Exam 1 PEDS- ch 3, 4, 8, and 9

9- A four year old child is having a vision screening performed. What screening chart would be best for determining the child's visual acuity? a. Snellen b. Ishihara c. Allen figures d. CVTME

C

T or F: Children who are homeless are exposed to an environment that does not effect appropriate growth and development.

False

T or F: Infants' respirations are primary thoracic

False

T or F: Reliance upon a security item (blanket, doll, or stuffed animal) in a stressful situation is indicative of a potential problem in the household.

False

T or F: The average toddler gain 5-10 pounds per year

False

T or F: The nurse should always inspect the infant's throat by placing a tongue blade in the infant's mouth.

False

T or F: To prevent obesity later in life, toddlers should be weaned from the breast by 12 months.

False

T or F: Vocabulary at 3 years should constitute about 500 words

False

9- A nurse is working to provide health promotion services throughout the community. What institutions or organizations best serve as important avenues for disseminating health promotion information? (Select all that apply.) a. churches, synagogues, and mosques b. political organizations c. environmental groups d. day care centers e. schools (private and public)

A, D, E

4- Parents who just moved into their "dream home" are concerned because their toddler, who had achieved daytime bowel and bladder control, has begun wetting and defecating in the underwear. The nurse explains this is called: a. egocentrism b. regression c. ritualism d. autonomy

B

3- A 5 month old infant being assessed was born at 32 weeks. The nurse doing the well-child check up should compare the baby to what norms? a. the development of a 3 month old b. the growth of a 5 month old c. the development of a 10 week old d. the growth of a 2 month old

A

3- The nurse is teaching the parent of a 2 month old infant about the social and emotional developments that will occur in the next 8 weeks. Which behavior is most likely to occur a. mimicking parents facial expressions b. crying when the parent is out of sight c. participating in a game of peek-a-boo d. becoming clingy around strangers

A

3- What feeding practice used by the parents of an 8-month-old should the nurse discourage? a. placing all liquids given the child in a no spell sippy cup b. continuing to offer foods the child rejects c. giving the child soft table food and finger foods d. including the infant at family meals in the high chair

A

8- The nurse has worked diligently with an adolescent to meet teaching-learning needs and make adaptations for managing the adolescent's illness to suit the adolescent's preferences and lifestyle. Even so, there is evidence of noncompliance. The nurse's interpretation is: a. some noncompliance should be expected due to the adolescent's desire for independence, expression of personal values, and peer acceptance b. because the adolescent did not pay attention during teaching sessions, the adolescent now does not know what to do. c. more assistance from the family is needed for the adolescent to manage one's care d. the developmental thinking skills of the adolescent prevent one from seeing the connection between actions and the effect on health

A

8- The nurse is explaining a diagnostic procedure to a 7-year-old child before the procedure begins. Which statement by the nurse best utilizes the principles of atraumatic care? a. "You will lie on a special bed that moves in the machine but you can still see out." b. "I don't think you will be in the X-ray department very long." c. "The technician needs to take several tubes of blood from you." d. "The big machine will look inside you to see why you are sick so just hold still."

A

8- Which statement is most appropriate when initiating a nursing action with a preschooler? a. "These sticky snaps are for your chest." b. "Can I put this little clip on your finger? (oxygen saturation monitor)" c. "Is it OK if I listen to your heart?" d. "It is time to take your temperature."

A

9- A dental home establishes a continuing comprehensive relationship of care with the child and family. The American Academy of Pediatric Dentistry (AAPD) recommends this dental home be established by the time the child is age: a. 1 year b. 1.5 years c. 2.5 years d. 2 years

A

9- The nurse is doing a health history for a 14-year-old pregnant client during a health supervision visit. For which condition should the client be screened? a. iron deficiency anemia b. congenital problems c. lead level d. hyperlipidemia

A

9- The nurse is planning to teach children about healthy food choices. At what age can the nurse begin to teach the child or children directly? a. preschool b. toddler c. school-age d. teenager

A

At what age can a child kick a ball? a. 24 months b. 15 months c. 18 months d. 36 months

A

Which should the nurse teach the parents is one of the most common causes of injury and death for a 9 month old infant? a. aspiration b. child abuse c. poisoning d. dog bites

A

9- Choose the options that will assist nurses in overcoming some of the barriers to having children fully immunized. (Select all that apply.) a. Using every health contact with the child (hospital, urgent care, emergency, and well-child visits) to check status/administer vaccines b. Checking the immunization status of siblings who accompany the child who has the healthcare appointment c. Using combination vaccines to reduce the number of injections children receive d. Having parents postpone all immunization when they are concerned about certain vaccines e. Using separate vaccines (except the well known DTaP) so parents can more readily track/understand immunizations received

A, B, C

3- The infant in the exam room has these signs and symptoms. Which will the nurse attribute to teething (select all that apply) a. increased sucking on hands b. drooling and biting c. refusing to eat d. irritability and awakening from sleep e. fever and diarrhea

A, B, C, D

3- A parent is discussing the 10 month olds to use in teaching a parenting group. Which comment indicates a need for teaching a. "I wipe my child's teeth every day with a fresh washcloth" b. "My child loves being in the walker and zips around the house" c. "My child gets a few sips of apple juice each day from a regular cup, not a sip. cup." d. "We have safety gates at the top and bottom of our stairs"

B

9- Due to a certain warning sign, the nurse is anticipating that health supervision for a 7-year-old child will be challenging. Which indicator supports this concern? a. the child has regular chores and responsibilities at home b. the parents made several negative remarks about the child c. the family maintains a large garden d. older grandparents play a significant role in the family

B

Separation anxiety and stranger fear normally begin to appear by: a. 4 years b. 6-8 months c. 4-6 weeks d. 12-14 months

B

3- A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is: a. shaking a rattle to enjoy the sound b. pushing a spoon from the high chair tray to the floor c. looking for a toy in the crib at the last place the infant saw it d. smiling at oneself in the mirror

C

3- The nurse is promoting a healthy diet to the parent of a 6 month old infant. Which action would have the most effect on the infant's neurologic development a. establishing an adequate level of dietary iron intake b. requiring more solid foods in the diet c. promoting continuation of breastfeeding d. addict fruit juice daily

C

4- A parent expresses surprise to the nurse that her toddler daughter has begun masturbating. The most important initial nursing response is: a. check for undue stress in your toddler's life b. toddler girls as well as boys will masturbate c. this is a normal and expected activity best treated matter of factly d. toileting teaches places much focus on the genitals

C

9- During the health interview, the mother of a four month old says, "I'm not sure my baby is doing what he should be." What is the nurse's best response? a. I'll be able to tell you more after I do this physical b. Fill out this developmental screening questionnaire and then I can let you know c. Tell me more about your concerns d. All mothers worry about their babies. I'm sure he's doing well

C

T or F: The "fifth vital sign" in children is considered a. development b. gender c. pain d. complete blood count

C

T or F: The parenting style that involves little parental control over the behavior of their children is referred to as a. Authoritative parenting b. Authoritarian parenting c. Permissive parenting

C

The assessment tool used to rate physical sexual maturity is the a. Piaget stages b. Freud stages c. Tanner stages d. Korotkoff stages

C

3- The nurse pulls the 5 month old to sitting position from supine and notes head lag. The nurse's response is to: a. consider this a normal response for the age b. conclude the earlier assessments carried out fatigued the infant c. suggest more awake tummy time for the child d. refer the infant for developmental and/or neurologic evaluation

D

9- The nurse has just finished administering the DTaP vaccine to a 2-month-old infant and is educating the parent about the immunization. Which statement is accurate? a. "You need to renew this immunization every 10 years" b. "The 'T' stands for tuberculosis" c. "There are no side effects from this vaccine" d. "Bring your infant back for the second dose when the infant is 4 months old"

D

9- The nurse is discussing measles, mumps, and rubella vaccination with a parent who is concerned about using the combined vaccine for her 12-month-old. Which statements by the nurse will be most helpful to the parent in accepting the vaccine? a. "This vaccine is approved by the American Academy of Pediatrics" b. "It is one of the most commonly used childhood vaccines" c. "this vaccine is recommended by the Center for Disease Control and Prevention" d. "the vaccine is shown to be effective and safe and will reduce the number of injections your child will need"

D

9- The nurse is performing a vision screening for a 2 month old. Which technique should the nurse use? a. hold a photo of a clown 10-12in in front of the child b. move a colorful toy through the field of vision c. move a small stuffed panda to midline d. moving a card with a black and white checkerboard pattern in a 180 degree arc past the infant

D

According to developmental theories, which important event is essential to the development of the toddler? a. the child learns to walk b. the child learns to feed themself c. the child develops friendships d. the child participates in being potty trained

D

The infant's anterior fontanel remains open until: a. 12-18 months b. 3-6 months c. 6-8 weeks d. 9-18 months

D

The unexpected abrupt death of an infant under 1 year of age that remains unexplained after a complete postmortem examination; the leading casue of death in children between the ages of 1 month and 1 year of age.

SIDS

T or F: Atraumatic care employes interventions that minimize physical and psychological stress to the child and family.

True

T or F: Cephalocaudal refers to the development of gross motor skills in a head to toe fashion

True

T or F: Children, especially younger children, will have an increased heart rate in response to fear, crying, fever and anxiety.

True

T or F: Family-centered care leads to better outcomes as well as a higher level of consumer satisfaction.

True

T or F: More children live in poverty than any other age group in America.

True

T or F: Neonatal mortality is determined by the number of deaths per 1,000 live births during the first 28 days of life.

True

T or F: Questions about the parent's employment status and occupation are relevant to the overall well-being of the child.

True

T or F: Rectal temperature measurement should be avoided in the neonate and the immunosuppressed child.

True

T or F: The World Health Orginization (WHO) defines health as a state of complete physical, mental, and social well-being.

True

T or F: The average toddler will grow 3 inches per year

True

3- The parent of an infant questions the nurse about the baby's teething. The nurse provides client education. Which statement by the parent indicates understanding of the information provided? a. "The first teeth that will likely appear are the lower incisors." b. "My baby will most. likely have the upper middle teeth come in first" c. "By 1 year my baby should have about three teeth" d. "My baby's first tooth will likely appear between 5-6 months"

A

4- A parent reports her 2-year-old daughter has gradually eaten more and more poorly since her 1-year-old well-child visit. The nurse assesses the child's growth and development as normal. What concept explains the parent's concern? a. physiologic anorexia b. improper snacking c. poor role modeling d. iron-deficiency anemia

A

4- The nurse is examining a 3-year-old child during a regular visit. Which finding would disclose a developmental delay in this child? a. the child demonstrates separation anxiety b. the child follows directions when made one at a time c. the child imitates the nurse in use of stethoscope d. the child copies a circle on a piece of paper

A

4- The nurse is playing a game with a toddler in the hospital room. What is the most important benefit of this nurse--client interaction? a. developing a trusting relationship with the nurse b. occupying the toddler's time while the parents are meeting with the health care provider c. utilizing clinical time when the unit is not busy d. distracting the toddler from expending too much energy with active pay

A

4- The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old child. Which statement best accomplishes this? a. a regular routine and rituals will provide stability and security b. aggressive behaviors such as hitting and biting are common in toddlers c. emotions of a 12 month old are labile. He can move from calm to a temper tantrum rapidly d. a sense of control can be provided through offering limited choices

A

4- What statement by the parent of a 20 month old indicates a need for further teaching about nutrition a. I give my child juice at breakfast and when my child is thirsty during the day b. When my child doesn't eat well at meals we give nutritious snacks c. New foods are offered along with ones my child likes d. My child drinks thee 6 ounce cups of whole milk each day

A

3- the nurse is preparing a list of abilities of 10 month olds to use in teaching a parenting group. Which ability should appear at this age? a. sits from standing position b. cruises around furniture c. feeds self with spoon (but spills) d. uses two or three words with meaning

B

4- The nurse is examining a 2-year-old child for speech and language development. Which finding would suggest a delay in speech development? a. the child repeats what the parents say out of context and at random moments b. the child does not use the name of familiar objects c. the child does not speak clearly but shows understanding of what is said d. the child puts together sentences of two words

B

4- The nurse is teaching the parent of a 2-year-old child about age-appropriate toys. Which would be of most interest plus stimulating to the growth and development of this child? a. giving the child a toy vacuum cleaner b. giving the child bowls, pot, pans, and large spoons c. providing a brightly colored plastic bucket and shovel d. offering the child a variety of large stuffed toys

B

3- the parents of a 4 day old infant report concern about the infant's weight loss. What is the best response by the nurse? a. weight loss after birth is normal b. with appropriate nutrition weight gain will commence with a return to the birth weight within 2 weeks c. babies will begin to rapidly regain weight and will double birth weight around 6 months of age d. babies may loose up to 10% of their body weight in the first month of life

B

4- The nurse is visiting a day care center and watches two toddlers at play. What best describes the play observed? a. playing for significant stretches of time in one activity b. playing alongside one another c. sharing stuffed animals d. sitting quietly with several toys

B

9- Which facility fulfills the characteristics of a medical home a. An urgent care center b. A primary care pediatric practice c. A mobile outreach immunization program d. A dermatology practice

B

3-The nurse conducting a 6-month well baby check up assesses for the presence/absence off the asymmetric tonic neck reflex. At this age the reflex a. should be pronounced ad easy to elicit b. should have disappeared c. is expected to appear within 1 month d. is a protective reflex and retained for life

B

4- In discussing with the nurse their 2-year-old's behavior, which of the parents' descriptors suggests the child may be ready for toilet teaching? a. the child often removes her shoes and socks b. the child hides behind her bedroom door when defecating c. the toddler walks with a wide, swaying gait d. the child frequently repeats words parents just said

B

4- Parents are proud of their toddler's fast-developing fine motor skills. Which skill should the nurse point out as a safety risk? a. hold crayon to write b. ability to turn knobs c. turn book pages d. put shapes into matching openings

B

4- The nurse is reviewing sleep and rest activities of a 16-month-old child with the parents. The parent states, "I have told my spouse it is unhealthy for our child to sleep with us. It's time for the child to sleep in one's own bed. What do you think?" What is the nurse's best initial response? a. "It must be difficult for the two of you to both feel strongly about what is best for you and your child" b. "Co-sleeping is viewed acceptable by some professionals, but interfering with the child's independence by others" c. "Have you thought about just trying to let your child sleep in one's own bed to see how it goes" d. "I will not this in your child's chart for the healthcare provider to see"

A

8- A family is anxious for information about the status of their ill infant. The parents do not understand English, but the 14-year-old child is competent in spoken and written English. The healthcare provider is present, but an interpreter is unavailable. The nurse should: a. coordinate the healthcare provider and interpreter schedules and arrange an information-sharing session for later in the day. b. develop a written account of the infant's status with the health care provider that the child can read and explain to the parents c. support the 14 year old while the child interprets for the parents and the healthcare provider at the bedside d. have the adolescent and healthcare provider discuss the information throughly and help the adolescent share this data with the parents

A

8- An urgent care nurse is cleaning a forehead laceration on a 7-year-old. The parent is present. The child is crying and screaming. The nurse should: a. tell the child, "It's OK to cry, but I need you to hold still." b. close the door tightly. and reassure the child. "I am being gentle and am almost done" c. ask the child to be less noisy because he is "scaring and bothering other children" d. have the parent speak firmly to the child to correct the crying and screaming

A

9- The nurse working with children and families knows there are certain universal screening tests all children should receive. Which tests are included in this group? (Select all that apply.) a. Phenylketonuria b. Auditory brain stem response c. Hyperlipidemia d. Lead levels e. Denver II

A and B

4- The nurse is assessing a 2-year-old toddler. Which observations would alert the nurse that the child may be developmentally delayed? (Select all that apply.) a. the child's vocabulary consists of the words ball, dada, mum, drink, and up b. the child is unable to stack one block on top of another c. the child will not pick up a toy or touch the nose when directed by the nurse d. the child pushes and pulls the play vacuum cleaner in the toy room e. the child claps hands in response the nurse clapping hands

A and C

8- The nurse suggests to the parent of a preschooler who had unexpected surgery that the child be given a healthcare provider/nurse kit to play with at home. The nurse bases this advice on which reasons that this would be an effective strategy? (Select all that apply.) a. role-play is an age-appropriate, common form of play for preschoolers through which experimentation and learning occur b. the parent can observe the child's play to identify any misperceptions about the unprepared-for experience and correct them. c. the preschooler can pretend to be a health care provider or nurse practitioner who has the power to control events that the child lacked as a recipient of care d. the child can use the kit with dolls or stuffed animals to work through feelings about the health care experience

A, B, C, D

4- The parent of a toddler half-jokingly states: "I am so tired of hearing 'NO!' I wish he would stop!" What suggestions will the nurse offer to reduce toddler negativism? (Select all that apply.) a. Use humor to make "no" funny: "Do cows bark?" b. Offer simple choices: "Blue shirt or red one?" c. Make statements: "It is time for lunch." d. Avoid ending a request with "Okay?" e. Avoid "yes" and "no" questions. f. Emphasize what is not to be done: "Don't sit there"

A, B, C, D, E

9- The nurse practitioner inspects a toddler's teeth. The nurse practitioner encourages the family to establish a dental home in order to achieve optimal dental health for the various family members. Which does the nurse recognize as the rationale(s) for the establishment of a dental home? (Select all that apply.) a. Comprehensive health care is possible only if oral health is part of the equation b. Poor oral health care for children can result in systemic health problems c. A dental home with secure comprehensive care from infancy to adolescence d. Dental care is the most unmet health need of children in the United States e. Certain dental interventions including fluoride treatments could significantly reduce the cost of oral care for children.

A, B, C, D, E

4- A stay-at-home parent wants to purchase commercial toddler meals because the 16-month-old child recently choked on table food. Which food items will the nurse suggest not be given to this child? (Select all that apply.) a. Round foods such as hot dogs, whole grapes, and cherry tomatoes b. Hard foods such as nuts, raw carrots, and popcorn c. Fruits such as peaches, pears, and kiwi d. Vegetables such as corn, green beans, and peas e. Sticky foods like peanut butter alone, gummy candies, and marshmallows

A, B, E

8- The nurse is meeting an 8-year-old child with cancer and the family for the first time. What will best help to establish a relationship with the child and family? (Select all that apply.) a. keeping both a relaxed posture and word flow b. redirecting the conversation to maintain focus c. avoid the use off the parents' and child's descriptors d. listening to the child and family while interjecting one's own knowledge of the events e. sitting at eye level with the child and parents

A, B, E

9- During the health history of a 3-month-old, the nurse identified risk factors for developmental delay and is preparing to assess the child's development. Which risk factors did the nurse find? (Select all that apply.) a. the infant suffered a perinatal or congenital infection b. the parent did not complete high school c. the infant was delivered via a scheduled cesarean section d. a sibling was born prematurely e. the infant's parent is a single parent

A, B, E

3- The nurse is teaching the parent of 5 month old boy who is concerned about thumb sucking. What should be included in the teaching plan? Select all that apply a. Advising the parent this behavior is a form of self-comfort b. Advising the parent to draw attention to the issue at this may help child learn to stop c. Inform the parent that thumb sucking occurs more often during periods of stress d. assuring the parent this behavior won't cause malocclusion e. telling the parent this behavior usually decreases by 6-9 month of age

A, C, D, E

4- The student nurse is assigned to care for a 15-month-old child. When developing a care plan addressing the nutritional needs of the toddler, which client goals demonstrate the student nurse's understanding of these needs? (Select all that apply.) a. "The child will drink amounts suggested by the pediatrician of milk and other fluids on a daily basis." b. "The child will drink milk from a bottle every day for the next 2 months" c. "The child will learn to drink from a cup within the next month." d. "The child will be weaned from breast feeding within the next month" e. "The child will stop drinking from a bottle while in bed within the next 2 weeks."

A, C, E

3- A parent mentioned to the nurse that the usually smiling, happy 8-month-old child was clingy and intensely serious when the grandparent visited from a distant city. The nurse explained the child was experiencing: a. changes in temperament b. stranger anxiety c. colic d. separation anxiety e. cephalocaudal development

B

3- A young breastfeeding parent calls the telephone nurse because the parent is concerned about the 3-months-old's stools. Which information indicates a possible problem? a. "The infant's stools are loose and seedy." b. "The stools are foamy and smell terrible" c. "The infant hasn't has a stool for 3 days" d. "The infant grunts and squirms when filling the diaper"

B

3- At birth the newborn's head and chest circumference were measured. The nurse knows that the head should be about a. 1/2 in smaller than the chest b. 1 in larger than the chest c. 2 in larger than the chest d. equal in size to the chest

B

3- The nurse is assessing development of a 4 month old infant during a well child visit. Which observation needs further investigation. a. the infant shows interest in looking at near or high contrast objects b. the infant responds to the parent when the infant sees him or her but not at other times when the parent is near c. the infant makes babbling sounds, coos, and smiles d. the infant turns the head in the direction of a squeak toy

B

3- The nurse is examining an 8 month old child for appropriate development during a regular check up. Which observation points to a developmental risk a. picks up small objects using entire hand b. uses only the left hand to grasp c. cannot pull self to standing d. crawls with stomach down

B

3- The nurse is performing an assessment on an 8-month-old infant. The infant's medical history notes that he was born at 32 weeks' gestation. The infant is progressing normally. At what adjusted age should the nurse expect the infant's developmental accomplishment? a. by 8 months, the child's skill level will vary greatly and cannot be predicted b. the infant will most likely present with developmental skills consistent with a 6 month old infant c. the infant can be expected to display developmental skills consistent with a 8 month old infant d. the infant will likely show the skills of an infant with the adjusted age of 7 months

B

3- a 12 month old seen at a walk in clinic weight 8lb 4oz (3.75kg) at birth. Weight now is 20lb 8oz (9.3kg). The nurse determines: a. the child weighs the expected amount for age b. the child weighs less than expected for age c. the child weighs more than expected for age d. the weight assessment is blatantly inaccurate

B

8- A 5-month-old infant has had a head-to-toe assessment by the nurse, been examined by a teaching team of healthcare providers, and now experienced a blood draw. What behaviors might this infant manifest? a. opening eyes widely, kicking, and looking intently at a black and white mobile b. yawning, turning away, and making little eye contact c. turning toward new sounds and bright toys and making throaty verbalization d. assuming a tonic neck reflex posture while looking toward the opposite wall

B

8- A 5-year-old child is obviously relieved yet angry following a procedure he resisted and needed to be restrained to complete. Which nursing action may be most helpful to this kindergartener? a. finding an age appropriate action DVD for the child to view b. providing play-doh for him to manipulate c. discussing the reasons for the procedure with the child and parents d. getting paper and markers so that the child can draw and color

B

8- A parent rooming-in with the 10-month-old infant appears upset following the visit of a consulting healthcare provider. The parent has questions but states, "The healthcare provider is always so busy." The nurse will: a. ask the parent for her questions so that the nurse can relay them to the medical team b. assist the parent in preparing a list of questions for the healthcare provider's next visit c. encourage the parent to remain at the infant's bedside so as not to miss any future consultant visits d. explain to the parent the limits on the consultant's time

B

8- A parent wants to wait outside the room while a procedure is completed on the young child, saying, "I don't think I can stand to see you do this!" The nurse's best response is: a. "Stay, It will be less scary for your child." b. "Certainly. I will stay with your child during the procedure" c. "Come, stand by your child's head. You won't see much up there" d. "This will only take a few minutes. You should be with your child"

B

8- How much ahead of time should nurses recommend that a school-ager be prepared for elective surgery? a. 1 hour b. a few days c. immediately before d. 1 week

B

8- The nurse is caring for a 2 year old in the hospital, and the mother expresses concern that the toddler will be scarred. Which response by the nurse would be most appropriate? a. Don't worry; we practice family-centered and atraumatic care here b. We will do our best to minimize the stress that your child experiences c. It will probably be upsetting for you as well, says you should stay home d. Our practice of atraumatic care will eliminate all pain and stress for your child

B

8- The nurse is caring for a 6-year-old child who will be undergoing a surgical procedure that will result in a temporary ileostomy. Which approach would be most effective in helping prepare the child for surgery? a. draw a picture that explains the procedure b. use a doll to role-play the events surrounding the surgical experience and the procedure. c. show the child photographs of another child with the ileostomy d. show the child teaching DVD about ileostomy care

B

8- The nurse is providing care for a 2-year-old child with a chronic respiratory disease present since birth. Which would be of least help in working effectively with the parents? a. maintain complete honesty with the parents b. expect parents to perform procedures precisely as taught. c. provide positive feedback to mother and father for care and parenting well done d. consider parents equal partners in care

B

8- The nurse is teaching a 6-year-old child and the parent about home care for an eye infection. Which communication techniques would be least effective with this child? a. asking permission to touch the child before doing so b. standing beside the child when doing the teaching c. talking directly to the child even though the parent makes comments d. listening attentively to the child while giving time to finish thoughts and ideas

B

8- The nurse is teaching the parents of a newborn with a metabolic problem about the disorder and its treatment. What is the least effective teaching technique? a. using the food pyramid diagram to teach necessary nutrition alterations b. providing a print handout for the parent to read and asking for questions c. explaining the disorder in common terms d. discussing how to handle a possible emergency situation

B

8- When planning education for a child and parents, what is the first step the nurse should take? a. Decide which procedures and medication the child will be discharged on b. Determine the child's and families learning needs and styles c. Ask the family if they have ever performed this type of procedure d. Tell the child and family what the goals of the teaching session are

B

8- When working with children and families, which is a critical strategy for promoting therapeutic communications? a. detailed explanations b. attentive listening c. comforting touch d. closed-ended questions

B

9- An infant boy is at your facility for his initial health supervision visit. He is 2 weeks old and responds to a bell during his examination. You review all his birth records and find no documentation that a newborn hearing screening was performed. What is the best action by the nurse? a. Do nothing; Responding to the bell proves the infant does not have a hearing deficit b. Schedule the infant immediately for newborn hearing screening c. Asked the mother to observe for signs that the infant is not hearing well d. Screen again with the bell at the infants 2 month help supervision visit

B

9- During a health maintenance visit, the nurse determines that a 12-year-old client is overweight for his age and height. Which approach for promoting healthy weight will help the client maintain self-esteem? a. suggesting the client record one's weight weekly on a calendar b. emphasizing how activity and a nutritious diet promote health c. showing the client where he or she plots on a growth chart d. encouraging the family to purchase a scale

B

9- The 4-year-old child due for a DTaP, IVP, MMR, and varicella vaccines has a runny nose, slight cough, and temperature of 99° F (37.2° C). What should be the response of the nurse? a. reschedule the visit b. do the well child examination and give the immunization due c. complete the well child examination and reschedule the immunizations d. suggest fever and cough control for home care, do the well child examination, and reschedule the immunization

B

9- The nurse has just taken the blood pressure of a 13-year-old, and the percentile rank is 88%. Why would the nurse categorize the child as having an elevated blood pressure? a. the teenager eats a high-fat diet b. the teenager's blood pressure was 122/83 c. the teenager was born at 33 weeks' gestation d. the teen gets no regular exercise

B

9- Which question by the nurse is the best one to elicit complete information about a young client's immunization status? a. "Tell me which immunization your child needs today" b. "When and where did your child receive his last immunization" c. "Do you have any questions about the immunization children need at various ages?" d. "Are your children's immunization up-to-date"

B

The nurse can expect that an infant will respond to his/her own name by about: a. 3 months b. 4 months c. 6 months d. 10 months

B

When caring for children, how does the nurse best incorporate the concept of family-centered care? a. encourages the family to allow the physician to make health care decisions for the child. b. uses the concept of respect, family strengths, diversity, and collaboration with the family c. advises the family to choose a pediatric provider who is on the child's health care plan d. Recognizes that families undergoing stress related to the child's illness cannot make good decisions

B

When toddlers speak with only essential words they are demonstrating which type of speech. a. expressive b. telegraphic c. echolalia d. receptive

B

4- The parent of a preschooler reports that the child seems to believe in magic. The parent voices concern that this "fantasy world" may become a problem. What response by the nurse is indicated? (Select all that apply.) a. While imagination is normal, this type of fantasy world can cause problems for your child and should be discouraged b. Your child is engaging in what we call magical thinking c. This type of imagination is not normally seen until a child is school aged d. Fantasy play is most often seen in lonely children in an attempt to occupy themselves e. This type of though process allows your child to begin to observe the differences in the world

B and E

9- A nursing student is asked to provide reasons it is important for the healthcare provider or nurse practitioner to have knowledge of the community in which the families and children seen in the practice live. Which reason(s) should the student provide? (Select all that apply.) a. Developing partnership with community agencies facilitates overcoming barriers to care b. Awareness of agencies serving children results from knowing the community c. Understanding the community promotes improved working relationships between families and healthcare providers d. Knowing the community is necessary in developing appropriate health surveillance programs e. The community can be a contributor to child-family health or a cause of illness

B, C, D, E

9- The student nurse is preparing to administer an immunization to an 18-month-old child under the direction of a registered nurse. Which actions by the student nurse indicate the need for the registered nurse to intervene? (Select all that apply.) a. The student nurse obtains a 23G needle to use for the injection b. The student nurse reports that IM injections are to be avoided for children under the age of 2 years c. The student nurse prepares the triceps muscle for the IM injection d. The student selects a needle that is 5/8in to perform an IM injection into the deltoid muscle e. The student nurse reports plans to use a 20G needle for an IM deltoid injection.

B, C, E

Fusion of two ocular images that begins to develop at 6 weeks and should be well established by age 4 months.

Binocularity

4- The nurse finds the diet of a 30-month-old child to be low in calcium. What suggestion can significantly increase this toddler's calcium intake? a. offer chocolate milk to increase milk intake b. include dark greens and spinach in her meals c. give her slices of cheddar cheese as a snack d. use unsweetened applesauce as a dessert

C

4- The nurse is assessing speech development in the 2-year-old whose family uses both Spanish and English in the home. What finding is of concern? a. the child mixes words from the two languages within a sentence b. the parent understand the child much of the time c. the toddler speaks 15 words between the two languages d. some words the toddler speaks are a blend off English and Spanish

C

4- The nurse is discussing proper discipline with the parent of a 15-month-old child. Which statement is most important? a. toddler are unable to learn rules easily b. rules and limits should be simple and few c. never spank the child for any reason d. use praise when the child is doing something right

C

4- The nurse is promoting language and cognitive development to the parents of a 3-year-old child. Which guidance about reading with their child will be most helpful? a. keep story time a reward for being good b. read a different book if he knows the story c. ask the child questions as you read d. have the child sit still during the story

C

4- The nurse is recommending food items for an 18-month-old child. Which ones will benefit the child's neurologic system most? a. ground beef, broccoli, and apple slices b. vegetable soup, whole wheat bread, and blueberries c. peanut butter on crackers, cheese, and whole milk d. oatmeal pancakes with bananas

C

4- The nurse is teaching parents how to avoid a power struggle with their 2-year-old child. Which comment indicates that more teaching is needed? a. childproofing our home will make it less necessary to say "No!" b. both of us, as parents, will agree on and consistently enforce the limits we set c. we will make sure out child shares toys with cousins of this age d. we will give our child a choice whenever possible

C

4- The parents of a 2-year-old child report to the nurse because their child is "such a picky eater." Which recommendation would be most helpful for developing healthy eating habits in this child? a. encouraging the parents to eat a variety of wholesome foods themselves b. assuring the parents that food jags are normal, and they can be honored safely c. offering a variety of foods along with the foods the child likes d. advising the parents to minimize distractions at mealtime

C

4- Which suggestion by the nurse meant to promote good dental health in the 15 month old is inappropriate a. avoid grazing (continual snacking) throughout the day b. wean the child from the bottle c. brush the child's teeth with a pea-sized amount of fluoride containing toothpaste d. arrange for your child's first dental visit as soon as possible

C

8- A new staff member asks veteran nurses about the meaning of atraumatic care for children. These nurses explain that the concept is based on: a. the child's need to experience no trauma b. peers being helped to develop empathy for the child c. the underlying premise of "do no harm" d. units staffed to provide one nurse for each child

C

8- The nurse is working with an interpreter to meet the health needs of a family with limited skills in the English language. Which action is not recommended? a. meeting with the interpreter before, including the family, to provide some background information b. having the interpreter review printed information with the family c. talking one-on-one with the interpreter at numerous points throughout the session with the family d. pausing after approximately 30 seconds of speaking so the interpreter can translate

C

8- The nurse suspects poor literacy skills in a child's family member when which statement is made? a. "I need you to review once more the best way to be sure the child swallowed all the medicine." b. "The cild gets a suppository every 3 days to prevent constipation" c. "I forgot my glasses, so I'll read this when I get home and let you know if I have questions." d. "We communicate with the special education teachers and school daily with a notebook"

C

8- When caring for hospitalized teens, nurses should choose their words and actions carefully since adolescents typically are concerned about: a. mutilation of their body b. separation from peers and family c. appearing out of control of the situation and/or themselves d. mobility restrictions

C

9- A family of five seeks care for their preschooler with an upper respiratory infection. The facility has no medical record for the family. Why does the nurse encourage this family to establish a medical home? a. to receive priority treatment in urgent situations b. to obtain improved health insurance coverage c. to establish a continuing relationship with a healthcare provider or nurse practitioner d. to ensure all the children receive low cost immunizations

C

9- The parent of a 5 month-old tells the nurse that the child may have difficulty hearing. The nurse anticipates assisting with which hearing tests to assess this 5 month-old child's hearing? (Select all that apply.) a. tympanometery b. conditioned play audiometry (CPA) c. auditory brain stem response d. pure-tone (conventional) audiometry e. otoacoustic emissions (EOAE)

C and E

Paroxysmal abdominal pain manifested by a duration of more than 3 hours and by drawing up of the legs to the abdomen in an infant under the age of 3 months.

Colic

3- Parents state they are "worn out" at their child's 6 month check-up because their child awakens each night and cries. The nurse suggests which measures? a. at bedtime, rock the child to sleep and then place in crib b. during night awakening, do not interact with the child c. add rice cereal to the evening bottle to prevent hunger and awakening d. establish a quitting ritual before bedtime

D

3- The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the parent's first child. What should be the priority nursing intervention? a. recommend the parent offer smaller and more frequent feedings b. offer assurance that spitting up is normal c. describe the capacity of a 5 week old infant's stomach d. observe the parent during feeding and burping the infant

D

3- The nurse is conducting a physical examination of a 5 month old infant. Which observation may be cause for concern about the infant's neurologic development a. the infant grasps a finger when it is placed in the palm b. the toes hyperextend when the bottom of the foot is stroked c. the anterior fontanel l is open and easily palpated d. the infant displays an asymmetric tonic neck reflex (fencing reflex)

D

3- The nurse is providing anticipatory guidance regarding the respiratory development of a 4-week-old infant for the parent. Which action is accurate? a. advising the parent that the infant's usual respiratory. rate should slow to about 20 breaths per minute by age 6 months b. telling the parent that abdominal breathing disappears by 9 months of age c. inform the parent that the respiratory system reaching maturity similar to the adult's by 12 months of age d. explaining to the parent the risk for infection is high due to the lack of antibodies

D

3- the nurse is helping the parent of a 5 month old infant understand the importance of developmentally appropriate play. Which one of the toys best meet the needs of this child? a. pots and pans from the kitchen cupboard b. a push pull toy c. bright colored stacking toy d. a yellow rubber duck for the bath

D

4- Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay? a. half of speech understood by outsider b. talks about a past event c. asks why often d. uses two word sentences or phrases

D

4- Parents of a toddler describe how they handled their child's temper tantrum in a shopping mall. What action of the parents indicates need for additional teaching? a. remained relatively calm even though embarrassed b. made sure the child was rested and not hungry before going to the mall c. tried to refocus the child's attention as tantrum behavior cues appeared d. reasoned with the child to stop the behavior

D

8- An adolescent remarks rather sarcastically about feeling like a "lab rat." What is the priority nursing action? a. enable the adolescent to stay in contact with peers electronically b. provide more physical privacy for this adolescent c. arrange for additional bedside activities of the adolescent's choice d. ensure information is shared with and decisions about care are made with and not for the adolescent.

D

8- The nurse is assessing the learning needs for a 12-year-old child with a chronic health condition and the parents. Which aspect would be least pertinent to a learning needs assessment? a. finding that the parent relies on American Sign Language b. concluding that the parents are emotionally distraught c. discovering that the parent is highly. healthcare literate d. the family belongs to a mainline traditional faith community

D

8- The nurse is teaching a 15-year-old child with diabetes mellitus and the parents how to monitor glucose levels. Which communication technique is least effective? a. paraphrasing the parents' comments before responding b. using reflection to clarify the parents' understandings c. using the adolescent's words during the conversation d. ignoring the adolescent's tirade about the therapy

D

8- The nurse is teaching home care to the parents of a 4-year-old child with asthma. Which information would be least important to the family's immediate needs? a. explaining what kinds of things can trigger an attack b. having emergency instruction and phone numbers c. demonstrating how to administer medication with a nebulizer d. determining if the child should enroll in a preschool

D

8- What action might the nurse take to stimulate trust and open communication with an adolescent? a. avoid using medical terminology altogether b. while admitting the adolescent, use closed questions so only limited response is required of the reluctant adolescent c. speak to the parents while the adolescent listen and observe d. listen actively while maintaining a relaxed, open body posture

D

8- When providing atraumatic care to a child which action would be the most appropriate? a. applying restraints for any procedure that would be uncomfortable b. keeping the lights on in the child's room throughout the day and night c. limiting the use of topical anesthetics for painful injections d. allowing parents and children an informed choice about being together

D

9- A 15 month old girl is having her first health supervision visit at your facility. Her mother has not brought a copy of the child's immunization record but believes she is fully immunized: "She has immunizations three months ago at the local health department." What would be the best action by the nurse? a. My mother to bring the records to the 18 month health supervision visit b. Start the catch-up schedule because there are no immunization records c. Keep the child at the facility while the mother returns home for the records d. Call the local health department and verify the child's immunization status

D

9- A nurse asking questions during an infant's health surveillance visit has the parent tell her: "My baby was premature and weighed 3 lb at birth." The medical record provides an Apgar score of 5 at 5 minutes and indicates the child received gentamicin in the neonatal intensive care unit (NICU). What should the nurse consider as the greatest risk for this child? a. hypertension b. visual deficit c. gross motor problems d. hearing deficit

D

9- A pediatric nurse will state that the priority reason to have a thorough grasp of the growth and development of children is to: a. interact with children in age-appropriate, nonthreatening ways b. give parents anticipatory guidance as their children grow and change c. thoroughly enjoy working with the different age groups d. identify developmental risks or delays promptly.

D

9- A single parent has brought her 9-month-old, recently adopted Chinese child for a health supervision visit. Although there are screening documents from China and the child seems healthy, the nurse plans to screen for infectious diseases. What explains the nurse's caution? a. many babies adopted from foreign countries have pediculosis b. the child may have come from rural China c. infants tend to have insidious symptoms d. testing by the child's home country is unreliable.

D

9- During the health history of a 2-week-old neonate, the nurse discovers the child has not yet had a hearing screening. What test should the nurse schedule? a. tympanometry b. weber test c. rinne test d. auditory brain stem response test

D

9- During the health surveillance of a 13-year-old client, the nurse recorded the following information: blood pressure 108/48, pulse 70, respirations 18; dieting, dislikes meat; eats yogurt, drinks two glasses low-fat milk daily; gymnastics team member; fairly regular, normal menstrual periods. What risk would the nurse identify? a. inadequate calcium in the diet b. prehypertension c. risk for injury d. iron deficiency anemia

D

The type of play that toddler typically engage in, where they play alongside another child is referred to as: a. egocentric play b. cooperation play c. solitary play d. parallel play

D

Which fine motor skill develops around 10 months of age? a. transfer objects from one hand to another b. grasps a rattle c. feeds self with cup or spoon d. fine pincer grasp

D

3- Place these primitive protective reflex of infancy in the order in which they will disappear as the child matures (longest time-shortest time) a. moro b. step c. root d. plantar e. babinski

E, C, B, D, A

A sign of inadequate growth resulting from the inability to obtain or use calores required for growth.

Failure to thrive

T or F: A standard of care is the maximum level of care that should be provided by a caregiver in a given situation

False