NURS 325 peds practice test 1 (ch. 26-31, 39, & 40)

A 5-year-old child is brought to the Emergency Department with abrupt onset of sore throat, pain with swallowing, fever, and sitting upright and forward. Acute epiglottitis is suspected. What are the most appropriate nursing interventions? (Select all that apply.) A. Vital signs B. Throat culture C. Medical history D. Assessment of breath sounds E. Emergency airway equipment readily available

A. Vital signs C. Medical history D. Assessment of breath sounds E. Emergency airway equipment readily available

Cystic fibrosis may affect singular or multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is: A. Atrophic changes in the mucosal wall of intestines. B. Hypoactivity of the autonomic nervous system. C. Hyperactivity of the sweat glands. D. Mechanical obstruction caused by increased viscosity of mucous gland secretions.

D. Mechanical obstruction caused by increased viscosity of mucous gland secretions.

The nurse finds that a newborn weighs 3 kg (7 lb). By the time the child reaches 2 years, she weighs 12 kg (26 lb). What would be the child's approximate weight by 6 years of age? 1 20-22 kg (44-48 lb) 2 27-29 kg (59-64 lb) 3 30-32 kg (66-70 lb) 4 36-38 kg (79-84 lb)

1. 20-22 kg (44-48 lb)

What is the corresponding stage of spiritual development of a child who states, "All women with big stomachs have babies"? 1 Mythical-literal 2 Undifferentiated 3 Synthetic-convention 4 Individuating-reflexive

1. Mythical-literal

A preschool child watches a nurse pour medication from a tall, thin glass to a short, wide glass. Which statement is appropriate developmentally for this age group? 1 The amount of medicine is less. 2 The amount of medicine did not change, only its appearance. 3 Pouring medicine makes the medicine hot. 4 The glass changed shape to accommodate the medicine.

1. The amount of medicine is less.

The nurse is reviewing Erikson's theory about the autonomy versus shame and doubt stage. The nurse is trying to correlate it to Freud's psychosexual theory. Which stage would the nurse review in Freud's theory? 1 Oral 2 Anal 3 Phallic 4 Latency

2. Anal

Which parameters should the nurse monitor in the infant with hypothermia to ensure effective care? 1 Hemoglobin levels 2 Blood glucose levels 3 White blood cell count 4 Serum potassium levels

2. Blood glucose levels

The nurse instructs a child's parent to be cautious because the child is hyperactive and difficult. What assessment would the nurse have performed to confirm the child's behavior? 1 Restlessness 2 Temperament 3 Hypothermic conditions 4 Neurological maturation

2. Temperament

The nurse is assessing an infant with delayed motor development. The nurse finds that the infant is able to move her neck without support. The ability to perform which activity should develop next in this child? 1 Crawling 2 Creeping 3 Sitting 4 Standing

3. Sitting

Parents have understood teaching about prevention of childhood otitis media if they make which statement? a. "We will only prop the bottle during the daytime feedings." b. "Breastfeeding will be discontinued after 4 months of age." c. "We will place the child flat right after feedings." d. "We will be sure to keep immunizations up to date."

d. "We will be sure to keep immunizations up to date."

23. The nurse should expect the anterior fontanel to close at age: a. 2 months. b. 2 to 4 months. c. 6 to 8 months. d. 12 to 18 months.

d. 12 to 18 months.

Chronic otitis media with effusion (OME) is differentiated from acute otitis media (AOM) because it is usually characterized by: a. Fever as high as 40° C (104° F). b. Severe pain in the ear. c. Nausea and vomiting. d. A feeling of fullness in the ear.

d. A feeling of fullness in the ear.

The nurse is doing a prehospitalization orientation for a 7-year-old child who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that she will not be able to talk because of an endotracheal tube but that she will be able to talk when it is removed. This explanation is: a. Unnecessary. b. The surgeon's responsibility. c. Too stressful for a young child. d. An appropriate part of the child's preparation.

d. An appropriate part of the child's preparation.

It is important to make certain that sensory connectors and oximeters are compatible since wiring that is incompatible can cause: a. Hyperthermia. c. Pressure necrosis. b. Electrocution. d. Burns under sensors.

d. Burns under sensors.

The nurse approaches a group of school-age patients to administer medication to Sam Hart. To identify the correct child, the nurse should: a. Ask the group, "Who is Sam Hart?" b. Call out to the group, "Sam Hart?" c. Ask each child, "What's your name?" d. Check the patient's identification name band.

d. Check the patient's identification name band.

11. A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain? a. FACES pain rating tool b. Numeric scale c. Oucher scale d. FLACC tool

d. FLACC tool

Which information should the nurse teach workers at a day care center about respiratory syncytial virus (RSV)? a. RSV is transmitted through particles in the air. b. RSV can live on skin or paper for up to a few seconds after contact. c. RSV can survive on nonporous surfaces for about 60 minutes. d. Frequent hand washing can decrease the spread of the virus.

d. Frequent hand washing can decrease the spread of the virus.

An appropriate intervention to encourage food and fluid intake in a hospitalized child is to: a. Force child to eat and drink to combat caloric losses. b. Discourage participation in noneating activities until caloric intake is sufficient. c. Administer large quantities of flavored fluids at frequent intervals and during meals. d. Give high-quality foods and snacks whenever child expresses hunger.

d. Give high-quality foods and snacks whenever child expresses hunger.

When caring for an infant with an upper respiratory tract infection and elevated temperature, an appropriate nursing intervention is to: a. Give tepid water baths to reduce fever. b. Encourage food intake to maintain caloric needs. c. Have child wear heavy clothing to prevent chilling. d. Give small amounts of favorite fluids frequently to prevent dehydration.

d. Give small amounts of favorite fluids frequently to prevent dehydration.

The mother of a toddler yells to the nurse, "Help! He is choking to death on his food." The nurse determines that lifesaving measures are necessary based on: a. Gagging. b. Coughing. c. Pulse over 100 beats/min. d. Inability to speak.

d. Inability to speak.

Which statement is characteristic of acute otitis media (AOM)? a. The etiology is unknown. b. Permanent hearing loss often results. c. It can be treated by intramuscular antibiotics. d. It is treated with a broad range of antibiotics.

d. It is treated with a broad range of antibiotics.

1. Kyle, age 6 months, is brought to the clinic. His parent says, "I think he hurts. He cries and rolls his head from side to side a lot." This most likely suggests which feature of pain? a. Type b. Severity c. Duration d. Location

d. Location

The nurse is preparing for the admission of an infant who will have several procedures performed. In which situation is informed consent required (Select all that apply)? a. Catheterized urine collection b. Intravenous (IV) line insertion c. Oxygen administration d. Lumbar puncture e. Computed tomography (CT) scan with contrast

d. Lumbar puncture e. Computed tomography (CT) scan with contrast

Why do infants and young children quickly have respiratory distress in acute and chronic alterations of the respiratory system? a. They have a widened, shorter airway. b. There is a defect in their sucking ability. c. The gag reflex increases mucus production. d. Mucus and edema obstruct small airways.

d. Mucus and edema obstruct small airways.

When caring for a child with an intravenous infusion, the nurse should: a. Use a macrodropper to facilitate reaching the prescribed flow rate. b. Avoid restraining the child to prevent undue emotional stress. c. Change the insertion site every 24 hours. d. Observe the insertion site frequently for signs of infiltration.

d. Observe the insertion site frequently for signs of infiltration.

Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing considerations should include: a. Do not administer pancreatic enzymes if the child is receiving antibiotics. b. Decrease dose of pancreatic enzymes if the child is having frequent, bulky stools. c. Administer pancreatic enzymes between meals if at all possible. d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

Skin testing for tuberculosis (the Mantoux test) is recommended: a. Every year for all children older than 2 years. b. Every year for all children older than 10 years. c. Every 2 years for all children starting at age 1 year. d. Periodically for children who reside in high-prevalence regions.

d. Periodically for children who reside in high-prevalence regions.

When administering a gavage feeding to a school-age child, the nurse should: a. Lubricate the tip of the feeding tube with Vaseline to facilitate passage. b. Check the placement of the tube by inserting 20 mL of sterile water. c. Administer feedings over 5 to 10 minutes. d. Position the child on the right side after administering the feeding.

d. Position the child on the right side after administering the feeding.

An 8-month-old infant is restrained to prevent interference with the intravenous infusion. The nurse should: a. Remove the restraints once a day to allow movement. b. Keep the restraints on constantly. c. Keep the restraints secure so the infant remains supine. d. Remove the restraints whenever possible.

d. Remove the restraints whenever possible.

The parent of an infant with nasopharyngitis should be instructed to notify the health care professional if the infant: a. Becomes fussy. b. Has a cough. c. Has a fever over 99° F. d. Shows signs of an earache.

d. Shows signs of an earache.

A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse recognizes that these symptoms are characteristic of which respiratory condition? a. Allergic rhinitis b. Bronchitis c. Asthma d. Sinusitis

d. Sinusitis

Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis? a. Bronchoscopy b. Serum calcium c. Urine creatinine d. Sweat chloride test

d. Sweat chloride test

14. Which parameter correlates best with measurements of the body's total protein stores? a. Height b. Weight c. Skin-fold thickness d. Upper arm circumference

d. Upper arm circumference

Which is the preferred site for intramuscular injections in infants? a. Deltoid c. Rectus femoris b. Dorsogluteal d. Vastus lateralis

d. Vastus lateralis

Which vitamin supplements are necessary for children with cystic fibrosis? a. Vitamin C and calcium b. Vitamins B6 and B12 c. Magnesium d. Vitamins A, D, E, and K

d. Vitamins A, D, E, and K

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

d. Wrap foot in a warm washcloth.

21. When palpating the child's cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm. The best explanation for this is: a. some form of cancer. b. local scalp infection common in children. c. infection or inflammation distal to the site. d. infection or inflammation close to the site.

d. infection or inflammation close to the site.

8. The nurse caring for the child in pain understands that distraction: a. can give total pain relief to the child. b. is effective when the child is in severe pain. c. is the best method for pain relief. d. must be developmentally appropriate to refocus attention.

d. must be developmentally appropriate to refocus attention.

2. Physiologic measurements in children's pain assessment are: a. the best indicator of pain in children of all ages. b. essential to determine whether a child is telling the truth about pain. c. of most value when children also report having pain. d. of limited value as sole indicator of pain.

d. of limited value as sole indicator of pain.

31. The nurse must assess a child's capillary refilling time. This can be accomplished by: a. inspecting the chest. b. auscultating the heart. c. palpating the apical pulse. d. palpating the skin to produce a slight blanching.

d. palpating the skin to produce a slight blanching.

A mother tells the nurse that she doesn't want her infant immunized because of the discomfort associated with injections. The nurse should explain that: a.This cannot be prevented. b.Infants do not feel pain as adults do. c.This is not a good reason for refusing immunizations. d.A topical anesthetic, eutectic mixture of local anesthetic (EMLA), can be applied before injections are given.

d.A topical anesthetic, eutectic mixture of local anesthetic (EMLA), can be applied before injections are given.

The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. The nurse's response should be based on knowledge that this is: a.Unacceptable because of the risk of sudden infant death syndrome (SIDS). b.Unacceptable because it does not encourage achievement of developmental milestones. c.Unacceptable to encourage fine motor development. d.Acceptable to encourage head control and turning over.

d.Acceptable to encourage head control and turning over.

Austin, age 6 months, has six teeth. The nurse should recognize that this is: a.Normal tooth eruption. c.Unusual and dangerous. b.Delayed tooth eruption. d.Earlier-than-normal tooth eruption.

d.Earlier-than-normal tooth eruption.

Which is the most appropriate action when an infant becomes apneic? a.Shake vigorously. b.Roll head side to side. c.Hold by feet upside down with head supported. d.Gently stimulate trunk by patting or rubbing.

d.Gently stimulate trunk by patting or rubbing.

The parents of a 12-month-old child ask the nurse if the child can eat hot dogs. The nurse's reply should be based on knowing that: a.The child is too young to digest hot dogs. b.The child is too young to eat hot dogs safely. c.Hot dogs must be sliced into sections to prevent aspiration. d.Hot dogs must be cut into small, irregular pieces to prevent aspiration.

d.Hot dogs must be cut into small, irregular pieces to prevent aspiration.

An important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS) is to: a.Explain how SIDS could have been predicted and prevented. b.Interview parents in depth concerning the circumstances surrounding the infant's death. c.Discourage parents from making a last visit with the infant. d.Make a follow-up home visit to parents as soon as possible after the infant's death.

d.Make a follow-up home visit to parents as soon as possible after the infant's death.

Parents tell the nurse that their 1-year-old son often sleeps with them. They seem unconcerned about this. The nurse's response should be based on the knowledge that: a.Children should not sleep with their parents. b.Separation from parents should be completed by this age. c.Daytime attention should be increased. d.This is a common and accepted practice, especially in some cultural groups.

d.This is a common and accepted practice, especially in some cultural groups.

An 18-month-old child is seen in the clinic with AOM. Trimethoprim-sulfamethoxazole (Bactrim) is prescribed. Which statement made by the parent indicates a correct understanding of the instructions? a. "I should administer all the prescribed medication." b. "I should continue medication until the symptoms subside." c. "I will immediately stop giving medication if I notice a change in hearing." d. "I will stop giving medication if fever is still present in 24 hours."

a. "I should administer all the prescribed medication."

2. Which data would be included in a health history? (Select all that apply.) a. Review of systems b. Physical assessment c. Sexual history d. Growth measurements e. Nutritional assessment f. Family medical history

a. Review of systems c. Sexual history e. Nutritional assessment f. Family medical history

The nurse is doing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. This should be interpreted as: a.A normal finding. b.A questionable finding—the infant should be rechecked in 1 month. c.An abnormal finding—indicates the need for immediate referral to a practitioner. d.An abnormal finding—indicates the need for developmental assessment.

a.A normal finding.

18. The best play activity to provide tactile stimulation for a 6-month-old infant is to: a.Allow to splash in bath. c.Play music box, tapes, or CDs. b.Give various colored blocks. d.Use infant swing or stroller.

a.Allow to splash in bath.

In terms of gross motor development, what would the nurse expect a 5-month-old infant to do? a.Roll from abdomen to back. c.Sit erect without support. b.Roll from back to abdomen. d.Move from prone to sitting position.

a.Roll from abdomen to back.

In terms of gross motor development, what would the nurse expect a 5-month-old infant to do (select all that apply)? a.Roll from abdomen to back. b.Put feet in mouth when supine. c.Roll from back to abdomen. d.Sit erect without support. e.Move from prone to sitting position.

a.Roll from abdomen to back. b.Put feet in mouth when supine.

. A child is receiving total parenteral nutrition (TPN; hyperalimentation). At the end of 8 hours, the nurse observes the solution and notes that 200 mL/8 hr is being infused rather than the ordered amount of 300 mL/8 hr. The nurse should adjust the rate so that how much will infuse during the next 8 hours? a. 200 Ml c. 350 mL b. 300 mL d. 400 mL

b. 300 mL

Asthma in infants is usually triggered by: a. Medications. b. A viral infection. c. Exposure to cold air. d. Allergy to dust or dust mites.

b. A viral infection.

17. Which tool measures body fat most accurately? a. Stadiometer b. Calipers c. Cloth tape measure d. Paper or metal tape measure

b. Calipers

Cardiopulmonary resuscitation is begun on a toddler. Which pulse is usually palpated because it is the most central and accessible? a. Radial b. Carotid c. Femoral d. Brachial

b. Carotid

Which information should the nurse include in teaching parents how to care for a child's gastrostomy tube at home? a. Never turn the gastrostomy button. b. Clean around the insertion site daily with soap and water. c. Expect some leakage around the button. d. Remove the tube for cleaning once a week.

b. Clean around the insertion site daily with soap and water.

The nurse is assessing a child with acute epiglottitis. Examining the child's throat by using a tongue depressor might precipitate which symptom or condition? a. Inspiratory stridor b. Complete obstruction c. Sore throat d. Respiratory tract infection

b. Complete obstruction

b-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is their action? a. Liquefy secretions b. Dilate the bronchioles c. Reduce inflammation of the lungs d. Reduce infection

b. Dilate the bronchioles

Which type of croup is always considered a medical emergency? a. Laryngitis b. Epiglottitis c. Spasmodic croup d. Laryngotracheobronchitis (LTB)

b. Epiglottitis

An important nursing consideration when performing a bladder catheterization on a young boy is to: a. Use clean technique, not Standard Precautions. b. Insert 2% lidocaine lubricant into the urethra. c. Lubricate catheter with water-soluble lubricant such as K-Y Jelly. d. Delay catheterization for 20 minutes while anesthetic lubricant is absorbed.

b. Insert 2% lidocaine lubricant into the urethra.

Guidelines for intramuscular administration of medication in school-age children include to: a. Inject medication as rapidly as possible. b. Insert the needle quickly, using a dartlike motion. c. Penetrate the skin immediately after cleansing the site, before skin has dried. d. Have the child stand, if possible, and if he or she is cooperative.

b. Insert the needle quickly, using a dartlike motion.

The nurse has just collected blood by venipuncture in the antecubital fossa. Which should the nurse do next? a. Keep arm extended while applying a bandage to the site. b. Keep arm extended, and apply pressure to the site for a few minutes. c. Apply a bandage to the site, and keep the arm flexed for 10 minutes. d. Apply a gauze pad or cotton ball to the site, and keep the arm flexed for several minutes.

b. Keep arm extended, and apply pressure to the site for a few minutes.

Which nursing action is the most appropriate when applying a face mask to a child for oxygen therapy? a. Set the oxygen flow rate at less than 6 L/min. b. Make sure the mask fits properly. c. Keep the child warm. d. Remove the mask for 5 minutes every hour.

b. Make sure the mask fits properly.

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (rhDNase). This drug: a. May cause mucus to thicken. b. May cause voice alterations. c. Is given subcutaneously. d. Is not indicated for children younger than 12 years.

b. May cause voice alterations.

A venipuncture will be performed on a 7-year-old girl. She wants her mother to hold her during the procedure. The nurse should recognize that this: a. Is unsafe. b. May help the child relax. c. Is against hospital policy. d. Is unnecessary because of the child's age.

b. May help the child relax.

1. The nurse must check vital signs on a 2-year-old boy who is brought to the clinic for his 24-month checkup. Which criteria should the nurse use in determining the appropriate-size blood pressure cuff? (Select all that apply) a. The cuff is labeled "toddler." b. The cuff bladder width is approximately 40% of the circumference of the upper arm. c. The cuff bladder length covers 80% to 100% of the circumference of the upper arm. d. The cuff bladder covers 50% to 66% of the length of the upper arm.

b. The cuff bladder width is approximately 40% of the circumference of the upper arm. c. The cuff bladder length covers 80% to 100% of the circumference of the upper arm.

4. What is an important consideration for the nurse who is communicating with a very young child? a. Speak loudly, clearly, and directly. b. Use transition objects such as a doll. c. Disguise own feelings, attitudes, and anxiety. d. Initiate contact with the child when the parent is not present.

b. Use transition objects such as a doll.

36. The nurse is meeting a 5-year-old child for the first time and would like the child to cooperate during a dressing change. The nurse decides to do a simple magic trick using gauze. This should be interpreted as: a. inappropriate, because of child's age. b. a way to establish rapport. c. too distracting, when cooperation is important. d. acceptable, if there is adequate time.

b. a way to establish rapport.

7. When the nurse interviews an adolescent, it is especially important to: a. focus the discussion on the peer group. b. allow an opportunity to express feelings. c. emphasize that confidentiality will always be maintained. d. use the same type of language as the adolescent.

b. allow an opportunity to express feelings.

12. The nurse is taking a sexual history on an adolescent girl. The best way to determine whether she is sexually active is to: a. ask her, "Are you sexually active?" b. ask her, "Are you having sex with anyone?" c. ask her, "Are you having sex with a boyfriend?" d. ask both the girl and her parent if she is sexually active.

b. ask her, "Are you having sex with anyone?"

A nurse is conducting education classes for parents of infants. The nurse plans to discuss sudden infant death syndrome (SIDS). Which risk factors should the nurse include as increasing an infant's risk of a SIDS incident(select all that apply)? a.Breastfeeding b.Low Apgar scores c.Male sex d.Birth weight in the 50th or higher percentile e.Recent viral illness

b.Low Apgar scores c.Male sex e.Recent viral illness

18. By what age do the head and chest circumferences generally become equal? a. 1 month b. 6 to 9 months c. 1 to 2 years d. 2.5 to 3 years

c. 1 to 2 years

16. With the National Center for Health Statistics (NCHS) criteria, which body mass index (BMI)-for-age percentile indicates a risk for being overweight? a. 10th percentile b. 9th percentile c. 85th percentile d. 95th percentile

c. 85th percentile

It is generally recommended that a child with acute streptococcal pharyngitis can return to school: a. When the sore throat is better. b. If no complications develop. c. After taking antibiotics for 24 hours. d. After taking antibiotics for 3 days.

c. After taking antibiotics for 24 hours.

Nursing considerations related to the administration of oxygen in an infant include to: a. Humidify the oxygen if the infant can tolerate it. b. Assess the infant to determine how much oxygen should be given. c. Ensure uninterrupted delivery of the appropriate oxygen concentration. d. Direct the oxygen flow so that it blows directly into the infant's face in a hood.

c. Ensure uninterrupted delivery of the appropriate oxygen concentration.

The nurse must suction a child with a tracheostomy. Interventions should include: a. Encouraging the child to cough to raise the secretions before suctioning. b. Selecting a catheter with a diameter three-fourths as large as the diameter of the tracheostomy tube. c. Ensuring that each pass of the suction catheter take no longer than 5 seconds. d. Allowing the child to rest after every 5 times the suction catheter is passed.

c. Ensuring that each pass of the suction catheter take no longer than 5 seconds.

30. Which term is used to describe breath sounds that are produced as air passes through narrowed passageways? a. Rubs b. Rattles c. Wheezes d. Crackles

c. Wheezes

An infant has been pronounced dead from sudden infant death syndrome (SIDS) in the emergency department. Which is an appropriate question to ask the parents? a."Did you hear the infant cry out?" b."Why didn't you check on the infant earlier?" c."What time did you find the infant?" d."Was the head buried in a blanket?"

c."What time did you find the infant?"

The nurse should teach parents that which age is safe to give infants whole milk instead of commercial infant formula? a.6 months c.12 months b.9 months d.18 months

c.12 months

Parent guidelines for relieving colic in an infant include: a.Avoiding touching the abdomen. b.Avoiding using a pacifier. c.Changing the infant's position frequently. d.Placing the infant where the family cannot hear the crying.

c.Changing the infant's position frequently.

A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. The nurse should recommend that the infant be given: a.Skim milk. c.Commercial iron-fortified formula. b.Whole cow's milk. d.Commercial formula without iron.

c.Commercial iron-fortified formula.

Latasha is a breastfed infant being seen in the clinic for her 6-month checkup. Her mother tells the nurse that Latasha recently began to suck her thumb. The best nursing intervention is to: a.Recommend that the mother substitute a pacifier for Latasha's thumb. b.Assess Latasha for other signs of sensory deprivation. c.Reassure the mother that this is very normal at this age. d.Suggest that the mother breastfeed Latasha more often to satisfy sucking needs.

c.Reassure the mother that this is very normal at this age.

According to Piaget, the 6-month-old infant would be in what stage of the sensorimotor phase? a.Use of reflexes c.Secondary circular reactions b.Primary circular reactions d.Coordination of secondary schemata

c.Secondary circular reactions

26. The most frequently used test for measuring visual acuity is the: a. Denver Eye Screening test. b. Allen picture card test. c. Ishihara vision test. d. Snellen letter chart.

d. Snellen letter chart.

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

d. normal because the lower back and leg muscles are not yet well developed.

A parent asks the nurse whether her infant is susceptible to pertussis. The nurse's response should be based on which statement concerning susceptibility to pertussis? a.Neonates will be immune the first few months. b.If the mother has had the disease, the infant will receive passive immunity. c.Children younger than 1 year seldom contract this disease. d.Most children are highly susceptible from birth.

d.Most children are highly susceptible from birth.

The parents of a 9-month-old infant tell the nurse that they have noticed foods such as peas and corn are not completely digested and can be seen in their infant's stool. The nurse bases her explanation on knowing that: a.Children should not be given fibrous foods until the digestive tract matures at age 4 years. b.The infant should not be given any solid foods until this digestive problem is resolved. c.This is abnormal and requires further investigation. d.This is normal because of the immaturity of digestive processes at this age.

d.This is normal because of the immaturity of digestive processes at this age.

Which best describes Piaget's cognitive stage of formal operations? 1 Deductive and abstract reasoning 2 Inductive reasoning and beginning logic 3 Transductive reasoning and egocentrism 4 Cause-and-effect reasoning and object permanence

1. Deductive and abstract reasoning

Based on Piaget's theory of cognitive development, what is one basic concept a child is expected to attain during the first year of life? 1 If an object is hidden, that does not mean that it is gone. 2 He or she cannot be fooled by changing shapes. 3 Parents are not perfect. 4 Most procedures can be reversed.

1. If an object is hidden, that does not mean that it is gone.

The nurse is caring for a child with a genetic disorder and is instructed to not give the child milk or milk products. What type of disorder does this child probably have? 1 Phenylketonuria 2 Sickle cell disorder 3 Down syndrome 4 Turner syndrome

1. Phenylketonuria

The nurse assesses a child born to a patient with epilepsy and notices teratogenic effects in the baby. Which factors should the nurse assess to determine the cause of the teratogenic effects? 1 The medication history of the patient 2 The presence of environmental triggers 3 Abnormal CCR5 gene found in the patient 4 A family history of genetic abnormalities

1. The medication history of the patient

The nurse is caring for a newborn who weighs 3 kg (7 lb). The nurse assesses the child 4 years later and notes that the child weighs 13 kg (30 lb). What should the nurse do with this information? 1 This finding is normal; continue to monitor. 2 Instruct the parents to provide supplements. 3 Assess the child for nutritional deficiencies. 4 Talk to the police about parental neglect.

1. This finding is normal; continue to monitor.

During their school-age years, children best understand concepts that can be seen or illustrated. The nurse knows this type of thinking is termed as: 1 concrete operations. 2 preoperational. 3 school-age rhetoric. 4 formal operations.

1. concrete operations.

The nurse finds that a newborn infant weighs approximately 3 kg (7 lb). Approximately how much would the child weigh when he reaches 2.5 years of age? 1 9 kg (20 lb) 2 12 kg (27 lb) 3 15 kg (33 lb) 4 17 kg (38 lb)

2. 12 kg (27 lb)

A child is 50 cm (20 inches) long in the second month of infancy. The nurse checks the baby 2 months later and finds healthy growth in the child. Approximately how long would the baby be at 4 months? 1 52 cm 2 55 cm 3 57 cm 4 60 cm

2. 55 cm

In what age group should the nurse expect a child to develop gross motor skills? 1 Birth through infancy 2 Early childhood 3 Later childhood 4 Middle childhood

2. Early childhood

The nurse is assessing a child and asks the child to climb the chairs to check for motor development. What is the age group of the child that the nurse is assessing? 1 Infancy 2 Early childhood 3 Middle childhood 4 Later childhood

2. Early childhood

The nurse is caring for a 2-day-old neonate who is healthy but has a low body temperature. The nurse instructs the infant's mother to place the unclothed infant on her bare chest. Which finding in the infant indicates ineffective management of the infant's condition? 1 Hyperglycemia 2 Metabolic acidosis 3 Body weight of 21 lbs 4 Body weight of 7.5 lbs 00:00:15 Question Answer Confidence ButtonsJust a guessPretty sureNailed it

2. Metabolic acidosis

A nurse is knowledgeable about both growth and development. Which assessment finding indicates the child's development is on target? 1 The child has not gained weight for 3 months. 2 The child can throw a large ball but not a small ball. 3 The child's arms are the most rapidly growing part of the child's body. 4 The child can pull herself or himself to her or his feet before the child is able to sit steadily.

2. The child can throw a large ball but not a small ball.

Which statement helps explain the growth and development of children? 1 Development proceeds at a predictable rate. 2 The sequence of developmental milestones is predictable. 3 Rates of growth are consistent among children. 4 At times of rapid growth, there is also acceleration of development.

2. The sequence of developmental milestones is predictable.

The nurse is assessing a newborn who weighs 3 kg (7 lb). At what growth stage would the child weigh 12 kg (26 lb)? 1 Infancy 2 Toddlerhood 3 Preschool age 4 School age

2. Toddlerhood

The nurse is teaching a student nurse about a child who only has one X chromosome. What abnormality does the child have? 1 Down syndrome 2 Turner syndrome 3 Fragile X syndrome 4 Contiguous gene syndrome

2. Turner syndrome

A nurse is examining a toddler and is discussing with the mother psychosocial development according to Erikson's theories. Based on the nurse's knowledge of Erikson, the most age-appropriate activity to suggest to the mother at this stage is to: 1 feed lunch. 2 allow the toddler to start making choices about what to wear. 3 allow the toddler to pull a talking-duck toy. 4 turn on a TV show with bright colors and loud songs.

2. allow the toddler to start making choices about what to wear.

A patient who is undergoing stem cell therapy asks the nurse about undifferentiated cells. Which response given by the nurse is most appropriate? "These cells:" 1 are able to divide at a very rapid rate." 2 multiply to form any part of the body." 3 can perform specialized functions." 4 are similar to all other cells in the body."

2. multiply to form any part of the body."

The nurse is speaking to a group in the community about psychosocial development according to Erikson's life-span approach. The nurse instructs the group not to impose too many expectations on a child because the child may develop an inferiority complex. What age group of children is nurse referring to here? 1 1-3 years 2 3-6 years 3 6-12 years 4 12-18 years

3. 6-12 years

The Kohlberg moral development theory states that children are concerned with conformity and loyalty at a stage of their growth. When this stage is correlated with the cognitive development of children, what would the age group be? 1 0-2 years 2 2-7 years 3 7-11 years 4 11-15 years

3. 7-11 years

The nurse assesses a child's cognitive development to determine whether the child has mastered the concept of conservation. In which age group is the concept of conservation usually attained? 1 0-2 years 2 2-7 years 3 7-11 years 4 11-15 years

3. 7-11 years

During a home visit, the parent of a 9-year-old child tells the nurse that after coming in from playing outside, the child does not want to do homework. The child feels feverish. What should the nurse tell the child's mother? 1 "Your child has a fever due to impaired thermoregulation." 2 "Your child should play indoor games for 1 hour daily." 3 "A child's body temperature increases after playing." 4 "Your child should drink milk immediately after playing."

3. A child's body temperature increases after playing."

An infant's blood glucose levels are low, and the nurse instructs the mother to perform kangaroo care. Which condition would the nurse have assessed in the child? 1 Irregular sleep patterns 2 Reduced metabolism 3 Improper thermoregulation 4 Impaired maturation

3. Improper thermoregulation

A child is assessed and categorized in the industry versus inferiority stage according to Erikson's theory. The nurse compares the child with Freud's psychosexual development theory. At what stage would the child be categorized in Freud's theory? 1 Anal 2 Phallic 3 Latency 4 Genital

3. Latency

The nurse is assessing a child. The nurse asks the parents, "Has your child started sleeping less lately?" Which attribute of temperament is the nurse assessing? 1 Adaptability 2 Distractibility 3 Rhythmicity 4 Activity

3. Rhythmicity

During assessment of a 7-month-old child, the nurse checks the child's height and weight and compares them with previous assessment records. The nurse finds that the child's height has increased by 1.25 cm, and the weight is 140 g more than in the previous month. What does the nurse infer from this observation? 1 The child is displaying symptoms of Down syndrome. 2 The child's weight is not ideal in relation to height. 3 The child's height and weight are ideal. 4 The child has a calcium deficiency due to malnutrition.

3. The child's height and weight are ideal.

The nurse is caring for two children. The younger child creates complex imaginary stories using dolls and toys. The older child is engaged in building a model airplane. Which stages of development are the children likely in, according to Erikson? 1 The younger child is in the trust versus mistrust stage; the older child is in the initiative versus guilt stage. 2 The younger child is in the industry versus inferiority stage; the older child is in the identity versus role confusion stage. 3 The younger child is in the initiative versus guilt stage; the older child is in the industry versus inferiority stage. 4 The younger child is in the identity versus role confusion stage; the older child is in the trust versus mistrust stage.

3. The younger child is in the initiative versus guilt stage; the older child is in the industry versus inferiority stage.

The nurse is talking to a group of parents about different types of play in which children engage. Which statement made by a parent indicates a correct understanding of the teaching? 1 "Parallel-play children borrow and lend play materials and sometimes attempt to control who plays in the group." 2 "In associative play, children play independently but among other children." 3 "During onlooker play, children play alone with toys different from those used by other children in the same area." 4 "Cooperative play is organized, and children play in a group with other children."

4. "Cooperative play is organized, and children play in a group with other children."

Which intervention should the nurse incorporate to prevent hypothermia in an infant? 1 Give hot milk or hot water to the infant at regular intervals. 2 Place the unclothed, diapered infant in the sun for few hours. 3 Feed the infant formula, which is higher in calories. 4 Put the unclothed, diapered infant on the mother's bare chest.

4. Put the unclothed, diapered infant on the mother's bare chest.

Asthma is classified into four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent. Clinical features used to determine these categories include: (Select all that apply.) A. Lung function. B. Associated allergies. C. Frequency of symptoms. D. Frequency and severity of exacerbations.

A. Lung function. C. Frequency of symptoms. D. Frequency and severity of exacerbations.

The parent of a child with cystic fibrosis calls the clinic nurse to report that the child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic because these symptoms are suggestive of: A. Pneumothorax. B. Bronchodilation. C. Carbon dioxide retention. D. Increased viscosity of sputum.

A. Pneumothorax.

An infant with a congenital heart defect is receiving palivizumab (Synagis). The purpose of this is to: A. Prevent respiratory syncytial virus (RSV) infection. B. Make isolation of infant with RSV unnecessary. C. Prevent secondary bacterial infection. D. Decrease toxicity of antiviral agents.

A. Prevent respiratory syncytial virus (RSV) infection.

A 4-year-old boy needs to use a metered-dose inhaler to treat asthma. He cannot coordinate the breathing to use it effectively. The nurse should suggest that he use a: A. Spacer. B. Nebulizer. C. Peak expiratory flow meter. D. Trial of chest physiotherapy.

A. Spacer.

When caring for a child after a tonsillectomy, the nurse should: A. Watch for continuous swallowing. B. Encourage gargling to reduce discomfort. C. Position the child on the back for sleeping. D. Apply warm compresses to the throat

A. Watch for continuous swallowing.

Using knowledge of child development, the best approach when preparing a toddler for a procedure is to: a. Avoid asking the child to make choices. b. Demonstrate the procedure on a doll. c. Plan for the teaching session to last about 20 minutes. d. Show necessary equipment without allowing child to handle it.

B. Demonstrate the procedure on a doll.

An immediate intervention when an infant chokes on a piece of food would be to: A. Have infant lie quietly while a call is placed for emergency help. B. Position the infant in a head-down, face-down position and administer five quick blows between the shoulder blades. C. Administer mouth-to-mouth resuscitation. D. Give water by cup to relieve the obstruction.

B. Position the infant in a head-down, face-down position and administer five quick blows between the shoulder blades.

The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37° C. The nurse suspects croup and should recommend: A. Controlling fever with acetaminophen and calling if the cough gets worse during the night. B. Trying a cool-mist vaporizer at night and watching for signs of difficulty breathing. C. Trying over-the-counter cough medicine and coming to the clinic in the morning if there is no improvement. D. Admitting to the hospital and observing for impending epiglottitis.

B. Trying a cool-mist vaporizer at night and watching for signs of difficulty breathing.

It is important that a child with Group A ß-hemolytic streptococci (GABHS) infection be treated with antibiotics to prevent: A. Otitis media. B. Diabetes insipidus. C. Nephrotic syndrome. D. Acute rheumatic fever.

D. Acute rheumatic fever.

A child with asthma is having pulmonary function tests. The purpose of the peak expiratory flow rate (PEFR) is to: A. Confirm the diagnosis of asthma. B. Determine the cause of asthma. C. Identify "triggers" of asthma. D. Assess the severity of asthma.

D. Assess the severity of asthma.

One of the goals for children with asthma is to prevent respiratory infection. This is because respiratory infection: A. Lessens effectiveness of medications. B. Encourages exercise-induced asthma. C. Increases sensitivity to allergens. D. Can trigger an episode or aggravate an asthmatic state.

D. Can trigger an episode or aggravate an asthmatic state.

A 4-year-old girl is brought to the emergency room. She has a "froglike" croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should: A. Examine her oral pharynx and report to the physician. B. Make her lie down and rest quietly. C. Auscultate her lungs and make preparations for placement in a mist tent. D. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.

D. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.

A humidified atmosphere is recommended for a young child with an upper respiratory tract infection because this environment facilitates: A. liquefying secretions. B. improving oxygenation. C. promoting ventilation. D. soothing inflamed mucous membrane.

D. soothing inflamed mucous membrane.

2. The nurse is using the FLACC scale to evaluate pain in a preverbal child. The nurse makes the following assessment: Face: occasional grimace; Leg: relaxed; Activity: squirming, tense; Cry: no cry; Consolability: content, relaxed. The nurse records the FLACC assessment as ________. (Record your answer as a whole number.)

FLACC of 2

Abdominal thrusts (the Heimlich maneuver) are recommended for airway obstruction in children older than: a. 1 year. b. 4 years. c. 8 years. d. 12 years.

a. 1 year.

A nurse is interpreting the results of a tuberculin skin test (TST) on an adolescent who is human immunodeficiency virus (HIV) positive. Which induration size indicates a positive result for this child 48 to 72 hours after the test? a. 5 mm c. 15 mm b. 10 mm d. 20 mm

a. 5 mm

When liquid medication is given to a crying 10-month-old infant, which approach minimizes the possibility of aspiration? a. Administering the medication with a syringe (without needle) placed along the side of the infant's tongue b. Administering the medication as rapidly as possible with the infant securely restrained c. Mixing the medication with the infant's regular formula or juice and administering by bottle d. Keeping the child upright with the nasal passages blocked for a minute after administration

a. Administering the medication with a syringe (without needle) placed along the side of the infant's tongue

Katie, 4 years old, is admitted to outpatient surgery for removal of a cyst on her foot. Her mother puts the hospital gown on her, but Katie is crying because she wants to leave on her underpants. The most appropriate nursing action is to: a. Allow her to wear her underpants. b. Discuss with her mother why this is important to Katie. c. Ask her mother to explain to her why she cannot wear them. d. Explain in a kind, matter-of-fact manner that this is hospital policy.

a. Allow her to wear her underpants.

A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests: a. Asthma. b. Pneumonia. c. Bronchiolitis. d. Foreign body in the trachea.

a. Asthma.

An infant's parents ask the nurse about preventing otitis media (OM). What should the nurse recommend? a. Avoid tobacco smoke. b. Use nasal decongestant. c. Avoid children with OM. d. Bottle-feed or breastfeed in supine position.

a. Avoid tobacco smoke.

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include: a. Avoiding use for more than 3 days. b. Keeping drops to use again for nasal congestion. c. Administering drops until nasal congestion subsides. d. Administering drops after feedings and at bedtime.

a. Avoiding use for more than 3 days.

A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered? a. Before chest physiotherapy (CPT) b. After CPT c. Before receiving 100% oxygen d. After receiving 100% oxygen

a. Before chest physiotherapy (CPT)

10. The nurse is interviewing the mother of an infant. She reports, "I had a difficult delivery, and my baby was born prematurely." This information should be recorded under which heading? a. Birth history b. Present illness c. Chief complaint d. Review of systems

a. Birth history

3. Which dietary recommendations should a nurse make to an adolescent patient to manage constipation related to opioid analgesic administration? (Select all that apply.) a. Bran cereal b. Decrease fluid intake c. Prune juice d. Cheese e. Vegetables

a. Bran cereal c. Prune juice e. Vegetables

A school-age child has had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of: a. Bronchitis. b. Bronchiolitis. c. Viral-induced asthma. d. Acute spasmodic laryngitis.

a. Bronchitis.

An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which of the following? (Select all that apply). a. Cluster care to conserve energy b. Round-the-clock administration of antitussive agents c. Strict intake and output to avoid congestive heart failure d. Administration of antibiotics e. Placement in a mist tent

a. Cluster care to conserve energy d. Administration of antibiotics

The nurse is teaching a mother how to perform chest physiotherapy and postural drainage on her 3-year-old child, who has cystic fibrosis. To enable the mother to perform percussion, the nurse should instruct her to: a. Cover the skin with a shirt or gown before percussing. b. Strike the chest wall with a flat-hand position. c. Percuss over the entire trunk anteriorly and posteriorly. d. Percuss before positioning for postural drainage.

a. Cover the skin with a shirt or gown before percussing.

4. A nurse is performing an assessment on a school-age child. Which findings suggest the child is receiving an excess of vitamin A? (Select all that apply.) a. Delayed sexual development b. Edema c. Pruritus d. Jaundice e. Paresthesia

a. Delayed sexual development c. Pruritus d. Jaundice

In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind? a. Diet should be high in carbohydrates and protein. b. Diet should be high in easily digested carbohydrates and fats. c. Most fruits and vegetables are not well tolerated. d. Fats and proteins must be greatly curtailed.

a. Diet should be high in carbohydrates and protein.

The nurse gives an injection in a patient's room. What should the nurse do with the needle for disposal? a. Dispose of syringe and needle in a rigid, puncture-resistant container in patient's room. b. Dispose of syringe and needle in a rigid, puncture-resistant container in an area outside of patient's room. c. Cap needle immediately after giving injection and dispose of in proper container. d. Cap needle, break from syringe, and dispose of in proper container.

a. Dispose of syringe and needle in a rigid, puncture-resistant container in patient's room.

A nurse is charting that a hospitalized child has labored breathing. Which describes labored breathing? a. Dyspnea b. Tachypnea c. Hypopnea d. Orthopnea

a. Dyspnea

5. A nurse is planning to use an interpreter during a health history interview of a non-English speaking patient and family. Which nursing care guidelines should the nurse include when using an interpreter? (Select all that apply.) a. Elicit one answer at a time. b. Interrupt the interpreter if the response from the family is lengthy. c. Comments to the interpreter about the family should be made in English. d. Arrange for the family to speak with the same interpreter, if possible. e. Introduce the interpreter to the family.

a. Elicit one answer at a time. d. Arrange for the family to speak with the same interpreter, if possible. e. Introduce the interpreter to the family.

An appropriate nursing intervention when caring for a child with pneumonia is to: a. Encourage rest. b. Encourage the child to lie on the unaffected side. c. Administer analgesics. d. Place the child in the Trendelenburg position.

a. Encourage rest.

Kimberly, age 3 years, has a fever associated with a viral illness. Her mother calls the nurse, reporting a fever of 102° F even though Kimberly had acetaminophen 2 hours ago. The nurse's action should be based on knowing that: a. Fevers such as this are common with viral illnesses. b. Seizures are common in children when antipyretics are ineffective. c. Fever over 102° F indicates greater severity of illness. d. Fever over 102° F indicates a probable bacterial infection.

a. Fevers such as this are common with viral illnesses.

The nurse is preparing a 12-year-old girl for a bone marrow aspiration. She tells the nurse that she wants her mother with her "like before." The most appropriate nursing action is to: a. Grant her request. b. Explain why this is not possible. c. Identify an appropriate substitute for her mother. d. Offer to provide support to her during the procedure.

a. Grant her request.

Which statement expresses accurately the genetic implications of cystic fibrosis (CF)? a. If it is present in a child, both parents are carriers of this defective gene. b. It is inherited as an autosomal dominant trait. c. It is a genetic defect found primarily in non-Caucasian population groups. d. There is a 50% chance that siblings of an affected child also will be affected.

a. If it is present in a child, both parents are carriers of this defective gene.

When teaching a mother how to administer eyedrops, where should the nurse tell her to place them? a. In the conjunctival sac that is formed when the lower lid is pulled down b. Carefully under the upper eyelid while it is gently pulled upward c. On the sclera while the child looks to the side d. Anywhere as long as drops contact the eye's surface

a. In the conjunctival sac that is formed when the lower lid is pulled down

1. The nurse is seeing an adolescent boy and his parents in the clinic for the first time. What should the nurse do first? a. Introduce himself or herself. b. Make the family comfortable. c. Explain the purpose of the interview. d. Give an assurance of privacy.

a. Introduce himself or herself.

The advantages of the ventrogluteal muscle as an injection site in young children include which of the following (Select all that apply)? a. Less painful than vastus lateralis b. Free of important nerves and vascular structures c. Cannot be used when child reaches a weight of 20 pounds d. Increased subcutaneous fat, which increases drug absorption e. Easily identified by major landmarks

a. Less painful than vastus lateralis b. Free of important nerves and vascular structures e. Easily identified by major landmarks

The earliest recognizable clinical manifestation of cystic fibrosis (CF) is: a. Meconium ileus. b. History of poor intestinal absorption. c. Foul-smelling, frothy, greasy stools. d. Recurrent pneumonia and lung infections.

a. Meconium ileus.

9. Which medication is the most effective choice for treating pain associated with sickle cell crisis in a newly admitted 5-year-old child? a. Morphine b. Acetaminophen c. Ibuprofen d. Midazolam

a. Morphine

A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. When preparing for a lumbar puncture, the nurse's best action is to: a. Prepare child for conscious sedation during the test. b. Set up a tray with equipment the same size as for adults. c. Reassure the parents that the test is simple, painless, and risk free. d. Apply EMLA to puncture site 15 minutes before procedure.

a. Prepare child for conscious sedation during the test.

Which information should the nurse teach families about reducing exposure to pollens and dust (Select all that apply)? a. Replace wall-to-wall carpeting with wood and tile floors. b. Use an air conditioner. c. Put dust-proof covers on pillows and mattresses. d. Keep humidity in the house above 60%. e. Keep pets outside.

a. Replace wall-to-wall carpeting with wood and tile floors. b. Use an air conditioner. c. Put dust-proof covers on pillows and mattresses.

A 6-year-old child is hospitalized for intravenous (IV) antibiotic therapy. He eats little on his "regular diet" trays. He tells the nurse that all he wants to eat is pizza, tacos, and ice cream. Which is the best nursing action? a. Request these favorite foods for him. b. Identify healthier food choices that he likes. c. Explain that he needs fruits and vegetables. d. Reward him with ice cream at the end of every meal that he eats.

a. Request these favorite foods for him.

10. Which assessment indicates to a nurse that a school-aged child is in need of pain medication? a. The child is lying rigidly in bed and not moving. b. The child's current vital signs are consistent with vital signs over the past 4 hours. c. The child becomes quiet when held and cuddled. d. The child has just returned from the recovery room.

a. The child is lying rigidly in bed and not moving.

A nurse is conducting an in-service on asthma. Which statement is the most descriptive of bronchial asthma? a. There is heightened airway reactivity. b. There is decreased resistance in the airway. c. The single cause of asthma is an allergic hypersensitivity. d. It is inherited.

a. There is heightened airway reactivity.

What is critical information for the nurse to incorporate into her care when using restraints on a child? a. Use the least restrictive type of restraint. b. Tie knots securely so they cannot be untied easily. c. Secure the ties to the mattress or side rails. d. Remove restraints every 4 hours to assess skin.

a. Use the least restrictive type of restraint.

29. What type of breath sound is normally heard over the entire surface of the lungs, except for the upper intrascapular area and the area beneath the manubrium? a. Vesicular b. Bronchial c. Adventitious d. Bronchovesicular

a. Vesicular

The nurse wore gloves during a dressing change. When the gloves are removed, the nurse should: a. Wash hands thoroughly. b. Check the gloves for leaks. c. Rinse gloves in disinfectant solution. d. Apply new gloves before touching the next patient.

a. Wash hands thoroughly.

A nurse is caring for a child in Droplet Precautions. Which instructions should the nurse give to the unlicensed assistive personnel caring for this child (Select all that apply)? a. Wear gloves when entering the room. b. Wear an isolation gown when entering the room. c. Place the child in a special air handling and ventilation room. d. A mask should be worn only when holding the child. e. Wash your hands upon exiting the room.

a. Wear gloves when entering the room. b. Wear an isolation gown when entering the room. e. Wash your hands upon exiting the room.

24. During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is: a. a normal finding. b. an abnormal finding; the child needs referral to an ophthalmologist. c. a sign of a possible visual defect; the child needs vision screening. d. a sign of small hemorrhages, which usually resolve spontaneously.

a. a normal finding.

6. The nurse is caring for a child receiving intravenous (IV) morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to: a. administer naloxone (Narcan). b. discontinue the IV infusion. c. discontinue morphine until the child is fully awake. d. stimulate the child by calling his or her name, shaking gently, and asking the child to breathe deeply.

a. administer naloxone (Narcan).

33. The nurse has a 2-year-old boy sit in "tailor" position during palpation for the testes. The rationale for this position is that: a. it prevents cremasteric reflex. b. undescended testes can be palpated. c. this tests the child for an inguinal hernia. d. the child does not yet have a need for privacy.

a. it prevents cremasteric reflex.

3. The pediatric nurse understands that nonpharmacologic strategies for pain management: a. may reduce pain perception. b. make pharmacologic strategies unnecessary. c. usually take too long to implement. d. trick children into believing they do not have pain.

a. may reduce pain perception.

22. The nurse has just started assessing a young child who is febrile and appears very ill. There is hyperextension of the child's head (opisthotonos) with pain on flexion. The most appropriate action is to: a. refer for immediate medical evaluation. b. continue the assessment to determine the cause of neck pain. c. ask the parent when the child's neck was injured. d. record "head lag" on the assessment record and continue the assessment of the child.

a. refer for immediate medical evaluation.

A nurse has completed a teaching session for parents about "baby-proofing" the home. Which statements made by the parents indicate an understanding of the teaching (select all that apply)? a."We will put plastic fillers in all electrical plugs." b."We will place poisonous substances in a high cupboard." c."We will place a gate at the top and bottom of stairways." d."We will keep our household hot water heater at 130 degrees." e."We will remove front knobs from the stove."

a."We will put plastic fillers in all electrical plugs." c."We will place a gate at the top and bottom of stairways." e."We will remove front knobs from the stove."

By what age does the posterior fontanel usually close? a.6 to 8 weeks c.4 to 6 months b.10 to 12 weeks d.8 to 10 months

a.6 to 8 weeks

Which interventions should the nurse implement when caring for a family of a sudden infant death syndrome (SIDS) infant (select all that apply)? a.Allow parents to say goodbye to their infant. b.Once parents leave the hospital, no further follow-up is required. c.Arrange for someone to take the parents home from the hospital. d.Avoid requesting an autopsy of the deceased infant. e.Conduct a debriefing session with the parents before they leave the hospital.

a.Allow parents to say goodbye to their infant. c.Arrange for someone to take the parents home from the hospital. e.Conduct a debriefing session with the parents before they leave the hospital.

Clinical manifestations of failure to thrive caused by behavioral problems resulting in inadequate intake of calories include: a.Avoidance of eye contact. b.An associated malabsorption defect. c.Weight that falls below the 15th percentile. d.Normal achievement of developmental landmarks.

a.Avoidance of eye contact.

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

a.Easily grasped handle b.One-piece construction e.Sturdy, flexible material

A parent of an infant with colic tells the nurse, "All this baby does is scream at me; it is a constant worry." The nurse's best action is: a.Encourage parent to verbalize feelings. b.Encourage parent not to worry so much. c.Assess parent for other signs of inadequate parenting. d.Reassure parent that colic rarely lasts past age 9 months.

a.Encourage parent to verbalize feelings.

Which is an important nursing consideration when caring for an infant with failure to thrive? a.Establish a structured routine and follow it consistently. b.Maintain a nondistracting environment by not speaking to the infant during feeding. c.Place the infant in an infant seat during feedings to prevent overstimulation. d.Limit sensory stimulation and play activities to alleviate fatigue.

a.Establish a structured routine and follow it consistently.

Which information could be given to the parents of a 12-month-old child regarding appropriate play activities for this age? a.Give large push-pull toys for kinesthetic stimulation. b.Place cradle gym across crib to facilitate fine motor skills. c.Provide child with finger paints to enhance fine motor skills. d.Provide stick horse to develop gross motor coordination.

a.Give large push-pull toys for kinesthetic stimulation.

Sara, age 4 months, was born at 35 weeks' gestation. She seems to be developing normally, but her parents are concerned because she is a "more difficult" baby than their other child, who was term. The nurse should explain that: a.Infants' temperaments are part of their unique characteristics. b.Infants become less difficult if they are not kept on scheduled feedings and structured routines. c.Sara's behavior is suggestive of failure to bond completely with her parents. d.Sara's difficult temperament is the result of painful experiences in the neonatal period.

a.Infants' temperaments are part of their unique characteristics.

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

a.Is old enough to understand the word "No."

The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the baby's formula faster. The nurse should recommend: a.Never heating a bottle in a microwave oven. b.Heating only 10 ounces or more. c.Always leaving the bottle top uncovered to allow heat to escape. d.Shaking the bottle vigorously for at least 30 seconds after heating.

a.Never heating a bottle in a microwave oven.

A 3-month-old infant, born at 38 weeks of gestation, will hold a rattle if it is put in her hands; however, she will not voluntarily grasp it. The nurse should interpret this as: a.Normal development. b.Significant developmental lag. c.Slightly delayed development caused by prematurity. d.Suggestive of a neurologic disorder such as cerebral palsy.

a.Normal development.

With the goal of preventing plagiocephaly, the nurse should teach new parents to: a.Place the infant prone for 30 to 60 minutes per day. b.Buy a soft mattress. c.Allow the infant to nap in the car safety seat. d.Have the infant sleep with the parents.

a.Place the infant prone for 30 to 60 minutes per day.

An appropriate play activity for a 7-month-old infant to encourage visual stimulation is: a.Playing peek-a-boo. c.Imitating animal sounds. b.Playing pat-a-cake. d.Showing how to clap hands.

a.Playing peek-a-boo.

The nurse notices that a 10-month-old infant being seen in the clinic is wearing expensive, inflexible, high-top shoes. The nurse should explain that: a.Soft and flexible shoes are generally better. b.High-top shoes are necessary for support. c.Inflexible shoes are necessary to prevent in-toeing and out-toeing. d.This type of shoe will encourage the infant to walk sooner.

a.Soft and flexible shoes are generally better.

In terms of fine motor development, the infant of 7 months should be able to: a.Transfer objects from one hand to the other. b.Use thumb and index finger in a crude pincer grasp. c.Hold a crayon and make a mark on paper. d.Release cubes into a cup.

a.Transfer objects from one hand to the other.

What is the most appropriate statement for the nurse to make to a 5-year-old child who is undergoing a venipuncture? a. "You must hold still or I'll have someone hold you down. This is not going to hurt." b. "This will hurt like a pinch. I'll get someone to help hold your arm still so it will be over fast and hurt less." c. "Be a big boy and hold still. This will be over in just a second." d. "I'm sending your mother out so she won't be scared. You are big, so hold still and this will be over soon."

b. "This will hurt like a pinch. I'll get someone to help hold your arm still so it will be over fast and hurt less."

19. The earliest age at which a satisfactory radial pulse can be taken in children is: a. 1 year. b. 2 years. c. 3 years. d. 6 years.

b. 2 years.

25. Binocularity, the ability to fixate on one visual field with both eyes simultaneously, is normally present by what age? a. 1 month b. 3 to 4 months c. 6 to 8 months d. 12 months

b. 3 to 4 months

8. The nurse is taking a health history on an adolescent. Which best describes how the chief complaint should be determined? a. Ask for a detailed listing of symptoms. b. Ask the adolescent, "Why did you come here today?" c. Use what the adolescent says to determine, in correct medical terminology, what the problem is. d. Interview the parent away from the adolescent to determine the chief complaint.

b. Ask the adolescent, "Why did you come here today?"

3. A school nurse is screening children for scoliosis. Which assessment findings should the nurse expect to observe for scoliosis? (Select all that apply.) a. Complaints of a sore back b. Asymmetry of the shoulders c. An uneven hemline d. Inability to bend at the waist e. Unequal waist angles

b. Asymmetry of the shoulders c. An uneven hemline e. Unequal waist angles

The parent of a toddler calls the nurse, asking about croup. What is a distinguishing manifestation of spasmodic croup? a. Wheezing is heard audibly. b. It has a harsh, barky cough. c. It is bacterial in nature. d. The child has a high fever.

b. It has a harsh, barky cough.

The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What is essential in this child's care? a. Monitor pulse oximetry. b. Monitor arterial blood gases. c. Administer oxygen if respiratory distress develops. d. Administer oxygen if child's lips become bright, cherry red.

b. Monitor arterial blood gases.

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include: a. Force fluids. b. Monitor pulse oximetry. c. Institute seizure precautions. d. Encourage a high-protein diet.

b. Monitor pulse oximetry.

4. Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period? a. Codeine b. Morphine c. Methadone d. Meperidine

b. Morphine

In preparing to give "enemas until clear" to a young child, the nurse should select: a. Tap water. c. Oil retention. b. Normal saline. d. Fleet solution.

b. Normal saline.

Which consideration is the most important in managing tuberculosis (TB) in children? a. Skin testing annually b. Pharmacotherapy c. Adequate nutrition d. Adequate hydration

b. Pharmacotherapy

A 2-year-old child comes to the emergency department with dehydration and hypovolemic shock. What best explains why an intraosseous infusion is started? a. It is less painful for small children. b. Rapid venous access is not possible. c. Antibiotics must be started immediately. d. Long-term central venous access is not possible.

b. Rapid venous access is not possible.

The nurse finds that an infant with a cleft palate is at risk for obstructive apnea. Which associated findings does the nurse expect? Select all that apply. A Clubfoot B Recessed mandible C Abnormally placed tongue D Congenital amputation E Congenitally sparse hair

b. Recessed mandible c. Abnormally placed tongue

Which statement best describes why children have fewer respiratory tract infections as they grow older? a. The amount of lymphoid tissue decreases. b. Repeated exposure to organisms causes increased immunity. c. Viral organisms are less prevalent in the population. d. Secondary infections rarely occur after viral illnesses.

b. Repeated exposure to organisms causes increased immunity.

2. The nurse is monitoring a patient for side effects associated with opioid analgesics. Which side effects should the nurse expect to monitor for? (Select all that apply.) a. Diarrhea b. Respiratory depression c. Hypertension d. Pruritus e. Sweating

b. Respiratory depression d. Pruritus e. Sweating

The nurse is planning how to best prepare a 4-year-old child for some diagnostic procedures. Guidelines for preparing this preschooler should include: a. Planning for a short teaching session of about 30 minutes. b. Telling the child that procedures are never a form of punishment. c. Keeping equipment out of the child's view. d. Using correct scientific and medical terminology in explanations.

b. Telling the child that procedures are never a form of punishment.

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. The nurse's rationale for this action is primarily that: a. Mothers of hospitalized toddlers often experience guilt. b. The mother's presence will reduce anxiety and ease the child's respiratory efforts. c. Separation from the mother is a major developmental threat at this age. d. The mother can provide constant observations of the child's respiratory efforts.

b. The mother's presence will reduce anxiety and ease the child's respiratory efforts.

35. Kimberly is having a checkup before starting kindergarten. The nurse asks her to do the "finger-to-nose" test. The nurse is testing for: a. deep tendon reflexes. b. cerebellar function. c. sensory discrimination. d. ability to follow directions.

b. cerebellar function.

7. When pain is assessed in an infant, it is inappropriate for the nurse to assess for: a. facial expressions of pain. b. localization of pain. c. crying. d. thrashing of extremities.

b. localization of pain.

28. The appropriate placement of a tongue blade for assessment of the mouth and throat is the: a. the center back area of the tongue. b. the side of the tongue. c. against the soft palate. d. on the lower jaw.

b. the side of the tongue.

The nurse is assessing a 6-month-old healthy infant who weighed 7 pounds at birth. The nurse should expect the infant to now weigh approximately: a.10 pounds. c.20 pounds. b.15 pounds. d.25 pounds.

b.15 pounds.

At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli? a.1 month c.3 months b.2 months d.4 months

b.2 months

When is the best age for solid food to be introduced into the infant's diet? a.2 to 3 months c.When birth weight has tripled b.4 to 6 months d.When tooth eruption has started

b.4 to 6 months

A nurse is teaching parents about prevention and treatment of colic. Which should the nurse include in the teaching plan? a.Avoid use of pacifiers. b.Eliminate all secondhand smoke contact. c.Lay infant flat after feeding. d.Avoid swaddling the infant.

b.Eliminate all secondhand smoke contact.

The clinic is lending a federally approved car seat to an infant's family. The nurse should explain that the safest place to put the car seat is: a.Front facing in back seat. b.Rear facing in back seat. c.Front facing in front seat if an air bag is on the passenger side. d.Rear facing in front seat if an air bag is on the passenger side.

b.Rear facing in back seat.

A nurse is preparing to administer routine immunizations to a 4-month-old infant. The infant is currently up to date on all previously recommended immunizations. Which immunizations will the nurse prepare to administer (select all that apply)? a.Measles, mumps, and rubella (MMR) b.Rotavirus (RV) c.Diphtheria, tetanus, and acellular pertussis (DTaP) d.Varicella e.Haemophilus influenzae type b (HIB) f.Inactivated poliovirus (IPV)

b.Rotavirus (RV) c.Diphtheria, tetanus, and acellular pertussis (DTaP) e.Haemophilus influenzae type b (HIB) f.Inactivated poliovirus (IPV)

27. The nurse is testing an infant's visual acuity. By what age should the infant be able to fix on and follow a target? a. 1 month b. 1 to 2 months c. 3 to 4 months d. 6 months

c. 3 to 4 months

An appropriate method for administering oral medications that are bitter to an infant or small child would be to mix them with: a. A bottle of formula or milk. b. Any food the child is going to eat. c. A small amount (1 teaspoon) of a sweet-tasting substance such as jam or ice cream. d. Large amounts of water to dilute medication sufficiently.

c. A small amount (1 teaspoon) of a sweet-tasting substance such as jam or ice cream.

A child is diagnosed with influenza, probably type A disease. Management includes: a. Clear liquid diet for hydration. b. Aspirin to control fever. c. Amantadine hydrochloride to reduce symptoms. d. Antibiotics to prevent bacterial infection.

c. Amantadine hydrochloride to reduce symptoms.

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

c. Are of no value in treating hyperthermia.

Frequent urine testing for specific gravity and glucose are required on a 6-month-old infant. The most appropriate way to collect small amounts of urine for these tests is to: a. Apply a urine-collection bag to the perineal area. b. Tape a small medicine cup to the inside of the diaper. c. Aspirate urine from cotton balls inside the diaper with a syringe. d. Aspirate urine from a superabsorbent disposable diaper with a syringe.

c. Aspirate urine from cotton balls inside the diaper with a syringe.

The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the child's care (Select all that apply)? a. Administer antibiotics. b. Administer cough syrup. c. Encourage infant to drink 8 ounces of formula every 4 hours. d. Institute cluster care to encourage adequate rest. e. Place on noninvasive oxygen monitoring.

c. Encourage infant to drink 8 ounces of formula every 4 hours. d. Institute cluster care to encourage adequate rest. e. Place on noninvasive oxygen monitoring.

32. What heart sound is produced by vibrations within the heart chambers or in the major arteries from the back-and-forth flow of blood? a. S1, S2 b. S3, S4 c. Murmur d. Physiologic splitting

c. Murmur

In some genetically susceptible children, anesthetic agents can trigger malignant hyperthermia. The nurse should be alert in observing that, in addition to an increased temperature, an early sign of this disorder is: a. Apnea. c. Muscle rigidity. b. Bradycardia. d. Decreased blood pressure.

c. Muscle rigidity.

20. Where is the best place to observe for the presence of petechiae in dark-skinned individuals? a. Face b. Buttocks c. Oral mucosa d. Palms and soles

c. Oral mucosa

1. An appropriate tool to assess pain in a 3-year-old child is the: (Select all that apply.) a. Visual Analog Scale (VAS) b. Adolescent and pediatric pain tool c. Oucher tool d. FACES pain-rating scale

c. Oucher tool d. FACES pain-rating scale

9. Where in the health history should the nurse describe all details related to the chief complaint? a. Past history b. Chief complaint c. Present illness d. Review of systems

c. Present illness

12. A nurse is gathering a history on a school-age child admitted for a migraine headache. The child states, "I have been getting a migraine every 2 or 3 months for the last year." The nurse documents this as which type of pain? a. Acute b. Chronic c. Recurrent d. Subacute

c. Recurrent

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

c. Refer the child for further evaluation.

A nurse must do a venipuncture on a 6-year-old child. An important consideration in providing atraumatic care is to: a. Use an 18-gauge needle if possible. b. If not successful after four attempts, have another nurse try. c. Restrain the child only as needed to perform venipuncture safely. d. Show the child equipment to be used before procedure.

c. Restrain the child only as needed to perform venipuncture safely.

Which age-group is most concerned with body integrity? a. Toddler b. Preschooler c. School-age child d. Adolescent

c. School-age child

It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because they may develop: a. Cough. b. Osteoporosis. c. Slowed growth. d. Cushing's syndrome.

c. Slowed growth.

Tepid water or sponge baths are indicated for hyperthermia in children. The nurse should: a. Add isopropyl alcohol to the water. b. Direct a fan on the child in the bath. c. Stop the bath if the child begins to chill. d. Continue the bath for 5 minutes.

c. Stop the bath if the child begins to chill.

A parent whose two school-age children have asthma asks the nurse in what sports, if any, they can participate. The nurse should recommend: a. Soccer. b. Running. c. Swimming. d. Basketball.

c. Swimming.

Which intervention for treating croup at home should be taught to parents? a. Have a decongestant available to give the child when an attack occurs. b. Have the child sleep in a dry room. c. Take the child outside. d. Give the child an antibiotic at bedtime.

c. Take the child outside.

The emergency department nurse is cleaning multiple facial abrasions on 9-year-old Mike. His mother is present. He is crying and screaming loudly. The nurse should: a. Ask him to be quieter. b. Have his mother tell him to relax. c. Tell him it is okay to cry and scream. d. Suggest that he talk to his mother instead of crying.

c. Tell him it is okay to cry and scream.

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

c. The child's developmental level

What should the nurse consider when having consent forms signed for surgery and procedures on children? a. Only a parent or legal guardian can give consent. b. The person giving consent must be at least 18 years old. c. The risks and benefits of a procedure are part of the consent process. d. A mental age of 7 years or older is required for a consent to be considered "informed."

c. The risks and benefits of a procedure are part of the consent process.

What nursing action is appropriate for specimen collection? a. Follow sterile technique for specimen collection. b. Sterile gloves are worn if the nurse plans to touch the specimen. c. Use Standard Precautions when handling body fluids. d. Avoid wearing gloves in front of the child and family.

c. Use Standard Precautions when handling body fluids.

2. Which action is most likely to encourage parents to talk about their feelings related to their child's illness? a. Be sympathetic. b. Use direct questions. c. Use open-ended questions. d. Avoid periods of silence.

c. Use open-ended questions.

The nurse is caring for an unconscious child. Skin care should include: a. Avoiding use of pressure reduction on the bed. b. Massaging reddened bony prominences to prevent deep tissue damage. c. Using draw sheet to move child in bed to reduce friction and shearing injuries. d. Avoiding rinsing skin after cleansing with mild antibacterial soap to provide a protective barrier.

c. Using draw sheet to move child in bed to reduce friction and shearing injuries.

11. When interviewing the mother of a 3-year-old child, the nurse asks about developmental milestones such as the age of walking without assistance. This should be considered because these milestones are: a. unnecessary information because the child is age 3 years. b. an important part of the family history. c. an important part of the child's past growth and development. d. an important part of the child's review of systems.

c. an important part of the child's past growth and development.

5. A lumbar puncture is needed on a school-age child. The most appropriate action to provide analgesia during this procedure is to apply: a. 4% Liposomal Lidocaine (LMX) 15 minutes before the procedure. b. a transdermal fentanyl (Duragesic) patch immediately before the procedure. c. eutectic mixture of local anesthetics (EMLA) 1 hour before the procedure. d. EMLA 30 minutes before the procedure.

c. eutectic mixture of local anesthetics (EMLA) 1 hour before the procedure.

6. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is to: a. ask her why she wants to know. b. determine why she is so anxious. c. explain in simple terms how it works. d. tell her she will see how it works as it is used.

c. explain in simple terms how it works.

13. When doing a nutritional assessment on an Hispanic family, the nurse learns that their diet consists mainly of vegetables, legumes, and starches. The nurse should recognize that this diet: a. indicates that they live in poverty. b. is lacking in protein. c. may provide sufficient amino acids. d. should be enriched with meat and milk.

c. may provide sufficient amino acids.

15. An appropriate approach to performing a physical assessment on a toddler is to: a. always proceed in a head-to-toe direction. b. perform traumatic procedures first. c. use minimal physical contact initially. d. demonstrate use of equipment.

c. use minimal physical contact initially.

The parent of 2-week-old Sarah asks the nurse if Sarah needs fluoride supplements because she is exclusively breastfed. The nurse's best response is: a."She needs to begin taking them now." b."They are not needed if you drink fluoridated water." c."She may need to begin taking them at age 6 months." d."She can have infant cereal mixed with fluoridated water instead of supplements."

c."She may need to begin taking them at age 6 months."

An infant experienced an apparent life-threatening event and is being placed on home apnea monitoring. The parents have understood the instructions for use of a home apnea monitor when they state: a."We can adjust the monitor to eliminate false alarms." b."We should sleep in the same bed as our monitored infant." c."We will check the monitor several times a day to be sure the alarm is working." d."We will place the monitor in the crib with our infant."

c."We will check the monitor several times a day to be sure the alarm is working."

A parent asks the nurse "At what age do most babies begin to fear strangers?" The nurse responds that most infants begin to fear strangers at age: a.2 months. c.6 months. b.4 months. d.12 months.

c.6 months

At which age can most infants sit steadily unsupported? a.4 months c.8 months b.6 months d.10 months

c.8 months

By what age should the nurse expect that an infant will be able to pull to a standing position? a.6 months c.9 months b.8 months d.11 to 12 months

c.9 months

Which behavior indicates that an infant has developed object permanence? a.Recognizes familiar face such as the mother b.Recognizes familiar object such as a bottle c.Actively searches for a hidden object d.Secures objects by pulling on a string

c.Actively searches for a hidden object

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

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