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10. Parents are asking the clinic nurse about an appropriate toy for their toddler. Which response by the nurse is appropriate? "A 25-piece puzzle would help your child develop recognition of shapes." "Your child would enjoy playing a board game." "An action figure toy would be a good choice." "A toy your child can push or pull would help develop muscles."

"A toy your child can push or pull would help develop muscles." Toys should be appropriate for the child's age. A toddler would benefit from a toy he or she could push or pull. The child is too young for a board game, action figure, or 25-piece puzzle.

In terms of language and cognitive development, a 4-year-old child would be expected to have which traits? (Select all that apply.) Tell exaggerated stories. Think in abstract terms. Follow simple directional commands. Understand conservation of matter.

- Tell exaggerated stories. - Follow simple directional commands.

42. In order to prevent separation anxiety in a hospitalized toddler, which of the following should the nurse do? - have the parents to remain at the bedside always - establish a routine that is similar to that of the child's home - assume the parental role when parents are not able to be at the bedside - rotate nursing staff so the child becomes comfortable with all the nurses

- establish a routine that is similar to that of the child's home Same routine similar to home decreases anxiety and provides security.

What gauge and needle size would a nurse select when giving an IM injection to a 6-month old infant? 18 gauge and 5/8 inch needle 23 gauge and 2 inch needle 23 gauge and 1 inch needle 18 gauge and 1 inch needle

23 gauge and 1 inch needle (thin) IM for a 6-month old, use 23 gauge and 1 inch needle, others are too big in gauge and length.

Which toys should a nurse provide to promote imaginative play for a 3-year-old hospitalized child? (Select all that apply.) Farm animals and equipment Plastic telephone Hand puppets Board game

Farm animals and equipment Plastic telephone Hand puppets

Which is a useful skill that the nurse should expect a 5-year-old child to be able to master? Tie shoelaces. Replace a light bulb Make change out of a quarter. Hammer a nail

Tie shoelaces.

A critically ill child has hyperthermia. The parents ask the nurse to give an antipyretic such as acetaminophen (Tylenol). The nurse should explain that antipyretics: are of no value in treating hyperthermia may cause malignant hyperthermia may cause febrile seizures are of limited value in treating hyperthermia

are of no value in treating hyperthermia Unlike with fever, antipyretics are of no value in hyperthermia because the set point is already normal. Cooling measures are used instead.

33. Which dietary recommendations should a nurse make to an adolescent patient to manage constipation related to opioid analgesic administration? (Select all that apply) seeds and nuts bran cereal vegetables decrease fluid intake

seeds and nuts bran cereal vegetables foods that help with constipation: whole grains, such as whole wheat bread and pasta, oatmeal, and bran flake cereals. legumes, such as lentils, black beans, kidney beans, soybeans, and chickpeas. fruits, such as berries, apples with the skin on, oranges, and pears. seeds and nuts.

22. The nurse caring for a 9-month-old is using the FLACC scale to rate her pain level. The child's parents ask the nurse what the FLACC scale is. Which is the nurse's best statement? " it estimates the child's level of pain utilizing behavioral and physical responses." " It estimates the child's level of pain based on parent's perception." " It estimates the child's level of pain utilizing vital sign information." " it estimates the child's level of pain utilizing a numeric scale from 0 to 5."

" it estimates the child's level of pain utilizing behavioral and physical responses." The FLACC scale or Face, Legs, Activity, Cry, Consolability scale is a measurement used to assess pain for children between the ages of 2 months and 7 years or individuals that are unable to communicate their pain based on behavioral and physical responses.

The parent of 16-month-old Chris asks, "What is the best way to keep Chris from getting into our medicines at home?" The nurse should advise which of the following? "Medicines should not be kept in the homes of small children." "All medicines should be locked securely away." "Chris just needs to be taught not to touch medicines." "The medicines should be placed in high cabinets."

"All medicines should be locked securely away."

46. The nurse is caring for an adolescent who had an external fixator placed after suffering a fracture of the wrist during a bicycle accident. Which statement by the adolescent should be expected about separation anxiety? "I hope my friends don't forget about visiting me." "I think I would like for my siblings to visit me but not my friends." "I will be embarrassed if my friends come to the hospital to visit." "I wish my parents could spend the night with me while I am in the hospital."

"I hope my friends don't forget about visiting me." Loss of peer-group contact may pose a severe emotional threat to an adolescent because of loss of group status, so friends visiting are an important aspect of hospitalization for an adolescent. Most adolescents do not need a parent to spend the night during hospitalization and sometimes view the hospitalization as a welcome event. Adolescents would be more concerned about friends visiting than siblings. Adolescents want visitors to keep control and maintain social status among their group of peers.

Steven, 16 months old, falls down a few stairs. He gets up and "scolds" the stairs as if they caused him to fall. This is an example of which of the following? Animism Ritualism Irreversibility Delayed cognitive development

Animism

In terms of fine motor development, which should the 3-year-old child be expected to do? Lace shoes and tie shoelaces with a bow. Draw a person with seven parts and correctly identify the parts. Use scissors to cut pictures, and print a few numbers. Draw a circle and name what has been drawn.

Draw a circle and name what has been drawn.

In preparing to give "enemas until clear" to a young child, the nurse should select which solution? Fleet solution Tap water Isotonic solutions Oil retention

Isotonic solutions Isotonic solutions are recommended for children.

Which one of the following techniques is best for dealing with the negativism of the toddler? Provide few or no choices for child. Quietly and calmly ask the child to comply. Remain serious and intent. Offer the child choices.

Offer the child choices.

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

Ritualism, common at this age

The nurse must do a heel stick on an ill neonate to obtain a blood sample. Which of the following is recommended to facilitate this? Wrap foot in a warm compress. Apply cool, moist compresses. Elevate foot for 5 minutes. Apply a tourniquet to ankle.

Wrap foot in a warm compress. Before the blood sample is taken, the heel is heated with warm moist compresses for 5 to 10 minutes to dilate the blood vessels in the area.

41. A nurse is caring for a child who is near death. Which physical signs indicate the child is approaching death? (Select all that apply.) speech becomes rapid decreasing tactile sensation body feels warm difficulty swallowing

decreasing tactile sensation difficulty swallowing Physical Signs that Death is Nearing: Loss of Appetite. decreased energy, Increased Physical Weakness. Labored Breathing. Changes in Urination. decreased sensation difficulty swallowing

48. A 2-year-old was admitted to the pediatric unit for respiratory distress. The nurse knows that the most definitive measurement for temperature is obtained by using which route? axillary oral rectal tympanic

rectal Most definitive route for temperature of a toddler in a pediatric unit is rectal.

An 8-month-old infant is restrained to prevent interference with the IV infusion. The nurse's action is to: remove the restraints once a day to allow movement. keep the restraints on constantly. keep the restraints secure so infant remains supine. remove restraints whenever possible.

remove restraints whenever possible. The nurse should remove the restraints whenever possible. When parents or staff are present, the restraints can be removed and the IV site protected. Restraints must be checked and documented every 1 to 2 hours. They should be removed for range of motion on a periodic basis. The child should not be securely restrained in the supine position because of risks of aspiration.

20. The nurse is using calipers to measure skin-fold thickness over the triceps muscle in a school-age child. What is the purpose of doing this? to determine accuracy of weight measurement to determine arm circumference to measure muscle mass to measure body fat

to measure body fat Measurement of skin-fold thickness is an indicator of body fat. Arm circumference is an indirect measure of muscle mass. The accuracy of weight measurement should be verified with a properly balanced scale. Body fat is just one indicator of weight.

49. A mother asks the nurse how to handle her 4-year-old child, who recently started wetting the pants after being completely toilet-trained. The child just started attending nursery school 2 days per week. Which statement by the mother indicates understanding of the situation? "My child is punishing me for sending him away for a few hours." "He must have inherited this from my husband. My husband did the same thing when he started nursery ." "My child hates school." "My child is most likely regressing back to a behavior that increases his sense of security."

"My child is most likely regressing back to a behavior that increases his sense of security." The statement about regression indicates understanding because the stress of starting nursery school may trigger a return to a level of successful behavior from earlier stages of development. A child's skills remain intact, although increased stress may prevent the child from using these skills. The child's behavior isn't an indication that he hates school or wants to punish the mother. Regression isn't a trait that can be inherited.

Informed consent is given by the child's parent or guardian allowing an invasive procedure to be performed to a minor. The parents ask the nurse to explain the contents in the informed consent. Which is the nurse's best response? Informed consent is obtained by the nurse and explains the condition and treatment" "Informed consent is not necessary if the child is given assent" "Informed consent is not a legal document" "Possible benefits and significant risks associated with the proposed treatment must be included in the informed consent"

"Possible benefits and significant risks associated with the proposed treatment must be included in the informed consent"

6. A bulging anterior fontanel noted on physical examination is associated with which of the following conditions. increased intracranial pressure dehydration brain tumor macrocephaly

increased intracranial pressure Bulging anterior fontanel signifies an increased intracranial pressure. Sunken fontanel will be due to dehydration.

A visitor arrives at a daycare center during lunch time. The preschool children think that every time they have lunch a visitor will arrive. Which preoperational characteristic is being displayed? intuitive reasoning egocentrism transductive reasoning conservation reasoning

transductive reasoning Transductive reasoning is when two events occur together, they cause each other. The expectation that every time lunch is served a visitor will arrive is descriptive of transductive reasoning. Egocentrism is the inability to see things from any perspective than their own. Intuitive reasoning (e.g., the stars have to go to bed just as they do) is predominantly egocentric thought. Conservation (able to realize that physical factors such as volume, weight, and number remain the same even though outward appearances are changed) does not occur until school age.

The nurse is caring for a hospitalized 4-year-old boy. His parents tell the nurse that they will be back to visit at 6 PM. When the child asks the nurse when his parents are coming, the nurse's best response is? "I will tell you every time I see you how much longer it will be." "They will come after dinner." "Let me show you on the clock when 6 PM is." "They will be here soon." Time associated to events for a preschooler.

"They will come after dinner." A 4-year-old child understands time in relation to events such as meals. Children perceive soon as a very short time. The nurse may lose the childs trust if his parents do not return in the time he perceives as soon. Children cannot read or use a clock for practical purposes until age 7 years. I will tell you every time I see you how much longer it will be assumes the child understands the concepts of hours and minutes, which does not occur until age 5 or 6 yr

A parent of a 17-month old toddler is frustrated with the toddler's behaviors. The parent tells the nurse that the child is "bad" but doesn't know how to make the toddler behave better. Which of the following are appropriate responses made by the nurse that she understands toddler's growth and development? (Select all that apply) "Toddlers need developmentally appropriate expectations and rewards" "Consistently enforce well-defined limits, such as no climbing on the counters" "Allow your child to learn by trial and error" "Punish and spank your child when he behaves badly"

"Toddlers need developmentally appropriate expectations and rewards" "Consistently enforce well-defined limits, such as no climbing on the counters"

Which of the following statements best describes the infant's physical development? Maternal iron stores persist during the first 12 months of life. Anterior fontanel closes by age 6 to 10 months. Binocularity is well established by age 8 months. Birth weight doubles by age 5 to 6 months and triples by age 1 year.

Birth weight doubles by age 5 to 6 months and triples by age 1 year.

36. A 3-year-old girl is attending her grandfather's funeral. Her parents have told her that her grandfather is in heaven with God. The child is taken up to the open casket with her parents. Which statement by the child describes a 3-year-old child's understanding of spirituality and developmental level? Grandpa's is in heaven. Is this heaven? Grandpa's spirit is no longer in his body Grandpa's body is here with us on Earth, and his spirit is in heaven Grandpa's won't need his body in heaven 3-year olds are literal thinkers and has intuitive reasoning

Grandpa's is in heaven. Is this heaven? 3-year olds are literal thinkers and has intuitive reasoning. Grandpa is in heaven, so they must be in heaven.

50. A preschool-age child scheduled for surgery in the morning is admitted to the facility for the first time. Which nursing action would ease the child's anxiety? Having the child act out the surgical experience using dolls and medical equipment Beginning preoperative teaching as soon as possible Explaining that the child will be "put to sleep" during the operation and will feel nothing Explaining preoperative and postoperative procedures step by step

Having the child act out the surgical experience using dolls and medical equipment Having the child act out the surgical experience using dolls and medical equipment would ease anxiety and give the nurse an opportunity to clarify the child's misconceptions. Preschoolers have a limited concept of time, so the nurse should provide preoperative teaching just before surgery rather than starting it as soon as possible; also, a delay between teaching and surgery may heighten anxiety by giving the child a chance to worry or fantasize. The nurse should avoid using such phrases as "put to sleep" because these may have a dual or negative meaning to a young child. Long explanations are inappropriate for the preschooler's developmental level and may increase anxiety.

26. Which of the following are factors that can have a direct impact on a child's growth and development? (Select all that apply) Heredity gender environment socioeconomic status

Heredity gender environment socioeconomic status All of the above will have an impact on growth and development as well as diseases, neuroendocrine factors and nutrition which is the most important.

Management for a child with attention deficit hyperactivity disorder (ADHD) should include all of the following except: Instruct parents that medications taken for ADHD will benefit all children Encourage expression of concerns and fears from family members Provide consistency and positive reinforcements Use organizational charts and list all the activities

Instruct parents that medications taken for ADHD will benefit all children

An appropriate method for administering oral medications that are bitter to a 7-month- infant or small child would be to mix them with: a small amount (1 teaspoon) of a sweet-tasting substance such as jam. a bottle of formula or milk. food that the child will have for lunch. large amounts of water to dilute medication sufficiently.

a small amount (1 teaspoon) of a sweet-tasting substance such as jam. Never mix medication with large amount of food or fluid, child may not finish the food and not take the medication, only use 1 teaspoon if necessary.

37. A preschooler is found digging up a pet bird that was recently buried after it died. The best explanation for this behavior is that: he has a morbid preoccupation with death the loss is not yet resolved, and professional counseling is needed he is looking to see whether a ghost took it away reassurance is needed that the pet has not gone somewhere else

reassurance is needed that the pet has not gone somewhere else The preschooler can recognize that the pet has died but has difficulties with the permanence, sees death as reversible. Digging up the bird gives reassurance that the bird is still present.

24. Determination of length. A 24-month old should be placed in ___ position when measuring length. recumbent prone standing sim's

recumbent Recumbent position is used to determine length for a child under 36 months.

40. Which are appropriate statements the nurse should make to parents after the death of their child? "I know how you feel." "Your child isn't suffering anymore and is at a better place." "You're feeling all the pain of losing a child." "You are still young enough to have another baby."

"You're feeling all the pain of losing a child." Acknowledge Their Pain. Accept Their Grief For What It Is. Let them express their feelings Show Respect Be empathetic Do not make assumptions

47. A 5-year-old is being screened for developmental delays using the Denver Developmental Screening test. The child's mother is explaining to the nurse her understanding of the screening test. Which statements by the mother are correct? (Select all that apply) "it screens my son's intelligence level "it screens my son's gross motor skills" "it screens my son's language development"

"it screens my son's gross motor skills" "it screens my son's language development" "it screens my son's fine motor skills" Denver dev test does not measure intelligence

Which of the following immunizations should be given to a 4-month old infant from the selections below? (Select all that apply) Varicella Diptheria, tetanus toxoids and pertussis Polio Pneumonococcal vaccine

- Diptheria, tetanus toxoids and pertussis - Polio - Pneumonococcal vaccine Varicella is not given until after 12 months.

Pacifiers can be extremely dangerous because of the frequency of use and the intensity of the infant's suck. In teaching the parents about appropriate pacifier selection, select all of the characteristics the pacifier should have. (Select all that apply) Sturdy, flexible material Ribbon or string to secure to clothing One-piece construction Easily grasped handle

- Sturdy, flexible material - One-piece construction - Easily grasped handle

A nurse is performing a Denver Developmental Screening test II on a 4 ½ -year old child. What behaviors should the nurse expect the child to demonstrate? (Select all that apply) The child is able to form simple sentences Skips and hops Draws circles Walks on tiptoe and balances on one foot for a few seconds

- Walks on tiptoe and balances on one foot for a few seconds - Skips and hops - Draws Circles - The child is able to form simple sentences

18. The nurse must assess 10-month-old infant. The infant is sitting on the father's lap and appears to be afraid of the nurse and of what might happen next. Which initial action by the nurse would be most appropriate? - undress the infant while he is still sitting on his father's lap - ask father to place the infant on the examination table - talk softly to the infant while taking him from his father - initiate a game of peek-a-boo

- initiate a game of peek-a-boo Peek-a-boo is an excellent means of initiating communication with infants while maintaining a safe, nonthreatening distance. The child will most likely become upset if separated from his father. As much of the assessment as possible should be done on the father's lap. The nurse should have the father undress the child as needed for the examination.

44. Amy, age 6 years, needs to be hospitalized again because of a chronic illness. The clinic nurse overhears her school-age siblings tell her, "We are sick of Mom always sitting with you in the hospital and playing with you. It isn't fair that you get everything and we have to stay with the neighbors." Which is the nurse's best assessment of this situation? - the siblings need to better understand their sister's illness and needs - the siblings are immature and probably spoiled - jealousy and resentment are common reactions to the illness or hospitalization of a sibling - family has ineffective coping mechanisms to deal with chronic illness

- jealousy and resentment are common reactions to the illness or hospitalization of a sibling Siblings experience loneliness, fear, and worry, as well as anger, resentment, jealousy, and guilt. The siblings experience stress equal to that of the hospitalized child. There is no evidence that the family has maladaptive coping mechanisms.

16. The nurse's approach when introducing hospital equipment to a preschooler should be based on which principle? - one brief explanation will be enough to reduce the child's fear - explaining the equipment will only increase the child's fear - the child may think the equipment is alive - the child is too young to understand what the equipment does Young children attribute human characteristics to inanimate objects. They often fear that the objects may jump, bite, cut, or pinch all by themselves without human direction. Equipment should be kept out of sight until needed. The child should be given simple concrete explanations about what the equipment does and how it will feel to the child. Simple, concrete explanations will help alleviate the child's fear. The preschooler will need repeated explanations as reassurance.

- the child may think the equipment is alive Young children attribute human characteristics to inanimate objects. They often fear that the objects may jump, bite, cut, or pinch all by themselves without human direction. Equipment should be kept out of sight until needed. The child should be given simple concrete explanations about what the equipment does and how it will feel to the child. Simple, concrete explanations will help alleviate the child's fear. The preschooler will need repeated explanations as reassurance.

27. The nurse must check vital signs on a 2-year-old boy who is brought to the clinic for his 24-month checkup. What criteria should the nurse use in determining the appropriate-size blood pressure cuff? (Select all that apply) - the cuff is labeled "toddler." - the cuff bladder width is approximately 40% of the circumference of the upper arm. - the cuff bladder covers 40% to 50% of the length of the upper arm. - the cuff bladder length covers 80% to 100% of the circumference of the upper arm.

- the cuff bladder width is approximately 40% of the circumference of the upper arm. - the cuff bladder length covers 80% to 100% of the circumference of the upper arm. Using a blood pressure cuff that's too large or too small can give you inaccurate blood pressure readings. The inflatable part of the blood pressure cuff should cover about 40% of the distance around (circumference of) your upper arm. The cuff should cover 80% of the area from your elbow to your shoulder, the circumference of the upper arm.

Which of the following patient is the highest priority for receiving the flu vaccine? An 18-year-old who is living in a college dormitory. A 7-year-old who attends public school. A 3-year-old with a history of diarrhea. A healthy 13-month-old who attends day care.

A healthy 13-month-old who attends day care. Immune system still developing; daycare increases risk

Preschoolers' fears can best be dealt with by which of the following interventions? Actively involving them in finding practical methods to deal with the frightening experience Forcing them to confront the frightening object or experience in the presence of their parents Using logical persuasion to explain away their fears and help them recognize how unrealistic the fears are Ridiculing their fears so that they understand that there is no need to be afraid

Actively involving them in finding practical methods to deal with the frightening experience

28. A mother of a 3-year-old tells a clinic nurse that the child is rebelling constantly and having temper tantrums. The nurse most appropriately tells the mother to? Allow the behavior at all times because this is normal at this age period Be consistent and set limits on the child's behavior Punish the child every time the child says "no", to change the behavior Ignore the child when this behavior occurs and walk away

Be consistent and set limits on the child's behavior Be consistent and set limits on child's behavior when child is rebelling. You may give them choices to obtain autonomy.

Imaginary playmates are beneficial to the preschool child because they do which of the following? Take the place of pets and other toys Become friends in times of loneliness Take the place of social interactions Accomplish what the child has already successfully accomplished

Become friends in times of loneliness

The nurse observes that a seriously ill 5-year old child passively accepts all painful procedures. The nurse should recognize that this is most likely an indication that the child is experiencing which of the following? Belief that procedures are an important part of care Sense of chronic sorrow Belief that procedures are a deserved punishment Sense of hopefulness

Belief that procedures are a deserved punishment

8. The nurse observes some children in the playroom. Which play situation exhibits the characteristics of parallel play? Danielle playing with a music box on her mother's lap Kimberly and Amanda sharing clay to each make things Brian playing with his truck next to Kristina playing with her truck Adam playing a board game with Kyle, Steven, and Erich Playing with trucks next to each other but not together is an

Brian playing with his truck next to Kristina playing with her truck Playing with trucks next to each other but not together is an example of parallel play. Both children are engaged in similar activities in proximity to each other; however, they are each engaged in their own play. Sharing clay to make things is characteristic of associative play. Friends playing a board game together is characteristic of cooperative play. A child playing with something by herself on her mother's lap is an example of solitary play.

31. A lumbar puncture is needed on a school-age child. The most appropriate action to provide analgesia during this procedure is to apply _____ before the procedure. - transdermal fentanyl (Duragesic) patch immediately Do not use anything since pre-medication will interact with the procedure EMLA (eutectic mixture of local anesthetics) 1 hour TAC (tetracaine-adrenaline-cocaine) 15 minutes

EMLA (eutectic mixture of local anesthetics) 1 hour EMLA is an effective analgesic agent when applied to the skin 60 minutes before a procedure. It eliminates or reduces the pain from most procedures involving skin puncture. TAC provides skin anesthesia about 15 minutes after application to nonintact skin. The gel can be placed on the wound for suturing. Transdermal fentanyl patches are useful for continuous pain control, not rapid pain control. For maximal effectiveness, EMLA must be applied approximately 60 minutes in advance.

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

Is old enough to understand the word "No." By age 10 months, children are able to associate meaning with words. The child should be old enough to understand the word "No." The 10-month-old is too young to understand the purpose of an electrical outlet. The father is using both verbal and physical cues to teach safety measures and alert the child to dangerous situations. Physical discipline should be avoided.

A young child has just arrived at the emergency department after ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in which of the following ways? Mix with a flavorful beverage and serve in an opaque container with a straw. Serve in a clear plastic cup so the child can see how much has been drunk. Give half of the solution, and then give the other half in 1 hour. Administer through a nasogastric tube because the child will not drink it because of the taste.

Mix with a flavorful beverage and serve in an opaque container with a straw. Although the activated charcoal can be mixed with a flavorful beverage, it will be black and resemble mud. When it is served in an opaque container, the child does not have any preconceived ideas about its being distasteful.

Which one of the following statements best describes fear in the school-age child? Those who have numerous fears need continuous protective behavior by parents to eliminate these fears. They are increasingly fearful for body safety. Most of the new fears that trouble them are related to school. They should be encouraged to hide their fears to prevent ridicule by peers.

Most of the new fears that trouble them are related to school. During the school-age years, children experience a wide variety of fears, but new fears relate predominantly to school and family.

Parents tell the nurse that they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom. Which is the most appropriate recommendation the nurse should make? Neither condone nor condemn the curiosity. Punish children so this behavior stops. Get counseling for this unusual and dangerous behavior. Allow children unrestricted permission to satisfy this curiosity.

Neither condone nor condemn the curiosity.

A 4-year old child is infected with pinworms. The parents ask the nurse how to complete the tape test. Which is the nurse's best response? The tape test is only done once Place the sticky side outside of the tongue blade and firmly press onto the child's perianal area Place the sticky side inside the tongue blade and firmly press onto the child's Complete the test at bedtime

Place the sticky side outside of the tongue blade and firmly press onto the child's perianal area Tape, sticky side out place on tongue blade and firmly pressed onto the child's perianal area. Tape test needs to completed 3 times, before BM, bath, and completed in morning when child awakes. Prevent reinfection by handwashing !!!

A 13-month-old toddler is being discharged from the hospital. Which of the following potential health risks should be addressed with the parents? (Select all that apply) Burns Cholesterol screening Poisoning Falls

Poisoning Burns Falls Poisoning, burns, and falls are all potential risks for this age group because the child is gaining independence and becoming more curious. Elevated cholesterol levels may become an issue during adolescence. Peer pressure usually begins during the school-age years, becoming more of a risk during adolescence.

During a routine health assessment, the nurse notes that the 8-month-old infant has significant head lag. Which of the following is the nurse's most appropriate action? Recheck head control at next visit. Refer child for further evaluation if anterior fontanel is still open. Teach parents appropriate exercises. Refer child for further evaluation.

Refer child for further evaluation. Significant head lag after age 6 months strongly indicates cerebral injury and is referred for further evaluation.

A nurse is conducting an infant nutrition class for parents. Which of the following foods should the nurse tell parents that they may introduce before one year? (Select all that apply) Shrimp and shellfish Rice cereal Pureed fruits Honey

Rice cereal Pureed fruits Pureed fruits and rice cereal are recommended for infants around 6-months of age. Shrimp, shellfish, honey, eggs, and whole milk is recommended after the age of one.

Which of the following is the viral pathogen that frequently causes acute diarrhea in young children? Shigella organisms Giardia organisms Rotavirus Salmonella organisms

Rotavirus Rotavirus is the most frequent viral pathogen that causes diarrhea in young children.

A nurse is providing nutritional teaching to a group of parents whose children attend a local day care. Which of the following is the most effective way to encourage good nutritional habits for preschool children? Allow the child to eat what he or she wants Offer snacks that the child desires such as candy and cookies Make sure that the child eats all the food on the plate Serve adequate amount of nutritious foods on the plate

Serve adequate amount of nutritious foods on the plate

When teaching injury prevention during the school-age years, which of the following should the nurse include? Caution child against engaging in competitive sports. All school-age children may sit in the front seat of the car. Caution child from joining clubs. Teach basic rules of water safety.

Teach basic rules of water safety. Water safety instruction is an important source of injury prevention at this age. The child should be taught to swim, select safe and supervised places to swim, swim with a companion, check for sufficient water depth before diving, and use an approved flotation device.

12. A nurse is observing children at play. Which statement depicts associative play? children playing side by side but are participating in different activities children playing a board game The children at the carnival riding together The child playing alone

The children at the carnival riding together The children at the carnival riding together are demonstrating associative play. They are engaged in similar or identical activities. The child playing alone is demonstrating solitary play. The children playing on the beach depict parallel play. They are playing side by side but are participating in different activities. The children playing a board game are engaging in cooperative play.

A nurse is feeling the apical impulse of a 28-month-old child. Identify the area where the nurse should assess the apical impulse? The heart's apex for a toddler is located at the sixth intercostal space immediately to the left of the midclavicular line The heart's apex for a toddler is located at the fourth intercostal space immediately to the right of the midclavicular line The heart's apex for a toddler is located at the fourth intercostal space immediately to the left of the midclavicular line The heart's apex for a toddler is located at the fifth intercostal space immediately to the left of the midclavicular line

The heart's apex for a toddler is located at the fourth intercostal space immediately to the left of the midclavicular line

An ER nurse is assessing a 12-month-old female. Which statement accurately describes the best method for assessing this child? The nurse should assess the child in a head-to-toe sequence. The nurse should have the child's mom assist in holding her down. The nurse should assess the child while she is in her mother's lap. The nurse should assess the child on the examining table.

The nurse should assess the child while she is in her mother's lap. Infants are most secure when in proximity to the mother. The parent's lap is an excellent place to assess the child. Being held down will cause distress to child.

Which of the following is characteristic of the preoperational stage of cognitive development? Generalizations can be made. Thinking is concrete. Reasoning is inductive. Thinking is abstract.

Thinking is concrete. Preoperational thinking is concrete and tangible. Children in this age group cannot reason beyond the observable, and they lack the ability to make deductions or generalizations. Increasingly logical thought, inductive reasoning, and the ability to make generalizations are characteristic of the concrete operations stage of development, ages 7 to 11 years.

Which one of the following factors is most important in predisposing toddlers to frequent infections? Pulse and respiratory rates are slower than those in infancy. Respirations are abdominal. Defense mechanisms are less efficient than those during infancy. Toddlers have a short, straight internal ear canal and large lymph tissue.

Toddlers have a short, straight internal ear canal and large lymph tissue.

32. The nurse is completing a pain assessment on a 4-year-old child. Which pain scale tool should the nurse use with a child this age? visual analogue scale numeric pain tool word graphic scale Wong Baker Faces pain tool

Wong Baker Faces pain tool The pain scale appropriate for a 4-year-old child is the FACES (Wong-Baker) pain scale. Numeric pain scales can be used on children as young as age 5 as long as they can count and have some concept of numbers and their values in relation to other numbers. Word graphic scales and visual analogue scales are used preferably for school-age children.

The nurse is teaching feeding techniques to new parents. The nurse emphasizes the importance of slowly warming the formula and testing the temperature prior to feeding a 1-month old infant. The parent of a newborn asks,"Will the baby spit out the formula if it is too hot or cold?" Select the nurse's best response: Babies have a tendency to reject cold fluids but not hot fluids Your baby is too young to be physically capable of spitting out fluids and will automatically swallow anything Your baby will most likely spit out the hot formula, but could result in a burn Babies have a tendency to reject hot fluids but not cold fluids

Your baby is too young to be physically capable of spitting out fluids and will automatically swallow anything

38. At what developmental period do children have the most difficulty coping with death, particularly if it is their own? school-age adolescence toddlerhood preschool

adolescence Adolescents, because of their mature understanding of death, remnants of guilt and shame, and issues with deviations from normal, have the most difficulty coping with death.

17. The nurse is having difficulty communicating with a hospitalized 6-year-old child. What technique might be most helpful? suggest that the parent read fairy tales to the child ask the parent if the child is always uncommunicative suggest that the child keep a diary ask the child to draw a picture

ask the child to draw a picture Drawing is one of the most valuable forms of communication. Children's drawings tell a great deal about them because they are projections of the child's inner self. It would be difficult for a 6-year-old child who is most likely learning to read to keep a diary. Parents reading fairy tales to the child is a passive activity involving the parent and child. It would not facilitate communication with the nurse. The child is in a stressful situation and is probably uncomfortable with strangers.

You are assessing the respiratory rate of a 1-year-old child during a physical assessment. How should the respiratory rate (RR) be determined? auscultate the RR for 30 seconds auscultate the RR for 30 seconds and multiply this value by 2 auscultate the RR for 1 full minute auscultate the RR for 15 seconds and multiply this value by 4

auscultate the RR for 1 full minute Infant respiratory rate need to auscultated for 1 full minute since they are diaphragmic breathers.

21. Which method would the nurse use when determining the temperature of a newborn infant under a radiant heater in the nursery? axillary sensor rectal electronic thermometer rectal mercury glass thermometer tympanic membrane sensor

axillary sensor The axillary sensor measures the infrared heat energy radiating from the axilla. It can be used on wet skin, in incubators, or under radiant warmers. Ear thermometry does not show sufficient correlation with established methods of measurement. It should not be used when body temperature must be assessed with precision. Mercury thermometers should never be used. The release of mercury, should the thermometer be broken, can cause harmful vapors. Rectal temperatures should be avoided unless no other suitable way exists for the temperature to be measured.

5. According to Kohlberg, children develop moral reasoning as they mature. Which statement is most characteristic of a preschooler's stage of moral development? obeying the rules of correct behavior is important actions are determined as good or bad in terms of their consequences showing respect for authority is important behavior behavior that pleases others is considered good

behavior that pleases others is considered good Preschoolers are most likely to exhibit characteristics of Kohlberg's preconventional level of moral development. During this stage, they are culturally oriented to labels of good or bad, right or wrong. Children integrate these concepts based on the physical or pleasurable consequences of their actions. Obeying the rules of correct behavior, showing respect for authority, and engaging in behavior that pleases others are characteristics of Kohlberg's conventional level of moral development.

23. While caring for a critically ill child, the nurse observes that respirations are gradually increasing in rate and depth, with periods of apnea. What pattern of respiration will the nurse document? seesaw (paradoxic) respirations tachypnea cheyne-stokes respirations dyspnea

cheyne-stokes respirations Cheyne-Stokes respirations are a pattern of respirations that gradually increase in rate and depth, with periods of apnea. Dyspnea is defined as distress during breathing. Tachypnea is an increased respiratory rate. In seesaw respirations, the chest falls on inspiration and rises on expiration.

29. The nurse is caring for a 6-year-old girl who had surgery 12 hours ago. The child tells the nurse that she does not have pain, but a few minutes later she tells her parents that she does. Which should the nurse consider when interpreting this? children use pain experiences to manipulate their parents truthful reporting of pain should occur by this age children may be experiencing pain even though they deny it to the nurse inconsistency in pain reporting suggests that pain is not present

children may be experiencing pain even though they deny it to the nurse Children may deny pain to the nurse because they fear receiving an injectable analgesic or because they believe they deserve to suffer as a punishment for a misdeed. They may refuse to admit pain to a stranger but readily tell a parent. Truthfully reporting pain and inconsistency in pain reporting suggesting that pain is not present are common fallacies about children and pain. Pain is whatever the experiencing person says it is, whenever the person says it exists. Pain would not be questioned in an adult 12 hours after surgery.

A mother reports that her 6-year-old child is highly active, irritable, and irregular in habits and that the child exhibits periods of crying and often violent tantrums. The nurse should chart this type of temperament as: fast-to warm up slow-to warm up difficult easy

difficult Being highly active, irritable, irregular in habits, and adapting slowly to new routines, people, or situations is a description of difficult children, which compose about 10% of the population. Negative withdrawal responses are typical of this type of child, who requires a more structured environment. Mood expressions are usually intense and primarily negative. These children exhibit frequent periods of crying and often violent tantrums. Easy children are even tempered, regular, and predictable in their habits. They are open and adaptable to change. Approximately 40% of children fit this description. Slow-to-warm-up children typically react negatively and with mild intensity to new stimuli and adapt slowly with repeated contact. Approximately 10% of children fit this description. "Fast-to-warm-up" is not one of the categories identified.

9. Which type of play allows the child to reenact frightening or puzzling hospital experiences? expressive activities solitary play dramatic play therapeutic play

dramatic play Therapeutic play helps children with social or emotional deficits learn to communicate better, change their behavior, develop problem-solving skills, and relate to others in positive ways. Child playing by herself is an example of solitary play. Dramatic play reenacts frightening or puzzling hospital experiences.

45. Lucy, age 8 years, is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. Which will help her most in her adjustment to the hospital? - orient her parents, because she is young, to her room and hospital facility - explain hospital schedules to her, such as mealtimes - explain when parents can visit and why siblings cannot come to see her - use terms such as "honey" and "dear" to show a caring attitude

explain hospital schedules to her, such as mealtimes School-age children need to have control of their environment. The nurse should offer explanations or prepare the child for those experiences that are unavailable. The nurse should refer to the child by the preferred name. Explaining when parents can visit and why siblings cannot come to see her is telling the child all of the limitations, not helping her adjust to the hospital. At the age of 8 years, the child should be oriented to the environment along with the parents.

30. Which of the following are stressors common to hospitalized toddlers? (SATA) fear of being hurt social isolation sleep disturbances interrupted routine

fear of being hurt sleep disturbances interrupted routine Toddlers fear pain, interrupted routines, sleep eating changes. Social isolation and changes in self-concept for teens

39. The nurse is caring for a child who has just died. The parents ask to be left alone so that they can rock their child one more time. The nurse's most appropriate response is to: discourage this because it will only prolong their grief assess why they feel this is necessary grant their request kindly explain that they need to say good-bye to their child now and leave

grant their request The parents should be allowed to remain with their child after the death. The nurse can remove all the tubes and equipment and offer the parents the option of preparing the body.

Which behavior is most characteristic of the concrete operations stage of cognitive development? ability to think in abstract terms and draw logical conclusions progression from reflex activity to imitative behavior inability to put oneself in another's place or view point increasingly logical and coherent thought processes

increasingly logical and coherent thought processes During the concrete operations stage of development, which occurs approximately between ages 7 and 11 years, increasingly logical and coherent thought processes occur. This is characterized by the child's ability to classify, sort, order, and organize facts to use in problem solving. The progression from reflex activity to imitative behavior is characteristic of the sensorimotor stage of development. The inability to put oneself in another's place is characteristic of the preoperational stage of development. The ability to think in abstract terms and draw logical conclusions is characteristic of the formal operations stage of development.

34. Surgery has informed a nurse that the patient returning to the floor after spinal surgery has an opioid (morphine sulfate) epidural catheter for pain management. The nurse should prepare to monitor the patient for which side effects of an opioid epidural catheter?(Select all that apply.) itching nausea respiratory depression increased blood pressure

itching nausea respiratory depression side effects of morphine sulfate: CNS: confusion, sedation, dizziness, dysphoria, euphoria, floating feeling, hallucinations, headache, unusual dreams CV: hypotension, bradycardia Derm: flushing, itching, sweating EENT: blurred vision, diplopia, miosis Endo: adrenal insufficiency GI: constipation, nausea, vomiting GU: urinary retention Resp: Respiratory depression

25. During examination of a toddler's extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is: abnormal unless it occurs in conjunction with knock-knee normal because the lower back and leg muscles are not yet well developed normal if the condition is unilateral or asymmetric abnormal and requires further investigation

normal because the lower back and leg muscles are not yet well developed Lateral bowing of the tibia (bowlegged) is common in toddlers when they begin to walk. It usually persists until all their lower back and leg muscles are well developed. Further evaluation is needed if it persists beyond ages 2 to 3 years, especially in African-American children.

11. A 13-year-old male is being evaluated in the ER for an inguinal hernia. Which statement accurately describes how the nurse should approach him for his physical assessment? - nurse should explain to the child that the physical exam will not hurt - nurse should auscultate the child's heart, lungs, and abdomen first - nurse should explain to the child what the nurse will be doing in basic, understandable terms - nurse should ask the child's parents to remain in the room during the assessment

nurse should explain to the child what the nurse will be doing in basic, understandable terms Parents do not have to be present during assessment of a teenager. Honesty is the best policy to build trust. In ER, focus assessment is completed. Nurse should explain to the teenager what the nurse will be doing in basic, understandable terms.

7. _____________ is one of the most important aspects of a child's life and one of the most effective tools for managing stress? food and treats play school sleep

play Free play also helps kids learn to play together and get along, among many other benefits, which can also decrease stress as they will have lots of friends to play with and talk to.

43. The parents of a 2-year-old boy are concerned about his behavior. Since the child's admission to the hospital 2 days ago he has been crying much more than usual and is inconsolable much of the time. The nurse's best response to the child's parents is: - the child is in the protest stage, which is normal for children during hospitalization - the child is in the bargaining stage, which is normal for children during hospitalization - the child is in the despair phase, which is normal for children during hospitalization - the child is in the detachment phase, which is normal for children during hospitalization

the child is in the protest stage, which is normal for children during hospitalization Child is inconsolable in the protest stage. Detachment is a behavior manifestation of separation anxiety. Superficially it appears that the child has adjusted to the loss. Detachment is a sign of resignation, not contentment. Parents should be encouraged to be with their child. If parents restrict visits, they may begin a pattern of misunderstanding the child's cues and not meeting his needs.

19. According to developmental theorists, which important event does the nurse understand is essential to the development of the toddler? the child learns to walk the child learns to feed himself the child participates in being potty-trained the child develops friendships

the child participates in being potty-trained Sensitive period during toddler period is toilet training. Sensitive periods can lead to positive and negative influences.

35. A 4-year-old is at the doctor's office for his well-child checkup. The nurse will be administering three immunizations to the child. The nurse should expect which reaction from the child when she gives his immunizations? the child will likely remain still while telling the nurse that she is hurting him the child will likely cry and tell the nurse that it hurts the child will likely remain still the child will try to stall the nurse

the child will likely cry and tell the nurse that it hurts 4-year old usually cry when in pain. School-age uses stalling method.

14. What is the single most important factor to consider when communicating with children? the child's developmental level the child's physical condition presence or absence of the child's parent the child's nonverbal behaviors

the child's developmental level The nurse must be aware of the child's developmental stage to engage in effective communication. The use of both verbal and nonverbal communication should be appropriate to the developmental level. Although the child's physical condition is a consideration, developmental level is much more important. The parents' presence is important when communicating with young children but may be detrimental when speaking with adolescents. Nonverbal behaviors will vary in importance, based on the child's developmental level.

13. An ER nurse is assessing a 14-month-old female. Which statement accurately describes the best method for assessing this child? the nurse should assess the child on the examining table since they have to be in a recumbent position the nurse should assess the child in a head-to-toe sequence since it is efficient the nurse should assess the child while she is in her mother's lap the nurse should have the child's mother assist in holding her down The nurse should assess the child while she is in her mother's lap. The child

the nurse should assess the child while she is in her mother's lap The nurse should assess the child while she is in her mother's lap. The child will feel more secure and may decrease anxiety.

15. What is an important consideration for the nurse who is communicating with a very young child? use transition objects, such as a doll speak loudly, clearly, and directly initiate contact with child when parent is not present disguise own feelings, attitudes, and anxiety

use transition objects, such as a doll Using a transition object allows the young child an opportunity to evaluate an unfamiliar person (the nurse). This will facilitate communication with a child this age. Speaking in this manner will tend to increase anxiety in very young children. The nurse must be honest with the child. Attempts at deception will lead to a lack of trust. Whenever possible, the parent should be present for interactions with young children.