OB/PEDS Test 3

A child had a generalized tonic-clonic seizure that lasted 90 seconds. After a generalized tonic-clonic seizure, the nurse would expect that the child might be:

Sleepy.

What chart should the nurse use to assess the visual acuity of an 8 year old child?

Snellen chart.

The nurse observes that the legs of a child with cerebral palsy cross involuntarily, and the child exhibits jerky movements with his arms as he tries to eat. The nurse recognizes that he has which type of cerebral palsy?

Spastic.

A nurse is caring for a toddler who has had three ear infections in the past 5 months. Which of the following long-term complications is the child at risk for developing?

Speech delays.

The nurse palpated the anterior fontanel of a 14 month old infant and found that it was closed. What does this finding indicate?

This is a normal finding.

Which assessment should the nurse perform last when examining a 5 year old child?

Throat.

According to Piaget, a 9 year old child is in which stage of cognitive development?

Concrete operations.

When planning to answer a 16 year old girls questions about menstruation, the nurse must consider cognitive development. According to Piaget, the cognitive aspect that is developed during adolescence is the ability to:

Consider hypothetical situations.

The nurse counseling a lactating mother about diet would include instructions to:

Consume 500 more calories than her usual pre-pregnancy diet.

An infant is hospitalized for RSV bronchiolitis. Which type of precautions would the nurse use when caring for the infant?

Contact precautions.

The infant with bronchopulmonary dysplasia (BPD) who has RSV bronchiolitis is a candidate for which treatment?

Cool, humidified oxygen.

The nurse takes into consideration that the child most susceptible to an opportunistic infection is the one taking:

Corticosteroids.

The mother of an infant born prematurely tells the nurse, "The baby is irritable. He cries during diaper changes and feedings. Can you make some suggestions about what I should do to soothe him?" The most appropriate recommendation to help this parent would be:

Cover the baby snugly when you hold him.

The school nurse would suspect amblyopia when the child:

Covers one eye to read the board.

What term should be used in the nurses documentation to describe auscultation of breath sounds that are short, popping, and discontinuous on inspiration?

Crackles.

When preparing a teaching plan for a group of first-time pregnant women, the nurse expects to review how maternity care has changed over the years. Which of the following would the nurse include when discussing events of the 20th century?

Creation of free-standing birth centers.

A group of nursing students are reviewing information about vaccines used to prevent STIs. The students would expect to find information about which of the following?

HPV HAV HBV

The nurse understands that a fear unique to the preschool period is:

Fear of bodily harm.

A nurse is providing teaching to a new mother about her newborn's nutritional needs. Which of the following would the nurse be most likely to include in the teaching?

Feeding the newborn every 2 to 4 hours during the day Burping the newborns frequently throughout each feeding Using feeding time for promoting closeness

A child was sent to the school nurse because of a rash. The nurse noted the rash was present on the trunk, extremities, and face. The child's cheeks were bright red. The nurse is aware this type of rash is consistent with:

Fifth disease.

When assessing a family for possible barriers to health care, the nurse would consider which factor to be most important?

Finances.

An adolescent is taking tetracycline for a sexually transmitted disease. The nurse would stress in the instruction about this medication to:

Finish all of the medication.

Which findings would the nurse expect to find in a client with bacterial vaginosis?

Fish-like odor of discharge.

When obtaining a health history from a client, which factor woudl lead the nurse to suspect that the client has an increased risk for STIs?

Five different sexual partners.

A newborn is suspected of having fetal alcohol syndrome. Which of the following would the nurse expect to assess?

Flattened maxilla

The nurse characterizes the play of 5 year old children as:

Following rules.

What information should the nurse teach workers at a daycare about RSV?

Frequent handwashing can decrease the spread of the virus.

The nurse should assess a child who has had a tonsillectomy for:

Frequent swallowing.

A nurse is assigned to care for an Asian American client. The nurse develops a plan of care with the understanding that based on this client's cultural background, the client most likely views illness as which of the following?

From an imbalance of yin and yang.

The nurse is aware that, in general, the school-age child will:

Gain 5 to 7 pounds/year.

The nurse suggest an appropriate toy for a hospitalized 6 year old boy would be a:

Game Boy game.

When the 8 year old asks the nurse how she got the antibodies that kept her from getting whooping cough, the nurse explains that those shots:

Gave her a tiny case of whooping cough and she made her own antibodies.

The nurse understands that the adolescents avid sexual orientation to be based on Freud's theory, which describes adolescence as the ________ stage.

Genital.

The nurse is trying to get consent to care for an 11 year old boy with diabetic ketoacidosis. His parents are out of town on vacation, and the child is staying with a neighbor. Which action would be the priority?

Getting telephone consent with two people listening to the verbal consent.

Which intervention is appropriate for the infant hospitalized with bronchiolitis?

Give cool, humidified oxygen.

The nurse would delay the administration of DTaP when the mother says that her infant:

Had a temperature of 105 F from the precious inoculation.

The nurse would advise a mother who is concerned because her 10 month old is lethargic to:

Handle the infant slowly and gently.

The school nurse who is preserving a tooth that was knocked out on the school yard will be especially careful to:

Handle the tooth only by the crown.

The intervention that is most effective in dealing with occasional aggression in a 4 year old child is:

Have the child take a time-out in the corner for 4 minutes.

Which strategy is the best approach when initiating the physical examination of a 9 month old male infant?

Have the parent hold the child on his or her lap.

The nurse reminds the parents who are trying to select a dog for their allergic child that the best selection would be a female dog that is _______ and _________.

young; neutered.

The nurse is performing a comprehensive physical examination on a young child in the hospital. At what age can the nurse expect a child's head and chest circumferences to be almost equal?

1 year.

The nurse knows that an infants birthweight should be tripled by:

1 year.

The school nurse is planning a program for the girls about the physical changes of puberty; this program should be directed to girls of the age:

10 years.

The nurse advises the parents of a 6 year old to try and ensure at least ____________ hours of sleep daily.

11.

A parent is concerned because her son was exposed to varicella at preschool. The nurse would tell this parent that the incubation period for varicella is:

12 to 21 days.

The infant should be able to wlak independently by the age of:

12-15 months.

A parent brings a 6 month old to the pediatric clinic for her well-child examination. Her birthweight was 8 pounds, 2 ounces. The nurse weighing the infant today would expect her weight to be at least:

16 pounds.

A group of student are reviewing the historical aspects about childbirth. The students demonstrate understanding of the information when they identify the use of twilight sleep as s key event during which time frame?

1900s

The nurse is aware that the age at which the posterior fontanelle closes is:

2 to 3 months.

The nurse suggests that bladder training should start when the toddler can stay dry for ______ hours.

2.

The nurse reviews the CD4 counts of a client who is HIV-positive. As a result, less than which of the following woudl indicate to the nurse that the client has AIDS?

200 cells/mm3

The nurse discussing toilet training with parents would identify which of the following as an indicator of readiness? The child is:

Able to communicated that he or she is wet.

The nurse has explained the use of time-outs to the parent of a 3 year old. The nurse determines the parent understands the information when she states an appropriate period for a time-out is

3 minutes.

Assessment of a newborn's head circumference reveals that it is 34 cm. The nurse would suspect that this newborn's chest circumference would be:

32 cm.

A parent of a newborn asked the nurse, "When will my baby get the hepatitis B vaccine?" The nurse bases a response on the knowledge that the first dose of Convax should be given to infants born to a hepatitis B-negative mother at:

4 months.

The parent of a 3 month old infant asks the nurse, "At what age do infants usually begin drinking from a cup?" The nurse would reply:

5 months.

The nurse is aware that the age at which an infant is able to sit steadily alone is:

8 months.

A parent asked the nurse, "At what age are children capable of assuming more responsibility for personal belongings?" Based on a knowledge of growth and development, the nurse would respond:

9 years.

The situation in which the nurse would be suspicious about a hearing impairment is:

A 24 month old toddler who communicates by pointing.

A woman will be discharged 48 hours after a vaginal delivery. When planning discharge teaching, the information the nurse would include about lochia is:

A change in lochia from pink to bright red should be reported.

The school nurse recognizes the cardinal sign of a hyphema when she assesses:

A dark-red spot in front of the iris.

The nurse selects the most appropriate toy for a normal 2 year old child, which is:

A dump truck.

The nurse suggests that the most appropriate toy choice for a 3 year old would be:

A large construction set.

The parents of an 8 year old tell the nurse the child wakes the household crying out during his frequent nightmares. The nurses most helpful response is to explain that nightmares are:

A normal extension of the child's fear of mutilation.

The nurse is leading a discussion group with parents of adolescents. One parent comment, "My son can't do anything without checking with his friends first. My opinion doesn't count anymore." The nurse would formulate a response on the knowledge that this behavior is:

A normal phenomenon during adolescence.

The nurse is assessing a newborn's eyes. Which of the following would the nurse identify as normal?

Able to track object to midline Transient deviation of the eyes Involuntary repetitive eye movement

A parent reports that her child experiences episodes where he appears to be staring into space. This behavior is characteristic of which type of seizure?

Absence.

A nurse is caring for a toddler who has acute otitis media. Which of the following is the priority action for the nurse to take?

Administer analgesics.

The nurse getting an end-of-shift report on a child with status asthmaticus should question which intervention?

Administer oxygen by nasal cannula to keep oxygen saturation at 100%.

The nurse determines that mother understands instructions about administering an oral antibiotic for otitis media when the mother verbalizes that she will:

Administer prescribed doses until all the medication is used.

A nursing instructor is preparing a class discussion on case management in maternal and newborn health care. which of the following would the instructor include as a key component?

Advocacy Coordination Communication Resource management

When is the most appropriate time to inspect the genital area during a well-child examination of a 14-year-old girl?

After the abdominal assessment.

A nurse is assessing a client for possible risk factors for chlamydia and gonorrhea. Which of the following would the nurse identify?

Age under 25 years.

The type of precaution that is necessary when caring for a toddler with varicella is:

Airborne infection.

A client with trichomoniasis is to receive metronidazole (Flagyl). The nurse instructs the client to avoid which of the following while taking this drug?

Alcohol.

When interviewing the mother of a 3 year old child, the nurse asks about developmental milestones such as the age of walking without assistance. This should be considered:

An important part of the child's past growth and development.

The nurse points out to a group of parents that the most positive developmental significance of a peer group to the adolescent is that the group serves as:

An initial separation from family.

A nursing instructor is preparing a class discussion on the trends in healthcare and healthcare delivery over the past several centuries. When discussing the changes during the past century, which of the following would the instructor be least likely to include?

Analysis of morbidity and mortality.

When discussing preschoolers sexual curiosity with the parent, the nurse determines that the parent understands the information when she states she would:

Answer her questions when she asks.

The nurse is obtaining vital signs on a 1 year old child. What is the most appropriate site for assessing the pulse rate?

Apical.

What is an appropriate beverage for the nurse to give to a child who had a tonsillectomy earlier in the day?

Apple juice.

The nurse considers the appropriate snack for a 2 year old child would be:

Applesauce.

A parent is concerned because her infant has a diaper rash. The nurse would advise the parent to:

Apply a protective ointment on the area.

A nurse is preparing to administer the varicella vaccine to an adolescent. Which of the following questions should the nurse ask to determine whether there is a contraindication to administering the vaccine?

Are you currently taking corticosteroid medication?

A nurse is caring for a client who has postpartum psychosis. Which of the following actions is the nurse's priority?

Ask the client if they have thoughts of harming themselves or their infant.

When the school-age child becomes frustrated with a school assignment and says, "I can't do this!" the parent should:

Ask, "What is it that is so difficult?"

While making rounds in the nursery, the nurse sees a 6 hour old baby girl gagging and turning bluish. Which of the following would the nurse do first?

Aspirate the oral and nasal pharynx with a bulb syringe.

The parents of a newborn become concerned when they notice that their baby seems to stop breathing for a few seconds. After confirming the parent's finding by observing the newborn, which of the following actions would be most appropriate?

Assess the newborn for signs of respiratory distress.

The United States ranks 50th in the world for maternal mortality and 41st among industrialized nations for infant mortality rate. When developing programs to assist in decreasing these rates, which factor would most likely need to be addressed as having the greatest impact?

Assuring early and adequate prenatal care.

A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests:

Asthma.

The nurse would base a response to a parent about how his child got hepatitis A on the information that the child:

Ate shrimp while they were in Mexico.

A nurse is caring for an infant who has manifestations of acute otitis media. Which of the following factors places the infant at risk for otitis media?

Attends daycare 4 days a week Hx of cleft palate repair Parents smoke cigarette outside

The nurse planning a safety program for high school students should understand that most accidental deaths in adolescence are related to:

Automobiles.

The nurse planning post-operative teaching for a child who has had a tympanostomy with insertion of tubes would include:

Avoid getting water in the ears.

The nurse is planning to teach parents about the prevention of Reyes syndrome. What information would the nurse include in this teaching?

Avoid giving salicylate-containing medications to a child who has viral symptoms.

The nurse strokes the lateral sole of the newborn foot from the heel to the ball of the foot when evaluating which reflex?

Babinski.

Foods that would be a health choice for an adolescent who just finished playing in a strenuous game would be:

Bagel and skim milk.

A 3 year old child, while playing with her favorite toy in the playroom of the pediatric unit, is approached by another child who also wants to play with the same toy. The nurse anticipates that the 3 year old will:

Become angry and a physical response might ensue.

As part of an inservice program, a nurse is describing a transient, self-limiting mood disorder that affects mothers after childbirth. The nurse correctly identifies this as postpartum:

Blues.

The nurse instructed a postpartum woman about storing and freezing breast milk. The nurse determines that the teaching was effective when the woman says:

Breast milk can be stored in glass containers.

A primipara tells the nurse, "My afterpains get worse when I am breastfeeding." The most appropriate nursing response would be:

Breastfeeding releases a hormone that causes your uterus to contract.

A school-aged child had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of:

Bronchitis.

Which tool measures body fat most accurately?

Calipers.

Assessment of a female client reveals a thick, white vaginal discharge. She also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has:

Candidiasis.

While performing a physical assessment of a newborn boy, the nurse notes diffuse edema of the soft tissues of his scalp that crosses suture lines. The nurse documents this finding as:

Caput Succedaneum.

A parent remarks, "My 18 month old daughter carries her blanket around everywhere. Is this normal?" The nurse who has an understanding of toddler development might explain that:

Carrying her favorite blanket is self-consoling behavior.

A 4 year old child insists that he has more money with a nickel than his father has with a dime. The nurse is aware that this perception is described in Piaget's theory as:

Centering.

A 4 year old child tells the nurse that he will not eat peas because they are green. This is an example of:

Centering.

After teaching a group of nursing students about variations in newborn head size and appearance, the instructor determines that the teaching was successful when the students identify which of the following as a normal variation?

Cephalhematoma Molding Caput succedaneum

Kimberly is having a checkup before starting kindergarten. The nurse asks her to do the "finger-to-nose" test. The nurse is testing for:

Cerebellar function

The nurse encourages a female client with HP to receive continued follow-up care because she is at risk for:

Cervical cancer.

In which section of the health history should the nurse record that the parent brought the infant to the clinic today because of frequent diarrhea?

Chief complaint.

After teaching nursing students about the basic concepts of family-centered care, the instructor determines that the teaching was successful when the students state which of the following?

Childbirth affects the entire family and relationships will change.

When integrating the principles of family-centered care, the nurse would include which of the following?

Childbirth results in changes in relationships.

What is the best nursing response to the parent of a child with asthma who asks if his child can still participate in sports?

Children can usually play any type of sport if their asthma is well controlled.

A group of students are reviewing information about STIs. The students demonstrate understanding of the information when they identify which of the following as the most common bacterial STI in the United States?

Chlamydia.

The nurse's instructions for a new mother to care for the baby's umbilical cord will include:

Clean the stump with alcohol at every diaper change.

The nurse should teach the postpartum woman about perineal self-care by instructing her to:

Cleanse with warm water in a squeeze bottle from front to back.

Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?

Cocaine.

A group of students are reviewing an article describing information related to indicators for women's health and the results of a national study. Which of the following woudl the students identify as being satisfactory for women?

Colorectal cancer screening Mammograms

A nurse assessing a client who has postpartum depression. The nurse should expect which of the following manifestations?

Concerns about lack of income to pay bills Anxiety about assuming a new role as a parent Rapid decline in estrogen and progesterone Feeling of inadequacy with the new role as a parent

The nurse suggests measures that might be helpful for the child with enuresis, such as:

Decrease fluid intake after the evening meal.

The nurse places a newborn with jaundice under the phototherapy lights in the nursery to achieve which goal?

Decrease the serum bilirubin level

A nurse suspects that a postpartum client is experiencing postpartum psychosis. Which of the following would most likely lead the nurse to suspect this condition?

Delerium.

Assessment of a newborn reveals uneven gluteal (buttocks) skin creases and a "clunk" when Ortolani's maneuver is performed. Which of the following would the nurse suspect?

Developmental hip dysplasia

A woman gives birth to a health newborn. As part of the newborn's care, the nurse instills erythromycin ophthalmic ointment as a preventative measure related to which STI?

Gonorrhea.

The nurse would include in a teaching plan pertinent to the long-term administration of Dilantin that:

Gums should be massaged regularly to prevent hyperplasia.

The nurse explains that the only absolute contraindication for a mother to breastfeed her child is ________ infection.

HIV

While changing a female newborns diaper, the nurse observes a mucus0like slightly bloody vaginal discharge. Which of the following would the nurse do next?

Document this as pseudomenstruation.

Teaching safety precautions with the administration of antihistamines is important because of what common side effect?

Drowsiness.

A client is diagnosed with pelvic inflammatory disease. When reviewing the client's medical record, which of the following would the nurse expect to find?

Dysmenorrhea Dysuria Lower abdominal tenderness Discomfort with cervical motion

A girl tells the nurse that she and her best friend belong to the popular clique. She states, "I love Britney Spears and I want to be a singer." The nurse recognizes the girl's statement as characteristic of peer relationships in:

Early adolescence.

A nurse is developing a plan of care for a woman to ensure continuity of care during pregnancy, labor, and childbirth. Which of the following would be most important for the nurse to incorporate into that plan?

Educating the client about the importance of a support person.

Once an allergen is identified in a child with allergic rhinitis, the treatment of choice about which to educate the parents is:

Eliminating the allergen.

After teaching a group of students about pregnancy-related mortality, the instructor determines that additional teaching is needed when the students identify which condition as a leading cause?

Embolism.

After teaching a class on preventing pelvic inflammatory disease, the instructor determines that the teaching was successful when the class identifies which of the following as an effective method?

Emphasizing the need for infected sexual partners to receive treatment.

Which action is appropriate when the nurse is assessing breath sounds of an 18 month old crying child?

Encourage the child to play with the stethoscope to distract and to calm down before auscultating.

A nurse is providing care to a woman who has just delivered a health newborn. Which action would least likely demonstrate application of the concept of family-centered care?

Encouraging the woman to keep her other children at home.

When assessing a 13 year old boy, the nurse would keep in mind physical changes in the pubertal male, beginning with:

Enlargement of testicles.

Which statement, if made by parents of a child with cystic fibrosis, indicates that they understood the nurses teaching on pancreatic enzyme replacement?

Enzymes should be given with meals and snacks.

Which type of croup is always considered a medical emergency?

Epiglottitis

The nurse is assessing the skin of a newborn and notes a rash on the newborn's face and chest. The rash consists of small papules and is scattered with no pattern. The nurse interprets this finding as which of the following?

Erythema toxicum.

The nurse inspecting the skin of a dark-skinned child notices an area that is dusky red or violet color. This skin coloration is associated with what?

Erythema.

The parent of a 4 year old child tells the nurse, "Bedtime is difficult. I can't get my child to bed at night." The nurse and the child's mother discuss options and decide that the best choice would be to:

Establish a bedtime routines and use it consistently.

After birth, the nurse quickly dries and wraps the newborn in a blanket to prevent heat loss by:

Evaporation.

Which strategy is not always appropriate for pediatric physical examination?

Examine the child from head to toe.

What is a common trigger for asthma attacks in children?

Exercise.

An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is to:

Explain in simple terms how it works.

A nurse is preparing a presentation for a group of women at the clinic who have been diagnosed with genital herpes. Which of the following would the nurse expect to include as a possible precipitating factor for a recurrent outbreak?

Exposure to ultraviolet light Use of corticosteroids Emotional stress Sexual intercourse

The best way for the nurse to communicate with a 10 year old child who has a hearing impairment would be to:

Face the child and speak clearly in short sentences.

Which cranial nerve is assessed when the child is asked to imitate the examiners wrinkled frown, wrinkled forehead, smile, and raised eyebrow?

Facial.

A nurse is caring for a postpartum client who delivered their third infant 2 days ago. Which of the following manifestations coudl indicate postpartum depression?

Fatigue Insomnia Flat affect

A new mother who is breastfeeding her newborn asks the nurse, "How will I know if my baby is drinking enough?" Which response by the nurse would be most appropriate?

He should wet between 6 to 12 diapers each day.

Which measurement is not indicated for a 4 year old well child examination?

Head circumference.

The abnormal finding in an evaluation of growth and development for a 6 month old infant would be:

Head lag present.

For which problem should the child with chronic otitis media with effusion be evaluated?

Hearing loss.

The nurse is working with a group of community health members to develop a plan to address the special health needs of women. Which of the following conditions would the group address as the major problem?

Heart Disease.

A newborn is scheduled to undergo a screening test for PKU. The nurse prepares to obtain the blood sample from the newborns:

Heel.

The best advice the nurse can offer a parent concerned because her 2-year-old is very active and does not eat much is to:

Help the child to wind down with a quiet activity before mealtime.

Which of the following statements best describes the 3 year old child?

Helpful, wants to assist with chores.

A seventh-grade girl tells the school nurse that her art teacher, also a female, is her hero. The most appropriate interpretation of the girls comment is:

Hero worship is a normal phenomenon.

When developing a teaching plan for a community group about HIV infection, which group would the nurse identify as an emerging risk group for HIV infection?

Heterosexual women.

The nurse would choose to administer the immunization injection of:

Hib vaccine prepared in a separate syringe.

The nurse assessing a newborn recognizes a sign of hypoglycemia, which is:

High-pitched cry.

An adolescent's parent comments, "My son seems so preoccupied with his appearance these days. Is this normal?" The nurse's best response would be:

His preoccupation with his looks is quite normal.

A 16 year old excitedly tells his parents that he was offered a part-time job. Which response represents an effective problem-solving approach for his parents?

How do you think you will manage your school work and a job?

Assessment of a newborn reveals a heart rate of 180 beats/minute. To determine whether this finding is a common variation rather than a sign of distress, what else does the nurse need to know?

How many hours old is this newborn?

The parent of a toddler tells the nurse, "My daughter's appetite has decreased. Thank goodness she loves to drink milk." The most appropriate response for the nurse to make is:

How much milk does she drink in a day?

A neonate born to a mother who was abusing heroin is exhibiting signs and symptoms of withdrawal. Which of the following would the nurse assess?

Hypertonicity Excessive sneezing Tremors

When assessing a newborn 1 hour after birth, the nurse measures an axillary temperature of 95.8 F, an apical pulse of 114 beats/minute, and a respiratiory rate of 60 breaths/minutes. Which nursing diagnosis takes highest priority?

Hypothermia related to heat loss during birthing process.

The statement made by a parent that indicates correct understanding of infant feeding is:

I give the baby any new foods before he takes his bottle.

The statement made by a sexually active adolescent girl indicating an understanding of the prevention of sexually transmitted diseases is:

I insist that my partner wear a condom.

A nurse is teaching a woman with genital ulcers how to care for them. Which statement by the client indicates a need for additional teaching?

I need to abstain from intercourse primarily when the lesions are present.

The statement that indicates the mother of an 18 month old understand infant sleep patterns is:

I put the pacifier in the crib so she can find it when she wakes up.

The statement made by a parent indicating understanding about helping a 13 year old manage allowance money is:

I set amounts he can earn for particular chores.

Which state made by a parent indicates an understanding about treatment of streptococcal pharyngitis?

I should give the penicillin three times a day for 10 days.

A mother reports that she has a new job and her 12 year old child is home alone for a time after school. The statement made by the parent, indicating a potentially unsafe situation for this child is:

I told him that he could invite a few friends after school.

The statement that indicates the new mother is breastfeeding correctly is:

I will put the baby first on the breast that she took last in the previous feeding.

A nurse is assessing a postpartum client who is at home. Which statement by the client would lead the nurse to suspect that the client may be developing postpartum depression?

I'm feeling so guilty and worthless lately.

The nurse assesses that the 11 year old has moved from the mind set of egocentrism when he says:

I'm sorry. I bet that hurt your feelings.

A nurse is planning to administer recommended immunizations to a 4 year old child. Which of the following vaccines should the nurse plan to give?

IPV MMR VAR DTaP

One psychosocial task of adolescence on which the nurse must focus when planning care is the development of a sense of:

Identity.

A 13 year old boy states, "The girls in my class tower over me." The nurse's most informative response would be:

If may seem that way because girls have a growth spurt 2 years earlier than boys.

The statement made by a new mother that indicates she needs additional information about breastfeeding is:

If the baby gets fussy between feedings, I give her a bottle of water.

A pregnant woman asks the nurse, "I'm a big coffee drinker. Will the caffeine in my coffee hurt my baby?" Which response by the nurse would be most appropriate?

If you keep your intake to less than 300 mg/day, you should be okay.

When assessing development in a 9 month old infant, the nurse would expect to observe the infant:

Imitating sounds such as da-da.

A nurse is developing a plan of care for a client who is receiving highly active antiretroviral therapy (HAART) for treatment of HIV. The goal of this therapy is to:

Improve survival rates.

A mother brings her 12 year old daughter in for well-visit checkup. During the visit, the nurse is discussing the use of prophylactic HPV vaccine for the daughter. The mother agrees and the daughter receives her first dose. The nurse schedules the daughter for the next dose, which would be given at which time?

In 2 months

The nurse discusses safety-proofing the home with the mother of a 9 month old. The statement made by the mother indicates an unsafe behavior is:

In the car, she rides in a front-facing car seat.

When asked about her activities, a 10 year old girl responded, "I like school. I play the flute in the school band and I take tennis lessons." The nurse knows these activities will help this child develop a sense of:

Industry.

When palpating the child's cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm. What is the best explanation for this?

Infection or inflammation distal to the site.

The nurse is planning to administer immunizations at a well-child visit when a parent reports the 18 month old child is allergic to eggs. The vaccine that would be contraindicated is:

Influenza.

Examination of the abdomen is performed correctly by the nurse in which order?

Inspection, auscultation, and palpation.

The nurse would advise a parent when introducing solid foods to:

Introduce each new food 4 to 7 days apart.

The assessment finding that should be reported immediately if observed in a child with meningitis is:

Irregular respirations.

The parent of a toddler calls the nurse, asking about croup. What is a distinguishing manifestation of spasmodic croup?

It has a harsh, barky cough.

The nurse's best advice to a parent about a preschooler's "imaginary friend" would be that:

It is common for preschoolers to have imaginary friends.

What explanation should the nurse give to the parent of a child with asthma about using a peak flow meter?

It is used to monitor the child's breathing capacity.

The nurse has a 2-year-old boy sit in "tailor" position during palpation for the testes. What is the rationale for this position?

It prevents cremasteric reflex.

The nurse is auscultating a newborn's heart and places the stethoscope at the point of maximal impulse at which location?

Lateral to the midclavicular line at the fourth intercostal space.

The nurse would expect a 4 month old to be able to:

Lift head and shoulders.

The nurse planning anticipatory guidance for parents of a toddler would include which of the following instructions?

Limit setting should include praise.

The nurse is inspecting the external genitalia of a male newborn. Which of the following would alert the nurse to a possible problem?

Limited rugae.

A group of nursing students are reviewing information about factors affecting maternal, newborn, and women's health. The students demonstrate understanding of the information when they identify which of the following deficiencies as being associated with poverty?

Literacy Employment opportunities Mobility Political representation Skills

When teaching a class of pregnant women about the effects of substance abuse during pregnancy, which of the following would the nurse most likely include?

Low-birth-weight infants.

WHen talking with a parent about tooth eruption, the nurse explains that the first deciduous teeth to erupt are the:

Lower central incisors.

The nurse, in attempting to help a 7 year old girl express her feelings about being in a new school, woudl prompt the child with basic feeling words such as:

Mad Glad Sad Scared

When discussing fetal mortality with a group of students, a nurse addresses maternal factors. Which of the following would the nurse most likely include?

Malnutrition Preterm cervical dilation Underlying disease condition

A group of students are reviewing information about the effects of substances on the newborn. The students demonstrate understanding of the information when they identify which drug as not being associated with teratogenic effects on the fetus?

Marijuana.

Following delivery, the. nurses assessment reveals a soft, boggy uterus located above the level of the umbilicus. The appropriate intervention is to:

Massage the fundus.

What is the earliest recognizable clinical manifestation(s) of CF?

Meconium ileus.

A parent comments that her adolescent daughter seems to be daydreaming a lot these days. The nurse udnerstands that this behavior indicates she is:

Mentally preparing for real situations.

Which parameter correlates best with measurements of the body's total muscle-mass to fat ratio?

Mid-arm circumference.

The nurse assesses a 6 inch stain of rubra lochia on a pad that was worn for 2 hours. The nurse would document this as a _________ amount of lochia.

Moderate.

During a physical assessment of a newborn, the nurse observes bluish markings across the newborns lower back. The nurse documents this finding as which of the following?

Mongolian spots.

A parent is concerned about how to make his preschool age child stop sucking his thumb and asks the nurse for suggestions. The nurse's most helpful response would be:

Most children will stop thumb-sucking naturally by school age.

When a woman asks about resumption of her menstrual cycle after childbirth, the nurse responds that:

Most non-lactating women resume menstruation about 2 months postpartum.

When a child is experiencing a generalized tonic-clonic seizure, an appropriate nursing action would be to:

Move objects out of the child's immediate area.

What heart sound is produced by vibrations within the heart chambers or in the major arteries from the back and forth flow of blood?

Murmur.

The nurse can be assured that parents understand how long a child who has varicella is contagious when they state:

My child should stay home from school for 6 days after the pox appear.

Which statement indicates that parent of a toddler needs more education about preventing foreign body aspiration?

My toddle loves to play with balloons.

The nurse completes the initial assessment of a newborn. Which finding would lead the nurse to suspect that the newborn is experiencing difficulty with oxygenation?

Nasal flaring.

What sign is indicative of respiratory distress in infants?

Nasal flaring.

During examination of a toddler's extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is:

Normal, because the lower back and leg muscles are not yet well developed.

The nurse suggests a good dietary source of zinc for an adolescent who is a vegetarian would be:

Nuts.

You are the nurse admitting a toddler to the pediatric infectious disease unit. What is the single most important component of the child's physical examination?

Obtaining an accurate history.

The nurse explains that febrile seizures:

Occur when the temperature rises quickly.

To encourage a toddler to practice independence, the nurse would recommend that the child's mother:

Offer him a choice between two items.

What intervention can be taught to the parents of a 3 year old child with pneumonia who is not hospitalized?

Offer the child her favorite warm liquid drinks.

In the recover room, the nurse checks the newly delivered woman's fundus following a cesarean section. How would the nurse proceed with this assessment?

Palpate from the side of the uterus to the midline.

The nurse would document a rash that has erythematous circular raised lesions as:

Papular.

The nurse observed three toddlers playing side by side with dolls. Closer observation revealed that the children were not interacting with one another. This type of play would be characterized as:

Parallel.

The nurse explains that a common treatment for amblyopia is:

Patching the good eye to force the brain to use the affected eye.

After teaching a group of nursing students about the issue of informed consent. Which of the following, if identified by the student, would indicate an understanding of a violation of informed consent?

Performing a procedure on a 15 year old without consent.

A nurse is reviewing pediatric physical assessment techniques. Which statement about performing a pediatric physical assessment is correct?

Physical examinations process systematically from head to toes unless developmental considerations dictate otherwise.

The nurse observes a 10 month old infant using her index finer and thumb to pick up Cheerios. This behavior is evidence that the infant has developed the:

Pincer grasp.

A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the:

Placenta.

In planning care for a moderately retarded child, the type of play most appropriate is:

Play should be adjusted to her mental age rather than her chronological age.

The most appropriate activity to recommend to parents to promote sensorimotor stimulation for a 1 year old would be:

Play with push-pull toys.

A parent sates, "My 7 year odl really wants a dog. His 10 year old brother has allergies to animal dander. I don't know what to do." The nurse could advise this patient:

Poodles do not shed, making this dog a good choice for people with allergies.

Which assessment finding is considered a neurologic soft sign in a 7 year old child?

Poor muscle coordination.

A new mother has decided not to breastfeed her newborn. The nurse planning to teach the mother about formula feeding would include:

Position the bottle so that the nipple is full of formula during the entire feeding.

A nurse is assessing a postpartum client who is exhibiting tearfulness, insomnia, lack of appetite, and a feeling of letdown. Which of the following conditions are associated with these manifestations?

Postpartum blues.

A 5 year old child is brought to the emergency department with copious drooling and a croaking sound on inspiration. Her mother states that the child is very agitated and only wants to sit upright. What should be the nurse's first action in this situation?

Prepare intubation equipment and call the physician.

The nurse administers vitamin K intramuscularly to the newborn based on which of the following rationales?

Promote blood clotting.

A nurse is preparing to administer immunizations to a 4 month old infant. Which of the following actions should the nurse take to provide atraumatic care?

Provide sucrose solution on the pacifier.

A 13 year old female tells the school nurse that she is getting fate, especially in her hips and legs. The understanding by the nurse that would best guide the response is:

Puberty is often preceded by fat deposits in these areas.

The nurse is aware that the 7 month old can signal feeding readiness by:

Pulling spoon toward mouth Manipulating finger foods

The pediatric nurse assesses the child who has been diagnosed with diabetes to ensure that he does not come to believe that his disease is a form of ___________.

Punishment.

While instructing a new mother on formula preparation, the nurse will include information about formula choices, such as:

Ready-to-feed formula Concentrated liquid formula Powdered formula

A nurse at a local community clinic is developing a program to address STI prevention. Which of the following would the nurse least likely include in the program?

Recommending screening for symptomatic individuals.

Which instructions would the nurse include when teaching a woman with pediculosis pubis?

Remove the nits with a fine-toothed comb.

The nurse assessing vital signs on a 2 year old wold be concerned about the finding of:

Respirations 36 breaths/min.

Prior to discharging a 24-hour-old newborn, the nurse assesses her respiratory status. Which of the following would the nurse expect to assess?

Respiratory rate 45, irregular

Just after delivery, a newborn's axillary temperature is 94° C. What action would be most appropriate?

Rewarm the newborn gradually.

The priority nursing diagnosis for a hospitalized infant who is HIV-positive would be:

Risk for infection.

A mother calls the pediatricians office because her infant is colicky. The helpful measure the nurse would suggest to the parent is:

Rock the fussy infant slowly and gently.

A nurse is assessing an infant. Which of the following findings are clinical manifestations of acute otitis media?

Rolling head side to side Loss of appetite Crying

When assessing a newborn's reflexes, the nurse strokes the newborn's cheek and the newborn turns toward the side that was stroked and begins sucking. The nurse documents which reflex as being positive?

Rooting reflex.

A nurse is planning to administer recommended immunizations to a 2 month old infant. Which of the following vaccines should the nurse plan to give?

Rotavirus (RV) DTaP Hib PCV13 IPV

The nurse assesses the initial lochia post-delivery, which is:

Rubra.

After teaching a class on sexually transmitted infections, the instructor determines that the teaching was successful when the class identifies which statement as true?

STIs can affect anyone if exposed to the infectious organism.

When the fifth-grade class collected geckos in a special aquarium in the classroom, the school nurse cautioned the teacher to be alert for symptoms of ____________________ that can be carried by the reptiles.

Salmonella.

The nurse explains that the preferred social interactions for the school-age child is based on relationships that are:

Same-sex peer groups.

The tasks that would be appropriate to expect of a 5 year old would be:

Setting the table with paper plates.

After teaching a group of adolescents about HIV, the nurse asks them to identify the major means by which adolescents are exposed to the virus. The nurse determines that the teaching was successful when the group identifies which of the following?

Sexual intercourse.

Which classification of drugs is used to relieve an acute asthma episode?

Short-acting beta2-adrenergic agonist.

Assessment of a newborn reveals transient tachypnea. The nurse reviews the newborns medical record. Which of the following would the nurse be least likely to identify as a risk factor for this condition?

Shortened labor.

A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion, with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse recognizes that these symptoms are characteristic of which respiratory condition?

Sinusitis.

A 9 year old boy is often cranky and irritable and his school performance has declined. All the options are true about the child. The possible factor causing this behavior is that he:

Sleeps only 6 to 7 hours a night.

Which choice includes the components of a complete pediatric history?

Statistical information, client profile, health history, family, history, review of systems, lifestyle and life patterns.

The father of an infant calls the nurse to his son's room because he is making a strange noise. A diagnosis of laryngomalacia is made. What does the nurse expect to find on assessment?

Stridor.

When making a home visit, the nurse observes a newborn sleeping on his back in a bassinet. In one corner of the bassinet is a soft stuffed animal and at the other end is a bulb syringe. The nurse determines that the mother needs additional teaching because of which of the following?

Stuffed animals should not be in areas where infants sleep.

The nurse advises the parents of a 10 year old boy that, according to Erikson's theory, the most developmentally supportive experience for him would be:

Successful performance in Little League.

The nurse caring for a 5 month old with viral influenza suspects the development of Reyes sundrome when the child:

Suddenly vomits.

The nurse expects the initial plan of care for a 9-month-old child with an acute otitis media infection to include:

Symptomatic treatment and observation for 48 to 72 hours after diagnosis.

Which intervention for treating croup at home should be taught to parents?

Take the child outside.

On the second postpartum day, a mother bathed her newborn for the first time. She tells the nurse, "I don't think I did it right." Based on the mother's comment, she is most likely in the postpartum psychological stage of:

Taking hold.

The nurse assessing growth and development of a 2 year old child would expect to find:

That the child jumps with both feet.

The parent of a 3 year old child tells the nurse, "My daughter points whenever she wants me to get something for her but she understands me when I ask her to do something." Based on the parent's comment, the nurse recognizes that:

The child may have expressive language delay.

Which of these behaviors reported by a parent of an 18 month old toddler would the nurse report to the pediatrician as a cause for concern?

The child walks by holding onto furniture.

Which child requires a Mantoux test?

The child whose baby-sitter has received a tuberculosis diagnosis.

A nurse is teaching postpartum client and her partner about caring for their newborn's umbilical cord site. Which statement by the parents indicates a need for additional teaching?

The cord stump shoudl change from brown to yellow.

On a home visit, the nurse notes each of the following. The observation that requires teaching intervention to protect the 15 month old child who lives there is:

The dining room table has a tablecloth on it.

A parent comments that her infant has had several ear infections in the past few months. The nurse understands that infants are more susceptible to otitis media because:

The eustachian tube is short, straight, and wide.

A 9 year old child hospitalized for neutropenia is placed in protective isolation. What is the most appropriate response for the nurse to make when the child asks, "Why do you have to wear a gown and mask when you are in my room?"

The gown and mask are to protect you because you could get an infection very easily.

The nurse encourages the mother of a toddler with acute LTB to stay at the bedside as much as possible. The nurses rationale for this action is primarily that:

The mother's presence will reduce anxiety and ease child's respiratory efforts.

After teaching a group of students about the concept of maternal mortality, the instructor determines that additional teaching is needed when the students state which of the following?

The rate includes accidental causes for deaths.

A nursing instructor is describing the advantages and disadvantages associated with the newborn circumcision to a group of nursing students. Which statement by the students indicates effective teaching?

The rate of penile cancer is less for circumcised males.

The nurse can expect which of the following interventions to be ordered if the postpartum woman is not immune to rubella?

The rubella virus vaccine should be administered before discharge.

A woman who is HIV-positive is receiving HAART and is having difficulty with compliance. To promote adherence, which of the following areas would be most important to assess initially?

The woman's beliefs and education.

A client with genital herpes simplex infection asks the nurse, "Will I ever be cured of this infection?" Which response by the nurse would be most appropriate?

There is no cure, but drug therapy helps to reduce symptoms and recurrences.

The nurse is assessing a newborn of a woman who is suspected of abusing alcohol. Which newborn finding would provide additional evidence to support this suspicion?

Thin upper lip.

The nurse, planning to teach a class on nutrition to fourth-grade students, would keep in mind that school-age children:

Think logically and concretely.

The parents of a 4 year old boy are concerned because they have noticed him frequently touching his penis. The nurse would base a response on the knowledge that:

This behavior indicates a normal curiosity about sexuality.

A mother is concerned because her 9 year old has developed the habit of twitching his eyes and flipping his hair while communicating with anyone. The best nursing response to this parents is:

Tics appear when a child is under stress.

The nurse encourages the mother of a healthy newborn to put the newborn to the breast immediately after birth for which reason?

To facilitate maternal/infant bonding.

A preschool age child is asked, "Why do trees have leaves?" Which of the following responses would be an example of animism?

To hide behind when they are scared.

The nurse is assessing a newborn and suspects that the newborn was exposed to drugs in utero because the newborn is exhibiting signs of neonatal abstinence syndrome. Which of the following would the nurse expect to assess?

Tremors Regurgitation Shrill, high-pitched cry Frequent sneezing

An adolescent has just had a generalized seizure lasting 1 minute. Following the seizure, the nurse should:

Turn on the side.

The nurse percussing over an empty stomach expects to hear which sound?

Tympany.

The nurse explains that the physician will order RhoGAM in the event that an:

Unsensitized Rh-negative mother has an Rh-positive pregnancy.

A woman comes to the clinic complaining of vaginal discharge. The nurse suspects trichomoniasis based on which of the following?

Urinary frequency Yellow/green discharge

How would the nurse advise a parent who states, "I never know how much food to feed my child?"

Use 1 tablespoon of each food for each year of age as a guideline.

When assessing language development in a 2 year old, an expected finding would be:

Use of two word sentences.

What should the nurse teach a child about using an albuterol metered-dose inhaler for exercise-induced asthma?

Use the inhaler 30 minutes before exercise.

Which vitamin supplements are necessary for children with cystic fibrosis?

Vitamins A, D, E, and K.

Which assessment finding after tonsillectomy should be reported to the physician?

Vomiting bright red blood.

When planning the care of a newborn addicted to cocaine who is experiencing withdrawal, which of the following would be least appropriate to include?

Waking the newborn every hour.

A nurse is teaching new parents about bathing their newborn. The nurse determines that the teaching was successful when the parents state which of the following?

We should avoid using any kind of baby powder.

The nurse determined the parent understood the information when he stated:

We will wear long pants and long-sleeved shirts in the woods.

The nurse discusses preparation for school with the parents of a 6 year old girl who will soon be starting first grade. The nurse determines that the parents understood the information when the girls father states:

We'll have her meet some children in her class.

A new mother states her preference to formula feed her newborn. The nurse planning discharge instructions would tell her about a measure to help suppress lactation and promote comfort, which is:

Wear a well-fitting bra continuously for several days.

The nurse assessing the fundus of the uterus immediately after delivery would expect to find the uterus:

Well-contracted with its upper border at or just below the umbilicus.

A nurse is working to develop a health education program for a local community to address breast cancer awareness. Which of the following would the nurse expect to include when describing this problem to the group?

White women have higher rates of breast cancer than African American women. African American women are more likely to die from breast cancer at any age.

A nurse is preparing a presentation for a local women's group about heart disease and women. Which of the following would the nurse expect to address when discussing measures to promote health.

Women experiencing a heart attack are at greater risk for dying.

A parent is concerned about her children's reaction should their grandmother die. In planning a response, the nurse is guided by the understanding that:

Young children often understand that people die, but do not equate it with themselves.

A nurse is caring for a toddler who has had rhinitis, cough, and diarrhea for 2 days. Upon assessment, it is noted that the tympanic membrane has an orange discoloration and decreased movement. Which of the following statement should the nurse make?

Your child could experience transient hearing loss.

The nurse is assessing a 4 year old child's visual acuity. He is planning to attend preschool next week. The results indicate a visual acuity of 20/40 in both eyes. The child's father asks the nurse about his son's results. Which response, if made by the nurse, is correct?

Your child's visual acuity is normal for his age.