears white or blanched, feels solid, and is without sensation

The following statements are about hepatitis A illness or vaccination. Which one is correct? a. the illness has a gradual onset, with often dark urine and jaundice being the only symptoms b. the vaccine is recommended for all children at age 1 year c. the vaccine consists of a series of 3 injections timed 2 months apart d. the illness is spread by all body secretions

b. the vaccine is recommended for all children at age 1 year

20. The first goal in nursing care of the pregnant teenager is: a. to arrange for the pregnant teen to register for food supplement programs to ensure proper nutrition. b. to assist the pregnant teen in obtaining health care. c. to involve the boyfriend and parents in the pregnancy so that the pregnant teen will have support during her pregnancy. d. to educate the pregnant teen regarding child care.

b. to assist the pregnant teen in obtaining health care.

40. To prevent fluorosis, parents of toddlers should use all of the following strategies except: a. supervise the use of toothpaste. b. use fluoride mouthrinses. c. store fluoride products out of reach. d. administer fluoride supplements on an empty stomach.

b. use fluoride mouthrinses.

5. One of the most important digestive system changes completed during the toddler period is: a. increased acidity of the gastric contents. b. voluntary control of the sphincters. c. the protective function of the gastric contents. d. increased capacity of the stomach.

b. voluntary control of the sphincters.

3. By the age of 2 years, most toddlers demonstrate increased gross motor skills by: a. jumping using both feet. b. walking up and down stairs. c. running and skipping on alternate feet. d. jumping from a height of 3 feet without falling.

b. walking up and down stairs.

Which of the following current beliefs about acne formation is true? A cosmetics containing lanolin and lauryl alcohol are not known to contribute to acne formation. B there Is scientific research to support the theory that stress will cause an acne outbreak. C exposure to oils in cooking grease can be a precursor to acne in adolescence working over fast food restaurant oils. D acne usually worsens with intake of chocolates and other foods high in sugars.

c exposure to oils in cooking grease can be a precursor to acne in adolescence working over fast food restaurant oils.

steve, age 8, has been diagnosed with tinea capitis. which one of the following does the nurse include in the teaching plan for steve and his parents? a. no animal to person transmission is associated with this infection b. steven can continue to share hair-grooming articles with his younger brother c. griseofulvin should be administered with high fat foods d. treatment may be discontinued once symptoms subside

c griseofulvin should be administered with high fat foods

Care of bacterial skin infections in children may include all of the following except: a. good hand washing. b. changing clothes daily and washing in hot water. c. puncturing the surface of the pustule. d. applying topical antibiotics.

c puncturing the surface of the pustule.

1. Which of the following does not contribute to sleep disturbances during preschool years? a. Evening media use b. Inconsistent bedtime routines c. Growing pains d. Nighttime fears

c. Growing pains

Which of the following statements about polio vaccine and immunization is not correct? a. inactivated poliovirus (IPV) is now recommended for routine childhood vaccination in the U.S. b. Oral polio vaccine (OPV) has been associated with vaccine-associated polio paralysis c. KINRIX contains DTaP, hep B, and IPV and may be used only in children aged 4 years or older as the 4th dose d. The combination vaccine PEDIARIX (containing DTaP, hep B, and IPV) may be used as the primary immunization beginning at 2 months of age.

c. KINRIX contains DTaP, hep B, and IPV and may be used only in children aged 4 years or older as the 4th dose.

21. Which of the following characteristics is not typically seen in a gifted or talented child? a. Asynchrony across developmental domains b. Insatiable curiosity c. Less need for attention than other children d. Intensity of feelings and emotions

c. Less need for attention than other children

50. Which of the following guidelines, if provided to the adolescent about tanning, is correct? a. If using self-tanning cream, no further sun protection is required. b. Sunscreens should include a sun protective factor (SPF) higher than 15 and an alcohol base with lanolin. c. Long-term effects can include premature aging of the skin; increased risk for skin cancer; and, in some adolescents, phototoxic reactions. d. Dermatologists recommend tanning machines if used no more often than two times monthly.

c. Long-term effects can include premature aging of the skin; increased risk for skin cancer; and, in some adolescents, phototoxic reactions.

22. Of the following techniques, which is the best one to deal with the negativism of the toddler? a. Quietly and calmly ask the child to comply b. Provide few or no choices for the child c. Reduce the number of opportunities for "no" answer d. Remain serious and intent

c. Reduce the number of opportunities for "no" answer

19. Which of the following statements about school phobia is correct? a. School phobia is most common in boys over the age of 12. b. School phobia produces symptoms in children that are unrelieved when the student stays home from school. c. Students with school phobia that have separation anxiety are not typically afraid to go to school, but rather are afraid to leave home. d. School phobia fear is helped by a close intense relationship between the child and mother.

c. Students with school phobia that have separation anxiety are not typically afraid to go to school, but rather are afraid to leave home.

38. The school nurse is planning an educational program centered on smoking prevention for high school adolescents. Which of the following methods does the nurse recognize as the most effective way to present this program? a. Focus on the negative, long-term effects of smoking on health b. Teach methods of resistance to peer pressure c. Use peer-led programs that emphasize social consequences d. Use media, videotapes, and films on smoking prevention

c. Use peer-led programs that emphasize social consequences

12. Sex typing involves the process by which the preschooler develops: a. a strong attachment to the same-sex parent. b. an identification with the opposite-sex parent. c. behavior and beliefs for his or her culture and sex. d. all of the above.

c. behavior and beliefs for his or her culture and sex.

7. The first action parents should be taught to initiate in a poisoning is to: a. induce vomiting. b. take the child to the family physician's office or emergency center. c. call the poison control center. d. follow the instructions on the label of the product.

c. call the poison control center.

29. Developmentally by 12 months of age most children: a. use a spoon adeptly. b. relinquish the bottle voluntarily. c. eat the same food as the rest of the family. d. reject all solid food in preference for the bottle.

c. eat the same food as the rest of the family.

30. Adequate intakes (AIs), a category of the Dietary Reference Intakes, are based on nutrient intake of: a. preterm breast-fed infants. b. preterm bottle-fed infants. c. full-term breast-fed infants. d. full-term bottle-fed infants.

c. full-term breast-fed infants.

11. By the age of 2, the toddler generally: a. has clear body boundaries. b. participates willingly in most procedures. c. has a sense of maleness or femaleness. d. is unable to learn correct terms for body parts.

c. has a sense of maleness or femaleness.

8. The most common cause of malocclusion is: a. thumb sucking. b. tongue thrusting. c. hereditary factors. d. abnormal growth patterns.

c. hereditary factors.

28. Sexual abusers: i. can be anyone but most often a male who is known by the victim. ii. can hold full-time jobs and are active in community affairs. iii. are most often not family members. iv. often spend time with the victims to gain their trust before initiating any sexual contact. v. rarely abuse the younger child if the older child is not present. a. ii, iii, iv, and v b. i, iii, and iv c. i, ii, and iv d. iii, iv, and v

c. i, ii, and iv

The proper use of isotretinoin 12-cis-retinoic acid (Accutane) for adolescents includes: i. reserving its use for severe, cystic acne that has not responded to other treatments ii. limiting treatment to 20 weeks iii. watching for side effects, including mood changes, depression, and suicidal ideation iv. watching for detrimental side effects on bone mineralization v. recognizing that it is contraindicated in pregnancy and in sexually active females not using an effective contraceptive method vi. monitoring for elevated cholesterol and triglyceride levels before and during treatment a. i, ii, iv, and v b. i, iii, and v c. i, ii, iii, v, and vi d. i, ii, iii, iv, v, and vi

c. i, ii, iii, v, and vi

13. The nurse is discussing PID with a group of sexually active adolescent females. Which of the following is correct information? i. C. trachomatis is a common cause. ii. Using IUDs for birth control with more than one sexual partner increases the risk of developing PID. iii. Pain is not always found in patients presenting with PID. iv. After a single episode of PID, infertility occurs because of tubal scarring. v. After a single episode of PID, the risk for ectopic pregnancy increases. vi. All pregnant women with PID should be hospitalized and treated with parenteral antibiotics. a. i, ii, iii, and vi b. i, v, and vi c. i, ii, v, and vi d. ii, iv, v, and vi

c. i, ii, v, and vi

39. Adolescent girls of low socioeconomic status are particularly at risk for dietary deficiencies of i. Calories. ii. sodium. iii. calcium. iv. folic acid. v. iron a. i, ii, and il b. ii, iii, iv, and v c. iii, iv, and v d. i, ii, and v

c. iii, iv, and v

33. Physical assessment for child sexual abuse: a. includes documentation of only abnormal genital findings. b. includes collecting forensic evidence obtained directly from a prepubertal victim's body within 3 days of the incident. c. includes examination of the anal area. d. includes documentation of the size of the hymenal opening, since it is predictive of sexual abuse.

c. includes examination of the anal area.

13. Activated charcoal: a. is odorless, tasteless, and delivered with fewer complications via gastric lavage. b. stimulates the gastric mucosa. c. is often mixed with cola drinks and served through a straw from an opaque container. d. has a bitter taste.

c. is often mixed with cola drinks and served through a straw from an opaque container.

15. Research has shown that when two languages are presented to children simultaneously in early childhood, bilingual children are most likely to experience: a. adverse effects in their receptive language development. b. adverse effects in performance in the majority language. c. language milestones at similar stages to monolinguals. d. adverse effects to areas in addition to language

c. language milestones at similar stages to monolinguals.

7. Using Erikson's theory as a foundation, the primary developmental task of the toddler period is to: a. satisfy the need for basic trust. b. achieve a sense of accomplishment. c. learn to give up dependence for independence. d. acquire language or mental symbolism.

c. learn to give up dependence for independence.

30. Health concerns consistent with middle adolescence include: a. school performance. b. emotional health issues. c. physical appearance. d. future career or employment.

c. physical appearance.

32. School-linked clinics: a. are located on school property and serve adolescent populations from that campus. b. do not require parental consent before service can be provided to the adolescent. c. provide greater access to adolescents for preventive and primary care services. d. have not been widely accepted by the adolescents, since they are not receptive to services offered.

c. provide greater access to adolescents for preventive and primary care services.

49. Sleep patterns among adolescents: a. show that teens should get at least 10 hours of sleep nightly. b. show that one in eight teens is regularly sleep deprived. c. show that sleep deprivation contributes to school problems. d. show that one in four teens reports use of the Internet as the major reason for lack of sufficient sleep.

c. show that sleep deprivation contributes to school problems.

Which of the following statements about varicella vaccine is correct? a. Varicella vaccine is recommended for all children regardless of past disease history b. A single dose of 0.5 mL of varicella vaccine should be given by deep intramuscular injection c. the first dose of varicella vaccine is recommended for children ages 12 to 15 months, and to ensure adequate protection, a second varicella vaccination is recommended for children at 4 to 6 years of age d. Varicella vaccine should not be administered simultaneously with MMR

c. the first dose of varicella vaccine is recommended for children ages 12 to 15 months, and to ensure adequate protection, a second varicella vaccination is recommended for children at 4 to 6 years of age

Which of the following does the nurse recognize as contraindicated in providing comfort measures to children with communicable diseases? a. use of acetaminophen or ibuprofen for control of elevated temperature in children with varicella b. use of diphenhydramine (Benadryl) or hydroxyzine (Atarax) for itching c. use of aspirin to control elevated temperature and/or symptoms with varicella d. use of lozenges and saline rinses in an 8 year old child with sore throat

c. use of aspirin to control elevated temperature and/or symptoms with varicella

The nurses conducting an educational session with Cindy and her parents on medication used for acne, which of the following is correct information. 1. Benzoyl peroxide gel has a bleaching effect on bed coverings and towels to top. 2 topical Clindamycin is applied only to individual lesions. 3 oral contraceptive medication containing estrogen will increase acne formation and should be avoided 4. Tretinoin requires that Cindy protect herself from sun exposure 5. Oral antibiotics side effects may include GI upset, photo sensitivity, or vaginal candidiasis. 6 results are better if systemic antibiotics are combined with topical antibiotic creams. 7 early intervention with topical medications may prevent development of severe acne. A 1,4,6 B 123 4 C. 2456, 6 D. 1457.

d 1,4,5,7

Nancy, age 16 years, comes to see the nurse because of acne on her face and shoulders. After talking with Nancy, the nurse makes a nursing diagnosis of knowledge deficit related to proper skin care. Which of the following would the nurse include in the instruction plan for Nancy? a. Wash the areas vigorously with antibacterial soaps. b. Brush the hair down on the forehead to conceal the acne areas. c. Avoid the use of all cosmetics. d. Gently wash the areas with a mild soap once or twice daily.

d Gently wash the areas with a mild soap once or twice daily.

Cindy, age 8 years, is brought to the clinic with a sore on her arm. She tells the nurse that she scratched it on a piece of metal at the playground about 1 week ago. Which of the following signs would the nurse expect to find if the sore has become infected? a. Itching at the site of the sore b. Rough edges around the sore c. No pain at the site d. Increased erythema, especially around the sore

d Increased erythema, especially around the sore

Human bites are a treatable at home. B, do not require tetanus immunization. C should not be iced to the area. D. Should receive medical attention

d Should receive medical attention

Which of the following statements about use of topical therapy and pediatric population is true? A. Use of silver impregnated in dressing as foam decreases the bacterial burden and bio burden of the wound, and has little absorption effect in the pediatric population B. Application of heat provides a soothing effect to reduce inflammatory processes C The use of immunomodulators is suggested as first line treatment in children younger than two years of age. D The topical immunomodulators have been linked to possible skin cancer and lymphoma in children younger than two years of age.

d The topical immunomodulators have been linked to possible skin cancer and lymphoma in children younger than two years of age.

Causes of diaper dermatitis include prolonged contact with A urine B feces C detergents. D all of the above

d all of the above

Which of the Following foreign bodies is least likely to be successfully removed with tweezers. A pieces of glass, B, spines of a cactus, C embedded needle in a foot. D all of the above.

d all of the above.

the nurse recognizes that which of the following is not indicated for use in promoting wound healing? a. nutrition with sufficient protein, calories, vit C and D, zinc b. irrigation of wounds with normal saline c. application of an occlusive dressing d. application of povidone-iodine (Betadine) solution

d application of povidone-iodine (Betadine) solution

Billy has come in contact with poison ivy on a school picnic. the best intervention for the nurse to implement at this time is to: a. wash the area with a strong soap and water solution b. apply Calamine lotion to the area c. prevent spread by instructing Billy not to scratch the lesions d. flush the area immediately with cold water

d flush the area immediately with cold water

The nurses conducting a review of health records for incoming fifth grade students and discovered that Mary has a history of having had a severe life threatening systematic response to a Hymenoptera sting. which of the following is the most important for the nurse to do at this time? A make sure that Mary has an identification bracelet to alert others of her allergy. B contact Mary's parents about which hospital Mary should be sent to if a sting occurs at school. C. Talk to Mary and see if she has had skin testing to confirm her allergy. D. talk to Mary's parents and provider to obtain emergency medicine for married to use, if necessary, at school.

d talk to Mary's parents and provider to obtain emergency medicine for married to use, if necessary, at school.

Which of the following would the nurse not include while educating the family about managing atopic dermatitis? A. Keep fingernails cut short. B long sleeves and pants are recommended. C avoid irritating products. D use fabric softener to decrease fabric irritation.

d use fabric softener to decrease fabric irritation.

23. Amanda, age 18, comes to the school nurse's office early in the morning, visibly upset. She tells the nurse that she and her boyfriend were having sexual relations last night and the condom broke. Amanda asks the nurse about a new pill she has read about that will keep her from becoming pregnant. She wants the nurse to give her more information about this pill. Which of the following statements made to Amanda provides the best information about levonorgestrel? a. "It is available without a prescription and must be taken within 24 hours of the unprotected sexual intercourse." b. "It is very effective but has side effects, so you will need to be out of school at least 1 day." c. "It contains estrogen, so you will need to have a pregnancy test before it can be administered." d. "It is available to women age 17 years and older without a prescription. It must be taken within 120 hours of the unprotected sexual intercourse."

d. "It is available to women age 17 years and older without a prescription. It must be taken within 120 hours of the unprotected sexual intercourse."

18. Which of the following statements about posttraumatic stress disorder (PTSD) is true? a. PTSD is the development of characteristic symptoms after exposure to a traumatic experience or event that is usually not life threatening. b. The second phase of PTSD lasts approximately 4 weeks and is one of coping. c. The third phase of PTSD extends over 6 months and is a period of direct inquiry. The victim wants to know what happened and appears to be getting better when actually getting worse d. Any child exhibiting a sudden change in behavior needs to be assessed for exposure to a traumatic event.

d. Any child exhibiting a sudden change in behavior needs to be assessed for exposure to a traumatic event.

18. Ana, age 16, has not had a period for the past 3 months, and her pregnancy test is positive. Which of the following is not an appropriate action for the nurse to take at this time? a. Inform Ana privately that her test is positive. b. Review with Ana facts about the pregnancy, including the duration of pregnancy and anticipated due date. c. Understand that Ana's reaction may be one of ambivalence, shock, fear, or apathy. d. Arrange for Ana's parents to be present when Ana is given the news

d. Arrange for Ana's parents to be present when Ana is given the news

10. Jimmy, a 13-year-old, is sent to the school nurse because he and some of his peers were caught chewing tobacco while playing baseball. The nurse knows that the best way to influence Jimmy's behavior for health promotion would be which of the following? a. Tell Jimmy that he will be suspended from school if he continues to chew the tobacco. b. Show Jimmy pictures of oral cancer from chewing tobacco. c. Tell Jimmy about the dangers of chewing tobacco and stress the fact that girls do not like boys who chew tobacco. d. Arrange for a local baseball hero to talk with Jimmy and his friends, stressing that he does not use chewing tobacco, his friends do not chew tobacco, and chewing tobacco causes ugly teeth.

d. Arrange for a local baseball hero to talk with Jimmy and his friends, stressing that he does not use chewing tobacco, his friends do not chew tobacco, and chewing tobacco causes ugly teeth.

17. Which of the following statements about Tourette syndrome (TS) is true? a. Manifestations are stable in intensity and rarely change once developed. b. Children with TS have no associated obsessive-compulsive symptoms. c. Tics lead to physical deterioration and affect life expectancy. d. Behaviors are involuntary.

d. Behaviors are involuntary.

16. Which of the following about herpes simplex virus (HSV) is true? a. It presents with a less severe clinical course in men than women. b. It is treated with acyclovir, famciclovir, and valacyclovir for cure of the disease. c. It is treated with ointments containing cortisone to help reduce inflammation. d. Cesarean birth is recommended for women in labor or ruptured membranes with visible lesions present.

d. Cesarean birth is recommended for women in labor or ruptured membranes with visible lesions present.

The nurse is instructing parents on the test-tape diagnostic procedure for enterobiasis. Which of the following is included in the explanation? a. Use a flashlight to inspect the anal area while the child sleeps b. Perform the test 2 days after the child receives the first dose of antiparasitic medication c. Test all members of the family at the same time using frosted tape d. Collect the tape in the morning before the child has a bowel movement or bath

d. Collect the tape in the morning before the child has a bowel movement or bath

29. Karen is suspected of having bulimia nervosa. The nurse recognizes which of the following as clinically characteristic of this disease? a. Bulimia often begins with decreased dietary intake associated with poor relationships with family members. b. Once started, the bingeing decreases in frequency to only about once per day. c. Insulin production is decreased because of excessive self-induced vomiting. d. Impulse control and satiety regulation are problems in bulimic adolescents.

d. Impulse control and satiety regulation are problems in bulimic adolescents.

28. Cindy, age 16, has been sent to the school nurse because her gym teacher has noticed a marked decrease in Cindy's weight since vacation. Which of the following does the nurse recognize as a common finding in an adolescent girl with anorexia nervosa? a. Wears form-fitting clothes like tank tops and jeans b. Has strong peer relationships with classmates and several best friends c. Has poor schoolwork performance because of little interest in school d. Is present at meals and appears to family and friends to be eating appropriately

d. Is present at meals and appears to family and friends to be eating appropriately

10. In discussing prevention of STIs, the nurse tells the adolescent that which of the following is most effective? a. Birth control pills b. Natural skin condoms with nonoxynol-9 c. Spermicides d. Latex condoms

d. Latex condoms

31. School-based health promotion interventions for adolescents do not include which of the following? a. Classroom health education b. Adopting school-level policies c. Environmental changes at the school d. Mass media production

d. Mass media production

31. Which of the following parental behavioral responses should alert the nurse to the possibility of maltreatment of the child? a. Parent displays extreme care for the child, not wanting to leave the child's side. b. Parent displays signs of guilt, not being able to eat or sleep. c. Parent displays abnormal interest in the incident, going over each detail repeatedly. d. Parent belittles the child for being injured.

d. Parent belittles the child for being injured.

42. Which of the following statements as it relates to adolescent physical fitness is true? a. Female students are more likely to engage in vigorous physical activity. b. High levels of physical activity may increase cardiovascular disease risk factors during adolescence. c. Routine exercise has little positive effect on adolescents' risk for depression and emotional stress. d. Routine screening of all adolescents should include information about frequency, intensity, and type of physical activity.

d. Routine screening of all adolescents should include information about frequency, intensity, and type of physical activity.

43. Jim, who has no history of previous suicide attempts, is talking with the school nurse about his feelings of despair and hopelessness about the future. He tells the nurse he would be better off dead. The nurse's best response is which of the following? a. Recognize that Jim is going through a common phase of adolescence. b. Recognize that Jim is at low risk for suicide because he has not previously attempted it. c. Explain to Jim that suicide never solved anything and that he will feel better tomorrow. d. Take Jim seriously, allow time for him to verbalize his feelings, and stay with him until referral.

d. Take Jim seriously, allow time for him to verbalize his feelings, and stay with him until referral.

41. Early childhood caries may result from: a. using a pacifier coated with honey. b. feeding the last bottle just before bedtime. c. long, frequent nocturnal breastfeeding. d. all of the above.

d. all of the above.

44. The nurse has been asked to present an educational program on prevention of adolescent stress and suicide. In planning the program, the nurse should include: a. the importance of being supportive and establishing positive communication patterns between family and teens. b. the precipitating factors for suicide. c. effective coping mechanisms and problem-solving skills. d. all of the above.

d. all of the above.

6. Uninhibited scribbling and drawing can help the child develop: d. symbolic language. b. fine muscle skills. c. eye-hand coordination. d. all of the above.

d. all of the above.

24. Regression in toddlers occurs when there is: a. stress. b. a threat to their autonomy. c. a need to revert to dependency. d. all the above.

d. all the above.

30. In obtaining a history pertaining to an incident of abuse, the nurse should: a. expect the child to betray the parents by admitting to the abuse received. expect the child to defend the parents out of a sense of loyalty. c. recognize that the child will have a sense of relief after telling someone about the abuse. d. avoid biasing the child's retelling of the events.

d. avoid biasing the child's retelling of the events.

18. The formation of sexual identity development during adolescence usually involves which of the following? i. Forming close friendships with same-sex peers during early adolescence ii. Developing intimate relationships with members of the opposite sex during middle adolescence iii. Developing emotional and social identities separate from those of families iv. Incorporating sexuality successfully into intimate relationships a. i. ii, and iii b. ii, iii, and iv c. ii and iii d. i, ii, iii, and iv

d. i, ii, iii, and iv

22. Adolescents who feel close to their parents show: i. more positive psychosocial development. ii. greater behavioral competence. iii. less susceptibility to negative peer pressure. iv. less tendency to be involved in risk-taking behaviors. a. i, ii, and iv b. i and i c. iii and iv d. i, ii, iii, and iv

d. i, ii, iii, and iv

3. Physical inactivity has been linked with overweight children. Which of the following explain this decrease in childhood activity? i. Decrease in physical activity in secondary and elementary schools ii. Parental obesity and low levels of physical activity at home iii. Increased time spent with television, video games, computers, and the Internet iv. Lack of sidewalks, parks, and bike paths in low-income communities a. i, i, and iii b. ii and iii c. i and iv d. i, ii, iii, and iv

d. i, ii, iii, and iv

34. The nurse working with the abused child and family: i. should view the parent and child as victims. ii. should teach the parents through demonstration and example rather than lecture. iii. recognizes that parents need to correct abnormal behavior in the child (e.g., We told you not to go with strangers"). iv. recognizes that the goal of the nurse-child relationship is to provide a role model for the parents in helping them relate positively to their child. a. i, ii, iii, and iv b. ii, iii, and iv c. i and iii d. ii and iv

d. ii and iv

29. In identification of the abused child, the nurse knows: a. physical abuse can be readily identified during the physical examination. b. specific behavioral problems will be seen in the abused child. c. maltreated children easily admit to the abuse they received from their parents. d. incompatibility between the history and the injury is probably the most important criterion on which to base the decision to report suspected abuse.

d. incompatibility between the history and the injury is probably the most important criterion on which to base the decision to report suspected abuse.

20. Therapeutic interventions for lead poisoning do not include: a. removal of the source of lead. b. improving nutrition. c. using chelation therapy. d. intravenous administration of dimercaprol.

d. intravenous administration of dimercaprol.

3. The pelvic examination in the adolescent. a. should be performed on all females who are sexually active. b. should only be conducted when there is suspicion of a sexually transmitted disease. c. is always conducted with a parent or guardian in the room. d. is only indicated if the adolescent is experiencing genital tract, pelvic, urologic, or rectal problems.

d. is only indicated if the adolescent is experiencing genital tract, pelvic, urologic, or rectal problems.

17. Expected characteristics of emotional autonomy during early adolescence include: a. increased independence from friends. b. increased need for parental approval. c. belief that parents are all-knowing and all-powerful. d. less emotional dependence on parents.

d. less emotional dependence on parents.

The general contraindication for all immunizations is: a. minor illness such as common cold b. breastfeeding c. pregnancy d. severe febrile illness

d. severe febrile illness

33. Adolescents are more likely to participate in health care services when: a. they understand the potentially negative consequences of their health behavior. b. they rank confidential care and respect higher than site cleanliness. c. they view their health problems as not organic in nature. d. they see the health provider as caring and respectful

d. they see the health provider as caring and respectful

To prevent spread of contamination from one patient to another after procedures, the most important strategy the nurse can use is to: a. follow disease-specific infection control guidelines b. wear vinyl gloves c. avoid wearing nail polish d. wash the hands routinely after each patient contact and after removing gloves

d. wash the hands routinely after each patient contact and after removing gloves