NS 344 Exam 1 Practice Questions

How old does a child have to be to take aspirin?

12 years

By what age does the anterior fontanel usually close?

12-18 months

What can a child say at 24 months compared to 30 months?

24 months: first name 30 months: first and last name

What can a child draw at 3, 4 and 5 years old?

3 years: circle 4 years: square and walk up stairs with alternating feet 5 years: diamond

When are all baby teeth in?

30 months

How old does a child have to be to take Motrin?

6 months

List three elements that are critical in establishing a trusting relationship with an adolescent during a health interview.

Active listening, responding to an adolescent's emotions, and ensuring confidentiality and privacy

When does puberty begin?

Age 9-13 and girls start first

Erickson's stage of development: Toddler

Autonomy vs. Shame & Doubt

Difference between DTaP and TDaP?

DTaP: given UNDER 7 years (first vaccine at 2 months) Tdap: series, and booster q10years after 7 years

Children receive the rotavirus vaccine after 6 months. True or False

False

Erickson's stage of development: Adolescent

Identity vs. Role Confusion

Erickson's stage of development: School age

Industry vs. Inferiority

Erickson's stage of development: Preschool

Initiative vs. Guilt

Testicular cancer is painless. True or false.

True

The nurse is providing education for a family who recently adopted an 18 month-old child. The adopted child is the first child for the parents. Which of the following toys would be most appropriate to stimulate child development of an 18 month old? Select all that apply. a. Rocking horse b. Musical doll c. Pull toy d. Coloring books e. Cloth or cardboard book

a. Rocking horse c. Pull toy e. Cloth or cardboard book Rationale: 18 month-old need toys that encourage or allow movement, such as a rocking horse or push-pull toy. Quiet activities such as board books are also appropriate for toddlers. A musical doll or stuffed animal is appropriate for an infant. Coloring books are more suited to the preschooler.

The primary task to be accomplished between 12 & 15 months of age is to learn to: a. Walk erect b. Climb stairs c. Use a spoon d. Say simple words

a. Walk erect

The nurse is interviewing the father of a 10-month-old Megan. She is playing on the floor when she notices an electrical outlet and reaches up to touch it. Her fathers says "No" firmly and removes her from near the outlet. The nurse should use this opportunity to teach the father that Megan: a. is old enough to understand the word "No." b. is too young to understand the word "No." c. should already know that electrical outlets are dangerous. d. will learn safety issues better if she is spanked.

a. is old enough to understand the word "No."

What is normally the earilest age at which an infant begins teething with eruption of lower central incisors? a. 4 months b. 6 months c. 8 months d. 12 months

b. 6 months

Which of the following statements accurately describes physical development during the school-age years? a. The child's weight almost triples b. A child grows an average of 2 inches per year. c. Few physical differences are apparent among children at the end of middle childhood. d. Fat gradually increases, which contributes to the child's heavier appearance in the early school age period.

b. A child grows an average of 2 inches per year.

The nurse, realizing that the mother of a 2 month old baby with colic needs help coping, suggests that the mother: a. Give her son a warm bath to calm him down b. Arrange for some time away from her son each day to rest c. Provide her son with warm sweetened tea when he begins to cry d. Sit comfortably in a quiet, darkened room to hold her son when he cries.

b. Arrange for some time away from her son each day to rest

A 4-year-old boy is hospitalized with a serious bacterial infection. He tells the nurse that he is sick because he was "bad". Which of the following is the nurse's best interpretation of this comment? a. Sign of stress b. Common at this age c. Suggestive of maladaptation d. Suggestive of excessive discipline at home

b. Common at this age

The nurse observes a 2 year old at play & notes that this age toddler: a. Build a house with blocks b. Is extremely possessive with toys c. Attempts to stay in the lines when coloring d. Amuses himself with a picture book for 15 minutes

b. Is extremely possessive with toys

Which of the following is characteristic of development of a 2 1/2-year-old child? a. Birth weight has doubled b. Primary dentition is complete c. Anterior fontanel is open b. Binocularity may be established

b. Primary dentition is complete

Which of the following predisposes the adolescents to feel an increased need for sleep? a. An inadequate diet b. Rapid physical growth c. Decreased activity that contributes to a feeling of fatigue d. The lack of ambition typical of this age group

b. Rapid physical growth

When teaching a mother how to prevent accidents while caring for her 6 month old, the nurse should emphasize that at this age the child can usually: a. Sit up b. Roll over c. Crawl lengthy distances d. Stand while holding onto furniture

b. Roll over (need to know while changing diaper)

A 15 month old child is playing in a play-pen. The nurse observing the child's activities evaluates her ability with physical tasks to be at the age-related norms when the toddler is able to: a. Build a tower of 6 blocks b. Walk across the play pen with ease c. Throw all the toys out of the play-pen d. Stand in the play-pen holding onto the sides

b. Walk across the play pen with ease

The nurse should attempt to involve a preschool-age child in therapeutic play to give the child the opportunity to: a. Meet other children on the unit b. Work out ways of coping with fears c. Learn to accept the hospital situation d. Forget the reality of the situation for a while

b. Work out ways of coping with fears

A nurse is preparing to administer a 2nd DTaP immunization to a child. To screen for a contraindication to this dose, which of the following questions should the nurse ask the child's parent? a. "Did the child spit up?" b. "Did the child seem more fussy than usual?" c. "Did you notice any seizure activity after the first DTaP?" d. "Was your child's leg red and swollen?"

c. "Did you notice any seizure activity after the first DTaP?"

The nurse is preparing to administer a flu shot to a 16 month-old child. What gauge and length of needle should be used to administer the intramuscular injection into the vastus lateralis muscle? a. 5/8 to 1 inch; 22-25 gauge b. 1 inch to 1½ inch; 18-20 gauge c. 1 inch to 1 ¼ inch; 22-25 gauge d. 5/8 to 1 inch; 18 gauge

c. 1 inch to 1 ¼ inch; 22-25 gauge Rationale: For toddlers, the preferred site for IM injections is the vastus lateralis, using a dartlike motion. The needle gauge used would be 22-25, and the length 1-1 ¼ inches. The deltoid muscle is rarely used for IM injections in young children due to the small muscle mass present and the likelihood of injuring the child.

If an infant weighs 8 kg at 5 months, about how many kilograms was his or her probably birth weight? a. 3 kg b. 5 kg c. 4 kg d. 6 kg e. 10kg

c. 4 kg Rationale: An infant's birth weight typically doubles between 5-6 months of life.

A mother brings her 4 month old infant to a well baby clinic for immunizations. A nurse would prepare to administer which of the following immunizations to this infant? a. DTaP (diphtheria, tetanus, acellular pertussis), MMR (measles, mumps, rubella), & IPV (inactivated polio virus) b. MMR, Hib (haemophilus infuenzae type b), & DTaP c. DTaP, Hib, & IPV d. Varicella & hepatitis B vaccines

c. DTaP, Hib, & IPV

Unrealistic expectations or a sense of failing to meet standards would cause a schoolage child to develop a sense of which of the following? a. Shame b. Guilt c. Inferiority d. Role confusion

c. Inferiority Rationale: According to Erickson, children in schoolage years develop a sense of industry. Feelings of inadequacy and sensing failure to develop a sense of industry result in a sense of inferiority.

The best strategy for feeding a child with failure to thrive would be to: a. Avoid having the same nurse feed the child b. Distract the child during meals with television & toys c. Maintain a calm, even temperament during feedings d. Vary the feeding routines to make the feeding time more interesting.

c. Maintain a calm, even temperament during feedings

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. Minimum requirements Rationale: Minimum requirements include both health and safety features.

Which of the following interventions is helpful for a child who is scratching varicella lesions? a. Warm baths & anti-fungal powder b. Tepid sponge baths & lubricating creams c. Oatmeal baths & short fingernails d. Baths with baby soap & antibiotic ointment

c. Oatmeal baths & short fingernails

A parent brings a 5 year old to the nurse for a kindergarten physical & tells the nurse that the child stutters a lot when excited about something. What should the nurse explain to the parent? a. "Children at this age react negatively for no reason. Just ignore the behavior." b. "Your child will need speech therapy, but it's more successful with old children." c. "Do either of you stutter? It's often inherited." d. "Stuttering is common at this age. We can evaluate later if it continues."

d. "Stuttering is common at this age. We can evaluate later if it continues."

At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli? a. 1 month b. 2 months c. 3 months d. 4 months

d. 4 months (when they start laughing)

What are cues that a toddler is ready to begin potty training? a. The child expresses a desire to be dry and clean. b. The child is able to sit, walk and squat c. The child stays dry for 2 hours d. All of the above

d. All of the above Rationale: A child who is disinterested in using the potty, does not care if he/she is wet/dirty, and wet frequently is not yet ready to potty train.

Regression in toddlers occurs when there is: a. Stress b. A threat to their autonomy c. A need to revert to dependency d. All of the above

d. All of the above Rationale: A toddler's regression to babyhood (a time when he felt secure and close to parents or caregivers) may be caused by a number of factors. He or she may have conflicting feelings about growing up and becoming separate, or he/she may be feeling frustrated or overwhelmed by a developmental milestone. Regression can also be a reaction to a change or a stressful situation in his life, such as the arrival of a new sibling, starting preschool, or tension at home.

A parent asks the nurse about negativism in toddlers. The most appropriate recommendation is which of the following? a. Punish the child b. Provide more attention c. Ask child not always to say "no." d. Reduce the opportunities for a "no" answer.

d. Reduce the opportunities for a "no" answer.

A father tells the nurse that his daughter wants the same plate and cup used at every meal, even if they go to a restaurant. The nurse should explain that this is which of the following? a. A sign the child is spoiled b. A way to exert unhealthy control c. Regression, common at this age d. Ritualism, common at this age

d. Ritualism, common at this age

The school nurse has been asked to begin teaching sex education in the 5th graded. The nurse should recognize that: a. Children in 5th grade are too young for sex education. b. Children should be discouraged from asking too many questions c. Correct terminology should be reversed for children who are older. d. Sex can be presented as a normal part of growth and development.

d. Sex can be presented as a normal part of growth and development. (Puberty begins at 10-11 years old, start sex education before 5th grade)

The parents of a 9-month-old infant tell the nurse that they have noticed foods such as peas and corn are not completely digested and can be seen in their infant's stools. On which of the following should the nurse base her explanation of this? a. Child should not be given fibrous foods until digestive tract matures at age 4 years b. Child should not be given any solid foods until this digestive problem is resolved. c. This is abnormal and requires further investigation. d. This is normal because of the immaturity of digestive process at this age.

d. This is normal because of the immaturity of digestive process at this age.

How do toddlers play?

parallel play (alone)- right alongside each other but not with each other

When is a toddler ready for toilet training?

-Voluntary sphincter control (stays dry for 2 hours). Usually 18-24 months -Able to sit, walk & squat -Recognizes urge to urinate or defecate -Understands what toilet is for -Able to follow directions -Demonstrates desire to please parent -Expresses desire to be dry and clean

By what age does the posterior fontanel usually close?

6-8 weeks

At what age can a child count backwards from 20 and respond positively to rewards?

8-9 years old

True or False? It is acceptable to serve juice to an infant in a bottle.

False Juice should never be served in a bottle, but a sippy cup or regular cup due to the increased risk of dental caries. Sugary solutions such as Kool-Aid, soda, etc. should never be served by bottle.

True or False? The Measles, Mumps, & Rubella (MMR) and Varicella (Varivax) vaccines can be given before the age of 12 months.

False Rationale: The MMR and Varicella vaccines are live-vaccines. They cannot be administered to children under 12 months of age (after 1st birthday is preferred) or to anyone who is immunocompromised.

When should you apply an ice pack and a heat pack when noticing redness and swelling at an immunization site?

First 24 cold pack After 24 hours heat pack

What recommendations should be included in parent and teacher education relating to television, video games, and the Internet?

Limit playing time, monitor game selection and content, and increase access to games and information that are educational

True or False? Parents and caregivers should be educated about the common injuries that plague young children, such as drownings, poisonings, suffocation, aspiration, burns, and motor vehicle accidents.

True Rationale: The term for this type of education is called anticipatory guidance. Parents should be given anticipatory guidance education at every well-child visit.

Can children with Turners Syndrome go through puberty. True or False

True- girls still have a uterus however, they need hormone injection to go through puberty

Erickson's stage of development: Infant

Trust vs. Mistrust

First signs of puberty for men and women?

Women: breast buds Men: testicular enlargement

A parent of a 17-month old toddler is frustrated with the toddler's behavior. The parent tells the nurse that the child is "bad" but doesn't know how to make the toddler behave better. Which of the following responses should the nurse make to this parent? a. "Allow your child to learn by trial & error." b. "Consistently enforce well-defined limits, such as no climbing on the counters." c. Reward your child's good behavior, but ignore the bad behavior." d. "Punish your child when he behaves badly."

b. "Consistently enforce well-defined limits, such as no climbing on the counters."

A 6 month receives a diphtheria, tetanus, and acellular pertussis immunization at a well-baby clinic. The mother returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. The nurse tells the mother to: a. Apply a warm pack to the injection site b. Bring the infant back to the clinic c. Apply an ice pack to the injection site d. Monitor the infant for a fever.

c. Apply an ice pack to the injection site

According to Erickson, the task of toddler children is: a. Industry vs. Inferiority b. Trust vs. Mistrust c. Autonomy vs. Shame and Doubt d. Initiative vs. Guilt e. Identity vs. Role Confusion

c. Autonomy vs. Shame and Doubt (Toddler) Rationale: During Erikson's autonomy stage, Toddlers are developing physically and becoming more mobile. Between the ages of 18 months and three, children begin to assert their independence, by walking away from their mother, picking which toy to play, etc. The child is discovering that he or she has many skills and abilities, such as putting on clothes and shoes, playing with toys, etc. Such skills illustrate the child's growing sense of independence and autonomy. Erikson states it is critical that parents allow their children to explore the limits of their abilities within an encouraging environment which is tolerant of failure. or example, rather than put on a child's clothes a supportive parent should have the patience to allow the child to try until they succeed or ask for assistance. So, the parents need to encourage the child to become more independent while at the same time protecting the child so that constant failure is avoided.

Which age group believes their thoughts are all powerful? a. School-Age b. Toddler c. Preschooler d. Infant

c. Preschooler Rationale: Preschoolers are very creative individuals who engage in magical thinking through play activities. They believe their thoughts can cause events to happen.

A 6 year old is admitted to the hospital with a diagnosis of acute leukemia. When planning play activities for a 6 year old child the nurse should include: a. Action toys such as a hula hoop b. Stuffed animals, large puzzles, & large blocks c. Table games, simple card games, & crayons d. A record player, portable radio, & children's magazines

c. Table games, simple card games, & crayons

Which of the following describes moral development in younger school-age children? a. The standards of behavior now come from within themselves b. They do not yet experience a sense of guilt when they misbehave c. They know the rules and behaviors expected of them but do not understand the reasons behind them d. They no longer interpret accidents and misfortunes as punishment for misdeeds

c. They know the rules and behaviors expected of them but do not understand the reasons behind them

A nursing student is assigned to administer immunizations to children in a clinic. The nursing instructor asks the student about the contraindications to receiving an immunization. The student responds correctly by telling the instructor that a contradiction to receiving an immunization is if a child has: a. a cold b. otitis media c. mild diarrhea d. a severe febrile illness

c. a severe febrile illness

The school nurse tells adolescents in the clinic that confidentiality and privacy will be maintained unless a life-threatening situation arises. This practice is: a. not appropriate in a school setting b. never appropriate because adolescents are minors c. important in establishing trusting relationships d. suggestive that the nurse is meeting his or her own needs

c. important in establishing trusting relationships

Which of the following primitive infant reflexes best describes the following findings? Stroking the sole of the foot causes the toes to fan and the big toe to dorsiflex? a. Moro Reflex b. Extrusion Reflex c. Rooting Reflex d. Babinski Reflex

d. Babinski Reflex Rationale: The Moro Reflex (startle reflex), the Rooting Reflex (sucking reflex), extrusion reflex (tongue pushing anything out of the mouth when the tongue is touched) are primitive infant reflexes that disappear around 4 months of age. The Babinski reflex disappears between 12 months and 2 years of age. When the Babinski reflex is present in a child older than 2 years or in an adult, it is often a sign of a brain or nervous system disorder.