ATI G&D Practice Course Exit Exam

A nurse is caring for a 4-year-old child who had an incident of bedwetting during hospitalization. The child's parents expresses concern about the incident. What response should the nurse make?

"Children who are hospitalized often regress. The toileting skills will return when your child is feeling better." - A recently learned skill, such as toilet training, is often temporarily lost due to the stress of hospitalization. It is appropriate to reassure the parents that regression is an expected behavior in children who are hospitalized, and that they regain bladder control when their health improves.

A nurse at a pediatric hotline receives a call from a mother who plans to administer aspirin to a toddler for a fever and wants to know the dosage. What statement by the nurse is an appropriate response?

"Give her acetaminophen not aspirin." - The nurse should instruct the mother to administer acetaminophen. Administering aspirin to the toddler can cause Reye Syndrome, an acute encephalopathy condition.

A nurse is collecting data from a 10-year-old child during a well-child visit. What statement by the child indicates he is meeting the psychosocial development expectations of a school-age child?

"I really want to do well in school." - Erikson's stage of psychosocial development for a 10-year-old client is industry vs. inferiority. Children at this age want to perform well in school to develop a sense of accomplishment.

A nurse is reinforcing teaching about nutrition with a parent of an infant. What statement by the parent indicates an understanding of the teaching?

"I should wait to give my baby fruit juice until 6 months of age." - Fruit juice provides minimal nutritional value to the infant's diet. Therefore, the parent should limit the infant's fruit juice intake and not offer it until 6 months of age.

During a routine well-child visit, a nurse is reinforcing teaching with the parents of a preschool-age child whom they have difficulty getting to sleep. What statement by the parents indicates an understanding of the teaching?

"I will encourage my child to fall asleep with his favorite toy." - Transitional objects, such as a blanket or toy, provide a sense of comfort, which allows the child to fall asleep more quickly.

What statement by a nursing student about Kohlberg's theory of moral development indicates the need for further teaching about the theory?

"Individuals move through all six stages in a sequential fashion." - Kohlberg's theory states that individuals move through the six stages of development in a sequential fashion but that not everyone reaches stages 5 or 6 as part of their development of personal morality.

A nurse is talking with a 13-year-old female client who is having her annual health-screening visit. What of the following comments by the client should concern the nurse?

"None of the kids at my school like me, and I don't like them either." - This statement should concern the nurse, as developing a peer group is critical to adolescent development and self-esteem. The nurse should explore this comment in greater depth.

A nurse in a pediatric clinic is talking with the mother of a preschool-age child. The mother tells the nurse that her son is a "picky eater." What response should the nurse make?

"Preschool-age children eat slightly more than toddlers." - Preschool-age children eat about half the amount of an adult, and only slightly more than a toddler.

A nurse is reinforcing teaching about car seat safety with the parents of a 6-month-old infant. What statement by the parents indicates a need for further teaching?

"The car seat is front-facing in the back passenger seat." - This statement requires further teaching. At the age of 6 months, an infant should still be placed in a rear-facing position in the back seat of the vehicle.

The nursing instructor asks a nursing student to describe the formal operations stage of Piaget's cognitive developmental theory. The appropriate response by the nursing student is what?

"The child has the ability to think abstractly." - In the formal operations stage, the child has the ability to think abstractly and solve problems.

A nurse is selecting a toy for a 7-month-old infant. What toy should the nurse choose?

A soft toy that squeaks or crackles when squeezed - Toys for a 7-month-old infant should be light, soft, and easy to handle. The most popular toys for infants this age include toys that respond to manipulation.

A nurse is teaching a mother about the immunization schedule for her baby. Between what months of age should the measles vaccine be given?

12 and 15 - Between 12 and 15 months is the optimal age because maternal antibodies to measles are no longer present to block the formation of the child's own antibodies.

What stage of development is observed in a 9-year-old child according to Jean Piaget's cognitive development theory?

Concrete operational - The concrete operational stage is observed in children between 7 and 11 years of age. In this stage, the child can perform mental operations, and the thought process is more coherent.

While playing, a child takes a few pebbles and places them in order from smallest to largest. What stage of cognitive development does the child's behavior demonstrate?

Concrete operations - During the stage of concrete operations, the child's thought becomes more logical and coherent. The child in this stage is able to classify, sort, order, and organize facts about the world to use in problem-solving. Therefore, the child placing the pebbles in order of smallest to largest indicates that the child is in the stage of concrete operations.

A nurse is caring for an adolescent. The nurse should expect that the adolescent is working on what developmental tasks?

Defining a sense of self - An adolescent is working to meet Erickson's developmental task of identity vs. identity confusion. This stage is defined by the establishment of an identity or a sense of self.

A nurse is checking a school-age child for pediculosis capitis. What finding is a definitive indication of this condition?

Firmly attached white particles on the hair - Pediculus capitis, or head lice, are tiny parasitic insects that live on the scalp and are spread by close contact with other people. Their eggs (nits) appear much like flakes of dandruff, but stick firmly to hair shafts instead of flaking off the scalp.

A middle-aged adult contributes to future generations through parenthood, teaching, and community involvement. To what stage of Erikson's theory does this relate?

Generativity versus stagnation - In the generativity versus stagnation stage, the adult focuses on supporting future generations. Middle-aged adults achieve success in this stage by contributing to future generations through parenthood, teaching, and community involvement.

A nurse is reinforcing teaching with a client about relationship development. The nurse should explain that, according to Erikson, establishing relationships with commitment is a primary task of what stage of psychosocial development?

Intimacy versus isolation -During this stage, young adults (18 to 25 years) develop commitments to others and to their careers.

The nurse is caring for an older client who is terminally ill. What sign indicate to the nurse that death may be imminent?

Irregular, noisy breathing and cold, clammy skin - The clinical signs of impending or approaching death include inability to swallow; pitting edema; decreased gastrointestinal and urinary tract activity; bowel and bladder incontinence; loss of motion, sensation, and reflexes; cold or clammy skin; cyanosis; lowered blood pressure; noisy or irregular respiration; and Cheyne-Stokes respirations.

A nurse is collecting data from an 8-month-old infant. What finding should the nurse expect?

Positive Babinski reflex - The Babinski reflex does not disappear until a child is 12 months old. Therefore, this finding is expected in an 8-month-old infant.

A nurse is collecting data from a 6-month-old infant in the well child clinic. What finding should the nurse expect?

Posterior fontanel is closed - The nurse should expect a 6-month-old infant's posterior fontanel to be closed. The small, triangle-shaped fontanel on the back of the infant's head should close by the time the infant is 8 weeks old.

A nurse is caring for 3-year-old children. At what stage of cognitive thought does the nurse expect them to be?

Preconceptional - According to Piaget, at approximately 2 years of age the toddler enters the preconceptional phase of cognitive thought, which lasts, at most, until about 4 years of age; the preconceptional phase is a subdivision of the preoperational stage, which lasts from 2 years to 7 years of age.

A parent asks a nurse about toys to provide for a 10-month-old infant. What toy should the nurse suggest?

Push-pull toy - A push-pull toy will assist the 10 month-old infant to develop muscles and gross motor skills needed to walk unaided.

A nurse is reviewing the stages of sexual developmental with a 12-year-old male. The nurse should identify that what pubertal change occurs first?

Reddening of scrotal skin - Testicular enlargement, along with reddening and thinning of scrotal skin, are the first pubertal changes in males.

A nurse is preparing to administer scheduled immunizations to a 5-year-old child. What vaccine should the nurse plan to administer?

Varicella (VAR) - Varicella is a recommended vaccine for children. The first dose is given at 12 to 15 months. A second dose is given at 4 to 6 years of age.

The nurse is providing an education class to healthy older adults. What exercise will best promote health maintenance?

Walking three to five times a week for 30 minutes - One of the best exercises for an older adult is walking, with the goal of progressing to 30-minute sessions three to five times each week.

​A nurse is caring for several clients at various developmental stages. The nurse understands that according to Erikson, acceptance of death occurs at what stage of psychosocial development?

​Integrity vs. Despair - ​According to Erikson, during the integrity vs. despair stage, which occurs in late adulthood, acceptance of the worth and uniqueness of one's one life and death occurs.

A nurse in a pediatric clinic nurse is talking with a parent of a toddler. The parent tells the nurse that her toddler drinks a quart of milk a day. The nurse should recognize that the toddler is at risk for what disorders?

​Iron-deficiency anemia - Children between the ages of 12 and 36 months are at risk for iron-deficiency anemia when cow's milk, which is poor in iron, is a major component of their diet.

A nurse is assessing the psychosocial development of an 18-month old toddler. The nurse should recognize that this stage is characterized by what behavior?

Offering negative responses due to the need for autonomy - As toddlers develop new language and social skills, they begin to assert the need for autonomy through negativism.

A nurse is reinforcing health promotion teaching with the parents of a toddler. What of the following should the nurse include as the leading cause of death among this age group?

Unintentional injuries - The nurse should inform the parents that unintentional injuries are the leading cause of toddler mortality in the U.S.

A nurse is reinforcing teaching about health promotion with an adolescent. The nurse include what as the leading cause of death among this age group?

​Injuries - Unintentional injuries are the leading cause of death among adolescents.

The mother of a 4-year-old child tells a nurse that her child is reluctant to go to bed at night. Which of the following responses should the nurse make?

"Keep a night light on in your child's room." - The mother should leave a night light on in the child's room so the child can see the room if he becomes afraid. Other measures the mother can try include allowing the child to sleep with a favorite toy, following the same ritual each night at bedtime, and leaving a drink of water by the child's bed.

A nurse is reinforcing teaching with new parents on the proper way to use an infant car seat. What statement by the parents should indicate to the nurse a need for further teaching?

"My baby will be comforted in the back seat by being able to watch me while I drive." - The safest area for a car seat is in the back seat. Infants should travel in a rear-facing position for the best protection from airbags and neck and head injury. While in a rear-facing position, the back of the car seat supports the infant's weak neck muscles, soft fontanels, and spine in the event of a frontal motor vehicle crash. This statement demonstrates the parents do not understand car seat safety and require further teaching.

A nurse is collecting data from a 6-year-old child at a well-child visit. What statement by the child's parent should the nurse report to the provider?

"The teacher says my child has to squint to see the board." - Squinting is a manifestation of strabismus, which must be diagnosed early in order to prevent vision loss.

The parents of a 4-year-old child tell the nurse that they are concerned because the child has been masturbating. What is the appropriate response by the nurse?

"This is a normal behavior at this age." - According to Freud's psychosexual stages of development, the child is in the phallic stage between the ages of 3 and 6 years. At this time, the child devotes much energy to examining his or her genitalia, masturbating, and expressing interest in sexual concerns.

The father of a toddler asks a nurse at a well-child clinic what to do when his child kicks and screams during temper tantrums. What response should the nurse make?

"You should ignore your toddler's temper tantrums." - The parent should ignore the toddler's attention-seeking behavior, so the child realizes that expressing himself in this method is not effective way to communicate.

A nurse is providing palliative care to a client who is receiving hospice care and is approaching death. What action should the nurse take? (Select all that apply.)

Do not force the client to stay awake - As death approaches, the client's metabolic rate decreases causing the client to sleep more. Position the client on her side - As death approaches, the client is unable to cough up secretions effectively. Placing the client on her side will prevent aspiration of secretions. Perform mouth care with moist swabs - As death approaches, the lips and mucous membranes become dry. Performing frequent mouth care will provide comfort.

A nurse is caring for a hospitalized 2-year-old child who has a tantrum when a parent leaves. What action should the nurse take?

Give the child a stuffed animal - A nurse should provide a transitional object for a child who is experiencing separation anxiety and exhibiting temper tantrum behaviors. This object can aid the child in feeling safe.`

What developmental stage is Jean Piaget's first stage of cognitive development?

Sensorimotor - Jean Piaget's first stage of cognitive development is the sensorimotor stage (birth to 2 years).

A nurse is caring for a 6-month-old child. The child's provider has ordered a diphtheria, tetanus, and pertussis (DTaP) vaccine to be administered. What should cause the nurse to question the administration of this vaccine?

Temperature of 40.5° C (104.9° F) after last DTaP -The DTaP vaccine is a 3-in-1 vaccine that protects against diphtheria, pertussis, and tetanus. A high fever is a serious side effect. If a dose of DTaP vaccine were to be given again, it might cause a serious or life-threatening adverse reaction.

What is a characteristic of play among toddlers?

Toddlers play beside each other - Toddlers tend to play beside each other, not with each other. This type of play is called parallel play

A nurse has accepted a position on a pediatric unit and is learning more about psychosocial development. Identify the order of Erikson's stages of psychosocial development from birth through 18 years of. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

Trust vs. mistrust is the first stage of psychosocial development and is typically experienced between birth and one year of age. Children experience autonomy vs. shame and doubt between the ages of 1 and 3 years. Between the ages of 3 and 6 years, children experience the initiative vs. guilt stage. The next stage, industry vs. inferiority, is experienced between the ages of 6 and 11 years. Finally, the stage of identity vs. role confusion occurs during puberty.

A nurse in an urgent care clinic is assisting with the care of a toddler who ingested 30 tablets of aspirin. What substance should the nurse administer to the toddler?

Activated charcoal - The nurse should assist with administering activated charcoal to a toddler who has ingested aspirin because it will decontaminate the toddler's gastrointestinal tract.

A nurse is planning home care for a school-age child who is awaiting discharge to home following an acute asthma attack. What growth and development stages according to Erikson should the nurse consider in the planning?

Industry vs. inferiority - School-age children, according to Erikson's developmental stages of industry vs. inferiority, engage in tasks and activities that help them develop competence and perseverance.

A hospice nurse is caring for a client who is approaching death and has fecal incontinence. What action should the nurse take?

Keep disposable undergarments clean and dry - Keeping the skin clean and dry along with the use of disposable undergarments is an appropriate intervention to promote comfort.

A nurse is collecting data from 15-year-old adolescent client who has a new diagnosis of diabetes mellitus in order to assist with reinforcing teaching about self-management skills. The nurse should expect the client to be in at phase of cognitive development?

Formal operations phase -A child between the ages of 11 and 15 years old is in the formal operations phase of cognitive development. The child is able to think rationally and use deductive reasoning. Therefore, the nurse can explain reasons to support actions the adolescent should take to manage his disease and expect him to make rational decisions.

A nurse is reinforcing teaching with the parents of an adolescent about expected development. What developmental tasks should the nurse instruct the parents to expect the adolescent to achieve?

Identity - The adolescent should achieve the developmental task of establishing an identity.

The nurse is caring for a client with terminal cancer who is close to death. In reviewing the plan of care, the nurse determines that what action is a priority?

Maintain the client's dignity and self-esteem, and make the client as comfortable as possible. - The nurse needs to focus on the needs of the client, keep the client comfortable, and maintain dignity and self-esteem.

A nurse is reinforcing teaching with the mother of a 14-month-old child about safe food choices. What food choice should the nurse recommend?

Mashed potatoes - Mashed potatoes is a safe food choice for the nurse to recommend because it is soft and has a low risk of choking.

A nurse is planning care for a 4-year-old child who has been admitted to the hospital. What toy should the nurse plan to provide the child?

Modeling clay - Preschool-age children enjoy molding clay with their fingers. This activity provides an opportunity for creativity and entertainment, as well as a chance for fine motor development.