PEDIATRIC EXAM 1

Statistically how many children in the U.S serious emotional problems that affects their daily functioning?

1 out of 10 children

Statistically how many children in the U.S experience mental health problems that affects their daily functioning?

1 out of 5 children

Identify the age group of children per Erickson in the developmental stage of Autonomy vs. Shame & Doubt.

1-3

At what age should the nurse expect most infants to be saying Mama or Dada?

10 months

When assessing a family, the nurse determines that the parents expect rules to be followed rigidly and unquestioningly. This style of parenting is called?

Authoritarian

An adolescent patient wants to make a decision about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions?

Autonomy

Which of the following is true regarding deaths caused by unintentional injuries in childhood? The pattern of deaths does not vary widely among different ethnic groups The pattern of deaths does not vary according to age and sex

More deaths occur in males

What developmental achievements are demonstrated by a 4 y.o child? (Select all)

Commonly has an imaginary playmate Tends to be selfish and impatient Fears are common

What is the leading cause of death in children older than 1 year in the U.S.?

Complications from childhood unintentional injuries

Which is the leading cause of death in infants younger than 1 in the U.S?

Congenital anomalies

Select the heart sound produced by vibrations within the heart chambers or in the major arteries from the back and forth flow of blood.

Murmur

The most important criterion on which to base the decision to report suspected child abuse is which of the following?

Incompatibility between the history and injury observed

The nurse is conducting a teaching session for parents on nutrition. Which characteristics of families should the nurse consider that can cause families to struggle in providing adequate nutrition? (Select all)

Lower income migrant status Homelessness

Which of the following characteristics describes the child at high risk for childhood injuries?

Male with a high activity level and a stressful home life

A child has been diagnosed with giardiasis. Which prescribed medication should the nurse expect to administer?

Metronidazole (Flagyl) Tinidazole (Tindamax)

Which term describes irregular areas of deep blue pigmentation seen predominantly in infants of African, Asian, Native American, and Hispanic descent?

Mongolian spots

During a well-baby visit a parent asks the nurse when she should start giving solid foods. The nurse should instruct her to introduce which solid food first?

Rice cereal

Exposure to which of the following communicable diseases pose a serious threat to fetuses during the first trimester of pregnancy?

Rubella

Select the viral communicable disease from the following list, which has the classic symptoms of photophobia, kolpik, spots on the buccal mucosa, and a rash that begins on the face:

Rubeola

After the family, which has the greatest influence on providing continuity b/w generations?

School

A child begins to blame his father for his parent's divorce and has displayed intense anger towards his father. In which age group of children is this most likely to occur?

School age

A 17 month old child should be expected to be in which stage according to Piaget?

Sensorimotor

A 3 month old dies shortly after arrival at the emergency department. The infant has subdural and retinal hemorrhages but no external sign of trauma. The nurse should suspect:

Shaken baby syndrome -

What identified characteristics occur more frequently in parents who abuse their children? SATA

Socially isolated Few supportive relationships Single parent families

A Pediatric Nurse Practitioner (PNP) in the peds clinic is assessing the reflexes of a 6 month old infant. Which of the following reflexes should usually not be seen at this age?

Startle

Parents ask the nurse if there was something that should have been done during the pregnancy to prevent the child's cleft lip. Which statement should the nurse give as a response?

The malformation occurs at approximately 6 weeks of gestation, there is no known way to prevent This

By which age should the nurse expect that an infant will be able to pull to a standing position?

11 to 12 months

Identify the age group of children per Erickson in the developmental stage of Identity vs. Role Confusion.

13-21

Children do not like the discomfort associated with venous, arterial, and capillary punctures. Which of the following is the most appropriate pain reduction technique to use with most children before these painful procedures?

Apply EMLA cream topically over the site if time permits

At which age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?

2 months

Pertussis vaccination should begin at which of the following ages?

2 months

Identify the age group of children per Erickson in the developmental stage of Initiative vs Guilt.

3-6

Children may believe that they are responsible for their parent's divorce and interpret the separation as punishment. At which age is this most likely to occur?

4 years

Identify the age group of children per Erickson in the development stage of industry vs inferiority:

6-12

At what age can most infants sit steadily unsupported?

8 months

Which statement best describes the use of the word 'family'?

A group that is what an individual considers it to be

An 8 month old infant is sitting contentedly on the mother's lap. The nurse is preparing to perform a well baby checkup. Which of the following steps should the nurse do first?

Auscultate heart and lung sounds

Which of the following statements is true of X linked recessive inheritance?

Affected males have symptoms of the disorder

The nurse is administering the first hepatitis A vaccine to an 18 month old child. When should the child returns to the clinic for the second dose of hepatitis A vaccination?

After 6 months

A Pediatric nursing student, while assisting in teaching nutrition to new parents, informs them that eating preferences are influenced primarily by the family. At what age is lifelong eating habits usually established?

Age 3

A parent reports to the nurse that her child has inflamed conjunctivae of both eyes with itching and watery to thick stringy discharge. These manifestations suggest?

Allergic conjunctivitis

A pregnant teen agrees to chromosome analysis testing of her fetus. This is usually accomplished through testing of which of the following?

Amniotic fluid

The pediatric nurse is planning to educate and empower a family to use the information provided to build their competence. This preventative measure is referred to as?

Anticipatory guidance

Which of the following is the most consistent and commonly used data for assessment of pain in infants?

Behavioral

Choose the prevention strategies that have significantly decreased fatalities for children. (SATA)

Bicycle helmets Car restraints Smoke detectors

A parent brings a toddler, age 19 months, to the clinic for a regular check-up. What should the nurse expect to find when palpating the toddler's fontanels?

Closed posterior and anterior fontanels

Evidence based practice in clinical management is grounded in which of the following?

Cohort studies

Which statement below best describes family systems theory?

Change in one family member creates a change in other members

What is the single most important factor to consider when communicating with children?

Child's developmental level

The nurse is talking to a group of parents of school-age children at an after-school program about childhood health programs. Which of the following statements should the nurse include in the teaching?

Childhood Obesity can be prevented by lifestyle changes

Which of the following is an important consideration when using the APPT pain rating scale with children?

Children color the area with the color they choose to best describe their pain

Select the vaccines usually given to the children at 12 months of age according to the immunization schedule:

DTaP, HEP A, MMR

Select the vaccines usually given to children at 2 months of age according to the immunization schedule.

DTaP, IPV, PCV, HIB, RV

Select the vaccines usually given to children at 6 months of age according to the immunization schedule.

DTaP, RV, HIB, PCV

The nurse is finishing her shift on the pediatric unit. Because her shift is ending, which intervention takes top priority?

Documenting the care provided during her shift

The nurse is reviewing the Healthy People 202 leading health indicators for a child health promotion program, Which are included in the leading health indicators?(Select all)

Improve immunization rates Increase access to healthcare Decrease tobacco use

What childhood vaccine provides some protection against bacterial meningitis, epiglottitis, and bacterial pneumonia?

Hib vaccine

The components of the FLACC scale include:

Cry, leg movement, facial expression, activity and consolability

The parents of a child diagnosed with an autosomal recessive condition consult the nurse stating they want to have more children but are worried about subsequent children also inheriting the disease. What information should the nurse provide to the parents?

Each child has a 1 in 4 risk of inheriting the disease

Parents ask the nurse about the characteristics of autosomal dominant inheritance. Which statement is characteristic of autosomal dominant inheritance?

Each child of a heterozygous affected parent has a 50% chance of being affected .

Which of the following chromosomal disorders seen in affected newborns causes significantly shortened life span?

Edwards Syndrome

Select from the following list the two basic concepts used by Pediatric Nurses to foster family centered care with children and their families:

Enabling and Empowerment

Which of the following concepts provides a rational approach to decision making that facilitates best practice in nursing care?

Evidence Based Practice

A nurse is providing anticipatory guidance to the parents of a toddler. Which of the following should the nurse include in the teaching?

Expect negative behaviors associated with negativism and ritualism Develop food habits that will prevent dental caries Expression of bedtime fears is common

A blood pressure cuff size that is too small for a child will give which of the following readings?

False high reading

Infant mortality is defined as death in which of the following parameters?

First year of life

According to Piaget, adolescents tend to be in what stage of cognitive development?

Formal operational thought

Which of the following is the best method for performing a physical examination on a toddler?

From least to most intrusive

One of the most common intestinal parasitic pathogens in the United States acquired from a contaminated water source such as a lake or swimming pool is?

Giardia intestinalis

A nurse is assessing a 2 ½ y.o toddler at a well child visit. Which clinical finding should be reported to the healthcare provider?

Head circumference exceeds chest circumference (hydrocephalus)

The nurse is ready to perform a physical exam on a 9 month old infant. Where should the nurse place the infant?

On the parent's lap

A parent brings a toddler, age 9 months, to the clinic for a regular check-up. What should the nurse expect to find when palpating the toddler's fontanels?

Open anterior fontanels and closed posterior fontanels

Which of the following nonpharmacologic interventions appears to be effective in decreasing neonatal procedural pain?

Oral sucrose and nonnutritive sucking

When discussing discipline with the mother of a 4 y.o child, the nurse should include which of the following true statements?

Parental control should be consistent

Which of the following chromosomal disorders seen in affected newborn causes significantly shortened life span?

Patau Syndrome

When assessing a family, the nurse determines that the parents exert little or no control over their children. This style of parenting is called?

Permissive

A 7 month old patient with up-to-date immunization has a runny nose, low-grade fever, and a paroxysmal cough that has worsened over the past few days. The patient had coughed so hard that scleral hemorrhages are present. The most likely diagnosis is?

Pertussis

Phenylketonuria is a genetic disease that results in the body's inability to correctly

Phenylalanine

Select the disorders from the list classified as inborn error of metabolism diseases.(SATA)

Phenylketonuria Galactosemia

A child is admitted to the hospital with an undiagnosed rash. The best initial nursing action of the pediatric nurse should be?

Place child in contact precaution isolation

The nurse is having difficulty communicating with a hospitalized 6 yr old. Which technique should be most helpful?

Provide supplies for the child to draw a picture

Which of the following symptoms are usually seen in a child with Rubeola (Measles)?

Rash appearing on the 3rd day, Kolpik spots Conjunctivitis

Which of the following symptoms are usually seen in a child with chickenpox? (Select all)

Rash in 3 stages Vesicles that break easily Slight fever

The parent of an 8.2 kg 9 month old infant is borrowing a federally approved car seat from the clinic. The nurse should explain that the safest way to put in the car seat is what?

Rear facing in back seat

The Phenylketonuria blood screen test will be most reliable on a newborn if which of the following occurs initially?

Received breast milk or formula at least 24 hours before the test

The nurse is teaching student nurses about newborn screening. Which statement made by the student indicates understanding of the teaching?

The newborn screening is now mandatory in all 50 states

What do mortality statistics describe?

The number of individuals who have died over a specific period

What do morbidity statistics describe?

The prevalence of specific illness in the population at a particular time

A couple has given birth to their first child with a recessive disorder. The genetic counselor tells them that the risk of recurrence is one in four. Which statement is a correct interpretation of this information?

The risk factor remains the same for each pregnancy

Which concept reinforces the development of a sense of trust for an infant?

They can predict what is coming and their needs are consistently met

In terms of gross motor development, what should the nurse expect an infant aged 5 months to do?

Turn from the abdomen to the back

You are observing a 5 month old for developmental skills. Which of the following skills would concern you if the infant was not demonstrating?

Turn head to locate sound

Which is a sex chromosome abnormality that is caused by the absence of an X chromosomes in a female? (Question 1)

Turner

Select the developmental milestones usually seen in children during the toddler stage (1-3 years). SATA

Two to three word sentences Appears to be bowlegged and potbellied

Which condition/behavior manifested by an 11-month-old infant warrants further evaluation?

Unable to pull to a standing position

A 2 y.o is scheduled to have a tonsillectomy. How would you educate the patient?

Use picture books and puppets and repeat explanations

A 6 y.o male is diagnosed with a heart murmur that can be heard without the stethoscope. The nursing student is aware that this occurs at which of the following grades?

VI

The nurse is assessing breath sounds on a child. Which is a physiologically expected auscultated breath sound?

Vesicular

A child is in the intensive care unit after a motor vehicle collision. The child has numerous fractures and is in pain that is rated 9 or 10 on a 10-point scale. In planning care, the nurse recognizes that the indicated action is which?

c. Plan a preventive schedule of pain medication around the clock.

Parents of a preschool child ask the nurse, Should we set rules for our child as part of a discipline plan? Which is an accurate response by the nurse?

d. Set clear and reasonable rules and expect the same behavior regardless of the circumstances.