Peds Test 1 (Chapt 28, 34, 35, 36, 37, 38, 39)

John is 6 yr old. you should teach his parents that which of his body system should be reaching his peak point of development at this time? A) his neurological system B) his lymphatic system C) his respiratory system D)his musculoskeletal system

B)

Keoto's sister is 2 yr old and appears fearful of medical equipment. to preserve her comfort, you can exclude blood pressure measurement from your assessment until what age? A) 2.5 years B) 3 years C) 5 years D) 7 years

B)

A 10 yr old girl is newly diagnosed with diabetes. the nurse plans to teach her about nutrition related to her diagnosis. Which is the best approach to teach this child? A) play diabetic nutrition trivia game with her B) show her a video about meal planning C) give her a list of foods she cannot have D) have the doctor teach her this information

A)

A 5 yr old boy has been crying when the nurse enters the room. He denies having any pain, although he is cradling his fractured left arm. What would be the most likely reasons he denies having any pain? A) he receivee an injection in the ER B) he thinks he neess to be brave C) he is afraid of going to sleep D) he is afraid of the nurse

A)

A nurse is assisting a group of parents of adolescents to develop skills that will improve communication within the family. The nurse hears one parent state, "my son knows he better do what i say." which of the following parenting styles is the parent exhibiting? A) authoritarian B) Permissive C) authoritative D) passive

A)

A nurse is preparing to assess a preschool-age child. which of the following is an appropriate action by the nurse to prepare the child? A) allow the child to role play using miniature equipment B) use medical terminology to describe what will happen C) separate the child from her parent during the examination D) keep medical equipment visible to the child

A)

Felipe needs to have a 24 hr urine specimen collected and this will require you to coordinate your care with nurses on subsequent shifts. to ensure you have an accurately timed collection, when would you identify the collection's start point? A) the time you discard the first void B) the first time he voids in the morning C) a set time, which is most often 0700 D) at the time of his first void after the discarded urine

A)

Felipe's primary health care provider asks you to keep as accurate a record as possible of Felipe's intake and output whild he is undergoing diagnostic testing. Felipe vomits without warning on his gown and the floor. how should you document this form of output to ensure an accurate assessment? A) estimate the amount of emesis and describe the character in his health record B) describe the event in Felipe's health record and note that it was not possible to gauge the quantity C) weight his soiled gown and compare the weight to a clean gown of the same size D) ask his mother to tell you the approximate amount that he vomited

A)

In developing a plan of perioperative teaching for an adolescents, which is important for the nure to recognize? A) adolescents may act as if they know more than they actually do B) an adolescent will not be interest in reassurance that things will go well C) postop teaching should wait until after the surgery D) the adolscent will need few explanations of the procedure because he or she has seen medial shows on television

A)

Robin, 3 yr old, received analgesia intravenously. Her mother has asked the care team if she would possibly be a candidate for PCA. What advantage of PCA would you discuss with his mother? A) the child can gain a sense of control over his/her pain B) the child can have his or her pain relieved without the risk of adverse effects C) the child requires less nursing care in order to have his/her pain relieved D) the childs pain will from acute pain to chronic pain

A)

Suppose John, 6 yr old, tells you his broken leg wants to get better. when you are choosing an accurate and empathetic response, you should be aware that he is using what form of cognition? A) magical thinking B) deductive reasoning C) concrete operational thinking D) sensorial thought

A)

Terry has her IV site changed to her dominant hand. She has stated that she is "bored and kind of sad" what would be the best activity for her while her medication infuses? A) listening to a story you read B) playing kickball C) playing simon says with her parents D) building a tower in the play area with another child

A)

Which physical finding would best suggest that an infant is dehydrated? A) a depressed fontanelle B) a caput succedaneum C) curved finger beds D) A listless appearance

A)

You are collaborating with your interprofessional team in the care of becky, age 7, the social worker believes that she is showing the first signs of separation anxiety, what evidence would prompt the social worker to draw this conclusion? A) loud, demanding crying B) silent, sullen protesting C) quiet introspective thought D) inability to respond verbally

A)

You want to teach barry more about his hypercholesterolemia and he has expressed a preference for video resources, in order to ensure that such videos are safe, age appropriate, and accurate, you should do which of the following? A) preview any potential video resources before referring them to barry B) encourage barry to search youtube and then report back to you C) emphasize the fact that written materials are usually preferable to video materials D) refer barry to his local public library and have him liaise with librarian

A)

A nurse is planning to administer immunizations to a 2 month old infant. Which of the following should the nurse anticipate giving? (select all that apply) A) rotovirus (RV) B) diphtheria, tetanus, pertussis (DTaP) C) haemophilus influenza type b (Hb) D) hepatitis A (hepA) E) pneumococcal (PVC) F) inactivated poliovirus (IPC)

A,B,C,E

A nurse is performing family assessment. Which of the following should the nurse include? (select all that apply) A) medical history B) parents' education level C) child's physical growth D) support system E) stressors

A,B,D,E

A nurse is planning to administer immunizations to a 4 year old who has up to date immunizations, Which of the following should the nurse anticipate giving? (select all that apply) A) inactivated poliovirus (IPV) B) haemophilus influenza type b (Hb) C) measles, mumps, rubella (MMR) D) varicella (VAR) E) hepatitis B (HepB) F) diphtheria, tetanus, perussis (DTaP)

A,C,D,F

A nurse is planning care for an infant who is experiencing pain. which of the following should be included in the plan of care? (select all that apply) A) offer a pacifier B) use guided imagery C) use swaddling D) initiate a behavioral contract E) encourage kangaroo care

A,C,E

A nurse is performing a neurological assessment on an adolescents. Which of the following is an appropriate reaction by the adolescent when the nurse checks the trigeminal cranial nerve? (select all that apply) A) clenching teeth together tightly B) recognizing sour tastes on the back of the tongue C) identifying smells through each nostril D) detecting facial touches with eyes closed E) looking down and in with the eyes

A,D

A nurse is preparing a toddler for an IV insertion using atraumatic care. which of the following are appropriate interventions? (select all that apply) A) explain the procedure using the child's favorite toy B) ask the parents to leave during the procedure C) perform the procedure with the child in his bed D) allow the child to make one choice regarding the procedure E) apply EMLA cream to three potential insertion sites

A,D,E

Preschool children tend to "center" on information. which is the best description of this action? A) they learn only the middle part of a procedure B) they may concentrate on one part of a procedure and appear not to hear another C) they have to have printed material directly i front of them to understand it D) they do not retain information longer than a week

B)

Pressing a tongue blade against the back of the throat causes a gag reflex. when would you want your team members to know it is important not to elicit a gag reflex? A) when a child is under 5 yr of age B) when a child has symptoms of epiglottitis C) when a boy has a possible inguinal hernia D) when a girl has a georgraphic tongue

B)

A nurse is planning to administer the influenza vaccination to a toddler. Which of the following is an appropriate action for the nurse to take? A) administer subcutaneously in the abdomen B) use a 20 gauge needle C) divide the medication into two injections D) place the child in the supine position

D)

A father brings his 18 month old son to the clinic. He asks the nurse why his son is so difficult to please, has temper tantrums, and annoys him by throwing food from the table. Which principle of growth should the nurse explain? A) toddles need to be disciplined at this stage to prevent the development of antisocial behaviors B) the child is learning to assert independence, and his behavior is considered normal for his age C) this is abnormal behavior and the father should be referred for psychological help D) it is best to leave the child alone in the crib after calmly telling him why his behavior is unacceptable

B)

A nurse is assessing a 6 month old infant. which of the following reflexes should the infant exhibit? A) moro B) plantar grasp C) stepping D) tonic neck

B)

A nurse is caring for a preschooler. which of the following is an expected behavior for a preschool age child? A) describing manifestations of illness B) relating fears to magical thinking C) understanding cause of illness D) awareness of body functioning

B)

A nurse is caring for an infant who needs otic medication. which of the following is an appropriate action for the nurse to take? A) hold the infant in an upright position B) pull the pinna downward and straight back C) hyperextend the infants neck D) ensure that the medication is cool

B)

A nurse is completing a pain assessment of an infant. Which of the following pain scales should the nurse use? A) FACES B) FLACC C) Oucher D) non communicating childrens pain checklist

B)

Becky's mother and father ask you what type of therapeutic play would be best for becky. Which type of therapeutic play would best meet beckys needs if she will have a large bandage on her foot after surgery? A) letting her hold and handle a syringe (no needle) B) giving her a doll and a bandage to change C) supplying a video tape of a child having surgery for her to watch D) giving her a book to read about a childs hospitalization experience

B)

Conscious sedation is a pain management technique that is used with children. During conscious sedation for a preschooler, which of the following actions would be most important? A) keeping the room absolutely quiet so the child can sleep B) assessing vital signs frequently because they can become depressed C) asking the child to periodically count from 1-10 D) keeping the child's head in a dependent position

B)

Felipe will be having a fingertip puncture for serum glucose. What would be the best instruction to empower him before the procedure? A) "it won't hurt a bit; its only a small finger prick" B) "why dont you choose which finger you'd like me to use" C) "most other boys you age don't mind this at all" D) "make sure you hold still, otherwise you wont get a special treat."

B)

Robin's primary health care provider has prescribed both an oral analgesic and an IV antibiotic for her. What is the most important thing you need to know before you can safely administer these medications? A) which medicine robins mother prefers you give B) robins weight and the recommended doses based on her weight C) robin's precise age, because some medications are not prescribed for infants D) robins ability to participate in non-pharmacological interventions

B)

Robin, 3 yrs old, has just returned from having a bone marrow biopsy. Your documentation in her electronic health record would note the presence of what type of pain? A) cutaneous pain B) somatic pain C) visceral pain D) neuropathic pain

B)

School aged children run a high incidence of pediculi. Of the following, which best suggests pediculi? A) dry, brittle hair B) small white particles on the hair strands C) patches of hair loss D) weeping circular areas on the scalp

B)

The nurse is to give an intramuscular injection to an 8 month old infant. Which of the following sites is the best to use? A) a deep portion of the deltoid m. B) the muscle of the anterior thigh C) the largest bulk of the gluteus maximus D) the inner lower quadrant of the buttocks

B)

What would be a game you might play to urge a school aged child to ingest a high fluid intake? A) hangman B) simon says C) battleship D) hide and go seek

B)

When assessing a childs heart, which finding would be considered abnormal? A) physiologic splitting with inspiration B) presence of a fourth heart sounds C) an observable PMI D) dullness with percussion

B)

Which is the best option for measuring a pulse on an infant? A) radial pulse for 1 full minute B) apical pulse for 1 full minute C) anterior fontanelle for 1 minute D) brachial pulse for 1 full minute

B)

With the participation of her father, you obtain a helath history from Keoto. what question should you ask at the end of this and every interview? A) "where do you think we should go from here?" B) "is there anything else you'd like to discuss?" C) "are you still feeling okay?" D) "am I a good interviewer? I'm trying hard"

B)

You want barry, age 16 yr old, to increase his cognitive understanding of his condition. after teaching sessions, which statement from him would best show that his cognitive knowledge has increased? A) " i feel so much better now about the care i need" B) "i understand i have to take two types of medicine C) "i've finally learned how to swallow big capsules" D) "i hate having to take medicine but will take it"

B)

You want to encourage becky to drink a lot of water to promote hydration. last time you made rounds, she drank an entire 10 oz glass at once and vomitted several minutes later. considering the failed attempt to encourage oral hydration, what would be your best next course of action? A) teach becky about the consequences of failing to drink sufficient water B) set up a plan with beck and her parents to provide small glasses of water frequently C) continue to offer her large glasses of water so she does not have to drink so often D) alert her that if she does not increase her fluid intake she will likely have to receive IV fluids

B)

A nurse is assessing an infant, which of the following are clinical manifestations of pain in an infant? (select all that apply) A) pursed lips B) loud cry C) lowered eyebrows D) rigid body E) pushes away stimulus

B,C,D

A nurse on a pediatric unit is caring for a toddler. Which of the following toddler behaviors is an effect of hospitalization? (select all that apply) A) believes the experience is a punishment B) experiences separation anxiety C) displays intense emotions D) exhibits regressive behaviors E) manifests disturbance in body image

B,C,D

A nurse is teaching a parent of an infant about administration of oral medications. which of the following should the nurse include in the teaching? (select all that apply) A) use a universal dropper for medication administration B) ask the pharmacy to add flavoring to the medication C) add the medication to the formula bottle before feeding D) use the nipple of the bottle to administer the medication E) hold the infant in an semireclining position

B,D,E

A nurse is checking the vital sign of a 3 yr old child during a well child visit. which of the following findings should the nurse report to the provider? A) temp 37.2 C (99.0 F) B) pulse 106/min C) resp 30/min D) BP 88/54 mmHg

C)

A nurse is preparing to administer varicella vaccine to an adolescent, which of the following question should the nurse ask to determine whether there is a contraindication to administering the vaccine? A) "do you have allergy to eggs?" B) "have you ever had encephalopathy following immunizations?" C) "are you currently taking corticosteroids medications?" D) "do you have a hypersensitivity to yeast?"

C)

After Terry receives an antibiotic, her body must distribute it to the site where it will act. Which assessment parameter addresses her body's ability to distribute a drug? A) terry's renal function B) terry's arterial blood glucose C) terry's plasma protein levels D) terry's gallbladder function

C)

Although Terry is 8 years old, she doesnt know how to swallow pills. if you needed to delegate the administration of an oral medication to a licensed practical nurse, what instruction would you provide to your colleague? A) "draw a picture of a child swallowing medicine and talk about it" B) "tell the child that all medicine tastes sweet so she'll take it readily" C) give the child a small ice chip to use to practice swallowing D) "tip the child's head forward to avoid the possibility of choking"

C)

John is a school age child but still has difficulty learning piagets concept of conservation what would this imply? A) he doesnt understand why his mother insists he recycle plastic or metal soda cans B) he doesnt understand that when crossing a two way street, he must look both right and left C) he feels angry because his sisters piece of pie is long and thin where his is short and fat D) he tries to climb up onto the roof when playing with his imaginary friend

C)

John, at 6 yr old, is a school aged child. according to Freud, what would you want the members of your interprofessional team to know when caring for school age children? A) it's important for parents to teach children creativity during this time B) children develop their "moral compass" or religion during school age years C) Freud saw the school age period as a largely latent or inactive period D) every school age child needs responsibilities in order to learn trust and integrity

C)

Suppose you are going to give acetaminophen (Tylenol) to Terry in the emergency department and she has no ID band currently in place. What would be the best way to identify her? A) ask her to tell you what her name is B) tell her you need to know her name C) ask a parent to identify her for you D) ask to see her school student card

C)

The algorithm on the pediatric unit for addressing pain in children includes teaching robin guided imagery to help reduce pain. what is the rationale for using this technique to manage children's pain? A) children's pain is generally not as acute as that of adults B) IV pain relief is poorly distributed in children C) children's imaginations are at their peak in life D) children are typically more relaxed than adults

C)

Which is the best way for an infant's father to help his child complete the developmental task of the first year? A) expose her to many caregivers to help her learn variability B) talk to her at a special time each day C) respond to her consistently D) keep her stimulated with many toys

C)

You are going to restrain Felipe to obtain a blood sample from his hand. What type of restraint would be best to use? A) ask his mother to hold him tightly on her lap B) apply a jacket restraint to confine his body C) ask a fellow nurse to hold his hand firmly D) use a mummy restraint so he can't be hurt

C)

You are worried becky's 2 yr old roommate might aspirate a toy the family friend brought in for her. which of the following items is most likely to be aspirated, and therefore poses the greatest risk to safety? A) puzzle pieces B) clothing for a baby doll C) crayons D) block that are 1 in square

C)

You have heard from a colleague that barry 16 years old, hates school. when considering the use of informatics to respond to this statement, which principle should guide your actions? A) communication is most effective when it is enhanced by cutting edge technology B) referral to an appropriate evidence based web site can likely resolve this issue C) technology cannot usually substitute for skilled interpersonal communication D) communication skills are being replaced by technologic innovation in nursing

C)

You want Wolf, 3 yr old, to know how to do the hand exercises he will need to do after surgery, when collaborating with physiotherapist, which technique below would probably be most effective with Wolf? A) a pamphlet you read together B) a lecture form a sports hero C) playing a game of simon says D) a group discussion on hand pain

C)

A nurse is preparing to administer medication to a toddler. which of the following are appropriate actions for the nurse to take? (select all that apply) A) identify the toddler by asking the parent B) tell the parent to administer the medication C) calculate the safe dosage D) ask the toddle what toy he wants to hold during administration E) offer juice after the medication

C,D,E

A nurse is preparing to administer an IM injection to a child. which of the following muscle group is contraindicated? A) deltoid B) ventrogluteal C) vastus lateralis D) dorsal gluteal

D)

A nurse is teaching a parent about parallel play in children. Which of the following statements by the nurse should be included in the teaching? A) "children sit and observe others playing" B) "children exhibit organized play when in a group" C) "the child plays alone" D) " the child play independently when in a group"

D

A hospitalized 4 yr old cries and tries to bite during each physical assessment. which statement by the parent would help the nurse? A) "can you just come back later?" B) "he is just scared and cant help it" C) "i cant get him to stop biting at home so i know i wont be able to do so here" D) "You are going to the timeout chair if you try to bite again"

D)

A nurse is assessing a child's ears. which of the following is an expected finding? A) light reflex is located at the 2 o'clock position B) tympanic membrane is red in color C) bony landmarks are not visible D) cerumen is present bilaterally

D)

A nurse is planning care for a child following a surgical procedure. Which of the following interventions should be included in the plan of care? A) administer NSAIDs for pain greater than 7 B) administer inranasal analgesics PRN C) administer IM analgesics for pain D) administer IV analgesics on a schedule

D)

A nurse is preparing to administer immunizations to a 6 month old infant. Which of the following is an appropriate action for the nurse to take in providing atraumatic care? A) administer 81 mg of aspirin B) use the z track method when injecting C) ask the parents to leave the room during the injection D) provide sucrose solution on the pacifer

D)

A nurse is teaching a group of parents about separation anxiety. Which of the following should be included in the teaching? A) it is often observed in the school age child B) detachment is the stage exhibited in the hospital C) it results in prolonged issues of adaptability D) kicking a stranger is an example

D)

A nurse manager on a pediatric floor is preparing an education program on working with families for a group of newly hired nurses. which of the following should the nurse include when discussing the developmental theory? A) describe that stress is inevitable B) emphasizes that change with one member affects the entire family C) provides guidance to assist families adapting to stress D) denies consistences in how families change

D)

Becky's mom is worried becky will have a traumatic hospital experience. which of the following would you advise her to do to help make beckys hospitalization less traumatic? A) suggest she keep her visits short so becky can spend time with her nurse B) after visiting dont tell becky she is leaving. just try and slip quietly away C) insist becky have blood drawn by her bed because she fears the treatment room D) take becky to the playroom, a place where she can feel free from being hurt

D)

Felipe's mother is relieved that he does not need a CT scan because she tells you she "would not have allowed that." what would be your best response to her? A) "Xrays are the almost never used for children under 4 yrs so you don't have to worry" B) "aren't you prepared to take some risk to ensure Felipe's well being?" C) "if, at any point, Felipe does need an X ray be prepared to change your mind" D) "what is the reason you wouldn't have allowed a CT scan for your son?"

D)

John, 6 yr old, is a school age child. According to Erikson, health promotion activities should integrate what developmental task of this period? A) how to be creative B) how to think abstractly C) how to trust others D) how to do things well

D)

Keotos father wants to be sure keotos immunizations are up to date. when is the immunizations for human papillomavirus (HPV) recommended? A) at 12-18 months B) before kindergarten entrance C) at 16 years of age D) at 11-12 years of age

D)

Robin is scheduled for conscious sedation to have a repeat bone marrow aspiration. Your colleague will accompany Robin and her mother to procedure and you will subsequently join them and the other members of the care team. How should you instruct your colleague to explain conscious sedation to Robin? A) "you'll be given a special medicine to knock you out" B) "I'll give you some medicine, but you will still be awake and feel everything" C) "conscious sedation is an analgesic, not an anesthetic, method of pain relief" D) "I'll give you medicine so you'll be very sleep but can still talk to me"

D)

Suppose Terry, 8 years old, needs to have ear drops administered. if you consult the unit's policies and procedures, you should expect what directive? A) have the child self administer the drops to give the child a sense of control B) refrigerate the drug for at least 30 min so it numbs the ear canal C) pull the pinna of the childs ear down and straighten the canal D) Keep the childs head turned to the side to help retain the drops

D)

The nurse will be assisting with an intraosseous infusion on a 4 yr old. How would the nurse explain this to the child's parent? A) a fluid infusion into the subcutaneous tissue B) a convenient long term site for intravenous therapy C) an infusion into the skull bones of the head D) an infusion into the bone marrow cavity of a long bone

D)

When preparing to perform routine physical assessments on several children, for which of the following children would the nurse expect to obtain BP? A) 6 mth old infant B) 13 mth old infant C) 2 1/2 year old toddler D) 3 1/2 year old preschooler

D)

You are using you stethoscope to auscultate the sound of Keoto's mitral heart valve closing. the best location to listen would be which of the following? A) over the anterior sternum B) the right 9th or 10th intercostal space C) the left interior rim of the left clavicle D) the fourth or fifth left intercostal space at the nipple line

D)

You want to review some health educational materials with Barry, age 16 years. in order to maximize his learning and his comfort level, this activity should take place in which type of physical space? A) intimate space B) social space C) public space D) personal space

D)