Kaplan-Pediatric Growth and Development Quiz

Kaplan-Pediatric Growth and Development Quiz - infancy At birth, the newborn's head and chest circumference were measured. The nurse knows that the head should be about: a. 1 inch larger than the chest b. 1/2 inch smaller than the chest c. 2 inches larger than the chest d. Equal in size to the chest

a 1 inch larger than the chest The head is about 1 inch larger than the chest and will grow rapidly during the first 6 months. Chest circumference is not routinely measured after the newborn period.

Kaplan-Pediatric Growth and Development Quiz - safety The nurse teaches parents of young children to prevent burns by setting the water heater temperature at _____ degrees or less. a. 120 b. 105 c. 110 d. 115

a 120

Kaplan-Pediatric Growth and Development Quiz - school age The nurse at an elementary school is explaining the concept of industry versus inferiority to a group of nursing students. Which of the following is part of this stage of Erikson's theory? a. A sense of competence, mastery, and worth b. The conventional stage of development c. Lack of the ability to think abstractly d. The principle of conservation

a A sense of competence, mastery, and worth Erikson states that schoo-agers receive satisfaction from developing new skills and successfully using them to accomplish goals (industry). Failing (without adult support) or being unable to meet expectations that are set too high can result in feelings of inferiority.

Kaplan-Pediatric Growth and Development Quiz -infancy The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child? a. A yellow rubber duck for the bath b. Brightly colored stacking toy c. A push-pull toy d. Pots and pans from the kitchen cupboard

a A yellow rubber duck for the bath The rubber duck is most appropriate. It is safe, is visually stimulating while bobbing on the water, and adds pleasure to bath time. A push-pull toy promotes skill for a walking infant. Pots and pans from the kitchen cupboard are played with successfully after sitting is mastered. A 5-month-old does not have the fine motor coordination to use stacking toys.

Kaplan-Pediatric Growth and Development Quiz - Nutrient A 17 year-old girl needs to increase her iron intake but is concerned about weight gain. The nurse will suggest which of the following? a. Chicken, whole-wheat bread, watermelon b. Egg white omelet, broccoli, pear c. Cottage cheese, crackers, oranges d. Raspberry yogurt, granola, apple

a Chicken, whole-wheat bread, watermelon Chicken, whole-wheat bread and watermelon are all foods high in iron. The calorie content will not promote weight gain. All other options do not include good sources of iron but are nutritious foods. Calorie content is also acceptable.

Kaplan-Pediatric Growth and Development Quiz - toddler The nurse is teaching the mother of a 2-year-old boy about age-appropriate toys. Which of the following would be of most interest plus stimulating to the growth and development of this child? a. Giving the child bowls, pot, pans, and large spoons b. Offering the child a variety of large stuffed toys c. Providing a brightly colored plastic bucket and shovel d. Giving the child a toy vacuum cleaner

a Giving the child bowls, pot, pans, and large spoons The kitchen items are usually of most interest since they give opportunity to copy observed parental actions. Also, these items can be used not only to role model but also to stack, nest, make noise, and rearrange in many configurations. They are also inexpensive. However, all the other toys are appropriate and safe for toddlers.

Kaplan-Pediatric Growth and Development Quiz - nutrition Parents tell the nurse their 3 1/2-year-old refuses to eat meat but are pleased she drinks "lots of milk." What risk does the nurse identify? a. Iron deficiency b. Dental caries c. Obesity d. Interference with growth

a Iron deficiency Meat is an important iron source while calcium in milk consumed in large quantities can block iron absorption. Alternate protein sources can replace the meat in the child's diet for growth. Excess milk intake that boosts calories consumed can be an obesity-causing factor. Lactose from milk in constant contact with the teeth can promote development of dental caries. However, these risks are slight, with the iron deficiency risk pronounced.

Kaplan-Pediatric Growth and Development Quiz - Infancy The nurse is treaching the mother of a 2-month-old girl about the social and emotional developments that will occur in the next 8 weeks. Which of the following behaviors is most likely to occur? a. Mimicking mother's facial expressions b. Crying when the mother is out of sight c. Participating in a game of peek-a-boo d. Becoming clingy around stangers

a Mimicking mother's facial expressions Infants will mimic the facial expressions of their parents when they are 3 to 4 months old. Becoming clingy around strangers probably won't occur until the child reaches 6 months. Engaging in peek-a-boo becomes fun between 6 and 8 months. Crying when the mother is out of sight indicates separation anxiety and is common after 8 months of age.

Kaplan-Pediatric Growth and Development Quiz - school age The 10-year-old girl hospitalized for bladder surgery will be most stressed when nurses provide what care? a. Perineal and indwelling catheter care b. Abdominal dressing change c. Auscultation of breath and bowel sounds d. Change of hospital gown

a Perineal and indwelling catheter care School-ages are often quite uncomfortable with any type of sexually-related examination or care. Modesty is well developed and privacy important. The nurse should handle perineal and catheter care in a sensitive manner. Teaching the parent to provide this care is helpful. The abdominal dressing change may cause the school-ager some concern but can be done discreetly, as can listening to breath and bowel sounds and changing the hospital gown.

Kaplan-Pediatric Growth and Development Quiz - infancy A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms? a. The development of a 3-month-old b. The growth of a 5-month-old c. The development of a 0-week-old d. The growth of a 2-month-old

a The development of a 3-month-old The infant was born 8 weeks early. Tow months are subtracted from the present age of 5 months. Both growth and development should b assessed using 3-month norms.

Kaplan-Pediatric Growth and Development Quiz - preschool The nurse is caring for a 4-year-old girl following an appendectomy. The girl becomes fearful and starts to cry as soon as the nurse walks into the room. When the nurse asks about the crying, the girl says, "Nurses who wear shirts with flowers give shots." The nurse understands that the girl is demonstrating which of the following? a. Transduction b. Animism c. Beginning empathy d. Magical thinking

a Transduction The nurse identified transduction. Because the 4-year-old recently received an injection from a nurse in a flowered uniform, the girl believes that all nurses who wear flowered uniforms give shots. Transduction is reasoning by viewing one situation as the basis for another situation even though the two may or may not be casually linked. Magical thinking involves believing that one's thoughts are all-powerful. Animism is attributing life-like characteristics to inanimate objects. Empathy is the understanding of other's feelings.

Kaplan-Pediatric Growth and Development Quiz - adolescent With summer approaching, the nurse discusses sun safety with a group of teen girls. Which suggestion is most likely to be followed? a. Wear sunglasses b. Wear a hat when in the sun c. Do not attempt to get a tan d. Limit sun exposure between 10:00 AM and 2:00 PM

a Wear sunglasses Sunglasses can be a fashion statement and are likely to be accepted. The other pieces of advice are less appealing to adolescents who link a tan to body beauty. Unfortunately sun exposure is cumulative over a lifetime, and much of it occurs in youth making protecting young skin important.

Kaplan-Pediatric Growth and Development Quiz - toddler Development should continue during hospitalization. What play activities will the nurse choose for toddlers to accomplish this? Select all that apply. a. Putting together a large-piece puzzle b. Batting balloons c. Stacking blocks d. Watching a mobile e. Pulling a toy train

a, c, e Putting together a large-piece puzzle, Stacking blocks, Pulling a toy train Pulling a toy train encourages movement and the development of gross motor skills important to the toddler. Stacking blocks and putting together a puzzle uses fine motor skills and an understanding of shapes and space and is stimulating cognitively. Watching a mobile is appropriate for infant and may be unsafe if the toddler could reach it. Balloons are inappropriate in the hospital setting (latex sensitivity) and are an aspiration risk. Mylar balloons may be considered safe, although attached along strings or ribbons are not.

Kaplan-Pediatric Growth and Development Quiz - infancy The nurse is teaching the mother of a 5-month-old boy who is concerned about thumb sucking. Which of the following should be included in the teaching plan? Select all that apply. a. Informing the mother that thumb sucking occurs more often during periods of stress. b. Telling the mother this behavior usually will not decrease until the child is 18-24 months of age. c. Assuring the mother this behavior won't cause malocclusion. d. Advising the mother this behavior is a form of self-comfort.

a, c,d Informing the mother that thumb sucking occurs more often during periods of stress, Assuring the mother this behavior won't cause malocclusion, Advising the mother this behavior is a form of self-comfort. Thumb sucking usually decreases by 6 to 9 months of age. All other answers are accurate and should help the mother better understand and accept the behavior.

Kaplan-Pediatric Growth and Development Quiz - Adolescents The mother of a 15 year-old boy expresses sadness to the nurse that her son is "much more connected to his friends than his family." What understanding would benefit this parent? Select all that apply. a. Peers are needed for emotional security while stepping away from family. b. Peers provide the opportunity to learn and practice social roles. c. Peers can be positive or negative influences. d. Adolescents need little parental guidance as they move toward greater peer involvement.

a,b,c Peers are needed for emotional security while stepping away from family, Peers provide the opportunity to learn and practice social roles, Peers can be positive or negative influences. Adolescents need continued parental guidance as they move toward greater peer involvement. All other statements are correct.

Kaplan-Pediatric Growth and Development Quiz - toddler The mother of a toddler boy half-jokingly states, "I am so tired of hearing 'NO!' I wish he would stop!" What suggestions will the nurse offer to reduce toddler negativism? Select all that apply. a. Use humor to make "no" funny: "Do cows bark?" b. Make statements: "It's time for lunch." c. Offer simple choices: "Blue shirt or red one?" d. Avoid "yes" and "no" questions e. Emphasize what is not to be done: "Don't sit there". f. Avoid ending a request with "Okay?"

a,b,c,d,f Use humor to make "no" funny: "Do cows bark?", Make statements: "It's time for lunch.", Offer simple choices: "Blue shirt or the red one?", Avoid "yes" and "no" questions, Avoid ending a request with "Okay?" All suggestions except what not to do are positive and reduce the opportunity to say "no".

Kaplan-Pediatric Growth and Development Quiz - toddler The nurse is teaching parents how to avoid a power struggle with their 2-year-old girl. Which comment indicates that more teaching is needed? a. "We will give her a choice whenever possible." b. "We will make sure she shares her toys with cousins her age." c. "Childproofing our home will make it less necessary to say 'No!" d. "Both of us, as parents, will agree on and consistently enforce the limits we set."

b "We will make sure she shares her toys with cousins her age." A 2-year-old's thinking is not mature enough to include the concept of "sharing". She sees situations from her point of view (egocentrism). That makes sharing with another beyond what she can accept as an understandable action. All the other statements are age appropriate and support the capabilities and grwoing independence of the toddler.

Kaplan-Pediatric Growth and Development Quiz - adolescent A 15-year-old boy asks numerous questions about recovery from anesthesia and typical behaviors of someone awakening from sedation. The nurse interprets the concern of this teen to be: a. Anxiety related to the surgical procedure itself b. About his ability to control his own behavior c. About a change in body image d. Adequacy of postsurgical pain control

b About his ability to control his own behavior These questions point to anxiety about how the teen may act while he has limited control of his behaviors. It is likely he does not want to appear "stupid, babyish, or uncool." All the other factors are typical adolescent concerns that may surface during the hospital stay.

Kaplan-Pediatric Growth and Development Quiz - school age The nurse is caring for a technology-dependent school-age child in his home. Which of the following actions best builds a trusting relationship? a. Encouraging the parents to join a support group. b. Discussing care and treatment with the parent and child together. c. Talking with the brother of the child who feels ignored. d. Changing the date and time of the child's physical therapy to fit the family schedule.

b Discussing care and treatment with the parent and child together. To build a trusting relationship with the family, the nurse must remember the child is both the patient and a family member. He needs to be included in all discussions. Encourage parents to join a support group and talking with the sibling of the ill child who feels ignored are important and supportive activities. Changing the date and time of a therapy session to fit the family schedule is a case management activity. These are important elements of family-centered home care, but are not meant specifically to build trust.

Kaplan-Pediatric Growth and Development Quiz - infancy The nurse is providing anticipatory guidance regarding the respiratory development of a 4-week-old girl for her mother. Which of the following is accurate? a. Advising the mother that the infant's usual respiratory rate should show to about 20 breaths per minute by age 6 months. b. Explaining to the mother the risk for infection is high due to the lack of antibodies. c. Telling the mother that abdominal breathing disappears by 9 months of age. d. Informing the mother that the respiratory system reaches maturity similar to the adult's by 12 months of age.

b Explaining to the mother the risk for infection is high due to the lack of antibodies. Attributing frequent infections to a lack of antibodies is accurate. The infant lacks IgA in the mucosal lining of the upper respiratory tract. The infant's respiratory rate drops to 20 to 30 breaths per minute by the end of the first year. Abdominal breathing persists until 6 to 12 years of age. The respiratory system matures by age 7 years.

Kaplan-Pediatric Growth and Development Quiz - infancy The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the mother's first child. Which of the following should be the priority nursing action? a. Recommend the mother offer smaller and more frequent feedings. b. Observe the mother while she feeds and burps her infant. c. Describe the capacity of a 5-week-old infant's stomach. d. Offer assurance that spitting up is normal.

b Observe the mother while she feeds and burps her infant. Assessing the mother's feeding and burping technique is the first nursing action needed. The mother may be overfeeding or inadequately burping the child. Recommending smaller and more frequent feedings would be determined by the assessment. Assuring the mother that some spitting up is normal and describing the capacity of the infant's stomach is information helpful to parenting but not the priority.

Kaplan-Pediatric Growth and Development Quiz - infancy The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to: a. Consider this a normal response for the age. b. Refer the infant for developmental and/or neurologic evaluation. c. Suggest more awake tummy time for the child. d. Conclude the earlier assessments carried out fatigued the infant.

b Refer the infant for developmental and/or neurologic evaluation. There should be no had lag by 4 months. Head lag in the 5-month-old may indicate motor or neurologic problems and needs immediate follow-up. All other nursing actions indicate failure to recognize the problem.

Kaplan-Pediatric Growth and Development Quiz - toddler Parents who just moved into their "dream home" are concerned because their toddler boy, who had achieved daytime bowel and bladder control, has begun wetting and defecating in his underwear. The nurse explains this is called: a. Egocentrism b. Regression c. Autonomy d. Ritualism

b Regression He is returning (regressing) to an earlier, possibly safer stage of development caused by a stressor (moving). Autonomy is a stage of development in Erikson's theory. Egocentrism refers to the toddler's focus on self. Ritualism for toddlers provides sameness, the expected, and security.

Kaplan-Pediatric Growth and Development Quiz - infancy A father mentioned to the nurse that his usually smiling, happy 8-month-old boy was clingy and intensely serious when his grandmother visited from a distant city. The nurse explained the child was experiencing: a. Changes in temperament b. Stranger anxiety c. Separation anxiety d. Colic

b Stranger anxiety Stranger anxiety occurs around 8 months and manifests as the father described. This behavior indicates the infant sees himself as a separate person. The other options are incorrect and not related to social/emotional development.

Kaplan-Pediatric Growth and Development Quiz - school age a. Providing opportunity for nonnutritive sucking b. Supporting the parent in his or her presence and caregiving c. Keeping the infant warm and dry d. Holding and rocking the infant

b Supporting the parent in his or her presence and caregiving All the actions by the nurse would be helpful in reducing stress. However, the 6-month-old infant, who prefers his parent to other caregivers, will be stressed the least by having that person available to provide basic care and give comfort.

Kaplan-Pediatric Growth and Development Quiz - toddler A mother expresses surprise to the nurse that her toddler daughter has begun masturbating. The most important initial nursing response is: a. Toddler girls as well as boys will masturbate. b. This is a normal and expected activity best treated matter-of-factly. c. Check for undue stress in your toddler's life. d. Toilet teaching places much focus on the genitals.

b This is a normal and expected activity best treated matter-of-factly. Masturbation is a normal event to be done in private. Calling attention to the behavior may increase the frequency. Both girls and boys masturbate, and toilet teaching calls attention to the genital area. These two statements are accurate information but not the best first response. Excessive or public masturbation points to stress.

Kaplan-Pediatric Growth and Development Quiz - infancy Parents complain of being "worn out" at their child's 6-month check-up because their boy awakens each night and cries. The nurse suggests which measures? Select all that apply. a. Add rice cereal to the evening bottle to prevent hunger and awakening. b. During night awakening, keep interactions minimal. c. Establish a quieting ritual before bed. d. At bedtime, rock the child to sleep and then place in crib.

b,c During night awakening, keep interactions minimal, Establish a quieting ritual before bed. Bedtime rituals and minimal interactions during night awakening both promote sleep. Adding rice cereal to bottles does not promote sleeping through the night and isn't recommended. Putting the infant asleep into the crib does not teach the child to self-soothe and fall asleep independently.

Kaplan-Pediatric Growth and Development Quiz - safety The nurse is providing teaching about car seat safety for a patients' meeting at the preschool their children attend. Choose the points the nurse should make. Select all that apply. a. Keep children in the back seat until at least age 7. b. Children who are 4 to 7 years of age who weight less than 40 pounds should use a forward-facing car seat with a harness. c. Booster Seats should be used with both a shoulder and lap belt. d. Infants should be in rear-facing car seats until lat least age 1 or older.

b,c,d Children who are 4 to 7 years of age who weight less than 40 pounds should use a forward-facing car seat with a harness, Booster Seats should be used with both a shoulder and lap belt, Infants should be in rear-facing car seats until at least age 1 or older. It is recommended that children age up to 12 (or older, depending on size) be kept in the back seat because it is safer there. All other options are correct.

Kaplan-Pediatric Growth and Development Quiz - preschool Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of the following? Select all that apply. a. Spank with an open hand only and never with an object. b. When discussing improper behavior, call the behavior "bad" or "naughty", not the child. c. Books and stories can help preschoolers master proper behavior. d. Anticipate situations likely to cause misbehavior and redirect the child to another activity. e. A time-out of about 8 minutes would be appropriate for intentional misbehavior.

b,c,d When discussing improper behavior, call the behavior "bad" or "naughty", not the child, Books and stories can help preschoolers master the proper behavior, Anticipate situations likely to cause misbehavior and redirect the child to another activity. Spanking is the least effective discipline and discouraged by pediatric professionals. If chosen by parents, it should be infrequent and done only with an open hand. Labeling behavior and not the child support self-esteem. One minute per year of age is an appropriate length for time-outs. Redirecting from events that tend to lead to misbehavior is wise and reduces conflict. Prschoolers can learn much from stories and books including appropriate behavior.

Kaplan-Pediatric Growth and Development Quiz - toddler, nutrition A stay-at-home father wants to purchase commercial toddler meals because his 16-month-old girl recently choked on table food. Which food items will the nurse suggest not be given to this child? Select all that apply. a. Fruits such as peaches, pears, and kiwi b. Hard foods such as nuts, raw carrots, and popcorn c. Sticky foods like peanut butter alone, gummy candies, and marshmallow's d. Vegetables such as corn, green beans, and peas e. Round foods such as hot dogs, whole grapes, and cherry tomatoes.

b,c,e Hard foods such as nuts, raw carrots, and popcorn, Sticky foods like peanut butter alone, gummy candies, and marshmallow's, Round foods such as hot dogs, whole grapes, and cherry tomatoes. To offer soft round foods safely, cut hot dogs in uneven pieces and quarter grapes and cherry tomatoes. This prevents food from impacting an airway. Avoid the hard and sticky foods due to aspiration and airway occlusion risks. The cooked vegetables listed are safe as are the soft fruits.

Kaplan-Pediatric Growth and Development Quiz - school age The nurse is providing teaching for the parent of an 8-year-old girl who has undergone surgery. The nurse emphasizes the importance of maintaining adequate hydration. Which of the following responses by the mother would indicate a need for further teaching? a. "Anything that melts at body temperature is counted as a fluid." b. "I should offer her small amounts of fluid frequently." c. "I will remind her that she will need an IV if she does not drink." d. "Ice chips count as fluid intake, one cup of ice equals a half-cup of water."

c "I will remind her that she will need an IV if she does not drink." The child is likely to view an IV both as frightening and as punishment. Intravenous fluids should be seen as therapy. Threat such as this should not be used to achieve compliance with eating or drinking. The other statements show understanding.

Kaplan-Pediatric Growth and Development Quiz - preschool A 3 1/2-year-old shouts, "Look out for Boo-ga-loo!" as the nurse enters the exam room. The father explains Boo-ga-loo is his daughter's imaginary friend. How should the nurse respond? a. "Where did you get that funny name?" b. "Are you spoofing me?" c. "Tell me about Boo-ga-loo." d. "I don't see anyone."

c "Tell me about Boo-ga-loo." The imaginary friend serves as a companion and playmate for the preschooler. The child knows this friend is not real, yet is very invested in the imaginary playmate who can be and do anything the child's fantasy life can invent. The nurse should acknowledge this friend, not minimize the friend's importance. "Tell me..." does this. The other responses do not.

Kaplan-Pediatric Growth and Development Quiz - preschool A mother in the outpatient setting is explaining how she plans to prepare her 5-year-old for hospital admission. What remark indicates the parent requires additional teaching? a. "We found several books for him at the library that talk about being in the hospital." b. "We have a date to visit pediatrics and tour their department." c. "We told him to use his manners and behave like a big, brave boy." d. "We watched a program for kids on public television about being in the hospital."

c "We told him to use his manners and behave like a big, brave boy." Expecting manners and big, brave behavior is unrealistic. The child's coping skills are not yet well developed. Expressing true feelings should be allowed. The other preparations are helpful and promote understanding of the experience.

Kaplan-Pediatric Growth and Development Quiz - toddler a. The nurse expects the toddler's anterior fontanel to be closed by _____ months? a. 9 b. 24 c. 18 d. 12

c 18

Kaplan-Pediatric Growth and Development Quiz - toddler, preschool The nurse is promoting language and cognitive development to the parents of a 3-year-old boy. Which guidance about reading with their child will be most helpful? a. Have the child sit still during the story. b. Keep story time a reward for being good. c. Ask the child questions as you read. d. Read a different book if he knows the story

c Ask the child questions as you read. Engage the child by asking him questions as he listens. This gives him a chance to contribute to the story. The child does not have to sit still. He may want to move around or even act out part of the story. Story time should happen regularly and not be just a reward. Even if the child can tell the story, he may wish to hear it again because he enjoys the repetition and familiarity.

Kaplan-Pediatric Growth and Development Quiz - preschool In assessing the bilingual 4-year-old's speech and language development, the nurse should find that the child will: a. Avoid asking questions b. Mix the two languages in the same sentence c. Be able to use each language as a separate system d. Be prone to stuttering

c Be able to use each language as a separate system The ability to use both languages separately is developed by 4 years. Mixing the two languages occurred during toddlerhoold. The other options are not related to bilingualism and are incorrect.

Kaplan-Pediatric Growth and Development Quiz - school age A 6-year-old needs to cough and deep breathe following surgery. To accomplish this, the nurse will: a. Teach the young school-ager to use an incentive spirometer. b. Arrange for respiratory therapy to do coughing and deep breathing exercises with the child. c. Blow a pinwheel and bubbles with the child. d. Instruct the parents to remind the child to cough and deep breathe every 2 hours.

c Blow a pinwheel and bubbles with the child. All of the measures have potential to get the child to cough and deep breathe to some extent. The most playful and familiar methods of bubbles and a pinwheel will accomplish the most since they are likely to be accepted and even enjoyed.

Kaplan-Pediatric Growth and Development Quiz - infancy The nurse is preparing a list of abilities of 10-month-olds to use in teaching a parenting group. Which of the following should appear at this age? a. Feeds self with spoon (but spills) b. Sits from standing position c. Cruises around furniture d. Uses two or three words with meaning

c Cruises around furniture At 10 months, this ability appears and is practiced often in preparation for later independent walking. All the rest of the skills take an additional 2 months to develop and appear around age 1 year.

Kaplan-Pediatric Growth and Development Quiz - School age During an annual visit of a 6-year-old boy, the nurse observes dental caries on two of the child's primary teeth. What should be the nurse's first response? a. Encourage parents to supervise the child's tooth brushing. b. Suggest use of a fluoride supplement. c. Educate the parents about the importance of the primary teeth. d. Refer the child to a pediatric dentist.

c Educate the parents about the importance of the primary teeth. Parents need to understand the value of the primary teeth and not see them only as temporary and soon-to-be-replaced. Referral to a pediatric dentist and parental supervision of tooth brushing both lead to dental health and may be better appreciated once parents understand the importance of the primary teeth.

Kaplan-Pediatric Growth and Development Quiz - school age Which of the following will the nurse view as best maintaining normalcy in the life of a 10-year-old boy who is experiencing a lengthy hospitalization? a. Writing down his oral intake on the day and evening shifts. b. Choosing the time of his bath or shower. c. Keeping up with his school work. d. Playing board games with the child life specialist.

c Keeping up with his school work. A school-ager is exactly that - someone whose life is centered around school. Doing school and homework assignments is part of his usual day when not hospitalized. Watching daytime TV is not. Choosing the time hygiene activities occur provides him some control, while tacking his oral intake is an opportunity to participate in his care. Playing board games with the child life specialist is an age-appropriate activity that provides distraction. These support him developmentally but do not normalize his day as dose keeping up with school assignments. It will be easier for him to return to the classroom and feel more in step with his peers by doing this.

Kaplan-Pediatric Growth and Development Quiz - infancy The nurse is discussing proper discipline with the mother of a 15-month-old boy. Which statement is most important? a. Toddlers are unable to learn rules easily. b. Use praise when the child is doing something right. c. Never spank the child for any reason. d. Rules and limits should be simple and few.

c Never spank the child for any reason. Toddlers younger than 18 months of age should not be spanked due to the possibility of injury. All the other statements describe toddler characteristics accurately and are basic to good discipline but are not the most important for this young toddler.

Kaplan-Pediatric Growth and Development Quiz - adolescent Nurses should provide anticipatory guidance to males to prepare them for what particular pubertal change in late adolescence? a. Reddening of the scrotum b. Breast enlargement c. Nocturnal emissions d. Lengthening of the penis

c Norturnal emissions This involuntary ejaculation during the night can be distrubing to the adloescent male who has little or no understanding of what is happening in his body. Lengthening of the penis begins to occur in early adolescence as does reddening of the scrotum, Breast enlargement occurs in some males in middle adolescence and resolves in late adolescence.

Kaplan-Pediatric Growth and Development Quiz - toddler The parents of a 2-year-old boy complain to the nurse because their child is "such a picky eater." Which recommendation would be most helpful for developing healthy eating habits in this child? a. Assuring the parents that food jags are normal, and they can be honored safely. b. Encouraging the parents to eat a variety of wholesome foods themselves. c. Offering a variety of foods along with the foods the child likes. d. Advising the parents to minimize distractions at mealtime.

c Offering a variety of foods along with the foods the child likes. Toddlers require fewer calories proportionately than infants, and their appetite decreases (physiologic anorexia). Offering a variety of healthy foods along with foods the child likes will acknowledge preferences while keeping the door open to new foods. Prolonged particular food preferences (food jags) are common. It is also important that mealtime be calm, pleasant, and focused on eating. Toddlers mimic behaviors observed. It is important that parents set a good example with their mealtime behaviors and food choices. All options encourage the development of health eating habits, but at this time, variety plus preferred foods will be most helpful.

Kaplan-Pediatric Growth and Development Quiz - toddler The toddler needs elbow restraints to keep his hands away from a facial wound. What will the nurse do to best ensure their safe use? a. Have the parent check for equal warmth bilaterally in his hands and fingers. b. Apply lotion to the skin prior to putting on the restraints. c. Remove one restraint at a time on a regular basis to check for skin irritation. d. Choose restraints long enough to fit closely under the arm and extend over the wrist.

c Remove one restraint at a time on a regular basis to check for skin irritation. Removing one restraint at a time provides for control of both hands. A long-sleeve shirt under the elbow restraints also protects the skin, and is a better choice than lotion will soften the skin and not be protective. The restraints should not extend into the axilla. Movement would create pressure and irritation. The parent can help monitor the restraints, but the nurse is responsible for the safety of their use.

Kaplan-Pediatric Growth and Development Quiz - school age The school nurse is performing a vision screening for a 7-year-old child. Which finding should trigger a referral? a. Visual acuity of 20/20 in both eyes. b. Peripheral vision similar to that of the school nurse. c. Slight misalignment of the eyes d. Ability to color discriminate

c Slight misalignment of the eyes Misalightment of the eyes (strabismus) interferes with vision and eye development. Amblyopia (vision loss) can result. Lack of alignment of the eyes needs referral and treatment. The rest represent normal visual findings in 7 year-old.

Kaplan-Pediatric Growth and Development Quiz - toddler In discussing with the nurse their 2-year-old's behavior, which of the parents' descriptors suggests the child may be ready for toilet teaching? a. The child frequently repeats words parents just said. b. The toddler walks with a wide, swaying gait. c. The child hides behind her bedroom door when defecating. d. The child often removes her shoes and socks.

c The child hides behind her bedroom door when defecating. Hiding while defecating indicates awareness of this need. Repeating words promotes language development but doesn't indicate readiness for toilet teaching. Walking with a wide, swaying gait is early walking behavior. Steady walking and running signals toileting readiness. Removal of shoes and socks is easily done. Greater fine motor clothing removal skill is needed for toileting.

Kaplan-Pediatric Growth and Development Quiz - infancy The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which of the following observations points to a developmental risk? a. Cannot pull self to standing b. Picks up small objects using entire hand c. Uses only the left hand to grasp d. Crawls with stomach down

c Uses only the left hand to grasp Favoring on hand over the other may be a warning sign that proper motor development is not occurring in the other arm or hand. Grasping small objects with the entire hand is common at 8 months and precedes the pincer grasp, which is used about 2 months later. Crawling with stomach down and being unable to pull to standing are abilities that may not occur for another 4 to 8 weeks.

Kaplan-Pediatric Growth and Development Quiz - safety The nurse is providing teaching about preventing poisoning. Which of the following statements by the mother would warrant further discussion? a. "I never transfer cleaning products out of their original containers." b. "We have the poison control number located near our phone." c. "We keep our lawn and garden products on a high shelf in the garage." d. "All medicine in our bathroom is in childproof containers."

d "All medicine in our bathroom is in childproof containers." The nurse should emphasize that while childproof caps on medications are important, all medications including those with childproof caps should still be kept locked. (Vitamins are medications.) The other statements are correct.

Kaplan-Pediatric Growth and Development Quiz - Adolescents The nurse is admitting a 14-year-old girl for a tonsillectomy and is preparing her for the procedure. Which of the following is the best statement or question? a. "Some of the sound in the hospital can be scary." b. "Are you feeling scared about the surgery?" c. "I have your discharge instructions for you." d. "Are you wondering about anything related to your tonsillectomy?"

d "Are you wondering about anything related to your tonsilectomy?" For a 14-year-old girl, the best approach would be to ask an open questions so that concerns, lack of understanding, or a need for information can be determined. Asking if the teen feels "scared" may get a "yes" or "no" response, which may or may not be honest depending on what the teen expects of herself or believes other expect of her. An adolescent is often reluctant to admit fear. Mentioning scary hospital sound provides no information and is inappropriate developmentally. Introducing discharge instruction needs to come later after other needs are met. Some discharge information is covered during admission since tonsillectomy is usually day surgery.

Kaplan-Pediatric Growth and Development Quiz - adolescent The nurse is talking with the parents of a depressed 16 year-old boy. Which question is of most importance? a. "How is his personal hygiene?" b. "Does he exercise?" c. "Have his sleeping and eating pattern changed?" d. "Is there a gun in your home?"

d "Is there a gun in your home? He may be at risk for suicide. Firearm-related suicides have been responsible for a large number of the suicide deaths in 15 to 19 year-olds nationwide. All the other questions assess for depression and do not protect against suicide.

Kaplan-Pediatric Growth and Development Quiz - safety The mother and father of a 5 year-old boy are discussing bicycle safety with the nurse. What comment indicates further teaching is needed? a. "Our son always wears a helmet." b. "He never rides in the street." c. "He is able to ride without training wheels." d. "We just got him a new bike he can grow into."

d "We just got him a new bike he can grow into." The bicycle should fit the rider. The balls of his feet should reach both pedals while he is sitting on the seat and has both hands on the handlebars. The other comments describe no safety risk.

Kaplan-Pediatric Growth and Development Quiz - School age While treating a minor playground injury for an 8-year-old girl, the school nurse discovers that the injury was the result of bullying. What should be the nurse's first action? a. Determine if there have been other playground bullying incidents. b. Immediately call the bullied child's parents. c. Question those responsible for the bullying. d. Assess the situation with the help of the school staff and parents.

d Assess the situation with the help of the school staff and parents. Assessing the situation and following the school's bullying protocol will be an important first step. Immediately calling the bullied child's parents may be premature. Questioning those responsible for the bullying and determining if there have been other playground incidents of bullying may be part of the overall assessment, but would not be the first action taken.

Kaplan-Pediatric Growth and Development Quiz - nutrition The nurse finds the diet of a 30-month-old girl to be low in calcium. What suggestion can significantly increase this toddler's calcium intake? a. Use unsweetened applesauce as a dessert. b. Include dark greens and spinach in her meals. c. Offer chocolate milk to increase milk intake. d. Give her slices of cheddar cheese as a snack.

d Give her slices of cheddar cheese as a snack. 2 ½ ounces of cheddar cheese provides the toddler's daily requirement of 500 mg of calcium. Chocolate milk provides calcium but the sugar it contains should not be a regular part of a toddler diet. Applesauce provides fiber, not calcium. Spinach and dark greens do contain calcium, but that calcium has limited bioavailability.

Kaplan-Pediatric Growth and Development Quiz - toddler A toddler needs to be transported to a far area of the hospital for noinvasive diagnostic testing. The nurse chooses to: a. Use a wheeled cart with sides to provides for safety. b. Transport the child in his crib surrounded by his toys. c. Have the mother carry the child wrapped in a blanket. d. Place the child on the mother's lap and push the two in a wheelchair.

d Place the child on the mother's lap and push the two in a wheelchair. The mother's arms and lap provide a safe and fun place to ride. Having the mother carry the child is reassuring to the child but many be tiring for the mother. In addition, the child may struggle to walk. A wheeled cart is unfamiliar and large, likely stressful. Transport by crib turns the child's bed into an unsafe place by taking this toddler to an area likely to be seen as frightening.

Kaplan-Pediatric Growth and Development Quiz - Toddler The nurse is visiting a daycare center and watches two toddlers at play. What best describes the play observed? a. Playing for significant stretches of time in one activity b. Sharing stuffed animals c. Sitting quietly with several toys d. Playing alongside one another

d Playing alongside one another daycare Playing beside on another is parallel play and typical of toddlerhood. Toddlers have short attention spans and frequently change toys and activities. Because toddlers are egocentric, sharing is difficult. Toddlers move about and explore during play rather and sit quietly.

Kaplan-Pediatric Growth and Development Quiz - Adolescents A 14 year-old girl arrives at the nurse's office carrying a tooth knocked out in gym. The nurse knows, prior to dental care, the action that will best preserve the tooth is: a. Place the tooth on ice in a clean container. b. Place the tooth in a dry, sterile container. c. Rinse the tooth and place in a container of warm water. d. Reinsert the tooth into the socket.

d Reinsert the tooth into the socket. If reinserting the tooth is possible, it will be preserved until the teen can get to the dentist. The other options for caring for the tooth are incorrect. If replacing it in the socket is not possible, placing it in cool milk or in normal saline for transport to the dentist is suggested.

Kaplan-Pediatric Growth and Development Quiz - school age The nurse is providing home care for an 8-year-old girl who is dependent on a ventilator and for her family. Which of the following is a part of case management for the child and family? a. Teaching the parents how to do passive range of motion (PROM) and active range of motion (AROM) with their child. b. Problem-solving with the parents and child ways to get the child's homework when she is unable to attend school. c. Doing the complex sterile dressing changes the child requires. d. Scheduling respite care of the child with a child care provider.

d Scheduling respite care of the child with a child care provider. Scheduling the respite care is case management since it involves coordinating healthcare services. Teaching PROM and AROM skills to the parent helps them meet their child's physical care needs with the nurse assuming a teaching role. Finding ways to get homework to the child by working with parents and the child promotes the development of a trusting relationship. The nurse is providing direct care (not case management) in doing the complex sterile dressing changes.

Kaplan-Pediatric Growth and Development Quiz - Adolescents In helping parents anticipate puberty in their son, the nurse explains that a first sign will be: a. Axillary hair b. Pubic hair c. Deepening of the voice d. Testicular enlargement

d Testicular enlargement

Kaplan-Pediatric Growth and Development Quiz - preschool The parents of a 5 year-old can the nurse for advice about night terrors. Which of the following is the most appropriate intervention? a. Explain that this is a developmental phase that will not last. b. Encourage the parents to let the child fall asleep in a safe place such as their bed. c. Tell the parents to be sure to wake the child up during the next episode. d. Wake the child up nightly 30-45 minutes after going to sleep.

d Wake the child up nightly 30-45 minutes after going to sleep. Awakening children early in their sleep cycle often interrupts the night terror events and should be continued nightly for about 7 days. Suggesting the parent wake the child during a night terror is both difficult and ineffective. A major reason parents find night terrors frightening is that the child does not respond to the parent's presence. Indicating this is a developmental phase may be somewhat accurate, but does not assist the parents in handling the situation. Having the child fall asleep in a "safe" place or the parents' bed is likely to predispose to other sleep problems without helping to solve this one.