Peds Final Exam

An adolescent weighing 55 kg is admitted to the hospital experiencing a sickle cell crisis. Intravenous fluid therapy as well as increased oral fluids are ordered as part of his treatment plan. Based on the understanding of the amount of fluids needed to promote hemodilution, the nurse would expect the adolescent to receive how much total fluid in 24 hours? ________ mL

8250

The nurse is caring for a child hospitalized with Reye syndrome who is in the acute stage of the illness. The nurse would assess the child most carefully for which of the following? A) Indications of increased intracranial pressure B) An increase in the blood glucose level C) A decrease in the liver enzymes D) A presence of protein in the urine

a

Which of the following nursing actions would be least helpful for a client who is a victim of violence? A) Assist the client to project her anger. B) Provide information about a safe home and crisis line. C) Teach her about the cycle of violence. D) Discuss her legal and personal rights.

a

A nurse is considering a change in employment from the acute care setting to community- based nursing. The nurse is focusing her job search on ambulatory care settings. Which of the following would the nurse most likely find as a possible setting? Select all that apply. A) Urgent care center B) Hospice care C) Immunization clinic D) Physician's office E) Day surgery center F) Nursing home

a d e

The nurse is assessing a 12-month-old boy with an English-speaking father and a Spanish- speaking mother. The boy does not say mama or dada yet. Which of the following is the priority intervention? A) Performing a developmental evaluation of the child B) Encouraging the parents to speak English to the child C) Asking the mother if the child uses Spanish words D) Referring the child to a developmental specialist

c

The nurse is assessing a 3-year-old boy's development during a well-child visit. Which response by the child indicates the need for further assessment? A) He says a swear word when he hurts himself playing. B) He says "pew" when his sister has soiled her diaper. C) He laughs when his brother cries getting vaccinated. D) He constantly asks "why?" whenever he is told a fact.

c

The nurse is assessing the motor skills of a 5-year-old girl. Which finding would cause the nurse to be concerned? A) Can copy a square on another piece of paper B) Can dress and undress herself without help C) Draws a person with three body parts D) Is beginning to tie her own shoelaces

c

6-month-old girl weighs 14.7 pounds during a scheduled check-up. Her birth weight was 8 pounds. Which of the following is the priority nursing intervention? A) Talking about solid food consumption B) Discouraging daily fruit juice intake C) Increasing the number of breastfeedings D) Discussing the child's feeding patterns

d

A 16-year-old boy complains to the school nurse of headaches and a stiff neck. Which of the following signs and symptoms would alert the nurse that the child may have bacterial meningitis? A) Fixed and dilated pupils B) Frequent urination C) Sunset eyes D) Sunlight is "too bright"

d

The nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl. Which of the following is the most effective anticipatory guidance? A) Encouraging breastfeeding until the sixth month B) Advocating iron supplements with bottle-feeding C) Advising fluid intake per feeding of 5 or 6 ounces D) Discouraging the addition of fruit juice to the diet

d

The nurse is providing anticipatory guidance to the parents of an 18-month-old girl. Which guidance will be most helpful for toilet teaching? A) Telling them either one may demonstrate toilet use B) Assuring them that bladder control occurs first C) Telling them that curiosity is a sure sign of readiness D) Advising them to use praise, not scolding

d

The nurse is teaching the parents of a 2-year-old girl how to deal with common toddler situations. Which is the best advice? A) Discipline the child for regressive behavior. B) Scold the child for public thumb sucking. C) Tell the older sibling to not act like a baby. D) Have the child help clean up a bowel accident.

d

A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through which of the following? A) Amniotic fluid B) Placenta C) Birth canal D) Breast milk

b

After assessing a 10-year-old girl, the nurse documents the appearance of breast buds, identifying this as which of the following? A) Menarche B) Thelarche C) Puberty D) Tanner stage 5

b

At which age would the nurse expect to find the beginning of object permanence? A) 1 month B) 4 months C) 8 months D) 12 months

b

Based on Erikson's developmental theory, which of the following is the major developmental task of the adolescent? A) Gaining independence B) Finding an identity C) Coordinating information D) Mastering motor skills

b

The nurse is assessing the respiratory system of a newborn. Which of the following anatomic differences place the infant at risk for respiratory compromise? Select all answers that apply. A) The nasal passages are narrower. B) The trachea and chest wall are less compliant. C) The bronchi and bronchioles are shorter and wider. D) The larynx is more funnel shaped. E) The tongue is smaller. F) There are significantly fewer alveoli.

a d f

A group of nursing students are reviewing information about childhood infectious diseases. The students demonstrate understanding of this information when they identify which of the following as a common childhood exanthema? A) Mumps B) Rabies C) Rubella D) West Nile virus

c

A nurse is conducting a physical examination of a 5-year-old with suspected iron- deficiency anemia. How would the nurse evaluate for changes in neurologic functioning? A) "Open your mouth so I can look inside your cheeks and lips." B) "Do you have any bruises on your feet or shins?" C) "Will you show me how you walk across the room?" D) "Let me see the palms of your hands and soles of your feet."

c

The nurse is caring for a 4-year-old boy with infectious conjunctivitis. Which intervention would be least appropriate to include in the child's plan of care? A) Rinsing the eye with cool water B) Educating the family about the disease C) Encouraging frequent hand washing D) Promoting eye safety

d

The nurse teaching safety to teens knows that which of the following is the leading cause of death among adolescents? A) Drowning B) Poisoning C) Diseases D) Unintentional injuries

d

A nurse is caring for a woman who was recently raped. The nurse would expect this woman to experience which of the following first? A) Denial B) Disorganization C) Reorganization D) Integration

b

The nurse assesses a child's level of consciousness, noting that the child falls asleep unless he is stimulated. The nurse documents this finding as: A) Confusion B) Obtunded C) Stupor D) Coma

b

The nurse is caring for a 2-week-old newborn girl with a metabolic disorder. Which of the following activities would deviate from the characteristics of family-centered care? A) Softening unpleasant information or prognoses B) Evaluating and changing the nursing plan of care C) Collaborating with the child and family as equals D) Showing respect for the family's beliefs and wishes

A

The nurse is providing home care for a 6-year-old girl with multiple medical challenges. Which of the following activities would be considered the tertiary level of prevention? A) Arranging for a physical therapy session B) Teaching parents to administer albuterol C) Reminding parent to give a full course of antibiotics D) Giving a DTaP vaccination at the proper interval

A

A 10-month-old is brought to the emergency department by her parents after they found her face down in the bathtub. The mother said, "I just left the bathroom to answer the phone. When I came back, I found her." Which of the following assessments would be the priority? A) Airway, breathing, and circulation B) Level of consciousness C) Vital signs D) Pupillary response

a

A 4-year-old boy has a history of seizures and has been started on a ketogenic diet. Which of the following food selections would be most appropriate for his lunch? A) Fried eggs, bacon, and iced tea B) A hamburger on a bun, French fries, and milk C) Spaghetti with meatballs, garlic bread, and a cola drink D) A grilled cheese sandwich, potato chips, and a milkshake

a

A child with increased intracranial pressure is being treated with hyperventilation. The nurse understands the need for this treatment is based on which of the following? A) PaCO2 levels decrease, causing vasoconstriction. B) Drainage of cerebrospinal fluid occurs. C) Activity is controlled via a stimulator. D) Hyperexcitability of the nerves is reduced.

a

A group of students are reviewing information about glucose-6-phosphate dehydrogenase (G6PD) deficiency. The students demonstrate understanding of the material when they identify this disorder as due to which of the following? A) X-linked recessive inheritance B) Deficiency in clotting factors C) An excess supply of iron D) Autosomal recessive inheritance

a

A group of students are reviewing information about head injuries in children. The students demonstrate understanding of this information when they identify which of the following as the most common type of skull fracture in children? A) Linear B) Depressed C) Diastatic D) Basilar

a

A mother brings her 6-year-old son in for a check-up because the child is complaining of stomachaches. It is the beginning of the school year. Which of the following might the mother also mention? A) The child cries before going to school. B) The child made friends the first day of school. C) The child fights with siblings more often. D) The child loves the crowds in the lunchroom.

a

A mother brings her 8-year-old son for evaluation because of a rash on his lower leg. Which finding would support the suspicion that the child has Lyme disease? A) Playing in the woods about a week ago B) Rash is papular and vesicular C) High fever occurring about 4 days before the rash D) Complaints of extreme pruritus with visible nits

a

A new mother expresses concern to the nurse that her baby is crying and grunting when passing stool. What is the nurse's best response to this observation? A) "This is normal behavior for infants unless the stool passed is hard and dry." B) "This is normal behavior for infants due to the immaturity of the gastrointestinal system." C) "This indicates a blockage in the intestine and must be reported to the physician." D) "This is normal behavior for infants unless the stool passed is black or green."

a

A nurse is preparing a presentation for a local health fair about meningitis and has developed a display that lists the following causes: Streptococcus group BHaemophilus influenzae type B Streptococcus pneumoniae Neisseria meningitidis Which of these would the nurse highlight as the most common cause of meningitis in newborns? A) Streptococcus group B B) Haemophilus influenzae type B C) Streptococcus pneumoniae D) Neisseria meningitides

a

A nurse is preparing a school-aged child for a lumbar puncture. The nurse would expect to position the child in which manner? A) On her side with the head flexed forward and knees flexed to the abdomen B) Sitting upright with the head flexed forward to the chest C) Supine with arms and legs pronated and extended D) Prone with the arms flexed under the chest

a

A nursing instructor is describing trends in maternal and newborn health care. The instructor addresses the length of stay for vaginal births during the past decade, citing that which of the following denotes the average stay? A) 24-48 hours or less B) 72-96 hours or less C) 48-72 hours or less D) 96-120 hours or less

a

After teaching a class on the role of white blood cells in infection, the instructor determines that the teaching was successful when the class identifies which type of white blood cells as important in combating bacterial infections? A) Neutrophils B) Eosinophils C) Basophils D) Lymphocytes

a

After teaching a group of parents about language development in toddlers, which of the following if stated by a member of the group indicates successful teaching? A) "When my 3-year-old asks 'why?' all the time, this is completely normal." B) "A 15-month-old should be able to point to his eyes when asked to do so." C) "At age 2 years, my son should be able to understand things like under or on." D) "An 18-month-old would most likely use words and gestures to communicate."

a

After teaching a group of students about sexual abuse and violence, the instructor determines that the teaching was successful when the students describe incest as involving which of the following? A) Sexual exploitation by blood or surrogate relatives B) Sexual abuse of individuals over age 18 C) Violent aggressive assault on a person D) Consent between perpetrator and victim.

a

After teaching a group of students about the changes in health care delivery and funding, which of the following, if identified by the group as a current trend seen in the maternal and child health care settings, would indicate that the teaching was successful? A) Increase in community settings for care B) Decrease in family poverty level C) Increase in hospitalization of children D) Decrease in managed care

a

After teaching a group of students about the different levels of prevention, the instructor determines a need for additional teaching when the students identify which of the following as a secondary prevention level activity in community-based health care? A) Teaching women to take folic acid supplements to prevent neural tube defects B) Working with women who are victims of domestic violence C) Working with clients at an HIV clinic to provide nutritional and CAM therapies D) Teaching hypertensive clients to monitor blood pressure

a

After teaching the parents of a 9-year-old girl about safety, which statement indicates the need for additional teaching? A) "She can ride in the front seat of the car once she is 10 years old." B) "We need to buy her a helmet so she can ride her scooter." C) "She should ride her bike with the traffic on the side of the road." D) "We signed her up for swim lesions at the local community center."

a

An infant is diagnosed with a congenital cataract. Which of the following would the nurse expect to assess? A) Absent red reflex B) Rapid irregular eye movement C) Misalignment of the eyes D) Enlarged eye appearance

a

An infant is diagnosed with infantile glaucoma. When developing the plan of care for the infant, the nurse would expect to prepare the infant and family for which of the following? A) Goniotomy B) Antibiotic therapy C) Contact lenses D) Patching of affected eye

a

During a health check-up without his parents, a 17-year-old tells the nurse he is gay. Which of the following approaches should the nurse take? A) "Tell me what makes you think you are gay." B) "This puts you in an at-risk category." C) "We need to talk about safe sex." D) "You're not gay; you're confused."

a

The mother of a 14-year-old girl complains to the nurse that her daughter is moody, shuts herself in her room, and fights with her younger sister. Which of the following comments is most valuable to the mother? A) "Calmly talk to her about your concerns." B) "This is normal for her age." C) "She may be hanging with a bad crowd." D) "Set some rules for family etiquette."

a

After teaching a class on sexual violence, the instructor determines that the teaching was successful when the class identifies which of the following as a type of sexual violence. (Select all that apply.) A) Female genital cutting B) Bondage C) Infanticide D) Human trafficking E) Rape

a b c d e

The mother of a 5-year-old girl brings the child to the clinic for an evaluation. The mother tells the nurse, "She seems to be so tired and irritable lately. And she looks so pale." Further assessment reveals pale conjunctiva and oral mucous membranes. The nurse suspects iron- deficiency anemia. Which additional finding would help provide additional evidence for this suspicion? A) Spooned nails B) Negative splenomegaly C) Oxygen saturation: 99% D) Bradycardia

a

The mother of a 7-year-old girl tells the school nurse that her child is deathly afraid of going to school. What would be the best intervention the nurse could suggest in this situation? A) Return the child to school and investigate the cause of the fear. B) Have the child stay home from school until any issues causing this fear are resolved. C) Investigate a new school for the child to attend that the child will not be afraid of. D) Tell the child that privileges will be taken away if she does not return to school.

a

The mother of a school-age child brings the child to the clinic for evaluation because he is having difficulty reading. His last visual screening was normal. He also complains of headaches and dizziness. Which of the following would the nurse suspect? A) Astigmatism B) Myopia C) Hyperopia D) Nystagmus

a

The nurse contacts a child life specialist (CLS) to work with children on a pediatric ward. What is the primary goal of the CLS? A) Decrease anxiety and fear during hospitalization and painful procedures B) Keep children who are hospitalized distracted from pain C) Perform medical procedures using atraumatic principles D) Act as a liaison between the nurse and the child

a

The nurse determines that it is necessary to implement airborne precautions for children with which of the following infections? A) Measles B) Streptococcus group A C) Rubella D) Scarlet fever

a

The nurse explains to parents of school-age children that according to Kohlberg's theory of moral development, their child is at the conventional stage of moral development. What is the motivation for school-age children to follow rules? A) They follow rules out of a sense of being a "good person." B) They follow rules out of fear of being punished. C) They follow rules in order to receive praise from caretakers. D) They follow rules because it is in their nature to do so.

a

The nurse in a community clinic is caring for a 6-month-old boy and his mother. Which of the following is the priority intervention to promote adequate growth? A) Monitoring the child's weight and height B) Encouraging a more frequent feeding schedule C) Assessing the child's current feeding pattern D) Recommending higher-calorie solid foods

a

The nurse is caring for a 10-year-old with allergic conjunctivitis. The nurse would be alert to the child's increased risk for which of the following? A) Atopic dermatitis B) Insect bite sensitivity C) Acute otitis media D) Frequent sore throats

a

The nurse is caring for a 14-year-old boy with an osteosarcoma. Which of the following communication techniques would be least effective for him? A) Letting him choose juice or soda to take pills B) Seeking the teenager's input on all decisions C) Discussing the benefits of chemotherapy with him D) Avoiding undue criticism of noncompliance

a

The nurse is caring for a 5-year-old girl posttonsillectomy. The girl looks out the window and tells the nurse that it is raining and says, "The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process? A) Magical thinking B) Centration C) Transduction D) Animism

a

The nurse is caring for a 7-month-old girl during a well-child visit. Which of the following interventions is most appropriate for this child? A) Discussing the type of sippy cup to use B) Advising about increased caloric needs C) Explaining how to prepare table meats D) Describing the tongue extrusion reflex

a

The nurse is caring for a 7-year-old girl who is scheduled for a hernia repair and is very scared. Which of the following fears would she also most likely have at this age? A) Fear of being kidnapped B) Fear of cutting her finger C) Fear of sudden loud noises D) Fear of the neighbor's dog

a

The nurse is caring for a child with thalassemia who is receiving chelation therapy at home using a battery-operated pump. After teaching the parents about this treatment, which statement by the mother indicates a need for additional teaching? A) "I can have the nurse administer the chelation therapy if I am uncomfortable." B) "I must be very careful to strictly adhere to the chelation regimen." C) "The deferoxamine binds to the iron so it can be removed from the body." D) "The medication can be administered while my child is sleeping."

a

The nurse is caring for a premature baby in the NICU. The mother reports that the infant's normally happy and outgoing 5-year-old sister is acting sad and withdrawn. The nurse understands that due to her developmental stage, the girl is at risk of which of the following? A) Viewing her baby sister's illness as her fault B) Harming the baby C) Experiencing clinical depression D) Creating an imaginary friend to cope with the situation

a

The nurse is conducting a physical examination of a toddler with suspected lead poisoning. Lab results indicate blood lead level 52 m g/dL. Which action would the nurse expect to happen next? A) Repeat testing within 2 days and prepare to begin chelation therapy as ordered B) Repeat testing within 1 week with education to decrease lead exposure C) Confirm with repeat testing in 1 month and referral to local health department D) Prepare to admit child to begin chelation therapy

a

The nurse is conducting a well-child assessment for a 5-year-old boy in preparation for kindergarten. The boy's grandmother is his primary caregiver because the boy's mother has suffered from depression and substance abuse issues. The nurse understands that the child is at increased risk for which developmental problem? A) Lack of social and emotional readiness for school B) Stuttering C) Speech and language delays D) Fine motor skills delay

a

The nurse is describing the maturation of various organ systems during toddlerhood to the parents. Which would the nurse correctly include in this description? A) Myelinization of the brain and spinal cord is complete at about 24 months. B) Alveoli reach adult numbers by 3 years of age. C) Urine output in a toddler typically averages approximately 30 mL/hour. D) Toddlers typically have strong abdominal muscles by the age of 2.

a

The nurse is developing a plan of care for a 5-year-old child with a severe hearing impairment focusing on psychosocial interventions based on assessment findings. Which behavior would the nurse have most likely assessed? A) Immature emotional behavior B) Self-stimulatory actions C) Inattention and vacant stare D) Head tilt or forward thrust

a

The nurse is explaining to parents that the preschooler's developmental task is focused on the development of initiative rather than guilt. Which of the following is a priority intervention the nurse might recommend for parents of preschoolers to stimulate initiative? A) Reward the child for initiative in order to build self-esteem. B) Change the routine of the preschooler often to stimulate initiative. C) Do not set limits on the preschooler's behavior as this results in low self-esteem. D) As a parent, decide how and with whom the child will play.

a

The nurse is helping the parents and their underweight adolescent collaborate on planning a healthy menu. Of which of the following nutritional requirements of adolescents should the nurse be aware? A) Teenagers have a need for increased calories, zinc, calcium, and iron for growth. B) Teenage girls who are active require about 1,800 calories per day. C) Teenage boys who are active require between 2,000 and 2,500 calories per day. D) Adolescents require about 1,000 to 1,200 mg of calcium each day.

a

The nurse is implementing care for a hospitalized toddler. What communication technique would the nurse use with the child to reflect the child's developmental level? A) Allow the child extra time to complete thoughts. B) Communicate solely through play. C) Provide simple but honest and straightforward responses. D) Remain nonjudgmental to avoid alienation.

a

The nurse is interviewing a 3-year-old girl who tells the nurse: "Want go potty." The parents tell the nurse that their daughter often speaks in this type of broken speech. What would be the nurse's appropriate response to this concern? A) "This is a normal, common speech pattern in the 3-year-old and is called telegraphic speech." B) "This is considered a developmental delay in the 3-year-old and we should consult a speech therapist." C) "This is a condition known as echolalia and can be corrected if you work with your daughter on language skills." D) "This is a condition known as stuttering and it is a normal pattern of speech development in the toddler."

a

The nurse is performing a physical examination of an 8-year-old girl who was bitten by her kitten. Which of the following assessments would lead the nurse to suspect cat- scratch disease? A) Swollen lymph nodes B) Strawberry tongue C) Infected tonsils D) Swollen neck

a

The nurse is performing an annual check-up for an 8-year-old child. Compared to the previous assessment of this child, which of the following characteristics would most likely be observed? A) Breathing is diaphragmatic. B) Pulse rate is increased. C) Secondary sex characteristics are present. D) Blood pressure has reached adult level.

a

The nurse is preparing a class for a group of adolescents about promoting safety. Which of the following would the nurse plan to include as the leading cause of adolescent injuries? A) Car accidents B) Firearms C) Water D) Fires

a

The nurse is providing anticipatory guidance to the mother of a 9-month-old girl during a well-baby visit. Which of the following topics would be most appropriate? A) Advising how to create a toddler-safe home B) Warning about small objects left on the floor C) Cautioning about putting the baby in a walker D) Telling about safety procedures during baths

a

The nurse is providing teaching about accidental poisoning to the family of a 3-year-old. The nurse understands that a child of this age is at increased risk of accidental ingestion due to which sensory alteration? A) A less discriminating sense of taste B) A lack of fully developed hearing C) Visual acuity that has not fully developed D) A less discriminating sense of touch

a

The nurse is teaching a new mother about the drastic growth and developmental changes her infant will experience in the first year of life. Which of the following describes a developmental milestone occurring in infancy? A) By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months, the brain weighs 2.5 times what it did at birth. B) Most infants triple their birthweight by 4 to 6 months of age and quadruple their birthweight by the time they are 1 year old. C) The head circumference increases rapidly during the first 6 months: the average increase is about 1 inch per month. D) The heart triples in size over the first year of life; the average pulse rate decreases from 120 to 140 in the newborn to about 100 in the 1-year-old.

a

The nurse is teaching the parents of an overweight 18-month-old girl about diet. Which intervention will be most effective for promoting proportionate growth? A) Remove high-calorie, low-nutrient foods from the diet. B) Ensure 30 minutes of unstructured activity per day. C) Avoid sharing your snacks and candy with the child. D) Reduce the amount of high-fat food the child eats.

a

The nurse is watching toddlers at play. Which of the following normal behaviors would the nurse observe? A) Toddlers engage in parallel play. B) Toddlers engage in solitary play. C) Toddlers engage in cooperative play. D) Toddlers do not engage in play outside the home.

a

The nurse knows that the school-age child is in Erikson's stage of industry versus inferiority. Which of the following is the best example of a school-ager working toward accomplishing this developmental task? A) The child signs up for after-school activities. B) The child performs his bedtime preparations autonomously. C) The child becomes aware of the opposite sex. D) The child is developing a conscience.

a

The nurse observing toddlers in a day care center notes that they may be happy and pleasant one moment and overreact to limit setting the next minute by throwing a tantrum. What is the focus of the toddler's developmental task that is driving this behavior? A) The need for separation and control B) The need for love and belonging C) The need for safety and security D) The need for peer approval

a

The nurse teaches parents of adolescents that adolescents need the support of parents and nurses to facilitate healthy lifestyles. Which of the following should be a priority focus of this guidance? A) Reducing risk-taking behavior B) Promoting adequate physical growth C) Maximizing learning potential D) Teaching personal hygiene routines

a

The nurse uses family-centered care to care for children in a pediatric office. Upon what concept is family-centered care based? A) The family is the constant in the child's life and the primary source of strength. B) The care provider is the constant in the child's life and the primary source of strength. C) The child must be prepared to be his or her own source of strength during times of crisis. D) The wishes of the family should direct the nursing care plan for the child.

a

The parent of a 6-month old infant asks the nurse for advice about his son's thumb sucking. What would be the nurse's best response to this parent? A) "Thumb sucking is a healthy self-comforting activity." B) "Thumb sucking leads to the need for orthodontic braces." C) "Caregivers should pay special attention to the thumb sucking to stop it." D) "Thumb sucking should be replaced with the use of a pacifier."

a

The parents of a 1-year-old girl, both of whom have perfect teeth, are concerned about their child getting dental caries. Which is the best advice the nurse can provide? A) Tell the parents to limit the child's eating to meal and snack times. B) Urge the parents to take the child to a dentist for a check-up. C) Advise the parents to reduce carbohydrates in the child's diet. D) Advise the parents to use fluoride toothpaste.

a

The parents of a 4-year-old who is a picky eater ask the nurse what foods to include in their child's diet to provide adequate iron consumption. Which of the following foods would the nurse recommend? A) Cooked lentils B) Whole milk C) Oranges D) Sweet potatoes

a

The parents of a 5-year-old have just found out that their child has head lice. Which statement by the parents would support the nursing diagnosis of deficient knowledge? A) "I can't believe it. We're not unclean, poor people." B) "We'll have to get that special shampoo." C) "Everybody in the house will need to be checked." D) "That explains his complaints of itching on his neck."

a

The physician has ordered rectal diazepam (Valium) for a 2-year-old boy with status epilepticus. Which of the following instructions is essential for the nurse to teach the parents? A) Monitor their child's level of sedation. B) Watch for fever indicating infection. C) Gradually reduce the dosage as seizures stop. D) Monitor for an allergic reaction to the medication.

a

When a nurse suspects that a client may have been abused, the first action should be to: A) Ask the client about the injuries and if they are related to abuse. B) Encourage the client to leave the batterer immediately. C) Set up an appointment with a domestic violence counselor. D) Ask the suspected abuser about the victim's injuries.

a

When developing a presentation for a local community organization on violence, the nurse is planning to include statistics on intimate partner abuse and its effects on children. In what percentage of the cases in which a parent is abused are the children battered also? A) 50% to 75% B) 25% to 50% C) 10% to 25% D) Less than 5%

a

When evaluating the hemogram of an 8-month-old infant, the nurse would identify which type of hemoglobin as being the predominant type? A) Hemoglobin A B) Hemoglobin F C) Hemoglobin A2 D) Hemoglobin S

a

When observing a group of preschoolers at play in the clinic waiting room, which type of play would the nurse be least likely to note? A) Parallel play B) Cooperative play C) Dramatic play D) Fantasy play

a

When providing anticipatory guidance to parents about lying during the preschool period, which of the following would the nurse emphasize? A) "You need to determine the reason for lying before punishing the child." B) "Lying typically occurs because the child is afraid of being punished." C) "The misbehavior is usually more serious than the lying itself." D) "It is okay to become angry when dealing with the child's lying."

a

When providing care to a child with aplastic anemia, which nursing diagnosis most likely would be the priority? A) Risk for injury B) Imbalanced nutrition, less than body requirements C) Ineffective tissue perfusion D) Impaired gas exchange

a

When the nurse is alone with a client, the client says, "It was all my fault. The house was so messy when he got home and I know he hates that." Which response would be most appropriate? A) "It is not your fault. No one deserves to be hurt. " B) "What else did you do to make him so angry with you?" C) "You need to start to clean the house early in the day." D) "Remember, he works hard and you need to meet his needs."

a

While a nurse is obtaining a health history, the client tells the nurse that she practices aromatherapy. The nurse interprets this as which of the following? A) Use of essential oils to stimulate the sense of smell to balance the mind and body B) Application of pressure to specific points to allow self-healing C) Use of deep massage of areas on the foot or hand to rebalance body parts D) Participation in chanting and praying to promote healing

a

The nurse is developing a plan of care for a child with thalassemia. Which of the following would the nurse expect to include? Select all that apply. A) Packed RBC transfusions B) Deferoxamine therapy C) Heparin therapy D) Opioid analgesics E) Platelet transfusions F) Intravenous immunoglobulin

a b

The nurse is assessing the psychosocial development of a preschooler. Which of the following are normal activities characteristic of the preschooler? Select all answers that apply. A) Plans activities and makes up games B) Initiates activities with others C) Acts out roles of other people D) Engages in parallel play with peers E) Classifies or groups objects by their common elements F) Understands relationships among objects

a b c

The nurse is assessing a child with aplastic anemia. Which of the following would the nurse expect to assess? Select all that apply. A) Ecchymoses B) Tachycardia C) Guaiac-positive stool D) Epistaxis E) Severe pain F) Warm tender joints

a b c d

The nurse is caring for preschoolers in a day care center. Of which of the following developmental milestones of this age group should the nurse be aware? Select all answers that apply. A) Counting 10 or more objects B) Correctly naming at least four colors C) Understanding the concept of time D) Knowing everyday objects E) Understanding the differences of others F) Forming concepts as logical as an adult's

a b c d

A nurse is working with a victim of intimate partner violence and helping her develop a safety plan. Which of the following would the nurse suggest that the woman take with her? (Select all that apply.) A) Driver's license B) Social security number C) Cash D) Phone cards E) Health insurance cards

a b c e

The nurse is teaching the parents of a child diagnosed with iron-deficiency anemia about ways to increase their child's intake of iron. The parents demonstrate understanding of the teaching when they identify which foods as good choices for the child? Select allthat apply. A) Tuna B) Salmon C) Tofu D) Cow's milk E) Dried fruits

a b c e

The school nurse providing school health screenings knows that the 7- to 11-year-old is in Piaget's stage of concrete operational thoughts. Which of the following should this age group accomplish when developing operations? Select all answers that apply. A) Ability to assimilate and coordinate information about the world from different dimensions B) Ability to see things from another person's point of view and think through an action C) Ability to use stored memories of past experiences to evaluate and interpret present situations D) Ability to think about a problem from all points of view, ranking the possible solutions while solving the problem E) Ability to think outside of the present and incorporate into thinking concepts that do exist as well as concepts that might exist F) Ability to understand the principle of conservation—that matter does not change when its form changes

a b c f

A nurse is developing a plan of care for a child who is admitted to the hospital for surgery. The child is visually impaired. Which of the following would be most appropriate for the nurse to include in the child's plan of care? Select all answers that apply. A) Explaining instructions using simple and specific terms the child understands B) Allowing the child to explore the postoperative equipment with his hands C) Touching the child on his shoulder before letting the child know someone is there D) Using the child's body parts to refer to the area where he may have postoperative pain E) Speaking to the child in a voice that is slightly louder than the usual tone of voice

a b d

A nurse suspects that an adolescent may have community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA). Which of the following would the nurse expect to assess? Select all answers that apply. A) Participation in contact sport B) Recent cut on the lower leg C) History of a recent sort throat D) Raised fluctuant lesions E) Erythematous rash over the trunk and face

a b d

The nurse is teaching the parents of a 4-year-old boy about the normal maturations of the child's organs during the preschool years and their effect on body functions. Which of the following statements accurately describe these changes? Select all answers that apply. A) Myelination of the spinal cord allows for bowel and bladder control to be complete in most children by age 3 years. B) The respiratory structures are continuing to grow in size, and the number of alveoli continues to increase, reaching the adult number at about 7 years of age. C) Heart rate increases and blood pressure decreases slightly during the preschool years; an innocent heart murmur may be heard upon auscultation. D) The bones continue to increase in length and the muscles continue to strengthen and mature; however, the musculoskeletal system is still not fully mature. E) The small intestine is continuing to grow in length, and stool passage usuallyoccurs once or twice per day in the average preschooler. F) The urethra remains long in both boys and girls, making them more susceptible to urinary tract infections than adults.

a b d e

The school nurse is helping parents choose books for their preschoolers. What literacy skills present in the preschooler would the nurse consider when making choices? Select all answers that apply. A) Preschoolers enjoy books with pictures that tell stories. B) Preschoolers like stories with repeated phrases as they help keep their attention. C) Preschoolers like stories that describe experiences different from their own. D) Preschoolers demonstrate early literacy skills by reciting stories or portions of books. E) Preschoolers may retell the story from the book, pretend to read books, and ask questions about the story. F) Preschoolers do not have enough focus and expanded attention to notice when a page is skipped during reading.

a b d e

A 15-year-old adolescent is brought to the emergency department by his parents. The adolescent is febrile with chills that started suddenly. He states, "I had a sinus infection and sore throat a couple of days ago." The nurse suspects bacterial meningitis based on which of the following? Select all answers that apply. A) Complaints of stiff neck B) Photophobia C) Absent headache D) Negative Brudzinski sign E) Vomiting

a b e

A nurse is preparing a teaching plan for a woman who is pregnant for the first time. Which of the following would the nurse incorporate into the teaching plan to foster the client's learning? (Select all that apply.) A) Teach "survival skills" first B) Use simple, nonmedical language C) Refrain from using a hands-on approach D) Avoid repeating information E) Use visual materials such as photos and videos

a b e

The school nurse is teaching parents risk factors for suicide in adolescents. Which of the following would the nurse discuss? Select all answers that apply. A) Mental health changes B) History of previous suicide attempt C) Higher socioeconomic status D) Greatly improved school performance E) Family disorganization F) Substance abuse

a b e f

When assessing adolescents for health risks, the nurse must keep in mind the factors related to the prevalence of adolescent injuries. Which of the following accurately describe these factors? Select all answers that apply. A) Increased physical growth B) Insufficient psychomotor coordination C) Tiredness, lack of energy D) Lack of impulsivity E) Peer pressure F) Inexperience

a b e f

The nurse is providing atraumatic care to children in a hospital setting. Which of the following are principles of this philosophy of care? Select all answers that apply. A) Avoid or reduce painful procedures B) Avoid or reduce physical distress C) Minimize parent-child interactions D) Provide child-centered care E) Minimize child control F) Use core primary nursing

a b f

The school nurse is conducting a seminar for parents of adolescents on how to communicate with teenagers. Which of the following guidelines might the nurse recommend? Select all answers that apply. A) Talk face to face and be aware of body language. B) Ask questions to see why he or she feels that way. C) Do not give praise unless the adolescent deserves it. D) Speak to your child as an authority figure, not an equal. E) Don't admit that you make mistakes. F) Don't pretend you know all the answers.

a b f

A pregnant woman asks the nurse about giving birth in a birthing center. She says, "I'm thinking about using one but I'm not sure." Which of the following would the nurse need to integrate into the explanation about this birth setting? (Select all that apply.) A) An alternative for women who are uncomfortable with a home birth. B) The longer length of stay needed when compared to hospital births C) Focus on supporting women through labor instead of managing labor D) View of labor and birth as a normal process requiring no intervention E) Care provided primarily by obstetricians with midwives as backup care

a c d

The nurse caring for newborns knows that infants exhibit phenomenal increases in their gross motor skills over the first 12 months of life. Which of the following statements accurately describe the typical infant's achievement of these milestones? Select all answers that apply. A) At 1 month the infant lifts and turns the head to the side in the prone position. B) At 2 months the infant lifts head and looks around. C) At 6 months the infant pulls to stand up. D) At 7 months the infant sits alone with some use of hands for support. E) At 9 months the infant crawls with the abdomen off the floor. F) At 12 months the infant walks independently.

a d e f

A 3-year-old boy has been on chemotherapy for cancer. He complains about a sore throat, is experiencing malaise, and has a temperature of 99.8°F orally. His mother calls the child's physician. What is the appropriate information for the nurse to tell his mother at this time? A) "Continue to watch the child, giving him aspirin and cool fluids for the fever." B) "Plan to bring the child into the physician's office today." C) "Monitor the temperature, but not to worry unless it gets above 104°F." D) "Keep the child warm and as comfortable as possible."

b

A battered pregnant woman reports to the nurse that her husband has stopped hitting her and promises never to hurt her again. Which of the following is an appropriate response? A) "That's great. I wish you both the best." B) "The cycle of violence often repeats itself." C) "He probably didn't mean to hurt you." D) "You need to consider leaving him."

b

A child is brought to the emergency department after sustaining a concussion. The child is to be discharged home with his parents. Which of the following would the nurse include in the child's discharge instructions? A) "Expect his headache to get worse initially and then disappear." B) "Wake him every 2 hours to check his movement and responses." C) "Call your medical provider if he vomits more than five times." D) "Any watery fluid draining from his ears is normal."

b

A child is diagnosed with bacterial conjunctivitis and is prescribed topical antibiotic therapy. The child's mother asks when he can return to school. Which response by the nurse would be most appropriate? A) "You need to wait until you finish the entire prescription of antibiotic." B) "Once the drainage is gone, he can go back to school." C) "You can send him to school this afternoon after his first dose of antibiotic." D) "He needs to be symptom-free for at least 72 hours."

b

A child is prescribed monthly injections of vitamin B12. When developing the teaching plan for the family, the nurse would focus on which type of anemia? A) Aplastic anemia B) Pernicious anemia C) Folic acid anemia D) Sickle cell anemia

b

A child with iron-deficiency anemia is prescribed ferrous fumarate, 3 mg/kg/day in two divided doses. The nurse interprets this order as indicating which of the following? A) The child requires a prophylactic dose of iron. B) The child has mild to moderate iron deficiency. C) The child has severe iron deficiency. D) The child is being prepared for packed red blood cell administration.

b

A child with suspected sickle cell disease is scheduled for a hemoglobin electrophoresis. When reviewing the child's history, which of the following would the nurse identify as potentially interfering with the accuracy of the results? A) Use of iron supplementation B) Blood transfusion 1 month ago C) Lack of fasting for 12 hours D) History of recent infection

b

A group of nursing students are reviewing the six links in the chain of infection and the nursing implications for each. The students demonstrate understanding of the information when they identify which precaution as helping to break the chain of infection to the susceptible host? A) Keeping linens dry and clean B) Maintaining skin integrity C) Washing hands frequently D) Coughing into a handkerchief

b

A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm. How might the nurse respond to this information? A) "This is a primitive reflex known as the plantar grasp." B) "This is a primitive reflex known as the palmar grasp." C) "This is a protective reflex known as rooting." D) "This is a protective reflex known as the Moro reflex."

b

A nurse is assessing a rape survivor for post-traumatic stress disorder. The nurse asks the woman, "Do you feel as though you are reliving the trauma?" The nurse is assessing for which of the following? A) Physical symptoms B) Intrusive thoughts C) Avoidance D) Hyperarousal

b

A nurse is conducting a health history for a 1-month-old with an infectious disorder. Which segment of the health history would be most helpful for the nurse when determining if the infant developed the infection from the mother? A) Family history B) Past medical history C) Home treatments D) Present illness history

b

A nurse is leading a discussion with a group of new mothers about newborn nutrition and its importance for growth and development. One of the mothers asks, "Doesn't the baby get iron from me before birth?" Which response by the nurse would be most appropriate? A) "You give the baby some iron, but it is not enough to sustain him after birth." B) "Because the baby grows rapidly during the first months, he uses up what you gave him." C) "The iron you give him before birth is different from what he needs once he is born." D) "If the baby didn't use up what you gave him before birth, he excretes it soon after birth."

b

A nurse is presenting a discussion on sexual violence at a local community college. When describing the incidence of sexual violence, the nurse would identify that a woman has which chance of experiencing a sexual assault in her lifetime? A) One in three B) One in six C) Two in 15 D) Three in 20

b

A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm3. Which medication would the nurse most likely expect to be ordered? A) Folic acid B) Intravenous immune globulin C) Dimercaprol D) Deferoxamine

b

A nurse is reading a journal article about sexual abuse. Which age range would the nurse expect to find as the peak age for such abuse? A) 7-10 years B) 8-12 years C) 14-18 years D) 18-22 years

b

A nurse is reviewing the medical record of a child with hearing loss and notes that the child's hearing loss is in the range 40 to 60 decibels (dB). The nurse interprets this as indicating which of the following? A) Mild loss B) Moderate loss C) Severe loss D) Profound loss

b

A nurse practicing in the community is preparing a presentation for a group of nursing students about this practice setting. Which of the following would the nurse include as characteristic of this role? A) Greater emphasis on direct physical care B) Broader assessment to include the environment C) Increased dependency on physician D) Limited decision making and support

b

A nursing instructor is teaching a group of students about the action of antipyretic agents in children. The instructor determines that the teaching has been successful when the students identify which of the following as the primary action? A) Cause vasodilation to promote heat loss B) Decrease the temperature set point C) Block release of histamine D) Promote prostaglandin production

b

A pregnant client tells her nurse that she is interested in arranging a home birth. After educating the client on the advantages and disadvantages, which statement would indicate that the client understood the information? A) "I like having the privacy, but it might be too expensive for me to set up in my home." B) "I want to have more control, but I am concerned if an emergency would arise." C) "It is safer because I will have a midwife." D) "The midwife is trained to resolve any emergency, and she can bring any pain meds."

b

After teaching a group of new parents about their newborns' eyes and vision, which statement by the group indicates effective teaching? A) "Our newborn can see at distances of about 1 to 2 feet." B) "We won't know the baby's eye color until he's at least 6 months old." C) "A baby can easily distinguish colors, but they must be bright colors." D) "A newborn can focus with both eyes at the same time shortly after birth."

b

After teaching a mother how to remove a tick from her 6-year-old boy's arm, the nurse determines that additional teaching is needed when the mother states which of the following? A) "I'll protect my fingers with a paper towel." B) "I'll grasp the tick and pull it away quickly." C) "I should put the tick in a plastic bag in the freezer." D) "I need to grasp the tick close to the child's skin."

b

Assessment of a child leads the nurse to suspect viral conjunctivitis based on which of the following? A) Mild pain B) Photophobia C) Itching D) Watery discharge

b

During a health history, the nurse explores the sleeping habits of a 3-yearold boy by interviewing his parents. Which of the following statements from the parents reflects a recommended guideline for promoting healthy sleep in this age group? A) "Our son sleeps through the night, and we insist that he takes two naps a day." B) "We keep a strict bedtime ritual for our son, which includes a bath and bedtime story." C) "Our son still sleeps in a crib because we feel it is the safest place for him at night." D) "Our son occasionally experiences night walking so we allow him to stay up later when this happens."

b

During a well-child visit, the nurse assesses an infant's ability to suck on a pacifier. The nurse is assessing which cranial nerve? A) Olfactory B) Trigeminal C) Facial D) Accessory

b

In addition to providing privacy, which of the following would be most appropriate initially in situations involving suspected abuse? A) Allow the client to have a good cry over the situation. B) Tell the client, "Injuries like these don't usually happen by accident." C) Call the police immediately so they can question the victim. D) Ask the abuser to describe his side of the story first.

b

The child life specialist (CLS) is preparing a 6-year-old child for a magnetic resonance imaging (MRI) scan. Which of the following statements reflects the use of atraumatic principles when explaining the procedure? A) "You will be taken to a magnetic resonance imaging machine for an x-ray of your liver." B) "You may hear some loud noises when you are lying in the machine, but they won't hurt you." C) "You have nothing to worry about; the MRI machine is safe and will not cause you any pain." D) "Let's just get you to the x-ray department for your test and you'll see how simple it is."

b

The mother of a 5-year-old boy calls the nurse and seeks advice on how to assist the child with the recent death of his paternal grandfather. The boy keeps asking when his grandpa is coming back. How should the nurse respond? A) "It is best to just ignore this and to not respond to his questions." B) "This is normal; children his age do not understand the permanence of death." C) "You have to keep repeating that his grandfather is never coming back." D) "He will eventually figure this out on his own."

b

The nurse is assessing a 2-year-old boy who has missed some developmental milestones. Which finding will point to the cause of motor skill delays? A) The mother is suffering from depression. B) The child is homeless and has no toys. C) The mother describes an inadequate diet. D) The child is unperturbed by a loud noise.

b

The nurse is assessing a 4-month-old boy during a scheduled visit. Which of the following findings might suggest a developmental problem? A) The child does not coo or gurgle. B) The child does not babble or laugh. C) The child never squeals or yells. D) The child does not say dada or mama.

b

The nurse is assessing a child with suspected thalassemia. Which of the following would the nurse expect to assess? A) Dactylitis B) Frontal bossing C) Presence of clubbing D) Presence of spooning

b

The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching? A) "We should avoid aspirin and drugs like ibuprofen." B) "He can resume participation in football in 2 weeks." C) "Swimming would be a great activity." D) "Our son cannot take any antihistamines."

b

The nurse is caring for a 3-month-old with nasolacrimal duct obstruction. Which intervention would be most appropriate for the nurse to implement? A) Being careful to prevent spread of infection B) Teaching the parents how to gently massage the duct C) Applying hot, moist compresses to the affected eye D) Referring the child to an ophthalmologist

b

The nurse is caring for a 4-week-old girl and her mother. Which of the following is the most appropriate subject for anticipatory guidance? A) Promoting the digestibility of breast milk B) Telling how and when to introduce rice cereal C) Describing root reflex and latching on D) Advising how to choose a good formula

b

The nurse is caring for a newborn and knows that his vision, unlike his hearing, is not fully developed. Which aspect of the child's vision would the nurse expect to be similar to his father's vision? A) Adequate color detection B) Visual acuity of 20/100 C) Nearsightedness D) Monocular vision

b

The nurse is conducting a well-child examination of a 5-year-old girl, who was 40 inches tall at her last examination at age 4. Which of the following height measurements would be within the normal range of growth expected for a preschooler? A) 41 inches B) 43 inches C) 45 inches D) 47 inches

b

The nurse is counseling parents of a picky eater on how to promote healthy eating habits in their child. Which of the following interventions would be appropriate advice? A) Allow the child to pick out his or her own foods for meals. B) Present the food matter-of-factly and allow the child to choose what to eat. C) Offer high-fat snacks if the child does not eat to get him or her to eat something. D) Offer the child a special treat if he or she eats all the food on the plate.

b

The nurse is counseling the mother of a newborn who is concerned about her baby's constant crying. What teaching would be appropriate for this mother? A) Carrying the baby may increase the length of crying. B) Reducing stimulation may decrease the length of crying. C) Using vibration, white noise, or swaddling may increase crying. D) Using a swing or car ride may increase the incidence of crying episodes.

b

The nurse is educating a first-time mother who has a 1-week-old boy. Which of the following is the most accurate anticipatory guidance? A) Describing the effect of neonatal teeth on breastfeeding B) Explaining that the stomach holds less than 1 ounce C) Informing that fontanels will close by 6 months D) Telling that the step reflex persists until the child walks

b

The nurse is evaluating the laboratory test results of a 7-year-old child with a suspected hematologic disorder. Which finding would cause the nurse to be concerned? A) WBC: 5.6 × 103/mm3 B) RBC: 2.8 × 106/mm3 C) Hemoglobin: 11.4 mg/dL D) Hematocrit: 35%

b

The nurse is examining a 3-year-old boy with acute otitis media who has a mild earache and a temperature of 38.5o C. Which of the following actions will be taken? A) Obtain a culture of the middle ear fluid. B) Instruct the parents to watch for worsening symptoms. C) Administer antibiotics. D) Administer antivirals.

b

The nurse is explaining a discharge plan to the parents of an infant being discharged from the hospital. Which of the following characteristics regarding adult learning should the nurse incorporate into her plan? A) Adults are dependent learners. B) Adults are problem focused. C) Adults are future focused. D) Adults do not value past learning.

b

The nurse is incorporating nonverbal communication with verbal communication when explaining the treatment plan for a child with juvenile diabetes. Which of the following should the nurse do to communicate effectively with this family? A) Relax; maintain an open posture, with the arms crossed. B) Sit opposite the family and lean forward slightly. C) Use eye contact sparingly to avoid embarrassment. D) Speak a verbal yes or no; do not use head nods.

b

The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development? A) The child has trouble undressing himself. B) The child is unable to push a toy lawnmower. C) The child is unable to unscrew a jar lid. D) The child falls when he bends over.

b

The nurse is performing a physical assessment of a 10-year-old boy. The nurse notes that during last year's check-up the child weighed 80 pounds. According to average growth for this age group, what would be his expected current weight? A) 83 pounds B) 85 pounds C) 87 pounds D) 89 pounds

b

The nurse is performing a physical examination of an 11-year-old girl. Which of the following observations would be expected? A) The child has not gained weight since last year. B) The child has grown 3 inches since last year. C) The child breathes abdominally. D) The child's third molars are about to erupt.

b

The nurse is presenting a class at a local community health center on violence during pregnancy. Which of the following would the nurse include as a possible complication? A) Hypertension of pregnancy B) Chorioamnionitis C) Placenta previa D) Postterm labor

b

The nurse is providing anticipatory guidance for parents of a preschooler regarding sex education. Which of the following is a recommended guideline when dealing with this issue? A) Be prepared to thoroughly cover a topic before the child asks about it. B) Before answering questions, find out what the child thinks about the subject. C) Expand upon the topic when answering questions to prevent further confusion. D) Provide a less than honest response to shelter the child from knowledge that is too advanced.

b

The nurse is providing anticipatory guidance for parents of a school-age child on teaching the dangers of drugs and alcohol. Which of the following advice might be helpful for these parents? A) School-age children are not ready to absorb information that deals with drugs and alcohol. B) School-age children can think critically to interpret messages seen in advertising, media, and sports. C) Parents must prevent their child from being exposed to messages that are in conflict with their values. D) Discussions with children need to be based on facts and focused on the past and future.

b

The nurse is providing anticipatory guidance to a mother of a 5-month-old boy about introducing solid foods. Which statement by the mother indicates that effective teaching has occurred? A) "I'll start with baby oatmeal cereal mixed with low-fat milk." B) "The cereal should be a fairly thin consistency at first." C) "I can puree the meat that we are eating to give to my baby." D) "Once he gets used to the cereal, then we'll try giving him a cup."

b

The nurse is talking with a chatty 7-year-old girl during her regular check-up. Which of the following behaviors would the child also be expected to exhibit? A) Showing no interest in what the nurse sees in her ears B) Explaining what is right and what is wrong C) Demonstrating independence from her mother D) Showing no concern when the nurse hurts her own finger

b

The nurse is teaching a new mother about the development of sensory skills in her newborn. Which of the following would alert the mother to a sensory deficit in her child? A) The newborn's eyes wander and occasionally are crossed. B) The newborn does not respond to a loud noise. C) The newborn's eyes focus on near objects. D) The newborn becomes more alert with stroking when drowsy.

b

The nurse is teaching good sleep habits for toddlers to the mother of a 2-year-old boy. Which response indicates the mother understands sleep requirements for her son? A) "I'll put him to bed at 7 p.m., except Friday and Saturday." B) "He needs 13 hours of sleep per day including his nap." C) "I need to put the side down on the crib so he can get out." D) "His father can give him a horseback ride into his bed."

b

The nurse is teaching the parents of a 12-year-old boy about appropriate approaches when raising an adolescent. Which of the following comments should be included in the discussion? A) "Find out if his friends are worthy of him." B) "Try to be open to his views." C) "Maintain a firm set of rules." D) "Remind him that he is still your little boy."

b

The nurse is teaching the parents of a 2-year-old toddler methods of dealing with their child's "negativism." Based on Erokson's theory of development, which of the following would be an appropriate intervention for this child? A) Discourage solitary play; encourage playing with other children. B) Encourage the child to pick out his own clothes. C) Use "time-outs" whenever the child says "no" inappropriately. D) Encourage the child to take turns when playing games.

b

The nurse is teaching the parents of a 9-year-old girl about the socialization that is occurring in their child through school contacts. Which of the following information would the nurse include in her teaching plan? A) Teachers are the most influential people in the development of the school-age child's social network. B) Continuous peer relationships provide the most important social interaction for school-age children. C) Parents should establish norms and standards that signify acceptance or rejection. D) A characteristic of school-age children is their formation of groups with no rules and values involved.

b

The nurse knows that barriers to the adolescent's health and successful achievement of the tasks of adolescence exist. Which of the following is the major barrier to health for this population? A) Cultural B) Socioeconomic C) Marital status D) Racial

b

The nurse knows that children have larger heads in relation to the body and a higher center of gravity. When developing a teaching plan for parents, the nurse includes information about an increased risk for which of the following problems? A) Febrile seizures B) Head trauma C) Caput succedaneum D) Posterior plagiocephaly

b

The nurse would recommend the use of which supplement as a primary prevention strategy to prevent neural tube defects with pregnant women? A) Calcium B) Folic acid C) Vitamin C D) Iron

b

The parents of a 10-year-old girl with a refractive error ask the nurse about the possibility of laser surgery to correct the vision. Which statement by the nurse would be most appropriate? A) "As she gets older, her vision will begin to correct itself." B) "Laser surgery typically is not done until she's 18 years old." C) "She looks so cute in her glasses; why put her through surgery?" D) "She can use contact lenses soon, so surgery isn't necessary."

b

The parents of a 2-year-old girl are frustrated by the frequent confrontations they have with their child. Which is the best anticipatory guidance the nurse can offer them? A) "Respond in a calm but firm manner." B) "You need to adhere to various routines." C) "Put her in time-out when she misbehaves." D) "It's important to toddler-proof your home."

b

The parents of a 4-year-old ask the nurse when their child will be able to differentiate right from wrong and develop morals. What would be the best response of the nurse? A) "The preschooler has no sense of right and wrong." B) "The preschooler is developing a conscience." C) "The preschooler sees morality as internal to self." D) "The preschooler's morals are their own, right or wrong."

b

The parents of a 5-year-old boy tell the nurse that their son is having frequent episodes of night terrors. Which of the following statements would indicate that the boy is having nightmares instead of night terrors? A) "It usually happens about an hour after he falls asleep." B) "He will tell us about what happened in his dream." C) "He is completely unaware that we are there." D) "When we try to comfort him, he screams even more."

b

The parents of an 11-year-old child ask the nurse for suggestions to promote good nutrition for their child. Which response by the nurse would be most appropriate? A) "Be sure to limit protein to one meal every day." B) "Use whole-grain or enriched breads and cereals." C) "Have eggs on the average of once a week." D) "Eat dark green leafy vegetables about twice a week."

b

The school nurse is conducting vision screening for a 7-year-old girl and documents the condition "amblyopia." What would the nurse tell the parents about this condition? A) "Amblyopia is an uncorrected refractive error of the eye." B) "Amblyopia is reduced vision in an eye that has not been adequately used during early development." C) "Amblyopia is a malalignment of the eye, which occurs at birth." D) "Amblyopia is a clouding of the lens of the eye caused by trauma to the eye."

b

The school nurse is performing a physical examination on a 13-year-old boy who is on the soccer team. Which of the following is a physical quality that develops during these early adolescent years? A) Coordination B) Endurance C) Speed D) Accuracy

b

The school nurse is preparing a program on sexuality and birth control for a class of 14- to 16-year-olds. Which of the following behaviors will have the most influence on how the information is presented? A) Teens are adjusting to new body images. B) Adolescents tend to take risks. C) Teenagers are able to think in the abstract. D) Adolescents understand that actions have consequences.

b

The school nurse knows that dating is a milestone for adolescents. Which of the following statements accurately describes a trend in teen dating? A) Most late adolescents spend more time in activities with mixed-sex groups, such as dances and parties, than they do dating as a couple. B) Most teens have been involved in at least one romantic relationship by middle adolescence. C) Teens that date frequently report slightly lower levels of self-esteem and decreased autonomy. D) Homosexual behavior as a teen usually indicates that the adolescent will maintain a homosexual orientation.

b

When describing the cycle of violence to a community group, the nurse explains that the first phase usually is: A) Somehow triggered by the victim's behavior B) Characterized by tension-building and minor battery C) Associated with loss of physical and emotional control D) Like a honeymoon that lulls the victim

b

When instructing the parents of a toddler about appropriate nutrition, which of the following would the nurse recommend? A) About 12 to 16 ounces of fruit juice per day B) Approximately 16 to 24 ounces of milk per day C) Fat intake of 30% to 40% of total calories D) An average of 10 to 12 grams of fiber per day

b

When providing anticipatory guidance to a group of parents with school-aged children, which of the following would the nurse describe as the most important aspect of social interaction? A) School B) Peer relationships C) Family D) Temperament

b

Which food suggestion would be most appropriate for the mother of a preschooler to ensure an adequate intake of calcium? A) Spinach B) White beans C) Enriched bread D) Fortified cereal

b

Which of the following statements is accurate regarding women's health care in today's system? A) Women spend 95 cents of every dollar spent on health care. B) Women make almost 90% of all health care decisions. C) Women are still the minority in the United States. D) Men use more health services than women.

b

Which of the following would the nurse describe as a characteristic of the second phase of the cycle of violence? A) The batterer is contrite and attempts to apologize for the behavior. B) The physical battery is abrupt and unpredictable. C) Verbal assaults begin to escalate toward the victim. D) The victim accepts the anger as legitimately directed at her.

b

Which of the following would the nurse include when teaching parents how to prevent otitis externa? A) Daily ear cleaning with cotton swabs B) Wearing ear plugs when swimming C) Using a hair dryer on high to dry the ear canals D) Using hydrogen peroxide to dry the canal skin

b

Which of the following would the nurse most likely find in a 10-year-old child in the period of concrete operational thought? A) Participation in abstract thinking B) Ability to classify similar objects C) Problem solving via the scientific method D) Ability to make independent decisions

b

Which reflex, if found in a 4-month-old infant, would cause the nurse to be concerned? A) Plantar grasp B) Step C) Babinski D) Neck righting

b

A child is diagnosed with a helminthic infection. Which of the following would the nurse expect to be prescribed? Select all answers that apply. A) Erythromycin B) Albendazole C) Pyrantel pamoate D) Acyclovir E) Metronidazole F) Permethrin

b c

A group of nurses are researching information about risk factors for intimate partner violence in men. Which of the following would the nurses expect to find related to the individual person? (Select all that apply.) A) Dysfunctional family system B) Low academic achievement C) Victim of childhood violence D) Heavy alcohol consumption E) Economic stress

b c d

The nurse assesses the spirituality of an adolescent. Which of the following are normal moral and spiritual milestones in this age group? Select all answers that apply. A) Adolescents will base their actions on the avoidance of punishment and theattainment of pleasure. B) Adolescents develop their own set of morals and values and question the status quo. C) Adolescents undergo the process of developing their own set of morals at different rates. D) Adolescents are more interested in the spiritualism of their religion than in the actual practices of their religion. E) Adolescents can understand the concepts of right and wrong and are developing a conscience. F) Adolescents are able to understand and incorporate into their behavior the concept of the "golden rule."

b c d

The nurse observes an infant interacting with his parents. Which of the following are normal social behavioral developments for this age group? Select all answers that apply. A) Around 5 months the infant may develop stranger anxiety. B) Around 2 months the infant exhibits a first real smile. C) Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. D) Around 3 months the infant will mimic the parent's facial movements, such as sticking out the tongue. E) Around 3 to 6 months of age the infant may enjoy socially interactive games such as patty- cake and peek-a-boo. F) Separation anxiety may also start in the last few months of infancy.

b c d f

A nurse is promoting the use of family-centered care in a local community clinic. Which of the following are advantages or disadvantages of this type of care provision? Selectall answers that apply. A) Recovery times are longer. B) Anxiety is decreased. C) Communication is improved. D) Health care costs are increased. E) Pain management is enhanced. F) More health care resources are utilized.

b c e

The pediatric nurse is aware of the maturation of organ systems in the school-age child. Which of the following accurately describe these changes? Select all answers that apply. A) The brain grows very slowly during the school-age years and growth is complete by the time the child is 12 years of age. B) Respiratory rates decrease, abdominal breathing disappears, and respirationsbecome diaphragmatic in nature. C) The school-age child's blood pressure increases and the pulse rate decreases, and the heart grows more slowly during the middle years. D) The school-age child experiences more gastrointestinal upsets compared withearlier years since the stomach capacity increases. E) Bladder capacity increases, but varies among individual children, and girlsgenerally have a greater bladder capacity than boys. F) Prepubescence typically occurs in the 2 years before the beginning of puberty and is characterized by the development of secondary sexual characteristics.

b c e f

A group of students are preparing a class discussion about rape and sexual assault. Which of the following would the students include as being most accurate? (Select all that apply.) A) Most victims of rape tell someone about it. B) Few women falsely cry "rape." C) Women have rape fantasies desiring to be raped. D) A rape victim feels vulnerable and betrayed afterwards. E) Medication and counseling can help a rape victim cope.

b d e

The nurse is helping parents prepare a healthy meal plan for their toddler. Which of the following guidelines for promoting nutrition should be followed when planning meals? Select all answers that apply. A) The child younger than 2 years of age should have his or her fat intake restricted. B) Extending breastfeeding into toddlerhood is believed to be beneficial to the child. C) Weaning from the bottle should occur by 6 to 12 months of age. D) Adequate calcium intake and appropriate exercise lay the foundation for proper bone mineralization. E) The toddler requires an average intake of 500 mg calcium per day. F) Toddlers tend to have the highest daily iron intake of any age group.

b d e

The parents of a preschooler ask the nurse to help them choose a preschool for their child. Which of the following are recommended guidelines and goals for choosing a preschool? Select all answers that apply. A) The main goal of preschool is to improve reading and writing skills and readiness for entering into grade school. B) When selecting a preschool the parent may want to consider the accreditation of the school and the teachers' qualifications. C) The teachers should decide how focused on curriculum the school should be for each individual student. D) The parent should observe the classroom, evaluating the environment, noise level, and sanitary practices. E) The type of discipline used in the school is also an important factor. Parents should choose a preschool that uses corporal punishment. F) The parent should observe the classroom to determine how the children interact with each other and how the teachers interact with the children.

b d f

A mother brings her child to the health care clinic because she thinks that the child has conjunctivitis. Which assessment finding would lead the nurse to suspect bacterial conjunctivitis? Select all answers that apply. A) Itching of the eyes B) Inflamed conjunctiva C) Stringy discharge D) Photophobia E) Mild pain F) Tearing

b e

A 5-year-old girl is diagnosed with iron-deficiency anemia and is to receive iron supplements. The child has difficulty swallowing tablets, so a liquid formulation is prescribed. After teaching the parents about administering the iron supplement, which statement indicates the need for additional teaching? A) "She needs to eat foods that are high in fiber so she doesn't get constipated." B) "We'll try to get her to drink lots of fluids throughout the day." C) "We will place the liquid in the front of her gums, just below her teeth." D) "We need to measure the liquid carefully so that we give her the correct amount."

c

A child is diagnosed with scarlet fever. The nurse is reviewing the child's medical record, expecting which medication to be prescribed for this child? A) Ibuprofen B) Acyclovir C) Penicillin V D) Doxycycline

c

A child with persistent otitis media with effusion is to undergo insertion of pressure- equalizing tubes via a myringotomy. The child is to be discharged later that day. After teaching the parents about caring for their child after discharge, which statement indicates that the teaching was successful? A) "The tubes will stay in place for about a month and then fall out on their own." B) "His chances for ear infections now have dramatically decreased." C) "He should wear earplugs when swimming in a pool or a lake." D) "We should keep the ears protected with cotton balls for the first 24 hours."

c

A group of nurses are reviewing the steps for developing cultural competence. The students demonstrate understanding when they identify which of the following as the final step? A) Cultural knowledge B) Cultural skills C) Cultural encounter D) Cultural awareness

c

A nurse is caring for a 4-year-old girl. The mother says that the girl is afraid of cats and dogs and does not like to go to the playground anymore because she wants to avoid the dogs that are often being walked at the park. What should the nurse tell the mother? A) "It is best to avoid the playground until she outgrows the fear." B) "She needs to face her fears head-on; take her to the park as much as possible." C) "Acknowledge her fear and help her develop a strategy for dealing with it." D) "Try to minimize her fears and insist that she go to the park."

c

A nurse is educating a client about a care plan. Which of the following statements would be appropriate to assess the client's learning ability? A) "Did you graduate from high school; how many years of schooling did you have?" B) "Do you have someone in your family who would understand this information?" C) "Many people have trouble remembering information; is this a problem for you?" D) "Would you prefer that the doctor give you more detailed medical information?"

c

A nurse is examining a 7-year-old boy with hordeolum. Which of the following would the nurse expect to find? A) Redness B) Scaling C) Pain D) Edema

c

A nurse is instructing a parent on how to obtain a stool culture for ova and parasites from a child with diarrhea. Which of the following would the nurse include in the teaching plan? A) "Give the child bismuth and then collect the next specimen." B) "Obtain the specimen from the toilet after the child has a bowel movement." C) "Keep the specimen from coming into contact with any urine." D) "Bring the specimen to the laboratory on the third day."

c

A nurse is providing teaching to the parents of a child who has had a shunt inserted as treatment for hydrocephalus. The parents demonstrate understanding of the teaching when they state which of the following? A) "Having the shunt put in decreases his risk for developmental problems." B) "If he doesn't get an infection in the first week, the risk is greatly reduced." C) "He will need more surgeries to replace the shunt as he grows." D) "The shunt will help to prevent any further complications from his disease."

c

A nursing student is reviewing information about documenting client care and education in the medical record and the purposes that it serves. The student demonstrates a need for additional study when the nurse identifies which of the following as a reason? A) Serves as a communication tool for the interdisciplinary team. B) Demonstrates education the family has received if legal matters arise. C) Permits others access to allow refusal of medical insurance coverage. D) Verifies meeting client education standards set by the Joint Commission.

c

A school-aged child with an infectious disease is placed on transmission-based precautions. Which nursing diagnosis would most likely be a priority? A) Impaired skin integrity related to trauma secondary to pruritus and scratching B) Fluid volume deficit related to increased metabolic demands and insensible losses C) Social isolation related to infectivity and inability to go to the playroom D) Deficient knowledge related to how infection is transmitted

c

After teaching a group of parents about ear infections in children, which statement indicates that the teaching was successful? A) Infants with congenital deformities have an increased risk for ear infections. B) Ear infections typically increase as the child gets older. C) The shorter and wider eustachian tubes of an infant increase the risk. D) Adenoids shrink as the child grows, allowing more bacteria to enter.

c

After teaching a group of students about visual disorders, the instructor determines that the teaching was successful when the students identify which of the following as the most common cause of visual difficulties in children? A) Astigmatism B) Strabismus C) Refractive errors D) Nystagmus

c

As a result of seizure activity, a computed tomography (CT) scan was performed and showed that an 18-month-old child has intracranial arteriovenous malformation. When developing the child's plan of care, the nurse would expect to implement actions to prevent which of the following? A) Drug interactions B) Developmental disabilities C) Hemorrhagic stroke D) Respiratory paralysis

c

During a follow-up visit to the clinic, a victim of sexual assault reports that she has changed her job and moved to another town. She tells the nurse, "I pretty much stay to myself at work and at home." The nurse interprets these findings to indicate that the client is in which phase of rape recovery? A) Disorganization B) Denial C) Reorganization D) Integration

c

During a health maintenance visit, a 15-year-old girl mentions that she is not happy with how overweight she is. Which of the following approaches is best for the nurse to take? A) "Good observation. Let's talk about diet and exercise." B) "Don't worry; you are within the weight and height guidelines." C) "What specifically have you been noticing?" D) "Tell me about your parents. Are they overweight?"

c

During class, a nursing student asks, "I read an article that was talking about integrative medicine. What is that?" Which response by the instructor would be most appropriate? A) "It refers to the use of complementary and alternative medicine in place of traditional therapies for a condition." B) "It means that complementary and alternative medicine is used together with conventional therapies to reduce pain or discomfort." C) "It means that mainstream medical therapies and complementary and alternative therapies are combined based on scientific evidence for being effective." D) "It refers to situations when a client and his or her family prefer to use an unproven method of treatment over a proven one."

c

Hydrocephalus is suspected in a 4-month-old infant. Which of the following would the nurse expect to assess? A) Sunken fontanels B) Diminished reflexes C) Lower extremity spasticity D) Skull symmetry

c

Teaching for victims who are recovering from abusive situations must focus on ways to: A) Enhance their personal appearance and hairstyle B) Develop their creativity and work ethic C) Improve their communication skills and assertiveness D) Plan more nutritious meals to improve their own health

c

The nurse has determined that an 8-year-old girl is at risk for being overweight. Which of the following interventions would be a priority prior to developing the care plan? A) Determining the need for additional caloric intake B) Asking the parents who they want to work with the child C) Interviewing the parents about their eating habits D) Discussing the influence of peers on the child's diet

c

The nurse has seen a 15-year-old girl and a 16-year-old boy during health surveillance visits. Which of the following physical characteristics would be seen in both teenagers? A) Decreased respiratory rates of 15 to 20 breaths per minute B) Eruption of last four molars C) Increased shoulder, chest, and hip widths D) Fully functioning sweat and sebaceous glands

c

The nurse is assessing the gross motor skills of an 8-year-old boy. Which of the following interview questions would facilitate this assessment? A) "Do you like to do puzzles?" B) "Do play any instruments?" C) "Do you participate in any sports?" D) "Do you like to construct models?"

c

The nurse is caring for a 13-year-old girl with von Willebrand disease. After teaching the adolescent and her parents about this disorder and care, which response by the parents indicates a need for additional teaching? A) "We need to administer Stimate prior to dental work." B) "We should be aware that she may suffer from menorrhagia." C) "We should administer desmopressin as often as needed." D) "We understand that she may have frequent nosebleeds."

c

The nurse is caring for a 6-year-old visually impaired boy and is about to begin the physical examination. Which intervention would be most appropriate to promote effective communication with the child? A) Show him the stethoscope. B) Describe the examination room. C) Use his name before touching him. D) Allow him to explore the exam room.

c

The nurse is caring for a neonate who is suspected of having sepsis. Which of the following assessment findings would the nurse interpret as most indicative of sepsis? A) Rash on face B) Edematous neck C) Hypothermia D) Coughing

c

The nurse is caring for an 8-year-old boy who has chronic epilepsy. Which of the following would be most important to address when teaching the child and parents about living with this condition? A) Multiple corrective surgeries to slowly remove diseased parts of his brain B) Physical, occupational, and speech therapy to maximize his potential C) Support for maintaining self-esteem because of his altered lifestyle D) Hyperventilation therapy to counteract the periods of decreased oxygenation

c

The nurse is counseling the parents of a 10-year-old child who was caught stealing at school. Which of the following topics should the nurse cover? A) Having the child return the property in front of his or her class B) Discussing ways for the child to save face C) Finding out what is currently going on at home D) Reminding the child daily that stealing is wrong

c

The nurse is developing a teaching plan for the mother of a 4-year-old girl with cold and fever. Which of the following would the nurse include in this teaching plan? A) Keeping the child covered and warm B) Calling the doctor if the child's fever lasts more than 36 hours C) Ensuring fluid intake to prevent dehydration D) Observing for changes in alertness resulting from brain damage

c

The nurse is discussing ways to promote discipline with parents who are becoming increasingly frustrated with their teenager. Which of the following would the nurse identify as most important? A) Establish rules and expectations. B) Collaborate to determine consequence. C) Make your responses consistent. D) Explain the rules to the adolescent.

c

The nurse is educating a 16-year-old girl who has just been diagnosed with acute myelogenous leukemia. Which of the following statements best demonstrates therapeutic communication? A) Discussing the treatment plan in detail for the next few weeks B) Using medical terms when describing the disease C) Assessing the adolescent's emotional status in private D) Talking about clothing and the stores where she shops

c

The nurse is examining a 10-month-old boy who was born 10 weeks early. Which of the following findings is cause for concern? A) The child has doubled his birthweight. B) The child exhibits plantar grasp reflex. C) The child's head circumference is 19.5 inches. D) No primary teeth have erupted yet.

c

The nurse is examining a 7-year-old boy with blepharitis. Which of the following would the nurse least likely expect to assess? A) Redness B) Scaling C) Pain D) Edema

c

The nurse is helping a new mother prepare for breastfeeding her infant. During which of the following newborn states of consciousness would the nurse recommendedattempting the feeding? A) Light sleep B) Drowsiness C) Quiet alert state D) Active alert state

c

The nurse is implementing interventions to prevent physical stressors for a 9-year-old child receiving chemotherapy in the hospital. Which of the following is an example of using atraumatic care for this child? A) Use restraint or "holding down" of the child during the procedure to prevent injury. B) Have the parent stand near and/or rub the child's feet during the procedure. C) Insert a saline lock if the child will require multiple doses of parenteral medications. D) Avoid using numbing techniques for multiple blood draws or IV insertion.

c

The nurse is instructing a 7-year-old child and his parents about using his prescribed corrective lenses. Which of the following would the nurse include in these instructions? A) "Make sure to take your glasses off from time to time to allow your eyes to rest." B) "Remove your glasses with both hands and lay them with the lens upright on the surface." C) "Clean the glasses every day with a mild soap and water or commercial cleaning agent." D) "Use paper towels or tissues to dry and periodically clean the lenses.

c

The nurse is performing a health assessment of a 3-month-old Black American boy. For what condition should this infant be monitored based on his race? A) Jaundice B) Iron deficiency C) Lactose intolerance D) Gastroesophageal reflux disease (GERD)

c

The nurse is performing a physical assessment of a 3-year-old girl. Which of the following would be a concern for the nurse? A) The toddler gained 4 pounds in weight since last year. B) The toddler gained 3 inches in height since last year. C) The toddler's anterior fontanel is not fully closed. D) The circumference of the child's head increased 1 inch since last year.

c

The nurse is performing a physical examination on a 9-year-old boy who has experienced a tick bite on his lower leg and is suspected of having Lyme disease. Which assessment finding would the nurse expect to find? A) Swelling in the neck B) Confusion and anxiety C) Ring-like rash on lower leg D) Hypersalivation

c

The nurse is performing risk assessments on adolescents in the school setting. Which one of the following teens should the nurse screen for hypertension? A) An Asian female B) A white male C) An African American male D) A Jewish male

c

The nurse is preparing a child and his family for a lumbar puncture. Which of the following would be a primary intervention instituted by the CLS to keep the child safe? A) Distraction methods B) Stimulation methods C) Therapeutic hugging D) Therapeutic touch

c

The nurse is promoting learning and school attendance to an 11-year-old girl. Which of the following factors will affect the child's attitude most? A) Her parents' values and desires B) The dramatic changes to her body C) Peer group behaviors and attitudes D) Desire for attention from boys

c

A 4-year-old boy has a febrile seizure during a well-child visit. Which of the following would be a priority? A) Hyperextending the child's head while placing him on his side B) Using a tongue blade to pry open the child's jaw C) Loosening the child's clothing to ensure a patent airway D) Protecting the child from harm during the seizure

d

The nurse is providing anticipatory guidance to a mother to help promote healthy sleep for her 3-week old baby. Which of the following recommended guidelines might be included in the teaching plan? A) Place the baby on a soft mattress with a firm flat pillow for the head. B) Place the head of the bed near the window to provide fresh air, weather permitting. C) Place the baby on his or her back when sleeping. D) If the baby sleeps through the night, wake him or her up for the night feeding.

c

The nurse is providing guidance after observing a mother interact with her negative 2- year- old boy. For which interaction will the nurse advise the mother that she is handling the negativism properly? A) Telling the child to stop tearing pages from magazines B) Asking the child if he would please quit throwing toys C) Telling the child firmly that we don't scream in the office D) Saying, "Please come over here and sit in this chair. OK?"

c

The nurse is providing suggestions to a female adolescent about foods to help meet her nutritional requirements for iron. Which food would the nurse suggest as a good source of iron? A) Broccoli B) Yogurt C) Peanut butter D) White beans

c

The nurse is reviewing the laboratory test results of a child diagnosed with disseminated intravascular coagulation (DIC). Which of the following would the nurse interpret as indicative of this disorder? A) Shortened prothrombin time B) Increased fibrinogen level C) Positive fibrin split products D) Increased platelets

c

The nurse is reviewing the white blood cell differential of a 4-year-old girl. Which value would lead the nurse to be concerned? A) Bands: 8% B) Segs: 28% C) Eosinophils: 10% D) Basophils: 0%

c

The nurse is supervising lunch time for children on a pediatric ward. Which of the following observations is considered abnormal for this age group? A) The child has a full set of primary teeth. B) The child has no difficulty chewing and swallowing meat. C) The child uses his fingers and refuses to use a fork. D) The child is a picky eater.

c

The nurse is taking a health history for a 9-year-old girl. Which finding would alert the nurse to a possible risk factor specifically associated with visual impairment? A) Being born at 39 weeks' gestation B) Having several hours of homework daily C) Being of African American heritage D) Being active in sports

c

The nurse is teaching a new mother the proper techniques for breastfeeding her newborn. Which of the following is a recommended guideline that should be implemented? A) Wash the hands and breasts thoroughly prior to breastfeeding. B) Stroke the nipple against the baby's chin to stimulate wide opening of the baby's mouth. C) Bring the baby's wide-open mouth to the breast to form a seal around all of the nipple and areola. D) When finished the mother can break the suction by firmly pulling the baby's mouth away from the nipple.

c

The nurse is teaching parents interventions appropriate to the emotional development of their toddlers. Which of the following is a recommended intervention for this age group? A) Remove children's security blankets at this stage to help them assert their autonomy. B) Distract toddlers from exploring their own body parts, particularly their genitals. C) Do not blame toddlers for aggressive behavior; instead, point out the results of their behavior. D) Offer toddlers many choices to foster control over their environment.

c

The nurse is teaching parents to plan nutritional meals for their son who is overweight. Which of the following guidelines might the nurse include in the teaching plan? A) School-age children with an average body weight of 20 to 35 kg need approximately 90 calories per kilogram daily. B) The average water requirement for a school-age child per 24 hours ranges from 2,000 to 2,500 mL per day. C) The school-age child needs 28 g of protein and 800 mg of calcium for maintenance of growth and good nutrition. D) In the school-age child, calories needed to sustain weight increase, while the appetite decreases.

c

The nurse is teaching the parents of a child with a hematologic disorder about the functions of the various blood cells. The nurse determines that the teaching was successful when the parents state which blood cell as being primarily responsible for blood clotting? A) Granulocytes B) Erythrocytes C) Thrombocytes D) Leukocytes

c

The nurse is teaching the student nurse how to communicate effectively with children. Which one of the following methods would the nurse recommend? A) Position self above the child's level to denote authority. B) If possible, communicate with the child apart from the parent. C) Direct questions and explanations to the child. D) Use the medical terms for body parts and medical care.

c

The nurse is testing the sensory development of a toddler brought to the clinic for a well visit. Which of the following might alert the nurse to a potential problem with the child's sensory development? A) The toddler places the nurse's stethoscope in his mouth. B) The toddler's vision tests at 20/50 in both eyes C) The toddler does not respond to commands whispered in his ear. D) The toddler's taste discrimination is not at adult levels yet.

c

The nurse is using the formula for bladder capacity to measure the bladder capacity of a 9-year-old girl. What number would the nurse document for this measurement? A) 9 ounces B) 10 ounces C) 11 ounces D) 12 ounces

c

The nurse knows that effective communication with children and their parents is critical to providing atraumatic quality nursing care. Which of the following statements accurately describes the communication patterns of children? A) Communication patterns are similar from one child to the next. B) Children often use more words than adults to describe their fears. C) Children rely more on nonverbal communication and silence. D) Parents more often require affective communication rather than neutral communication.

c

The nurse measures the head circumference of a 6-month-old infant. Which measurement would the nurse interpret as most appropriate? A) 33 cm B) 35 cm C) 43.5 cm D) 47 cm

c

The parents of a 5-year-old bring their son to the emergency department because of significant eyelid edema. The mother states, "He scratched himself near his eye a couple of days ago while playing outside in the yard." The nurse suspects periorbital cellulitis based on which of the following? A) Evidence of discharge B) Reddened conjunctiva C) Purplish discoloration of eyelid D) Altered visual acuity

c

The parents of a preschooler express concern to the nurse about their son's new habit of masturbating. Which of the following is an appropriate response to this concern? A) Tell the child in a firm manner that this behavior is not acceptable. B) When the child displays this behavior, place him in a "time-out." C) Treat the action in a matter-of-fact manner emphasizing safety. D) Consult a psychotherapist to determine the reason for this behavior.

c

The pediatric nurse is planning quiet activities for hospitalized 18-month-olds. Which of the following would be an appropriate activity for this age group? A) Painting by number B) Putting shapes into appropriate holes C) Stacking blocks D) Using crayons to color in a coloring book

c

The primary goal when working with victims of intimate partner violence is to: A) Convince them to leave the abuser soon B) Help them cope with their life as it is C) Empower them to regain control of their life D) Arrest the abuser so he or she can't abuse again

c

The school nurse is performing health assessments on students in middle school. Of which of the following developmental milestones should the nurse be aware? A) Height in girls increases rapidly after menarche and usually ceases immediately after menarche. B) Boys' growth spurt usually begins between the ages of 8 and 14 years and ends between the ages of 131/2 and 171/2 years. C) Peak height velocity (PHV) occurs at approximately 12 years of age in girls or about 6 to 12 months after menarche. D) Boys reach PHV and peak weight velocity (PWV) at about 16 years of age.

c

When assuming the role of discharge planner for a woman requiring ventilator support at home, the nurse would do which of the following? A) Confer with the client's mother B) Teach new self-care skills to the client C) Determine if there is a need for back-up power D) Discuss coverage with the insurance company

c

When caring for childbearing families from cultures different from one's own, which of the following must be accomplished first? A) Adapt to the practices of the family's culture B) Determine similarities between both cultures C) Assess personal feelings about that culture D) Learn as much as possible about that culture

c

When comparing community-based nursing with nursing in the acute care setting to a group of nursing students, the nurse describes the challenges associated with community-based nursing. Which of the following would the nurse include? A) Increased time available for education B) Improved access to resources C) Decision making in isolation D) Greater environmental structure

c

When describing an episode, the victim reports that she attempted to calm her partner down to keep things from escalating. This behavior reflects which phase of the cycle of violence? A) Battering B) Honeymoon C) Tension-building D) Reconciliation

c

When describing the various changes that occur in organ systems during adolescence, which of the following would the nurse include? A) Significant increase in brain size B) Ossification completed later in girls C) Decrease in heart rate D) Decrease in activity of sebaceous glands

c

When providing care to a newborn infant who was born at 29 weeks' gestation, the nurse integrates knowledge of potential complications, being alert for signs and symptoms of which of the following? A) Neonatal conjunctivitis B) Facial deformities C) Intracranial hemorrhage D) Incomplete myelinization

c

Which action would the nurse include in a primary prevention program in the community to help reduce the incidence of HIV infection? A) Provide treatment for clients who test positive for HIV B) Monitor viral load counts periodically C) Educate clients in how to practice safe sex D) Offer testing for clients who practice unsafe sex

c

Which of the following would be most important to include in the teaching plan for parents of a child with pinworm? A) "Seal the child's clothing in a plastic bag for at least 10 days." B) "Be sure your child wears shoes at all times." C) "Make sure the child washes his hands after using the bathroom." D) "After applying this special cream, leave it on for about 8 to 10 hours."

c

Which of the following would the nurse expect to find in an 18-month-old? A) Standing on tiptoes B) Pedaling a tricycle C) Climbing stairs with assistance D) Carrying a large toy while walking

c

While obtaining a health history from a male adolescent during a well check-up, the nurse assesses his sexual behavior and risk for sexually transmitted infections. Based on the information, the nurse plans to teach the adolescent about using a condom. Which of the following would the nurse include in the teaching plan? A) "You can reuse a condom if it's within 3 hours." B) "Store your condoms in your wallet so they are ready for use." C) "Put the condom on before engaging in any genital contact." D) "Use Vaseline with a latex condom for extra lubrication."

c

A nurse is developing cultural competence. Which of the following indicates that the nurse is in the process of developing cultural knowledge? Select all that apply. A) Examining personal sociocultural heritage B) Reviewing personal biases and prejudices C) Seeking resources to further understanding of other cultures D) Becoming familiar with other culturally diverse lifestyles E) Performing a competent cultural assessmentF) Advocating for social justice to eliminate disparities.

c d

The nurse is consulting with a child life specialist (CLS) to help minimize the stress of hospitalization for a child. Which of the following services would the CLS provide? Select all answers that apply. A) Medical preparation for tests, surgeries, and other medical procedures B) Support before and after, but not during, medical procedures C) Activities to support normal growth and development D) Grief and bereavement support E) Emergency room interventions for children and families F) Only inpatient consultations with families

c d e

A group of nursing students are reviewing information related to seizures that occur in infants and children. The students demonstrate a need for additional review when they identify which type as common in neonates? A) Tonic B) Focal clonic C) Multifocal clonic D) Myoclonic

d

A group of students are reviewing information about the anatomic differences in the eyes and ears of a child in comparison to an adult. The students demonstrate a need for additional study when they identify which of the following? A) Hearing is completely developed at the time of birth. B) Visual acuity develops from birth throughout childhood. C) Binocular vision is usually achieved by 2 months of age. D) The ability to discriminate colors is completed by birth.

d

A mother calls the school nurse and is concerned because her 13-year-old daughter's friends wear heavy makeup and black clothes. Which of the following is the best advice for the mother? A) "This can lead to piercings and tattoos." B) "The teen years are a time for experimenting." C) "Encourage her to socialize with the kids at church." D) "Teen appearance might not accurately reflect their actual values."

d

A mother is concerned about her infant's spitting up. Which suggestion would be most appropriate? A) "Put the infant in an infant seat after eating." B) "Limit burping to once during a feeding." C) "Feed the same amount but space out the feedings." D) "Keep the baby sitting up for about 30 minutes afterward."

d

A nurse develops a plan of care for a child that includes patching the eye. This plan of care would be most appropriate for which condition? A) Astigmatism B) Hyperopia C) Myopia D) Amblyopia

d

A nurse is engaged in providing family-centered care for a woman and her family. The nurse is providing instrumental support with which activity? A) Explaining to the woman and family what to expect during the birth process. B) Assisting the woman in breathing techniques to cope with labor contractions. C) Reinforcing the woman's role as a mother after birth D) Helping the family obtain extra financial help for prescribed phototherapy

d

A nurse is examining a child who has sustained blunt trauma to the eye area. The nurse suspects a simple contusion based on which of the following? A) Pain in the eye B) Impaired visual acuity C) Blurred vision D) Intact extraocular movements

d

A nurse is preparing a presentation for an expectant parent group about neural tube defects and prevention. Which of the following would the nurse emphasize? A) Smoking cessation B) Aerobic exercise C) Increased calcium intake D) Folic acid supplementation

d

A nurse is talking with the parents of a child who has had a febrile seizure. The nurse would integrate an understanding of which of the following into the discussion? A) The child's risk for cognitive problems is greatly increased. B) Structural damage occurs with febrile seizure. C) The child's risk for epilepsy is now increased. D) Febrile seizures are benign in nature.

d

A nursing instructor is presenting a class for a group of students about community-based nursing interventions. The instructor determines that additional teaching is needed when the students identify which of the following? A) Conducting childbirth education classes B) Counseling a pregnant teen with anemia C) Consulting with a parent of a child who is vomiting D) Performing epidemiologic investigations

d

A woman gives birth to a healthy newborn. As part of the newborn's care, the nurse instills erythromycin ophthalmic ointment as a preventive measure for which sexually transmitted infection (STI)? A) Genital herpes B) Hepatitis B C) Syphilis D) Gonorrhea

d

After teaching a class on date rape, the instructor determines that the teaching was successful when the class identifies which of the following as the most common date rape drug? A) Gamma hydroxybutyrate B) Liquid ecstasy C) Ketamine D) Rohypnol

d

After teaching the parents of a child with varicella zoster, the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time? A) After day 5 of the rash B) When the rash is completely healed C) Once the rash appears D) After the lesions have crusted

d

During a well-child check-up, the parents of a 9-year-old boy tell the nurse that their son's friends told him that soccer is a stupid game, and now he wants to play baseball. Which comment by the nurse best explains the effects of peer groups? A) "The child's best friends will continue playing soccer." B) "The children will cheer for each other regardless of the sport being played." C) "Your child will rarely talk to you about his friends." D) "Acceptance by friends, especially of the same sex, is very important at this age."

d

During class, a student states, "I didn't think children could have strokes. I thought this only occurred in older adults." When responding to the student, which of the following would be most important for the instructor to integrate into the response? A) Strokes in children often have an identifiable cause. B) The signs and symptoms in children are different from an adult. C) Research has identified specific treatments for children. D) Ischemic strokes are more common than hemorrhagic strokes.

d

The adolescent continues to develop self-concept and self-esteem. Which of the following is most important to a teen's self-esteem? A) Strong authority figures B) Spirituality C) Morals and values D) Body image

d

The mother of a 4-year-old boy tells the nurse that her son occasionally wets his pants during the day. How should the nurse respond? A) "Is there a family history of diabetes?" B) "Suddenly having accidents can be a sign of diabetes." C) "That's normal; don't worry about it." D) "Tell me about the circumstances when this occurs."

d

The neonatal nurse assesses newborns for iron-deficiency anemia. Which of the following newborns is at highest risk for this disorder? A) A postterm newborn B) A term newborn with jaundice C) A newborn born to a diabetic mother D) A premature newborn

d

The nurse emphasizes that a toddler younger than the age of 18 months should never be spanked primarily for which reason? A) Spanking in a child this age predisposes the child to a pro-violence attitude. B) The child will become resentful and angry, leading to more outbursts. C) Spanking demonstrates a poor model for problem-solving skills. D) There is an increased risk for physical injury in this age group.

d

The nurse has developed a teaching plan for the family of a 2-year-old boy who holds his breath when he gets frustrated. Which of the following will be most important to include in this plan? A) Provide cuddle time whenever the child begins to act out. B) Explain the child's behavior to the parents. C) Encourage the parents to interact more with the child. D) Stay close to prevent injury when he gets frustrated.

d

The nurse inspects the eyes of a child and observes that the sclera is showing over the top of the iris. The nurse documents this finding as: A) Decorticate posturing B) Nystagmus C) Doll's eye D) Sunsetting

d

The nurse is assessing the tympanic temperature of several children. The nurse documents that the child with which temperature reading has a fever? A) 99.5°F B) 99.2°F C) 100.0°F D) 100.8°F

d

The nurse is caring for a 2-year-old boy with hemophilia. His parents are upset by the possibility that he will become infected with hepatitis or HIV from the clotting factor replacement therapy. Which response by the nurse would be most appropriate? A) "Parents commonly fear the worst; however, the factor will help your child lead a normal life." B) "There are risks with any treatment including using blood products, but these are very minor." C) "Although factor replacement is expensive, there's more financial strain from missing work if he has a bleeding episode." D) "Since dry heat treatment of the factor began in 1986, there have been no reports of virus transmission."

d

The nurse is caring for a 4-year-old boy with Ewing sarcoma who is scheduled for a computed axial tomography (CAT) scan tomorrow. Which of the following is the best example of therapeutic communication? A) Telling him he will get a shot when he wakes up tomorrow morning B) Telling him how cool he looks in his baseball cap and pajamas C) Using family-familiar words and soft words when possible D) Describing what it is like to get a CAT scan using words he understands

d

The nurse is caring for a child recently diagnosed with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The nurse is teaching the parents about triggers that may result in oxidative stress. Which of the following responses indicates a need for further teaching? A) "I doubt he will ever eat fava beans, but they could trigger hemolysis." B) "He must avoid exposure to naphthalene, an agent found in mothballs." C) "He must never take methylene blue for a urinary tract infection." D) "My son can never take penicillin for an infection."

d

The nurse is caring for a child who has been admitted for a sickle cell crisis. Which of the following would the nurse do first to provide adequate pain management? A) Administer a nonsteroidal anti-inflammatory drug as ordered. B) Use guided imagery and therapeutic touch. C) Administer meperidine as ordered. D) Initiate pain assessment with a standardized pain scale.

d

The nurse is caring for a toddler who is in Piaget's sensorimotor stage of cognitive development. Which of the following tasks would the nurse expect the toddler to be able to perform? A) Completing puzzles with four pieces B) Winding up a mechanical toy C) Playing make-believe with dolls D) Knowing which are his or her toys

d

The nurse is designing a nursing care plan for a toddler with lymphoma, who is hospitalized for treatment. Which of the following is a priority intervention that the nurse should include in this child's nursing plan? A) Limiting visitors to scheduled visiting hours B) Planning physical therapy for the child C) Introducing the toddler to other toddlers in the unit D) Monitoring the toddler for developmental delays

d

The nurse is developing a nursing care plan for a hospitalized 6-year-old. Which of the following behaviors would warrant nursing intervention? A) The child pretends he is talking to an imaginary friend when the nurse addresses the child. B) The child states that her fairy godmother is going to come and take her home. C) The child starts talking about his grandmother and then quickly changes the subject to a new toy he received. D) The child does not want to play games with other children on the hospital ward.

d

The nurse is developing a teaching plan for toddler safety to present at a parenting seminar. Which of the following are safety interventions that the nurse should address? A) Encourage parents to enroll toddlers in swimming classes to avoid the need for constant supervision around water. B) Advise parents to keep pot handles on stoves turned outward to avoid accidental burns. C) Encourage parents to smoke only in designated rooms in the house or outside the house. D) Advise parents to use a forward-facing car seat with harness straps and a clip, placed in the backseat of the car.

d

The nurse is instructing the parents of a school-age child with an eye disorder how to care for her eye. Which of the following conditions would the nurse explain as resolving by itself without the use of antibiotics? A) Blepharitis B) Hordeolum C) Corneal abrasion D) Chalazion

d

The nurse is making a home visit to a client who had a cesarean birth 3 days ago. Assessment reveals that the client is complaining of intermittent pain, rating it as 8 on a scale of 1 to 10. She states, "I'm pretty tired. And with this pain, I haven't been drinking and eating like I should. The medication helps a bit but not much. My mom has been helping with the baby." Her incision is clean, dry, and intact. Which nursing diagnosis would the nurse identify as the priority for this client? A) Impaired skin integrity related to cesarean birth incision B) Fatigue related to effects of surgery and caretaking activities C) Imbalanced nutrition, less than body requirements related to poor fluid and food intake D) Acute pain related to incision and cesarean birth

d

The nurse is performing a cognitive assessment of a 2-year-old. Which of the following behaviors would alert the nurse to a developmental delay in this area? A) The child cannot say name, age, and gender. B) The child cannot follow a series of two independent commands. C) The child has a vocabulary of 40 to 50 words. D) The child does not point to named body parts.

d

The nurse is performing an assessment of the reproductive system of a 17-year-old girl. Which of the following would alert the nurse to a developmental delay in this girl? A) Areola and papilla separate from the contour of the breast B) Mature distribution and coarseness of pubic hair C) Developed breast tissue D) Occurrence of first menstrual period

d

The nurse is preparing a plan of care for a 5-year-old boy with chickenpox. Which of the following nursing interventions should be questioned? A) Administer antipyretics as ordered. B) Keep the child's fingernails short. C) Monitor fluid intake and output. D) Provide alcohol baths as needed.

d

The nurse is preparing a presentation for a local parent-teacher organization about the growth and development of school-age children. Which of the following would the nurse include? A) Boys mature much more quickly than girls of the same age during this time. B) From 6 to 12 years of age, children grow an average of 4 inches per year. C) The child's body size is in direct correlation with his or her maturity level. D) Secondary sex characteristics are often embarrassing for both sexes.

d

The nurse is preparing to obtain a blood specimen via capillary heel puncture. Which of the following would be most appropriate for the nurse to do? A) Apply a cool compress for several minutes before collection B) Elevate the extremity used after puncturing it C) Squeeze the area to facilitate specimen collection D) Wipe away the first drop of blood with dry gauze

d

The nurse is promoting nutrition to a 13-year-old boy who is overweight. Which of the following comments should the nurse expect to include in the discussion? A) "You need to go on a low-fat diet." B) "Eat what your parents eat." C) "Go out for a sport at school." D) "Keep a food diary."

d

The nurse is providing discharge teaching regarding formula preparation for a new mother. Which of the following guidelines would the nurse include in the teaching plan? A) Always wash bottles and nipples in hot soapy water and rinse well; do not wash them in the dishwasher. B) Store tightly covered ready-to-feed formula can after opening in refrigerator for up to 24 hours. C) Warm bottle of formula by placing bottle in a container of hot water, or microwaving formula. D) Do not add cereal to the formula in the bottle or sweeten the formula with honey.

d

The nurse is providing teaching about car safety to the parents of a 5-year-old girl who weighs 45 pounds. What should the nurse instruct the parents to do? A) "Place her in a booster seat with lap and shoulder belts in the front seat." B) "Place her in the back seat with the lap and shoulder belts in place." C) "Place her in a forward-facing car seat with a harness and top tether." D) "Place her in a booster seat with lap and shoulder belts in the back seat."

d

The nurse is using verbal skills to explain the nursing care plan to parents of a 10-year- old child with cancer. Which of the following describes a guideline the nurse should follow to provide appropriate verbal communication? A) Use closed-ended questions that do not restrict the child's or parent's answers. B) Allow the focus to change without redirecting the conversation. C) Restate the child's and parents comments in your own words. D) Paraphrase the child's or parent's feelings to demonstrate empathy.

d

The nurse of a preschool child is helping parents develop a healthy meal plan for their child. Which of the following nutritional requirements for this age group should the nurse consider? A) The 3- to 5-year-old requires 300 to 500 mg calcium and 10 mg iron daily. B) The 3-year-old should consume 10 mg dietary fiber daily. C) The 4- to 8-year-old requires 15 mg dietary fiber per day. D) The typical preschooler requires about 85 kcal/kg of body weight.

d

The parents of an 8-year-old boy are interested in promoting learning through reading to their son. Which of the following suggestions by the nurse would best promote this goal? A) Have the parents choose what he should read initially. B) Tell the child to read instead of watching TV with his parents. C) Tell the parents that reading is for the child to do by himself. D) Take the child to the library to check out some books.

d

The school nurse is planning to teach a segment on smoking during the freshman health classes. The nurse is aware that this needs to be a forum rather than a lecture. Which of the following techniques will also help deliver a "don't smoke" message? A) Showing a command of the facts on smoking B) Speaking with a tone of authority C) Keeping your personal experiences out of it D) Listening to all comments nonjudgmentally

d

The school nurse is preparing a talk on the influence of the media on school-age children to present at the next PTO meeting. Which of the following facts might the nurse include in the introduction? A) Children in the United States spend about 6 hours a day either watching TV or playing video games. B) A child will see 2,000 murders by the end of grade school and 20,000 commercials a year. C) A school-age child cannot determine what is real from what is fantasy; therefore, TV and video games can lead to aggressive behavior. D) Parents should limit television watching and video-game playing to 2 hours per day.

d

The school nurse is teaching parents about the effects of bullying on school children.Which of the following accurately describes this developmental concern? A) Children who bully are those who report themselves as being lonely and having difficulty in forming friendships. B) Children who are bullied are reported to have low self-esteem, poor grades, and poor interpersonal skills. C) In general, about 20% of all children attending school are frightened and afraid most of the day. D) Both boys and girls are bullied; boys usually bully boys and use force more often.

d

The school nurse knows that school-age children are developing metalinguistic awareness. Which of the following is an example of this skill? A) The child enjoys reading books. B) The child enjoys conversations with peers. C) The child enjoys speaking on the phone. D) The child enjoys telling jokes.

d

Two working parents are discussing with the school nurse the possibility of their 12- year- old girl going home alone after school. Which of the following suggestions should the nurse make? A) Provide entertainment until the parents come home. B) Allow the child to go to a friend's house. C) Teach her how to take a message if someone calls. D) Purchase caller ID for the phone.

d

Which activity would the nurse least likely include as exemplifying the preconceptual phase of Piaget's preoperational stage? A) Displays of animism B) Use of active imaginations C) Understanding of opposites D) Beginning questioning of parents' values

d

Which approach would be most appropriate when counseling a woman who is a suspected victim of violence? A) Offer her a pamphlet about the local battered women's shelter. B) Call her at home to ask her some questions about her marriage. C) Wait until she comes in a few more times to make a better assessment. D) Ask, "Have you ever been physically hurt by your partner?"

d

Which of the following statements would be most appropriate to empower victims of violence to take action? A) "Give your partner more time to come around." B) "Remember—children do best in two-parent families." C) "Change your behavior so as not to trigger the violence." D) "You are a good person and you deserve better than this."

d

Which of the following would lead the nurse to suspect that a child is beginning to develop increased intracranial pressure? A) Bradycardia B) Cheyne-Stokes respirations C) Fixed, dilated pupils D) Projectile vomiting

d

While reviewing various studies about the use of antipyretics possibly prolonging illness, the nurse notes that there are benefits to their use for the child with fever. Which of the following would the nurse identify as the best explanation related to the benefit of antipyretics? A) They slow the growth of bacteria. B) They increase neutrophil production. C) They encourage T-cell proliferation. D) They help decrease fluid requirements.

d

The nurse is choosing foods for a toddler's diet that are high in vitamin A. Which of the following could be added to the menu? Select all answers that apply. A) Applesauce B) Avocados C) Broccoli D) Sweet potatoes E) Spinach F) Carrots

d e f