exam 2 practice questions

The nurse is providing anticipatory guidance to the mother of a 6-month-old infant. What is the best instruction by the nurse in relation to the infant's oral health? "Start brushing her teeth after all the baby teeth come in." "Use a washcloth with toothpaste to clean her mouth." "Clean your baby's gums, then new teeth, with a washcloth." "Rinse your baby's mouth with water after every feeding."

"Clean your baby's gums, then new teeth, with a washcloth." -the infant's mouth should be cleansed with a damp washcloth as should the baby's new teeth. It is important to clean the mouth and the teeth in order to prevent dental caries. Toothpaste is unnecessary in infancy. Rinsing the infant's mouth would present a safety hazard.

The mother of a 3-month-old boy asks the nurse about starting solid foods. What is the most appropriate response by the nurse? A)"It's okay to start puréed solids at this age if fed via the bottle." B)"Infants don't require solid food until 12 months of age." C)"Solid foods should be delayed until age 6 months, when the infant can handle a spoon on his own." D)"The tongue extrusion reflex disappears at age 4 to 6 months, making it a good time to start solid foods."

"The tongue extrusion reflex disappears at age 4 to 6 months, making it a good time to start solid foods."

preconceptual stage

-2-4 years -child is egocentric, overextends and underextends word meanings

Creatinine range

0.6-1.2

The mother of a 3-year-old is concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response? 1)Hesitancy and dysfluency are normal during this period of development. 2)Reading to the child will help model appropriate speech. 3)Expressive language concerns warrant a developmental evaluation. 4)The mother should ask her child's physician for a speech therapy evaluation

1 -Preschoolers often have a period of dysfluency and hesitancy in their language development, but it usually resolves by about age 4 years.

Babinski reflex disappears

1 year

Which of the following are reasons that stealing occurs in school-age children? (Choose all that apply.) 1)To escape punishment 2)High self-esteem 3)Low expectations of family/peers 4) Lack of sense of property 5) Strong desire to own something

1,4,5 -stealing in the school-age years occurs for multiple reasons: to escape punishment, because of a lack of sense of propriety or ownership, and because of a strong desire to own something they do not have because of lack of money or refusal by parents. Stealing also occurs when a school-age child has low self-esteem and high expectations from his family or peers that the child cannot meet.

formal operational stage

11-15 - people begin to think logically about abstract concepts

Adolescent Blood Pressure

112-128 66-80

The mother of a 4-year-old asks for advice on using time-out for discipline with her child. What advice should the nurse give the mother? 1)If spanking is not working, then time-out is not likely to be helpful either. 2)Place the child in time-out for 4 minutes. 3)Use time-out only if removing privileges is unsuccessful. 4)The child should stay in time-out until crying ceases.

2 -The generally accepted guidelines recommend keeping the child in time-out for 1 minute per year of age.

Which activities will promote weight loss in an obese school-age child? (Choose all that apply.) 1)Unlimited computer and TV time 2)Role modeling by family 3)Becoming active in sports 4)Eating unstructured meals 5)Involving child in meal planning and grocery shopping 6)Drinking three glasses of water per day

2,3,5

Croup is found in children

3 months to 3 years

The nurse is providing teaching about accidental poisoning to the family of a 3-year-old. The nurse understands that a child of this age is at increased risk of accidental ingestion due to which sensory alteration? 1)A lack of fully developed hearing. 2)A less discriminating sense of touch. 3)Visual acuity that has not fully developed. 4)A less discriminating sense of taste.

4 -Less discriminating sense of taste. The young preschooler may have a less discriminating sense of taste than the older child, making him or her at increased risk for accidental ingestion. A less discriminating sense of touch and developing visual acuity would not increase the risk. Hearing is intact at birth and it does not increase the child's risk for accidental ingestion.

A 5-year-old child is not gaining weight appropriately. Organic problems have been ruled out. What is the priority action by the nurse? 1)Allow the child unlimited access to the sippy cup to ensure adequate hydration. 2)Encourage sweets for the extra caloric content. 3)Teach the mother about nutritional needs of the preschooler. 4)Assess the child's usual intake pattern at home.

4 -the nurse must first assess the child's current intake to determine if there is a deficiency.

By 12 months, how many teeth should a baby have?

4-8

Amylase and lipase are deficient in the infant and do not reach adult levels until about

5 months of age

BUN range

7-20

familiarization play

Allows children to handle and explore health care materials in nonthreatening and fun ways

The school nurse is assessing a 16 year old . She arrives with dilated pupils and is taking rapidly. What drug might she be using? Opiates Marijuana Barbiturates Amphetamiens

Amphetameins

A 10-year-old child on a regular diet refuses to eat the food on her meal tray. She requests chicken nuggets, French fries, and ice cream. What is the best nursing action? Ask that the child's desired foods be sent up from the kitchen. Negotiate with the child to eat at least part of the food on the tray. Remove a privilege. Offer the child cereal and milk from stock on the nursing unit.

Ask that the child's desired foods be sent up from the kitchen. -Within reason, the child on an unrestricted diet should be allowed to choose the foods that she likes. This increases the likelihood that she will get enough nutrition to support the healing process.

A 3-year-old child is to receive a medication that is supplied as an enteric-coated tablet. What is the best nursing action? Crush the tablet and mix it with apple sauce. Dissolve the medication in the child's milk. Place a pill in the posterior part of the pharynx and tell the child to swallow. Check with the prescriber to see if an alternative form can be used

Check with the prescriber to see if an alternative form can be used -Enteric-coated medication should not be crushed or dissolved because this would interfere with the action of the drug

Interventions for croup

Cool humidifier air Dexamethasone Racemix epinephrine

A 9-month-old infant's mother is questioning why cow's milk is not recommended in the first year of life as it is much cheaper than formula. What rationale does the nurse include in her response? -It is permissible to substitute cow's milk for formula at this age as he is so close to 1 year old. -Cow's milk is poor in iron and does not provide the proper balance of nutrients for the infant. -As long as the mother provides whole milk, rather than skim, she can start cow's milk in infancy. -If the mother cannot afford the infant formula, she should dilute it to make it last longer.

Cow's milk is poor in iron and does not provide the proper balance of nutrients for the infant.

2 months vaccines( 2 B DR HIP)

DTaP, RV, inactivated polio virus (IPV), Hib, PCV hep B

Ready to feed formula should be used as is and never

Diluted

A nurse is preparing a dose of insulin to give the client. Which action takes priority when preparing and administering this medication?

Double-check the dose with another RN before giving.

4 months vaccinations

Dtap RV HIB IPV PCV NO HEP B

The nurse is giving discharge instructions to a parent of a 3-month-old infant. What is the best information to give the parent concerning oral medication administration?

Give the medication with a syringe and direct the liquid toward the posterior side of the mouth while holding the infant upright.

Crying in infants is a late sign of

Hunger

The nurse is administering 2 puffs of an albuterol sulfate inhaler to a 4-year-old. Which side effect would the nurse instruct the parent to most likely expect?

Increased heart rate and restlessness

Toothpaste is unnecessary In

Infancy

How do breastfed stools look like

Loser in texture and seedy

As the nurse prepares to administer a medication to a preschooler, the nurse realizes that the child is extremely underweight for age. What action would the nurse take?

Measure the child's height and weight, and check whether the dose is correct for the child.

Soy formulas are for infants with

Milk allergy

a 3 month old has a moro reflex. which statment is most true of this reflex? -A Moro reflex present at 3 months of age requires referral for a neurologic exam. It is not important how long the reflex persists, only that it is present at birth. Most 3-month-old infants still have a Moro reflex. A Moro reflex normally lasts until 9 months.

Most 3-month-old infants still have a Moro reflex.

The nurse is caring for a hospitalized 4-year-old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment or intervention done to herself. The nurse identifies this preschooler's behavior as: 1)Problematic; the child is old enough to begin to have a basis in reality. 2)Normal, because the child is hospitalized and out of her routine. 3)Normal for this stage of growth and development. 4)Problematic, as it interferes with needed nursing care.

Normal for this stage of growth and development. -imaginary friends help the preschooler cope with stress in his or her life.

What is croup caused by?

Parainfluenza virus

When administering ear drops to a 2-year-old, which action would be most appropriate? Tell the child that the drops are to treat his infection. Pull the pinna of the child's ear down and back . Have the child turn his head to the opposite side after giving the drops. Massage the child's forehead to facilitate absorption of the medication

Pull the pinna of the child's ear down and back

A child has returned to the unit after having a lumbar puncture. Which instructions are important for the nurse to provide the parents and child?

The child will need to remain flat to prevent a headache.

A 2-year-old is having a temper tantrum. What advice should the nurse give the mother? -For safety reasons, the toddler should be restrained during the tantrum. -Punishment should be initiated, as tantrums should be controlled. -The mother should promise the toddler a reward if the tantrum stops. -The tantrum should be ignored as long as the toddler is safe.

The tantrum should be ignored as long as the toddler is safe. Ignoring tantrums is the best method for discouraging them. Any additional attention received because of the outburst may only contribute to another occurrence in the future.

sensorimotor stage

birth to about 2 -during which infants know the world mostly in terms of their sensory impressions and motor activities

when do kids loose deciduous teeth

by age 6

pincer grasp

the well-coordinated grasp that emerges at the end of the first year, involving thumb and index finger opposition 10 months-fine pincer 8-gross pincer (rakes)

The nurse is preparing to administer an IV antibiotic to a child. After calculating the recommended dose with the child's weight, the nurse discovers the prescribed dose exceeds the safe dose range in a pediatric drug book. The medication has been given to the child at this dose for 3 days. What action should the nurse take next?

Verify the dose with the prescribing health care provider.

solitary play

a child plays alone -seen in infants

onlooker play

a child watches other children play

which achievement best characterizes the physical development of a 3 month old infant

ability to lift head and chest from prone position

cooperative play

activity in which children actually play with one another organized play activity with group goals

the safest location for an infant car seat in an automobile is the

back seat middle

An infant is to receive intermittent gavage feedings via a nasogastric tube every 6 hours. The feeding tube was inserted with a previous feeding and remains in place. The nurse is preparing to administer the next scheduled feeding. Place the events in the proper sequence. a)Check the placement of the feeding tube. b)Position the infant on his right side with the head of the bed slightly elevated. c)Allow the feeding to come to room temperature. D)Flush the tube with water. e)Clamp the tube to prevent air from entering the stomach. f)Pour the solution into the barrel of the syringe.

c, a, f, d, e, b

preschoolers are egocentric meaning that they

can not see another persons point of view

6-9 months of age

can pull self to sitting position they start bouncing so much that they bounce out and start crawling by 8-9 months everything goes in mouth so SAFETY PRECAUTION!!

preschool like which type of play

cooperative play

at 3 months reflex begins to

fade smiles turns head to sound

Toddlers tend to prefer what kind of food?

finger food

Rotavirus is given

orally

9-12 months

walks holding on love to cruise around furniture shows stranger anxiety continues in solitary play

head lag

when the infant is lifted from the bed, the head will fall back, because newborn cannot maintain neutral position of the head

Foods to be avoided before 12 months

whole Milk eggs whites citrus fruits peanut butter

Birth weight doubles by

6 months

Neonate Blood Pressure

60-90 systolic 20-60 Diastolic

Concrete Stage

7 to 11 years of age -children gain the mental operations that enable them to think logically about concrete events

Glucose range for children

70-120

Infant Blood Pressure

87-105 53-66

what age does infant learn to distinguish himself from caregivers

9 months

Toddler Blood Pressure

95-105 53-66

preschool blood pressure

95-110 56-70

oral temperature for kids

95.9-99.5 Normal ( 97.4-99.6)

School aged BP

97-112 57-71

Armpit temperature

97.8-99.5

Rectum temperature for kids

97.9-100.4

nomogram

A graphic tool for estimating drug dosages using various body measurements

associative play

play in which two or more children actually interact with one another by sharing or borrowing toys or materials, although they do not do the same thing -playing with the same types of toys in an organized way

The nurse is providing anticipatory guidance to the mother of a 6-month-old infant. What is the best instruction by the nurse in relation to the infant's oral health? 1)"Start brushing her teeth after all the baby teeth come in." 2)"Use a washcloth with toothpaste to clean her mouth." 3)"Clean your baby's gums, then new teeth, with a washcloth." 4)"Rinse your baby's mouth with water after every feeding."

"Clean your baby's gums, then new teeth, with a washcloth."

What is the best advice about nutrition for the toddler? 1-Encourage cup drinking and give water between meals and snacks. 2-Encourage unlimited milk intake, because toddlers need the protein for growth. 3-Avoid sugar-sweetened fruit drinks and allow as much natural fruit juice as desired. 4-Allow the toddler unlimited access to the sippy cup to ensure adequate hydration.

1-Encourage cup drinking and give water between meals and snacks. -The toddler should wean to the cup by age 12 to 15 months. Limit real fruit juice to 4 to 6 oz per day and milk to 16 to 24 oz per day, and give it with meals and snacks. Offer water between meals and snacks

In developing a weight-loss plan for an adolescent, which would the nurse include? (Choose all that apply.) 1-Have parents make all of the meal plans. 2-Eat slowly and place the fork down between each bite. 3-Have the family exercise together. 4-Refer to an adolescent weight-loss program. 5-Keep a food and exercise diary.

2,3,4,5 -These are steps that promote weight loss in adolescents. Adolescents want to be involved in the process, so having parents make all of the meal plans would not promote acceptance by the adolescent.

Which is associated with early adolescence? (Choose all that apply.) 1-Uses scientific reasoning to solve problems 2-Still at times wants to be dependent upon parents 3-Incorporates own set of morals and values 4-Is influenced by peers and values memberships in cliques

2,4

As the school nurse conducting screening for vision in a 6-year-old child, you would refer the child to a specialist if the visual acuity in both eyes is: 20/20 20/25 20/30 20/50

20/50 -Visual acuity of 20/20 is not expected until 7 years of age.

tonic neck disappears

3-4 months

A 6-month-old infant requires restraint to prevent removal of his nasogastric tube. What is the priority nursing intervention? Tie the restraint loosely to prevent skin breakdown. Leave the baby unrestrained when directly observed. Position the restrained infant prone to prevent aspiration. Place the infant in a room near the nurses' station.

Leave the baby unrestrained when directly observed. -infants should be restrained only when necessary. Remove the restraints and provide direct observation as often as possible. Provide appropriate developmental stimulation while the restraints are on as well as off.

A nurse who works with pediatric clients will use what device to estimate body surface area (BSA) to calculate medication dosages?

nomogram

toddlers like which type of play

parallel play -play side to side but dont share

Immediately following administering a medication by enteral tube, the nurse will:

flush tube with water

Finger foods

foods a baby can self-feed using the fingers

Classic symptoms of croup

harsh barking cough and inspiratorystridor Occurs at night time

0-3 months

head lags by 2 months lifts heads and chest off bed totally dependent provide toys that are soft,cuddly and colorful

parallell play

independent play, but beside others -toddlers

during a well child check up, the nurse notices that a toddlers teeth are discolored and speckled with white. The nurse suspects that she

ingest too much fluride in her toothpaste

Piaget's stages of cognitive development

sensorimotor preoperational concrete operational formal operational

infants like what type of play

solitary

3-6 months

starts rolling over 6 mo-can SIT for short periods of time

which tool is used to assess sexual maturity

tanner

the parents of a 2 year old child complain that his appetite has greatly diminished. the nurse explains that

this is normal and is called physiologic anemia