OB 23-27 +42
A first-time father calls the pediatric nurse stating he is concerned that his 4- year-old daughter still wets the bed almost every night. Remembering his own experience of being punished for wetting the bed at 4 years old, he is not sure punishment is the best approach to address this. Which nursing instruction is the most appropriate?
"Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration."
The mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She does not agree with that suggestion. Which response should the nurse prioritize when addressing this situation with the mother?
"Bottles given at bedtime can cause erosion of the enamel on the teeth."
An 8-month-old child is diagnosed with a second ear infection and the father is concerned the infections are being caused by something he is doing or by something in the child's development. Which question should the nurse prioritize to collect more information to answer this father's questions?
"Does the baby go to bed with a bottle of formula each night?"
The nurse is presenting information about school-aged children at a community event. Which statement from the group should the nurse prioritize to address with further teaching and more information?
"Food is so expensive, we always make our children eat everything on their plates."
The caregiver of a 6-year-old is concerned the child is not getting proper nutrition because on some days, the child will only eat one type of food. Which response should the nurse prioritize for this caregiver?
"Food jags are common in this age. This probably won't last long."
The school nurse is discussing obesity with a group of caregivers of school-aged children. Which statement by the caregivers best illustrates that they are prepared to help their child prevent obesity?
"I always cook foods that are low in fat."
The mother of an 8-month-old infant appears frustrated and shares with the nurse she can't leave the room without her infant son crying. Which is the best response from the nurse to help this mother?
"If he cannot see you, he thinks you are gone and that is frightening."
The nurse is preparing to assess a 2-year-old at a well-child visit and notes the child was 22 lbs (9.98 kg) and 24 in (60.96 cm) tall at 1 year old. The nurse determines the child is following a normal pattern of growth after obtaining which set of current measurements?
32 lbs (14.54 kg) and 27 in (68.58 cm) tall
The nurse is addressing a caregiver's concerns regarding adequate sleep for an 11-year-old child who gets up at 6:30 a.m. each morning. The nurse should point out which time as the most appropriate bedtime for this child?
9:00 p.m.
A nurse is preparing a presentation for a health fair discussing various aspects of preschoolers. Which example should the nurse use to best illustrate dramatic play?
Acting out a troubling or stressful situation
Every time a toddler's mother asks her a question, the response is "No!" regardless of what the mother asks the child. What would the nurse recommend to the mother to help alleviate this behavior?
Allow the child choices when asking questions, such as "Do you want to wear the red or the blue top?"
A nurse is presenting a class on discipline for a group of parents of toddlers. What information would be important for the nurse to teach this group? Select all that apply.
B. Consistency in the rules is important so the child understands what is expected. C. If a child does something wrong, the parent must address the behavior immediately so the child understands what they did wrong. D. Even at this young age, children need boundaries.
A 2-year-old child is reported to be a "picky eater" by his father. What pointers could the nurse provide the parent to help minimize stress related to mealtime? Select all that apply.
Offer small portions of 1 to 2 teaspoons to the child. Mealtime for a toddler should not exceed 20 minutes. Do not use sweets as a reward for cleaning their plate.
The nurse is preparing a presentation for a health fair which will illustrate various ways to help introduce siblings to a new member of the family. Which suggestion should the nurse prioritize to help older siblings, especially toddlers, understand the change in the family dynamics?
Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant.
The caregivers of an infant state that their child cries when her mother leaves for even a short amount of time. What might the nurse suggest as a way to console the infant and develop a sense of security when the child's primary caregiver is out of sight?
Play peek-a-boo with the child when happy
The nurse is presenting an in-service on the types of playing that children may engage in. The nurse determines the session is successful when the attending nurses correctly choose which example as representing cooperative play?
Playing in an organized group with each other
The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. The nurse determines the session is successful when the group correctly chooses which example as best displaying toddlers playing?
Playing independently and are side by side
A mother tells the nurse that her toddler does not want to go to bed at night and keeps getting back up when she is put to bed. What recommendations would the nurse make to this mother to foster sleep in the toddler?
Read the child a book in bed and take time to calm the child down before turning out the lights.
A 2-year-old child is shopping with her mother when she suddenly falls to the ground and begins to scream, "I want it!" over and over regarding a bag of candy. What would the nurse recommend to the mother to deal with this behavior? Select all that apply.
Remain calm and ignore the tantrum Stay nearby to ensure the child's safety without giving in to the child's desires
The 6-year-old at a well-child office visit tells the nurse, "I can't play on teams because I am not as good at doing things as my big sister is." What suggestion should the nurse point out to the caregiver that will help increase the child's feelings of self-confidence?
Set up some playdates that include projects or activities in which the child can be successful.
The nurse is assessing a 12-week-old infant in the clinic at a well-baby visit. Which assessment finding does the nurse predict to assess in this healthy infant?
Smiles at significant others
The nurse is presenting nutritional information at a community health fair. Which suggestion should the nurse prioritize when illustrating proper nutrition for preschoolers?
Snacks throughout the day help the child meet nutritional requirements
The nurse is caring for several clients on the pediatric unit. When interacting with the preschool-age child, which action does the nurse predict will occur?
Takes in new information at a rapid rate and asks "why" and "how"
The nurse is preparing to teach a class to a group of young parents with infants the basics of introducing solid foods into the diet. Which factor about the food should the nurse point out the infants respond to best when introducing solid foods into the diet?
bland
The nurse is conducting a class at the local health department office for new mothers of infants who are in the various stages of weaning. Which alternative foodshould the nurse prioritize when questioned by a mother whose infant is refusingto drink milk from a cup to ensure the infant is consuming enough calcium?
cottage cheese
A 6-month-old arrives for a well-baby visit with a case of diaper rash that the parent believes is normal for infants. The parent reports changing the baby's diaper when he wakes up and before naps or bedtime. Which frequency should the nurse point out will better help heal and prevent future incidences of diaper rash?
every 2 to 4 hours
The 11-year-old arrives in the emergency department presenting with the following: nosebleed with no apparent trauma, disoriented, confused, difficulty walking, nausea, and coughing. The nurse should question the child concerning which potential activity?
experimenting with an inhalant
The nurse is assessing a 3-year-old at a routine well-child visit. Which assessment should the nurse prioritize in the vision check?
eye coordination
The nurse is preparing a variety of projects for the pediatric clients on the unit to work on in the playroom. In deciding on projects, the nurse determines the 8-year- old will be best suited to work on which activity?
form vases from blocks of clay
The school nurse is assessing a 6-year-old child's dentition. Which assessment should the nurse prioritize for this child?
has first permanent molars
The nurse notes a school-aged child in the pediatric unit playroom is busy sorting through the Legos and putting them in certain groupings. The nurse determines this child is illustrating which developmental concept?
hierarchical arrangement
The nurse is preparing a care plan for a school-age child to address the child's hospitalization. Which factor should the nurse incorporate into this plan?
increased attention span and interest in an activity for a long length of time
The nurse is caring for a toddler in the pediatric unit and notes the child is responding according to expected developmental stages. Which characteristic will the nurse predict this toddler to exhibit while in the hospital?
insists on doing a new skill and then asking for help
The nurse is assessing the motor skills of an infant who is 9 months old. Which motor skills should the nurse prepare to assess in an infant achieving normal growth and development milestones?
is eating cereal using the thumb and index finger
The nurse is conducting a training session for families who are to receive assistance from the Women, Infants, and Children (WIC) supplemental food program. The nurse determines the session is successful after the participants correctly choose which food items they will be able to receive through the program?
milk dry beans juice bread eggs
The nursing instructor is illustrating the various types of play. The instructor determines the class is successful when the students correctly choose which example as best representing onlooker play?
observing without participating
A first-time parent asks the nurse what toys would be appropriate for her son's second birthday next month. What recommendations would be nurse make?
play lawn mower
The pediatric nurse is presenting basic safety tips at a local health fair for families. The nurse should point out the majority of hospital visits for toddlers can be prevented by exercising which precaution?
safely store all chemical substances
The nurse is assessing a 9-year-old girl during her well-child checkup and notes the child weighs 86 lb (39 kg). After noting she weighed 9.5 lb (4.30 kg) at birth and her growth has been within normal patterns, the nurse determines this girl is within which category?
slightly overweight
Which statement by a parent would best prepare the toddler for the parent's return if the parent must leave the hospital?
"I will be back after you eat your dinner and SpongeBob goes off."
A nurse is reviewing important concepts related to bathing and tub baths with a parent of a toddler. Which statement by the parent indicates the need for additional teaching?
"It's okay to let my toddler take bubble baths and play in the bubbles."
The nurse is preparing a safety presentation for a health fair for families. Which instruction should the nurse prioritize when illustrating car safety and the family?
"Set a good example. Wear your own seat belt every time you drive."
A mother calls the pediatrician's office upset because her 2-year-old son has begun acting out now that the new baby is home. He wants to have a bottle like the newborn and has begun to have accidents in his pants. Which statement by the nurse would best address this problem?
"Set aside time to spend one-on-one with your older child and make him understand that he is still loved and very special."
The pediatric nurse is meeting with a group of preschoolers' family members to discuss various health topics. The nurse determines the sexual development session is successful after overhearing which comment by one of the participants?
"I feel better knowing that her curiosity is normal."
A grandmother who is the primary caregiver of a 2-year-old is expressing concern about how to best handle the temper tantrums that can occur two or three times a day, often in public places. She explains she spanked her own children for this but she is worried this is not the best way to handle the situation. Which response from the nurse will best address this concern?
"Remain calm, pick the child up, and move to a quiet and neutral place until the child gains self-control; don't give in to the child's demands."
The school nurse is meeting with a 10-year-boy who is concerned about his weight. He reports he doesn't eat much candy but loves fruit, pasta, potatoes, and bread. Which suggestion should the nurse prioritize to help him maintain a healthy weight?
Encourage activities that will increase his physical activity.
A single mother with three young children is reluctant to leave her crying and upset 16-month-old daughter overnight in the hospital but needs to go home to care for the other children. Which suggestion from the nurse will best address the fears and concerns of both the child and mother?
Encourage the mother to give the child a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return, such as "when breakfast comes in the morning."
The nursing instructor is leading a discussion on school-aged children. The instructor determines the session is successful when the students correctly choose which factor as being a priority for the school-aged child?
Needs 10 to 12 hours of sleep per night
The parents of 5-year-old boy are concerned about the how a recent motorcycle accident to his father will affect the child. Although the father has fully recovered, the child is very concerned if the father is away longer than expected; the child is not as talkative but appears withdrawn and quiet. The nurse should point out the child's behavior is likely related to which factor?
The boy believes he caused the accident by telling his father he "hoped he crashed" when the boy couldn't go along.
The nurse is meeting with a group of young parents to discuss nutrition and theirreschooler. Which response should the nurse prioritize when asked if using desserts as a reward for good behavior is an appropriate idea?
The child can use food to manipulate others' behavior
The nurse is preparing a presentation for a health fair illustrating the major milestones of infants as they grow and develop. Which fact should the nurse point out when illustrating an infant's teeth?
The first tooth usually erupts by 6 months
The mother has presented to the pediatric clinic with her 1-year-old infant for the next round of immunizations. The nurse would question administering the immunizations if which situation is noted on assessment?
The infant is being treated for a case of eczema
The nurse is meeting with a group of older siblings of infants to discuss various aspects of infant care.The group will be helping the parents with infant care. Which instruction should the nurse prioritize with this group?
The infant sleeps 10 to 12 hours at night and can take two to three naps during the day.
The nurse is observing 4-year-old twins during their well-child appointment. Which observation by the nurse would indicate the children are demonstrating cooperative play?
They are building a house for their dolls with blocks in the room.
The nurse is assessing an 6-month-old infant at a well-baby visit and is answering questions from the new mother. Which response should the nurse prioritize when addressing the mother's question concerning what the infant should be learning at this point in life?
Trust
The nursing instructor is conducting a class discussion exploring the normal dentition progression of the school-aged child. The instructor determines the session is successful when the students correctly choose which factor as most likely occurring in 10-year-olds?
Two of the cuspid teeth have erupted
When collecting data on a preschool-aged child during a well-child visit, the nurse discovers the child has gained 12 lb (5.4 kg) and grown 2.5 inches (6.3 cm) in the last year. The nurse interprets these findings to indicate which situation?
Weight is above an expected range and height is within an expected range
A 7-year-old seen in the clinic for a routine well-child visit is noted on assessment to have gained 5 lb (2.26 kg) and grown 5 in (12.70 cm) over the past year. The nurse determines this child is within which parameters?
Weight is within expected range and height is above expected range.
The pediatric nurse is discussing the daily activities of a 4-year-old with the caregiver to assess growth and development status. The nurse would documentthat the child has reached the initiative stage of development if the caregiver indicates the child participates in which activity?
tries to sweep up spilled cereal but cries when can't do well
The school nurse is preparing to conduct routine health screenings of the elementary school students. Which screening will the nurse prioritize for students ages 6 to 8?
vision and hearing
The nursing students working with a group of 8-year-olds have determined they will illustrate the concept of conservation of weight. Which activity would best help these children grasp this concept?
weighing a pound of oranges and a pound of bricks and counting how many of each make a pound
The nurse is preparing an in-service training session on Erikson's theories for the pediatric nurses. Which task should the nurse prioritize as an example for the school-aged child?
will work on a picture until it is finished
The nurse is supervising a play group of children on the unit. The nurse expects the toddlers will most likely be involved in which activity?
Playing with the plastic vacuum cleaner and pushing it around the room
A 6-year-old male has come to the clinic for a routine well-child visit. The nurse, after noting in the medical record that this child has followed basic growth and development standards, anticipates documenting which common assessment finding?
swayed back
The parent of a 4-year-old is expressing concern that this child is not talking as much—or as well—as her other children did at that age. Which question should the nurse prioritize when assessing this preschooler for this concern?
"Has your child had their hearing tested?"
The nurse is working with a group of 8-year-olds who are learning about the concept of conservation of numbers. Which activity will help teach this concept to these school-aged children?
Rearranging a group of coins first into a circle, then a triangle and then a square
The father of a 4-year-old is concerned his child is not telling the truth and blaming others for things that have happened. Which response should the nurse prioritize after the father shares that the child is blaming someone named "Andrew" for a broken tool, and they have no idea who this is?
"Your son may have a friend named Andrew, but it could be an imaginary friend."
During a well-child visit, the caregiver expresses concern that the 3-year-old child often stutters when speaking. Which response should the nurse prioritize to best assist this family?
"Children of this age may stutter while they search for just the right word."
A frustrated mother with a 9-month-old baby comes to the clinic because her son is refusing all solid food. When talking with this mother, the nurse discovers the mother has struggled with a weight problem all her life, which she attributes to being forced to eat even when she was full. Not wanting to treat her child the same way, each time her son pushes food away with his tongue she believes that he doesn't want it. Which statement would be most appropriate for the nurse to say to this mother?
"The baby needs to learn how to swallow, so catch the food and offer it again until the baby learns this."
The nurse takes a call from a concerned mother whose infant received routine immunizations the day before and now has a temperature of 101oF (38.3oC), is fussy, and pulling at the injection site. The mother wants to know what she should do. Which is the best response from the nurse to this mother?
"This is a common reaction. Give your child acetaminophen, cuddle him, and apply a cool compress to the injection site."
The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements reflecting height/weight would the nurse expect to document for this visit?
24 pounds (10.8 kg) and 30 inches (75 cm)
The nurse is monitoring children playing in the unit's playroom. The nurse notes that some children are involved in associative play by which actions?
pushing toy cars around on a large rug with roads
The nurse is meeting with a group of new mothers of infants and is leading the discussion related to weaning. Which suggestion should the nurse prioritize to this group of mothers concerning weaning their infant?
"It is important to let the infant set the pace for weaning, no matter what age they are."
The nurse is conducting a class for new parents of infants. The nurse determines the session is successful when the parents correctly choose which instruction concerning bathing their infant?
"When I bathe my baby, I shampoo his hair each time as well."
The mother of a 6-year-old is asking the nurse how to handle the child's lying and fabricated stories when confronted with questionable actions. Which response would be most appropriate by the nurse?
"Children this age sometimes can't distinguish between fantasy and reality."
Parents are beginning to potty train their 2-year-old child and seek advice from the nurse on how to be successful in this endeavor. Which statement by the parents indicates that further teaching is needed?
"He wants to accompany me to the bathroom but I prefer to go alone."
The nurse is caring for a 5-year-old who has been hospitalized after an episode of asthma. As the nurse prepares to teach the child how to use the nebulizer, which action should the nurse prioritize?
Allow the child to touch and play with the nebulizer for a few minutes before the treatment.
The nurse is admitting a 10-year-old for surgery. What action should the nurse prioritize when caring for this child?
Answer questions regarding pain
The parents of a toddler are concerned their child is not developing correctly and are questioning the nurse concerning the child's lack of effort to join other children in a group activity. Which response should the nurse prioritize in answering the parents?
"This is normal for this age group. It's referred to as solitary independent play."
The mother of a 15-month-old son is returning to work and wants to place her son in the day care close to work; however, they will only accept potty-trained children. Which response from the nurse will best address this situation in answering the mother's questions of how best to potty train her son?
"Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained."
A group of nursing students are preparing a presentation illustrating basic safety measures which can be utilized for infants. Which measures should the students prioritize in their presentation? Select all that apply.
-Crib and playpen bars should be no more than 2 3/8 inches apart. -Car seats should be placed in back seats. -A safe temperature for hot water heaters in households with infants is 120°F (48.9°C).
The mother of a 4-year-old is concerned her child is not eating well. In addressing the concerns of this mother, which foods should the nurse point out are high in protein? Select all that apply.
A. cheese and crackers C. whole grain granola with yogurt E. turkey sandwich
The nurse is preparing a presentation for a community health fair on the topic of helping school-aged children develop the self-confidence they will need to mature into responsible adults. Which suggestion should the nurse prioritize to caregivers to enable them to help their children in this area?
Caregivers should maintain consistent rules and expectations
The nurse is assessing a 3-year-old at a well-child visit and the child appears to be progressing well. Which activity will the nurse ask the child to attempt to appropriately assess the fine motor skills of this preschooler?
Button clothes
The nurse is monitoring a playgroup of children on the pediatric unit. The nurse predicts the school-age child will most likely be participating in which activity?
painting pictures in the art corner of the room
A 15-month-old toddler is brought to the pediatrician's office for a well-child checkup and the nurse is reviewing health promotion with the family. What recommendation(s) would the nurse make to the family to help ensure the child's health? Select all that apply.
C. Keep all medications locked up and out of reach for the child. D. Turn the hot water heater temperature down to 120°F (48.9°F). E. Never allow the child to ride in the car unless secured in a car seat.
While the nurse is taking a blood pressure on a 4-year-old, the child states that the blood-pressure cuff is too tight and angrily says, "That hurt, you big poo-poo head." What is the most appropriate response by the nurse?
Calmly explain that you don't mean to hurt her, loosen the cuff, and tell her that is isn't nice to call you names.
An 8-year-old boy's foster mother is concerned about three recent cavities found in his permanent teeth and reports the child eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. Which suggestion should the nurse prioritize to this mother in regard to the child's dental health?
Ensure that the child brushes his teeth after each meal and snacks.
A toddler is hospitalized and the nurse wants to make the transition from home to hospital as easy as possible for him. Which action by the nurse would be most beneficial to assist the toddler in adapting to the hospital?
Follow the child's home routines as much as possible while in the hospital
The pediatric nurse is careful to monitor and assess the growth and development of all clients. Which characteristic should the nurse prepare to assess in the infants?
Grows and develops skills more rapidly than at any other time in their life.
The nurse is assessing a 4-year-old on a routine well-child visit. When assessing the gross motor skills of this preschooler, which activity will the nurse predict the child to be able to successfully accomplish?
Hop on one foot
A mother brings her 2-year-old child to the pediatrician's office, voicing concerns about her toddler's growth over the last year. According to the child's records, the toddler has gained 6 pounds (2.7 kg ) and grown 2.5 in (6.25 cm) since the child's last visit a year ago. How should the nurse respond to this mother's concerns?
Inform the mother that her toddler's growth is within normal limits and there is nothing to be worried about
The nurse is reviewing the diet of an 8-month-old infant with the mother who reveals she has been using evaporated milk to make the formula. Which additional ingredient should the nurse ensure she is including in the formula?
Iron
The pediatric nurse is meeting with a group of young mothers of newborn infants who are questioning the "soft spot" on the head and when it will close. Which fact should the nurse point out to the mothers?
It may increase slightly in size the first few months of life
A nursing instructor is leading a class discussion exploring the various aspects of Erikson's theories of the developmental tasks of toddlers. The instructor determines the session is successful when the students correctly choose which task as a priority for toddlers?
Learning to act on one's own
The caregivers of a 2-year-old are concerned the child is not learning how to share and play well with other children. While acknowledging their concern and devotion, the nurse should point out which activity would be best for this child's developmental level?
Mowing the lawn with a toy lawnmower
The nurse has brought a group of preschoolers to the playroom to play. Which activity would the nurse predict the children to become involved in?
Pretending to be mommies and daddies in the playhouse
A breastfeeding mother asks the nurse about when she can begin feeding her 5-month-old infant some solids and vitamins. Which information provided by the nurse would most accurately address this mother's concerns?
The first food offered to an infant is iron-enriched rice cereal and can be started now. Additionally, the infant needs to receive vitamin D and iron.
A first-time mother calls the pediatrician's office to ask the nurse about her baby's tooth eruption. The baby is 8 months old and still does not have any teeth. What information can the nurse share with this mother that would correctly respond to her anxiety about her baby's dentition?
Tooth eruption is often genetically based, with some families having babies with early tooth eruption, while others have late tooth eruption.
A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby. Which suggestion should the nurse prioritize to help the mother establish healthy sleeping patterns in her infant?
Use the crib for sleeping only, not for play activities
The nurse is conducting an assessment on a 1-year-old healthy child and commends the parents for maintaining routine visits. When questioned by the parents as to the recommended schedule for future visits, which schedule should the nurse recommend?
at 15 months and at least annually thereafter
