Peds FINAL Exam PART 2 (Ch. 7, 10, & 18)
The newborn can fixate on a bright object that is within ______________ _____________ and in the midline of the visual field.
20 cm (8 inches)
Newborn visual acuity is reported to be between ________________ and ___________________.
20/100 and 20/400
Separation individuation begins between ages _________________ and _________________ months, when the infant begins to have some awareness of self and mother as separate beings.
4 and 8
A drug approved for medical abortion is mifepristone. Which of the following statements about this drug is true? A. The drug binds progesterone receptors and blocks the action of progesterone B. The drug acts directly on the cervix to soften and dilate and on the uterine muscle to stimulate contractions C. The abortion completion rate is 100% in pregnancies if used correctly D. The drug is administered intramuscularly up to 49 days after the last menstrual period
A
According to recent studies, the best place for the infant car restraint is in the: A. backseat of the car, facing the rear B. backseat of the car, facing front C. front passenger seat of the car with an airbag, facing front D. front passenger seat of the car without an airbag, facing back
A
Cultural beliefs and practices are significant influences on infant feeding. Identify which of the following statements is true. A. Many cultures do not give colostrum to newborns but wait until the milk has "come in" to start breastfeeding B. US-born Hispanic women are more likely to initiate breastfeeding than those recently immigrated C. Acculturation has led to increased rates of breastfeeding among immigrants D. Grandparent support increases breastfeeding rates among Chinese immigrants
A
If parents are concerned about the fact that their 14 month old infant is not walking, the nurse should evaluate the cephalocaudal gross motor skill patterns and particularly evaluate whether the infant: A. pulls up to furniture B. uses a pincer grasp C. transfers objects D. has developed object permanence
A
In screening for phenylketonuria, the nurse knows: A. that blood samples should be taken after 24 hours of age and again at 2 weeks of age. B. that blood should be drawn using a venous blood sample C. that preparation includes instructing parents to keep the infant NPO for 2 hours before the test D. to completely saturate the filter paper by applying blood to both sides of the paper
A
Leslie is a sexually active adolescent. She comes to the clinic with abdominal pain and vaginal bleeding. The nurse recognizes that which of the following must be ruled out immediately? A. Ectopic pregnancy B. ovarian cyst C. STIs D. endometriosis
A
Of the following hematopoietic changes that occur in infancy, the one that is considered abnormal in the first 5 months of life is: A. low iron levels B. physiologic anemia C. presence of fetal hemoglobin D. low hemoglobin level
A
The adolescent with testicular torsion is most likely to be initially seen with which of the following signs and symptoms? A. tender, painful swelling of the testes B. a mass in the posterior aspect of the scrotum that can be transilluminated C. a heavy, hard, painless mass palpable on the anterior or lateral surface of the testicle D. An asymptomatic scrotal mass that aches, especially after exercise or penile erection
A
The factor that best determines the quality of the infant's formulation of trust is the: A. parental attachment B. degree of mothering skill C. quantity of the mother's breast milk D. length of suckling time
A
The infant is predisposed to a more rapid loss of total body fluid and dehydration because: A. of a high proportion of extracellular fluid B. of a high proportion of intracellular fluid C. total body water is at about 40% D. extracellular fluid is 20% of the total
A
The infant's posterior fontanel usually closes by: A. 6-8 weeks B. 3-6 months C. 12-18 months D. 9-12 months
A
The nurse can expect that an infant will begin to respond discriminately to others, particularly the mother, and respond by crying, smiling, and vocalizing at about ____________________ of age: A. 2 to 3 months B. 4 to 5 months C. 6 to 7 months D. 8 to 9 months
A
The nurse should involve the parents in the care of their newborn. Which of the following is not appropriate teaching for parents? A. Use of alkaline soap, oils, powder, and lotions with each bath B. Bathing the infant, using plain warm water, no more than two or three times per week during the first 2 to 4 weeks of age C. Care of the umbilical stump, including placing the diaper below the cord to avoid irritation and wetness of the site D. Care of the circumcision site, explaining that on the second day a yellowish white exudate forms normally aspart of the granulation process
A
The primary goal of nursing care for the adolescent rape victim is: A. not to inflict further stress on the victim B. obtaining a complete history of the incident C. assisting in the physical examination D. notifying the police and the parents of the victim before proceeding with assessment
A
The purpose of nonnutritive sucking is to: A. satisfy the basic sucking urge B. take in food C. collect food and propel it into the esophagus D. provide an efficient way to process fluids
A
Therapeutic management for chlamydia includes: A. doxycycline B. intramuscular injection of Ceftriaxone (Rocephin) C. intramuscular injection of penicillin D. clarithromycin
A
When assessing BP in the newborn, the nurse knows which of the following is true? A. BP is affected by gestational age and birth weight B. Routine BP measurements of full-term neonates are an excellent predictor of hypertension C. A normal BP reading for a 3-day-old infant is approximately 90/60 D. BP should be measured routinely on all healthy newborns as recommended by the American Academy of Pediatrics
A
Which of the following adolescents does the nurse recognize as least likely to begin smoking? A. Johnny, age 16 years, whose father quit smoking 2 years ago B. Karen, age 15 years, whose older sister smokes C. Ted, age 17 years, who smoked a cigarette at home in front of his parents D. Lily, age 12, who feels uncomfortable with her early maturing body
A
Which of the following is a characteristic of the somatic swallow reflex? A. the mandible does not thrust forward B. the tongue remains in front of the central incisors C. the tongue is concave and inclined against the palate D. it is efficient for fluids but not for solids
A
Which of the following is least appropriate when developing an outpatient contract between the patient with an eating disorder and the therapist? A. begin the psychotherapy immediately before the contract is developed and before weight gain B. develop the contract so that the patient's feeling of control and responsibility toward recovery is established C. specify in the contract the weight at which tube feedings will be implemented D. specify in the contract when rewards for achievement will be implemented
A
Which of the following is not correct about the relationship of newborn weight to gestational age? A. All infants below the weight of 2500 g (5 lb, 8 oz) are preterm by gestational age. B. Gestational age is more closely related to fetal maturity than is birth weight. C. Classification of infants by both weight and gestational age can be beneficial for predicting mortality risks. D. Hereditary influences are a normal part of assessment.
A
Which of the following physical exam findings is suggestive of self-induced vomiting? A. Presence of distinctive lesions on the hands (Russell sign) B. hypertension, weakness, and cool skin C. elevated potassium, magnesium, and erythrocyte sedimentation rate D. a heart murmur diagnosed as mitral valve prolapse
A
Which of the following techniques is recommended to assist in weaning an infant? A. gradually replace one bottle-feeding or breastfeeding at a time B. always wean to a bottle first C. always wean directly to a cup D. eliminate the nighttime feeding first
A
condition that has more than 150 associated physical, psychologic, and behavioral symptoms that start with ovulation and then reoccur during the luteal phase of the menstrual cycle.
premenstrual syndrome
Prolonged penile erection
priapism
Inhalant abuse usually gives the child an inexpensive euphoria but is extremely dangerous and can cause two immediate life-threatening consequences. These consequences are:
rapid loss of consciousness and respiratory arrest.
Bulimia nervosa is characterized by:
repeated episodes of binge eating followed by inappropriate compensatory behaviors, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.
6 months or more irregular menses in a previous menstruating female
secondary amenorrhea
A stage of the sensorimotor period; lasts until 8 months of age; primary circular reactions are repeated and prolonged for the response that results; phase in which grasping and holding become shaking, banging, and pulling.
secondary circular reactions
Identify the following medication to be given as preventive care. Prophylactic eye treatment against ophthalmia neonatorum
silver nitrate, erythromycin, or tetracycline ophthalmic drops or ointment
condition that may manifest with vaginal pruritus and dysuria and is not a sexually transmitted infection (STI); treated with over-the-counter topical antifungal creams; characterized by "cottage cheese-like" discharge
vulvovaginal candidiasis
Identifies the first stage of the sensorimotor period; the experience of perceiving patterns or ordering; provides the foundation of the subsequent stages.
Use of reflexes
The most common treatable cause of male related impaired fertility
Varicocele
Numerous factors have been identified as predisposing a woman to a vaginal yeast infection. Describe them.
-Antibiotic therapy, broad spectrum antibiotics -diabetes especially uncontrolled in pregnancy -obesity -diets high in refined sugars or artificial sweeteners -use of corticosteroids and exogenous hormones, underwear or pantyhose made of non-absorbent materials create an environment in which vaginal fungus can grow
Describe the current policy of the American Academy of Pediatrics on circumcision of newborn male infants.
-It is the parent's choice (autonomy). -Benefits outweigh the risks. -Health benefits not great enough to recommend as routine. -Primary care practitioner ensures accurate and unbiased info given to parents about risks, benefits, etc. -If parents choose to have the circumcision, then procedural analgesia will be used.
Linda, age 16, started her menses at age 13 years. She comes into the school-based clinic with a history of secondary amenorrhea. Linda is an honor student and a long-distance runner who runs an average of 50 miles per week. The physical examination and laboratory testing results are normal with a negative pregnancy test. Linda's exercise program is thought to contribute to her amenorrhea. Discuss options for management.
-decrease the intensity or duration of her training. -modify her diet to include the appropriate nutrition for her age (a daily calcium intake of 1200-1500 mg plus 400-800 international units of vitamin D and 60-90 mg of potassium and a 20% increase in caloric intake are recommended) -explain the consequences of low bone density, osteoporosis, and stress fractures -discuss ways to prevent stress in her life and possible lifestyle changes
List three infant care practices that contribute to the development of early childhood caries.
1. Bottle propping 2. giving milk bottle in bed 3. giving juice in a bottle
Identify four nursing priorities for safe and effective care of the newborn.
1. Maintain patient airway 2. Maintain stable body temp 3. Experience no infection or injury 4. Receive optimum nutrition/promote parent-infant bonding
What are the 6 neuromuscular signs, and what results would indicate a higher maturity rating?
1. Posture- full flexion of arms/legs 2. Square window- pull flexion 3. Arm recoil- brisk return to full flexion 4. Popliteal angle- angle of less than 90 degrees 5. Scarf Sign- elbow does not reach midline 6. Heel-to-ear- knees flexed with a popliteal angle less than 10 degrees
List five behavioral stages that occur during successful feeding, and give an example of each.
1. Pre-feeding behavior: crying/fussing 2. Approach behavior: rooting reflex 3. Attachment behavior: activities when infant receives nipple and sucks 4. Consummatory behavior: sucking/swallowing 5. Satiety behavior: lets parent know they are satisfied by falling asleep
Identify the three leading causes of accidental injury in infants.
1. Suffocation 2. motor vehicle-related deaths 3. Drowning
What three factors make the infant more prone to problems of dehydration, acidosis, and overhydration?
1. rate of metabolism 2. development of acidemia 3. immature kidneys
What are the three main focus goals for the therapeutic management of anorexia nervosa?
1. reinstitution of normal nutrition or reversal of the malnutrition 2. resolution of disturbed patterns of family interaction 3. individual psychotherapy to correct deficits and distortions in psychologic functioning
Mark, age 14 years, has been rushed to the emergency department because of illegal drug ingestion at a party. Which of the following are most important for the nurse to collect to assist in the emergency treatment plan? (Select all that apply) A. the type and amount of drug taken B. the time the drug was taken and mode of administration C. number of times Mark has previously overdosed D. why the drug was taken
A and B
During the transition from fetal to neonatal circulation, the newborn's cardiovascular system accomplishes which of the following anatomic and physiologic alterations? (Select all that apply) A. Closure of the ductus venosus B. Closure of the foramen ovale C. Closure of the ductus arteriosus D. Increased systemic vascular resistance and decreased pulmonary vascular resistance
A, B, C, D
The nurse is discussing PID with a group of sexually active adolescent females. Which of the following is correct information? (select all that apply) A. C. trachomatis is a common cause B. using IUDs for birth control with more than one sexual partner increases the risk of developing PID C. pain is not always found in patients presenting with PID D. after a single episode of PID, infertility occurs because of tubal scarring E. after a single episode of PID, the risk for ectopic pregnancy increases F. all pregnant women with PID should be hospitalized and treated with parenteral antibiotics
A, B, E, F
True/False The newborn is expected to have the first void within the first 48 hours.
False
A nursing assistant has been assigned to work with you in the newborn nursery. Summarize what you would tell him or her about each of the following issues. A. The most important way to prevent cross-infection. B. Handling newborn infants before the first bath.
A. Wash hands between each infant. B. Use standard precautions (wearing gloves)
The phase with which the infant is overcoming a sense of concern, according to Erikson.
Acquiring a sense of trust, overcoming a sense of mistrust
True/False The pregnancies of adolescents under 15 years old are less frequently complicated by obstetric problems.
False
True/False The teenage pregnancy rate continues to increase for all age groups.
False
True/False The usual goal for the compulsive drug user is peer acceptance.
False
Uterine bleeding that is irregular in amount, duration, or timing and is not related to regular menstrual bleeding.
Abnormal uterine bleeding
Outward manifestation of emotion and feeling; seen as infants begin to develop a sense of permanency.
Affect
Assessment of the newborn includes which of the following? (Select all that apply) A. Clinical gestational age assessment B. General measurements C. General appearance D. Head-to-toe assessment E. Parent-infant attachment
All of the above
The nurse is conducting a sexual education program. What technique has been found helpful when dealing with the subject of sexual abstinence?
Allowing adolescents to role-play refusal skills (for sexual activity) in a safe environment.
Passage of meconium from rectum during first 48 hours of life
Anal patency
Period of no respiration for 20 seconds
Apnea
Which of the following is the most common method of successful suicide among adolescents? A. overdose of drugs B. firearms C. self-inflicted lacerations D. hanging
B
A 4 month old infant who does not express vocalization such as cooing, gurgling, or laughing should be evaluated for: A. tongue-tie (ankyloglossia) B. hearing impairment C. cleft palate D. vocal cord paralysis
B
According to Piaget's theory of cognitive development, the three crucial events of the sensorimotor phase are: A. trust, readjustment, and the regulation of frustration B. separation, object permanence, and mental representation C. imitation, personality development, and temperament D. ordering, comfort, and satisfaction with his or her body
B
After birth, maximum levels of immunoglobulin A, D, and E in humans are: A. reached during infancy B. attained in early childhood C. transferred from the mother D. reached before 9 months of age
B
Fine motor development is evaluated in the 10 month old infant by observing the: A. ability to stack blocks B. pincer grasp C. righting reflexes D. tonic neck reflex
B
Human papillomavirus (HPV): A. has 10 serotypes associated with causing genital warts B. has lesions that typically resolve on their own without treatment C. has lesions that decrease in size or disappear during pregnancy D. has lesions always visible to the naked eye on the cervix
B
Newborns lose up to 10% of their birth weight by 3 or 4 days of age. The factor that does not contribute to this process is: A. limited fluid intake in breast-fed infants B. incomplete digestion of complex carbs C. loss of excessive extracellular fluid D. passage of meconium
B
Separation anxiety and stranger fear normally begin to appear by: A. 4 weeks B. 6 months C. 8 months D. 12 months
B
The characteristic of the respiratory system that predisposes the infant to middle ear infection is the: A. short, angled eustachian tube B. short, straight eustachian tube C. close proximity of the trachea to the bronchi D. size of the lumen of the eustachian tube
B
The first goal in nursing care of the pregnant teenager is: A. to arrange for the pregnant teen to register for food supplement program is to ensure proper nutrition B. to assist the pregnant teen in obtaining health care C. to involve the boyfriend and parents in the pregnancy so that the pregnant teen will have support during her pregnancy D. to educate the pregnant teen regarding child care
B
The nurse can expect an infant whose birth weight was 7lbs to weigh _________________ pounds by 12 months of age. A. 14 B. 21 C. 28 D. 32
B
The nurse is using the Brazelton Neonatal Behavioral Assessment Scale to assess the newborn's behavioral responses. How should the nurse define habituation? A. Responsiveness to the newborn to auditory and visual stimuli B. Process whereby the newborn becomes accustomed to stimuli C. The ability of the infant to be easily aroused from sleep state D. A reactive Moro reflex by the infant, with good muscle tone and coordination
B
When introducing new food, the parents should not: A. decrease the quantity of the infant's milk B. mix food with formula to feed through a nipple C. introduce new foods in small amounts D. offer the new food by itself at first
B
Which of the following infant traits is most likely to contribute to shaken baby syndrome (traumatic brain injury)? A. laughing aloud B. crying C. soiling the diaper D. pulling up to furniture
B
Which of the following is associated with 75% of all penile neoplasias? A. human papillomavirus (HPV) type 6 and 11 B. HPV type 16 C. uncircumcised males D. paraphimosis
B
Which of the following statements regarding measuring temperature in pediatric patients is correct? A. Rectal temperature is taken in newborn infants because it is the most accurate. B. Axillary temperatures are taken in the newborn because insertion of a thermometer into the rectum can cause perforation of the mucosa. C. Skin temperature is slightly higher than core body temperature; therefore rectal temperature is less than axillary temperature. D. Infrared ear thermometry is the most accurate method of taking temperature in newborn infants and children under 2 years of age.
B
Which of these neonates will most likely need additional respiratory support at birth? A. The infant born by normal vaginal delivery B. The infant born by cesarean birth C. The infant born vaginally after 12 hrs of labor D. The infant born with high levels of surfactant
B
Mrs. Gonzalez is a first-time mother. She comes to the clinic because of painful nipples and is afraid she will have to terminate breastfeeding. The breast physical exam is normal. Which of the following actions does the nurse recognize as most likely causing the painful nipples? (Select all that apply) A. Using an electronic pump to express milk for the infant to drink when Mrs. Gonzalez is away from home. B. Washing the nipples before and after each feeding with soap and applying aloe vera gel. C. Shallow infant latch. D. Letting warm water flow directly over the breast in the shower. E. Leaving breast milk on the areola after feedings and letting it dry. F. Letting the infant breastfeed every 2 hours.
B, C
The nurse performs the following nursing actions during the transitional period. Arrange these actions in order of highest to lowest priority. A. Taking head and chest circumference measurements B. Assessing for neonatal distress C. Administering prophylactic medications D. Scoring for gestational age E. Assessing vital signs
B, E, A, C, D
Response with fanning of the toes and dorsiflexion of the great tow; disappears after 1 year of age.
Babinski reflex
Occurs in the second stage of infancy; infants learn they can hold on to what is their own and more fully control their environment; also brings internal relief from teething discomfort and a sense of power or control.
Biting
Yellow to golden; pasty consistency
Breast-fed infant stools
A 12 month old infant would be likely to have: A. 2 teeth B. 4 teeth C. 6 teeth D. 12 teeth
C
A formerly maltreated child who manifests behaviors such as lack of suspicion of strangers and poor impulse control may be suffering from: A. separation anxiety B. stranger fear C. disinhibited social engagement disorder D. spoiled child syndrome
C
A treatment of choice for adolescents with dysmenorrhea is: A. acetaminophen B. oral contraceptives C. nonsteroidal anti-inflammatory drugs D. estrogen-suppression drugs
C
Adolescents with anorexia nervosa are at risk for refeeding syndrome. Which of the following best describes refeeding syndrome? A. It reduces the risk for osteoporosis and returns the menses to normal B. the risk for heart failure is greatest during the first two days of treatment C. it occurs because of shifts in phosphate from extracellular to intracellular spaces in persons with total body phosphorus depletion D. it causes mitral valve prolapse and significant electrolyte imbalance
C
Cindy has been diagnosed with anorexia nervosa. Her therapeutic management plan includes dietary interventions combined with family psychotherapy. Which of the following would the nurse recognize as appropriate? A. Weight gain is a sign that the patient is not relapsing from the plan B. the patient is only allowed to participate in setting up a food plan as a reward for weight gain C. the plan needs to be firm but flexible D. a reasonable goal for weight gain is about 4 pounds per week
C
Contraindications to breastfeeding include which of the following? A. Mothers who have received chemotherapy in the past. B. Mothers with active TB and who are undergoing treatment C. Mothers living in the industrialized world who have HIV D. Mothers with herpes simplex lesion on the mouth
C
If the infant weighs 8 kg at age 5 months, about how many kilograms was his/her probable birth weight? A. 7kg B. 6kg C. 4kg D. 15kg
C
In guiding parents who are choosing a daycare center, the nurse should stress that state licensure represents a program that maintains: A. optimal care B. health features C. minimum requirements D. safety features
C
Infants of adolescents are at risk because: A. teenage mothers often neglect their infants, leaving them for long periods with grandparents B. teenage mothers supply excessive amounts of cognitive stimulation to their infants C. adolescents often lack knowledge about normal infant growth and development D. adolescents are less likely to treat their infant as love objects or play things
C
Limit-setting and discipline should begin in: A. middle childhood or adolescence B. toddlerhood, with voice tone and eye contact C. infancy, with voice tone and eye contact D. infancy, with time-out in a chair for misbehavior
C
Of the following characteristics of vision, the one that is developed at the earliest age is: A. binocularity B. stereopsis C. corneal reflex D. convergence
C
On assessment of a 24-hour-old newborn, the nurse makes the following observations. Which is normal? A. Cyanotic color centrally and peripherally B. Axillary temperature of 35.5 C (96 F) C. Flexion of the infant's head and extremities, which rest on the chest and abdomen D. Respirations of 68 breaths/minute
C
The _______________________ is the most immature of all the GI organs throughout infancy. A. large intestine B. pylorus C. liver D. lower esophageal sphinctor
C
The development of gender identity is reported to begin: A. after the first year B. during the phallic stage C. in utero D. at puberty
C
The expected immaturity of the infant's functioning endocrine system will be demonstrated in the infant's: A. growth patterns B. thyroid levels C. homeostatic control D. immunoglobulin levels
C
The nurse correctly identifies the need to notify the provider for which of the following neonates? A. The 24-hour-old neonate found to have Epstein pearls on the side of the hard palate. B. The 2-day-old neonate with periodic breathing C. The 24-hour-old neonate who has nasal flaring D. The 2-hour-old neonate who has a bluish, white, moist umbilical cord with one vein and two arteries visible
C
The nurse is performing the 5-minute Apgar on a newborn. Which of the following observations is included in the Apgar score? A. Blood pressure B. Temperature C. Muscle tone D. Weight
C
The nurse recognizes that tactile stimulation probably has some effect on initiation of respiration in the neonate. Which of the following is of no beneficial effect? A. Normal handling of the neonate B. Drying the skin of the neonate C. Slapping the neonates heel or buttocks D. Placing the infant skin-to-skin with the mother
C
The primary reason for introducing solid food to infants is to: A. increase their overall caloric intake B. provide a substitute for the milk source C. introduce a taste in chewing experience D. increase their weight
C
The school nurse is planning an educational program centered on smoking prevention for high school adolescents. Which of the following methods does the nurse recognize as the most effective way to present this program? A. Focus on the negative, long-term effects of smoking on health B. teach methods of resistance to peer pressure C. use peer-led programs that emphasize social consequences D. use media, video tapes, and films on smoking prevention
C
Which of the following means of identification for the newborn is recommended by the National Center for Missing and Exploited Children (NCMEC)? A. Color photographs kept in the medical record B. Storage of blood for DNA genotyping C. Use of footprints and a cord blood sample that is kept until after the newborn is discharged D. Use of password system between the staff and parent when the newborn is taken from the room
C
Which of the following play activities would be least appropriate to suggest to parents for their three-month-old infant? A. provide bright objects B. use rattles C. place in an infant walker D. place in an infant swing
C
Bright red, raised, soft, lobulated tumor occurring on the head, neck, trunk, or extremities; does not blanch with pressure.
Capillary hemangiomas
Edema of the soft scalp tissue.
Caput succedaneum
Hematoma between periosteum and skull bone.
Cephalhematoma
The ability to know; most commonly explained by Piaget's theory of development.
Cognition
Jim, who has no history of previous suicide attempts, is talking with the school nurse about his feelings of despair and hopelessness about the future. He tells the nurse he would be better off dead. The nurse's best response is which of the following? A. recognize that Jim is going through a common phase of adolescence B. recognize that Jim is at low risk for suicide because he has not previously attempted it C. explain to Jim that suicide never solved anything and that he will feel better tomorrow D. take Jim seriously, allow time for him to verbalize his feelings, and stay with him until referral
D
How can the nurse assess for hearing loss in the newborn?
Conduct auditory brainstem response or evoked otoacoustic emissions testing (universal newborn hearing screening) before discharge from hospital.
Heat loss from the body through direct contact of the skin with a cooler solid object is termed _______________________.
Conduction
Phenomenon resulting from excessive media coverage after an adolescent suicide.
Contagion suicide
Placing an infant in the direct flow of air from a fan causes rapid heat loss through ___________________________.
Convection
Karen is suspected of having bulimia nervosa. The nurse recognizes which of the following as clinically characteristic of this disease? A. Bulimia often begins with decreased dietary intake associated with poor relationships with family members B. once started, the bingeing decreases in frequency to only about once per day C. insulin production is decreased because of excessive self-induced vomiting D. impulse control and satiety regulation are problems in bulimic adolescents
D
Rape victims display a variety of manifestations. Which of the following might the nurse see in 16 year old Sally as she arrives at the emergency department for treatment after being raped? A. Hysterical crying or giggling B. calm and controlled behavior C. anger and rage alternating with helplessness and agitation D. all of the above
D
Studies have shown that excessive fruit juice consumption in infants and small children increases the risk for: A. hypervitaminosis B. fluorosis C. rickets D. dental caries
D
Transient mottling when infant is exposed to decreased temperature, stress, or overstimulation.
Cutis marmorata
A recent survey of breastfeeding mothers identified causes for the mother to stop breastfeeding before 6 months. Which of the following was not a cause for a mother to stop breastfeeding? A. concern about infant weight gain B. difficulties with lactation C. effort to pump and maintain milk supply D. infant refusing to nurse
D
All of the following digestive processes are deficient in an infant until about 3 to 6 months except: A. amylase B. lipase C. digestive enzymatic activity D. trypsin
D
Amanda, age 18, comes to the school nurse's office early in the morning, visibly upset. She tells the nurse that she and her boyfriend were having sexual relations last night and the condom broke. Amanda asks the nurse about a new pill she has read about that will keep her from becoming pregnant. She wants the nurse to give her more information about this pill. Which of the following statements made to Amanda provides the best information about levonorgestrel? A. "It is available without a prescription and must be taken within 24 hours of the unprotected sexual intercourse" B. "It is very effective but has side effects, so you will need to be out of school at least 1 day." C. "It contains estrogen, so you will need to have a pregnancy test before it can be administered" D. "It is available to women age 17 years and older without a prescription. It must be taken within 120 hours of the unprotected sexual intercourse"
D
Anna, age 16, has not had a period for the past 3 months and her pregnancy test is positive. Which of the following is not an appropriate action for the nurse to take at this time? A. Inform Anna privately that her test is positive B. review with Anna facts about the pregnancy, including the duration of pregnancy and anticipated due date C. understand that Anna's reaction may be one of ambivalence, shock, fear, or apathy D. arrange for Anna's parents to be present when Anna is given the news
D
Cindy, age 16, has been sent to the school nurse because her gym teacher has noticed a marked decrease in Cindy's weight since vacation. Which of the following does the nurse recognize as a common finding in an adolescent girl with anorexia nervosa? A. Wears form-fitting clothes like tank tops and jeans B. has strong peer relationships with classmates and several best friends C. has poor school work performance because of little interest in school D. is present at meals and appears to family and friends to be eating appropriately
D
Complete maturity of the kidneys occurs: A. at birth B. by 6 months C. by 1 year D. by 24 months
D
Human milk is preferable to cow's milk because: A. human milk has a nonlaxative effect B. human milk has more calories per ounce C. human milk has greater mineral content D. human milk offers greater immunological benefits
D
In discussing prevention of STIs, the nurse tells the adolescent that which of the following is most effective? A. Birth control pills B. natural skin condoms with nonoxynol-9 C. Spermicides D. latex condoms
D
In treating eating disorders: A. weight gain is a reliable sign a positive progress B. when a therapeutic environment is removed, relapses seldom occur C. antianxiety or antidepressant drug use has not been proven effective D. psychotherapy is aimed at resolving adolescent identity crisis and distorted body image
D
The nurse has been asked to present an educational program on prevention of adolescent stress and suicide. In planning the program, the nurse should include: A. the importance of being supportive and establishing positive communication patterns between family and teens. B. The precipitating factors for suicide. C. Effective coping mechanisms and problem-solving skills. D. All of the above.
D
The nurse implements all of the following actions to maintain a patent airway in a newborn. Which one will be least effective? A. Maintaining the infant in a supine position during sleep B. Performing oropharyngeal suctioning for up to 5 seconds with sufficient time between attempts to allow infant to reoxygenate C. Maintain a neutral neck position D. Continuing oral feedings for the infant with nasal flaring and intercostal retractions
D
The nurse recognizes that all of the following effects of maternal sex hormones are normal except: A. hypertrophied labia B. engorgement of the newborn breasts during the first 2 months of life C. pseudomenstruation D. bleeding from the breast nipples
D
The pelvic examination in the adolescent: A. Should be performed on all females who are sexually active B. Should only be conducted when there is suspicion of a STD C. Is always conducted with a parent or guardian in the room D. Is only indicated if the adolescent is experiencing genital tract, pelvic, urologic, or rectal problems
D
To prevent rickets, the mother who is exclusively breastfeeding should consider the administration of: A. iron B. calcium C. vitamin E D. vitamin D
D
Which of the following about herpes simplex virus (HSV) is true? A. It presents with a less severe clinical course in men than women B. It is treated with acyclovir, famciclovir, and valacyclovir for cure of the disease C. it is treated with ointments containing cortisone to help reduce inflammation D. cesarean birth is recommended for women in labor or ruptured membranes with visible lesions present
D
Which of the following actions by the nurse will least likely promote the attachment process between the infant and parent? A. Recognizing individual differences present in the infant and explaining these normal characteristics to the parent B. Helping the mother assume the en face position when she is presented with her infant C. Explaining to the parents how to respond to their infant with the use of reciprocal interacting D. Explaining to the parents the need for infants to have an organized schedule of daily activities that allows them to remain in their crib during awake periods
D
Which of the following is an abnormal finding when assessing the head of a newborn? A. Molding found in an infant after vaginal birth B. Inability to palpate the sphenoidal and mastoid fontanels C. Head lag and hyperextension when the infant is pulled into a semi-Fowler position D. Posterior fontanel palpated at about 2 to 3 cm
D
Which of the following observations from the eye assessment of a newborn is recognized as normal? A. Purulent discharge at age 48 hours B. Absence of the red reflex at age 24 hours C. No pupillary reflex at age 3 weeks D. Presence of strabismus at age 48 hours
D
This is an excellent bonding period and the best time to start breastfeeding.
First period of reactivity
Characterized by unilateral scrotal pain, redness, and swelling; may include urethral discharge, dysuria, fever, pyuria; treated with antibiotics
Epididymitis
Inflammation that is a result of infection, local trauma, or chemical irritant
Epididymitis
pink papular rash with vesicles superimposed on thorax, back, buttocks, and abdomen in the newborn.
Erythema toxicum
Loss of heat through skin moisture is termed ___________________________.
Evaporation
True/False Adolescents with alcoholism seldom drink alone.
False
True/False At birth the skeletal system contains larger amounts of ossified bone than cartilage.
False
True/False Deficiency of pancreatic lipase assists the neonate in the digestion of cow's milk.
False
True/False During a second pregnancy for a teenager, obstetric risk and risk to the infant are lower.
False
True/False Instruction in the skills needed to resist sexual intercourse has less influence on reducing sexual activity than does providing information on the dangers associated with sexual activity (STIs or pregnancy).
False
True/False Most salivary glands are functioning at birth even though most infants do not start drooling until teeth erupt.
False
True/False Nonshivering thermogenesis is an effective method of heat production in the neonate because it is able to produce heat with little use of oxygen.
False
True/False Pasteurized whole cow's milk is an acceptable alternative to breastfeeding in a six-month-old infant.
False
True/False The American Academy of Pediatric Dentistry recommends universal fluoride supplementation in infants beginning at 6 months of age.
False
True/False The less familiar an adolescent is with his or her partner, the more likely he or she is to use contraception during intercourse.
False
True/False The liver is the most mature of the gastrointestinal organs at birth.
False
True/False The longer the infant is attached to the placenta, the less blood volume will be received by the neonate.
False
_______________________, also known as the "date rape drug," is ten times more powerful than diazepam (Valium) and produces short term memory loss.
Flunitrazepam (rohyprol)
Pale yellow to light brown; firmer in consistency with more offensive odor
Formula-fed infant stools
Flexion caused by touching soles of feet near bases of digits or palms of hands.
Grasp reflex
Reaching out to others; initially reflexive; has powerful social meaning for the parents.
Grasping
Benign and temporary disease that occurs in about 70% of adolescent boys
Gynecomastia
Breast enlargement that occurs during puberty
Gynecomastia
Name two STIs for which there is a vaccine.
HPV and hepatitis B
Condition in which the lower half of the body becomes pink and upper half is pale when the newborn lies on side.
Harlequin color change
Identify the following medication to be given as preventive care. First dose given between birth and 2 days of age to decrease incidence of hepatitis B.
Hepatitis B vaccine
The newborn's exposure to __________________-frequency sound elicits an altering reaction.
High
You are a nurse assigned to the newborn nursery. While assessing a newborn, you see white patches on the inside of the mouth. How would you correctly determine whether this is a normal or abnormal finding?
If they cannot be wiped off it is abnormal (thrush)
Human behavior that requires the differentiation of selected acts from several events; developed by infants in the second half of the first year.
Imitation
Fine downy hair present on the newborn's skin
Lanugo
clear to cloudy vaginal discharge
Leukorrhea
Restriction can interfere with adequate sucking.
Lingual frenulum
The newborn's response to ____________________-frequency sounds is one of decreased motor activity and crying.
Low
The three chemical factors in the blood that stimulate the initiation of the first respiration in the neonate are _____________________, ______________________, and _________________________.
Low oxygen; low carbon dioxide, and low pH
How should the nurse assess auditory ability in the newborn?
Make a sharp, loud noise close to the infant's head and note the presence of the startle reflex or twitching of the eyelids.
Response with symmetric abduction and extension of the arms; fingers fan out; thumb and index finger form a C
Moro reflex
First stool; sticky consistency
Meconium
_________________________, with the street names of "crank" and "crystal", produces more stimulation than cocaine, and the user can remain "up" for hours.
Methanphetamine
Distended sebaceous glands that appear as tiny white papules on the cheeks, chin, and nose in the newborn.
Milia
Irregular areas of deep blue pigmentation, usually in sacral and gluteal regions, seen in the newborn.
Mongolian spots
True/False There is evidence that alcohol, marijuana, and cigarette use are associated with sexual intercourse at an earlier age.
True
Port-wine stain
Nevus flammeus
"Stork bites"; flat, deep pink, localized areas usually seen at the back of neck.
Nevus simplex
The realization that objects that exit the visual field still exist; a major accomplishment for the infant in the sensorimotor phase.
Object permanence
It is important to assess for nasal patency in the newborn, because newborns are usually ______________________ _____________________________.
Obligatory nose-breathers
Tight foreskin of the penis that cannot be retracted
Paraphimosis
Rupture of the corpus cavernosum as a result of trauma to the erect penis
Penile fracture
Rapid, non-labored respirations followed by pauses of less than 20 seconds
Periodic breathing
Activity in which infants take pleasure in performing acts after they have mastered them; consumes most of the infant's waking hours.
Play
Postpartum care of adolescents should be directed toward what goal?
Preventing subsequent pregnancies and enhancing life outcomes for adolescents and infant.
The absence of menses by 15 years, regardless of normal growth and development
Primary amenorrhea
Marks the beginning of the replacement of reflexive behavior with voluntary acts in the sensorimotor period; occurs from 1 to 4 months; sucking and grasping become deliberate acts to elicit certain responses.
Primary circular reactions
Associated with ovulatory cycles; arises from the release of prostaglandins with menses
Primary dysmenorrhea
Total concern for oneself; at its height in the newborns and early infancy.
Primary narcissism
The loss of heat to cooler solid objects in the environment that are not in direct contact with an infant is called _________________________.
Radiation
Wormlike mass that is palpated above the testicle and becomes smaller when the adolescent lies down
Varicocele
A psychological and developmental problem that stems from maladaptive or absent attachment between infant and parent (or caregiver).
Reactive attachment disorder (RAD)
Response in which touching cheek along the side of the mouth causes infant to turn head toward that side and begin to suck.
Rooting reflex
Gastric and respiratory secretions are increased; passage of meconium commonly occurs.
Second period of reactivity
During this period, infant sleeps 2 to 4 hours; heart rate and respiratory rate decrease.
Second stage of the first period of reactivity
Occurs during the fourth sensorimotor stage of Piaget; characterized by infants using previous behavior achievements as the foundation for adding new skills.
Secondary schemas
The term used by Piaget to describe the period from birth to 24 months.
Sensorimotor phase
A crucial event in the sensorimotor phase in which infants learn to detach themselves from other objects in the environment.
Separation
The type of play that infants engage in denotes one-sided play.
Solitary play
The primary thermal stimulus that helps initiate the first respiration is _______________________________________.
Sudden chilling of the infant (change in temp)
Preoccupation with thoughts about committing suicide.
Suicidal ideation
Deliberate act of self-injury with death as a result.
Suicide
Deliberate but unsuccessful act of self-injury.
Suicide-attempt
Mental representations; a major intellectual achievement of the sensorimotor period.
Symbols
Manifested by scrotum that is swollen, painful, red, and warm; pain radiating to groin, accompanied by nausea, vomiting, and abdominal pain; typically, an absence of fever and urinary symptoms; immediate surgery required to treat
Testicular torsion
Marked by the testis hanging free from its vascular structure; results in partial or complete venous occulusion
Testicular torsion
STI caused by an anaerobic parasitic protozoa
Trichomonas vaginitis
True or False Breastfed infants should be fed on demand.
True
True or False Galactosemia in the infant is a contraindication for breastfeeding.
True
True or False Infants need at least 2 hours of sucking daily.
True
True or False Propping the bottle is discouraged because it facilitates the development of middle ear infections in the infant.
True
True or False Supplemental water is not needed in infants, even in hot climates.
True
True or False Using a microwave oven to defrost frozen human milk destroys the antiinfective factors and Vitamin C content in the milk.
True
True/False A 2014 survey found that marijuana use and acceptance of marijuana rose from 2006 to 2011 and then leveled from 2011 to 2013, while alcohol use has been on the decline since the early 1980s.
True
True/False A person may be physically dependent on a narcotic without being addicted.
True
True/False Adolescents who have at least one supportive parent engage in less risky behavior.
True
True/False After birth, development of the nervous system proceeds in a cephalocaudal-proximodistal pattern.
True
True/False Brown fat, or brown adipose tissue, has a greater capacity to produce heat than does ordinary adipose tissue.
True
True/False Cigarette smoking is the chief avoidable cause of death.
True
True/False Contraception use increases among girls as the duration of the relationship increases.
True
True/False Cough and cold preparations such as NyQuil, Coricidin, and Robitussin are common substances abused by adolescents and young adults.
True
True/False Deficient production of pancreatic amylase impairs utilization of complex carbohydrates.
True
True/False Easy access to cars, unsupervised time at home, and changing family composition have contributed to the incidence of sexual experimentation among adolescents.
True
True/False Effective parent-child communication about sexuality can delay the onset of first sexual intercourse.
True
True/False Factors that predispose the neonate to excessive heat loss are large surface area, thin layer of subcutaneous fat, and the lack of shivering to produce heat.
True
True/False Iron-fortified rice cereal is recommended as the infant's first solid food.
True
True/False Pregnant adolescents often have diets deficient in iron, calcium, and folic acid.
True
True/False Reports show that adolescents believe that prescription medications, although not taken under practitioner orders, are safer than illicit substances.
True
True/False Smokeless tobacco has been proven to be carcinogenic, and regular use can cause dental problems, foul-smelling breath, and tooth erosion or loss.
True
True/False Teens between 12 and 16 years are at high risk for prolonged labor related to fetopelvic incompatibility.
True
True/False The American Academy of Pediatrics recommends that infants be started on solid foods beginning between 4 and 6 months of age.
True
True/False The abuse of prescription and synthetic drugs such as Xanax and oxycodone has increased significantly among adolescents.
True
True/False The stomach capacity is approximately 20 ml, leading to the need for small frequent feedings.
True
Cheeselike substance; mixture of sebum and desquamating cells covering the skin at birth.
Vernix caseosa
Identify the following medication to be given as preventive care. Administered by injection to prevent hemorrhagic disease of the newborn.
Vitamin K
Process of giving up one method of feeding for another; usually refers to relinquishing the breast or bottle for a cup.
Weaning
Infants have a visual preference for the colors _________________, ____________________, and ________________________ and for designs such as _______________________ _____________________ and ____________________________.
Yellow, green , and pink Geometric shapes and checkerboards
Anorexia nervosa is characterized by:
a strong fear of becoming fat, a distorted body image, and progressive weight loss.
The absence of menstrual flow
amenorrhea
Cyanosis of hands and feet
acrocyanosis
symptoms that include thin, malodorous, "fishy" vaginal discharge; diagnosis confirmed by clue cells on microscopic examination
bacterial vaginosis
The physical signs of narcotic abuse are:
constricted pupils, respiratory depression, cyanosis, and needle marks seen on extremities of chronic users.
The form of cocaine known as the purer and more menacing form is _____________________.
crack (rock)
abnormal vaginal bleeding that does not have a pathogenic cause
dysfunctional uterine bleeding
Pain during or shortly before menstruation
dysmenorrhea
painful sexual intercourse
dyspareunia
condition that may be caused by the presence of endometrial tissue outside the uterine cavity
endometriosis
Newborns receive passive immunity in the form of immunoglobulin G from the _______________________ ______________________ and _________________________ _________________.
maternal circulation and human milk
Behaviors range from gestures to attempts to kill oneself.
parasuicide
infection of the upper genital tract (endometrium, fallopian tubes, and ovaries), most commonly caused by sexually transmitted bacteria, such as Neisseria gonorrhoeae, Chlamydia trachomatis, and a variety of other anaerobic bacteria
pelvic inflammatory disease (PID)
characterized by a primary lesion, the chancre, which appears 14 to 21 days after infection
syphillis
