Pediatrics Test 2
A mother is concerned that her 9 year old daughter is carrying too much weight in her backpack at school and that it may injure her back. The child weighs 80 lb. The nurse tells the mother that her daughter's backpack should weigh no more than _____lb.
8 lbs (10%)
A 13 year old girl has recently begun menstruating. She is active is sports at school. Increased intake of which of the following nutrients should the nurse recommend to the girl to prevent anemia associated with menstruation? A. Iron B. Calcium C. Zinc D. Vitamin D
A
A 15 year old girl is in the hospital for surgery and is confined to bed. The nurse can tell that the client is nervous about being in the hospital. She tells the nurse that she feels gross and on display in her hospital gown. Which of the following should the nurse do to encourage a sense of autonomy and dignity related to the girl's body image? A. offer to assist the girl in washing her hair and let her pick the shampoo B. Allow the girl to wear her own clothes despite hospital policy C. Assist the girl with using the bedpan to urinate D. Brush the girl's her for her
A
A nurse is conducting a well child visit with a child who is to receive the recommended immunizations for 11-12 year olds. Which of the following immunizations should the nurse administer? Select all that apply A. Trivalent inactivated influenza (TIV) B. Pneumococcal (PCV) C. Meningococcal (MCV4) D. Tetanus and diphtheria toxoids and pertussis (Tdap) E. Rotavirus (RV)
A C D
A nurse is providing anticipatory guidance to the parents of a toddler. Which of the following should the nurse include? (Select all that apply) A. Develop food habits that will prevent dental caries B. Meeting caloric needs results in an increased appetite C. Expression of bedtime fears is common D. Behaviors associated with negativism and ritualism E. Importance of annual screenings for phenylketonuria
A C D
A nurse is preparing an education program about nutrition for preschool-age children for a group of parents. Which of the following should the nurse include? A. Saturated fats should equal 20% of total caloric intake B. Average daily intake should be 1,800 calories C. Finicky eating habits develop around 5 years of age D. Healthy diets include 8 g of protein each day
B
A nurse is speaking with a 7 year old boy in the hospital. The boy asks the nurse "Where is the westroom? I need to use the westroom" The nurse recognizes that this developmental problem is which of the following? A. Malocclusion B. Poor articulation C. Broken fluency D. Caries
B
A 17 year old boy chats excitedly with the nurse about his plans for college and a career. He says he has checked out every college in the region and determined which one is the best fit for him and which one offers the best career options for him. The nurse recognizes which developmental aspect of this young man? A. Role confusion B. Socialization C. Puberty D. Formal operational thought
D
A 13 year old girl is struggling to accept the new changes that are occurring in her body as a result of puberty. After talking with this client, the nurse recalls that Erikson's primary developmental task of yearly and mid-adolescence is which of the following. A. Autonomy versus shame or doubt B. Identity versus role confusion C. Intimacy versus isolation D. Trust versus mistrust
B
A 16 year old girl with acne has been prescribed tretinoin (Retin A cream). Which of the following instructions should the nurse give this girl related to prevention of a common side effect of this medication? A. If taking an oral contraceptive, switch to a different type of contraception while taking this medication B. Avoid prolonged sun exposure C. Take the medication on an empty stomach D. Be certain of the expiration date on the drug
B
A 5 year old girl is pretending to be a crocodile during a physical examination. Her mother just smiles and rolls her eyes at the nurse. Which of the following would be the best response for the nurse to give the child? A. Oh no! I have a crocodile in my room. Please don't bite me! B. What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile C. What happened to my patient? Did you eat her? D. My dear, you are a girl, not a crocodile. Now sit still so that I can examine you.
B
A father shares with a nurse that his 12 year old son has begun ejaculating in his sleep and is deeply embarrassed about it. The father says he has tried to to explain to his son that this is a normal occurrence in puberty, but the son is still humiliated by it. The nurse recognizes this occurrence as which of the following? A. Premature ejaculation B. Nocturnal emission C. Gynecomastia D. Dysmenorrhea
B
A mother is discussing with the nurse a recent story in the local news about a child being abducted. She is concerned about the safety of her preschool child and wonders what she should tel her child to keep her safe but without frightening her. Which of the following would be the best recommendation for the nurse to give the mother in this case? A. It is your responsibility to keep your child safe, not your child's; keep her in your sight at all times B. Don't worry about it; the odds of your ugly child being abducted are very low C. Explain in a calm and everyday manner how the child should stay away from strangers in cars D. Wait until the child is school-aged before telling her what to do, so she will be better able to handle it
C
A nurse is caring for a preschool age child who says she needs to leave the hospital because her doll is scared to be at home alone. Which of the following characteristics of pre operational thought is the child exhibiting? A. Egocentrism B. Centration C. Animism D. Magical thinking
C
A child's father, a police detective tells the nurse that he and his wife wish to take measures to prevent the child from being kidnapped. What action should you recommend to this family? A. Limit play-dates to the child's own home B. Withdraw the child from daycare to limit her exposure to other adults C. Describe common kidnapping culprits the father knows D. Be certain the child understands not to leave daycare with anyone but her parents
D
A child's grandmother often visits the family. When she does, she brings a number of medications with her. What precautions about unintentional poisoning would you like the family following? A. Advice the grandma to keep her medicine in her purse and stress that no one should open her purse but her B. Show the child his grandmother's pills and emphasize that he is not permitted to touch them C. Assure the grandmother that as long as her vials of medicine have childproof caps, there is no danger D. Buy the grandmother a medicine case that locks and place it on a high shelf when she visits
D
A mother brings her 8 year old daughter into the doctor's office because over the past year her tonsils have increased in size to the point that her her mother is concerned that there is something wrong. The girl has no other symptoms, however. The nurse knows that which of the following is most likely the cause of the enlarged tonsils? A. Tonsillitis B. An allergic reaction C. A pituitary disorder D. Normal growth of lymphatic tissue for this age
D
True or false? Conformity is vital to school-aged children.
True
True or false? Fear of mutilation is significant during the preschool age.
True
True or false? Hazing is a form of organized bullying.
True
True or false? Suicide is so common in adolescents it ranks third as a cause of death in the 15-19 year old age group.
True
A nurse is performing a developmental screening on an 18 month old. Which of the following skills should the toddler be able to perform? (Select all that apply) A. Build a tower with six blocks B. Throw a ball overhand C. Walk up and down stairs D. Draw circles E. Use a spoon without rotation
B E
A mother confides in a nurse that her preschool daughter only wants to play with her father as soon as he comes home from work in the evenings and doesn't seem to have any interest in spending time with the mother. This phenomenon is an example of which of the following? A. Electra complex B. Oedipus complex C. Centering D. Genu valgus
A
A nurse is performing a developmental screening on a 3 year old child. Which of the following skills should the child be able to perform? A. Ride a tricycle B. Hop on one foot C. Jump rope D. Throw a ball overhead
A
A nurse observes a 3-year old girl and her older brother playing together in the children's waiting area of the hospital. In which type of play should she expect to see this girl engaged? A. Imitative play B. Parallel play C. Nonverbal play D. Hand regard
A
A toddler seems unable to remain dry despite toilet training. Which patient teaching should be included in his plan of care? A. He probably is not yet physically ready for toilet training B. He is reacting to her emotional outbursts, responsible for delaying toilet training C. He may need to be examined by a child psychologist to solve this problem
A
An 8 year old boy who says he wants to be a doctor when he grows up pleads with the nurse to let him put on his own band aid after receiving an injection. The nurse agrees and watches as the boy very carefully lines up the bank aid with the mark left by the injection and applies it to his skin. Then, he asks, "Did I do it right?" and waits eagerly for the nurse's feedback. The nurse recognizes in the boy's attempt to master the primary developmental step of school age, which is what? A. Industry B. Perfectionism C. Accommodation D. Conservation
A
A nurse is conducting a well child visit with a child who is scheduled to receive the recommended immunizations for 4-6 year olds. Which of the following immunizations should the nurse administer? (Select all that apply) A. Diphtheria, tetanus, pertussis (DTaP) B. Inactivated poliovirus (IPV) C. Measles, mumps, rubella (MMR) D. Pneumococcal (PCV) E. Haemophilus influenza type b (Hib)
A B C
A nurse is discussing a 9-year old girl's obesity with her parents. Which of the following recommendations should she make to the parents? (Select all that apply) A. Participation in a formal weigh-control organization B. Intake of about 1,200 calories a day C. Preparation of a special meal just for the child D. Limiting time spent in physical inactivity E. Participation in formal exercise classes F. Adherence to a high-protein diet
A B D E
A client has confined in a nurse that her 13 year old daughter has recently changed dramatically in her social interactions with others. Which one of the following is a social behavior most likely to be exhibited by a girl at this age? A. Banding together with boys and girls but maintaining her own unique style B. Banding together with other girls and dressing like them C. Hanging out with girls but maintaining her own unique style D. Hanging out primarily with boys her own age
B
A father brings his 6 year old son in to the doctor's office. He says his son just began first grade a week ago and, after attending the first day of classes has refused to go to school each day since, complaining of stomach cramps and nausea. He says he has spoken to the boy's teacher, who says she did not notice anything unusual with her interaction with the boy, other than perhaps a bit of homesickness. After the nurse examines the boy and finds nothing wrong, the father asks how he should handle the problem. Which of the following should the nurse recommend? A. Hold the child back a year and let him try again next year B. Insist that the child return to school C. Homeschool the child D. Have the child attend a different school
B
A mother brings her 4 year old son in for a check up. Which of the following findings should the nurse be concerned about? A. No increase in appetite compared with that in toddler years B. Resting pulse rate of 120 beats/min C. Weight gain of 5 lb in the past year D. Ectomorphic body type
B
A nurse is assessing a 2 1/2 year old toddler at a well child visit. Which of the following findings should the nurse report to the provider? A. Height increased by 7.5 cm (3 in) in the past year B. Head circumference exceeds chest circumference C. Anterior and posterior fontanels closed D. Current weight equals four times the birth weight
B
A previously toilet trained 4 year old child has many episodes of urinary incontinence while in the hospital for a fractured femur. Which of the following actions should the nurse implement? A. Awaken the child every 2 hours through the night to try to use a bedpan. B. Explain that children will usually quickly regain control over a previously mastered skill once home again C. Send a urine specimen for analysis D. Limit consumption of fluids between meals
B
A toddler's mother is concerned because her toddler takes her blanket everywhere. Which advice would be most appropriate for her regarding this? A. Have her daughter be evaluated by a child psychologist B. Understand that this is probably a normal event C. Make subtle efforts to remove the blanket D. Destroy the blanket by cutting of a strip from it every day
B
An anxious 12 year old girl receives an injection from the nurse and sighs with relief when it is done. After a moment of reflection, the girl asks the nurse, "Is it hard to give someone an injection?" This girl's question is evidence that she has developed which cognitive skill? A. Class inclusion B. Accommodation C. Decentering D. Conservation
B
At a physical examination, a nurse asks the father of a 4 year old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to which of the following? A. Playing in an even number group of children B. Testing and identification of group role C. Regression D. The fact that preschoolers have a harder time sharing than toddlers
B
Toddlers learn a great deal about oral communication in the course of their development. Which of the following statements should you expect a 2 year old child to have mastered? A. Red tomatoes B. Daddy come C. Old MacDonald D. Please, Please
B
Which patient education should the nurse provide a mother of a preschooler's broken fluency? A. Encourage the preschooler to recite in front of friends B. Allow the preschooler to have time to talk C. Encourage the preschooler to speak slowly D. Stop the preschooler and tell him to start over
B
A nurse is instructing a young mother on how to ensure a safe bath time for her 4 year old son. Which of the following are important suggestions for the nurse to give to the mother? (Select all that apply) A. Do not hand a mobile over the tub B. Turn down the temperature of the water heater to below 120 F C. Assist the child in cleaning under fingernails and around ears D. Have the child drink cranberry juice to avoid developing infections from the bath E. Do not leave the child unsupervised in the bathtub F. Do not use bubble bath
B C E
A nurse is teaching a course about safety during the school age years to a group of parents. Which of the following information should the nurse include in the course? (Select all that apply) A. Gaiting stairs at the top and bottom B. Wearing helmets when riding bicycles or skateboarding C. Riding safely in the bed of pickup trucks D. Implementing firearm safety E. Wearing seat belts
B D E
The mother of a 15 year old boy confides in the nurse that she is concerned because her son is about to turn 16 years old and is pressuring her and her husband to buy him a motorcycle. Her husband is okay with the idea, but she is concerned about his safety. Which of the following should the nurse mention to the mother regarding motorcycle safety? (Select all that apply) A. Insist on age and not emotional maturity as the qualification for obtaining a driver's license B. Require the son to learn all relevant safety rules C. Require the son to wear a seat belt D. Require the son to wear full body covering E. Require the son to wear a helmet F. Require the son to wear long pants
B D E F
A 14 year old boy is far quite than usual when he visits his physician's office. The nurse asks him if anything is wrong, and the boys replies that he did not make the cut for the football team. Which of the following would be out appropriate for the nurse to say? A. That's okay; you can try out for basketball in a few months B. It not that big of a deal a lot of kids don't make the football team C. I'm really sorry. I know that must be a big disappointment D. Don't let it get you down. Sports are a waste of time anyway
C
A 4 year old boy will not stop throwing sand at his sister. Which of the following punishments would be most effective with this child? A. Send him to his room for 15 minutes B. Restrict television viewing for a day C. Sit him in time out for 4 minutes D. Spank him on his ass
C
A child's parent tells the nurse that the child keeps the entire family awake at night because she is so afraid of the dark. What would be the best suggestion for helping her overcome this fear? A. Assure her the room's window is locked so no one can kidnap her B. Suggest she temporarily sleep in the living room in front of the television set for safety C. Buy a night light for her room and inspect the room to be certain it appears to be safe D. Tach her that her fear is not grounded in reality
C
A father and his 4 year old son are waiting in an exam room when the nurse enters and greets them. Which of the following activities that the nurse observes the boy doing would best demonstrate the primary development task of the preschool-aged child according to Erikson? A. Singing a song he learned at preschool B. Roughhousing with his father C. Opening drawers in the room, pulling out supplies, and examining them D. Reading a book
C
A mother brings her 3 years old daughter in for a sick visit for the third time this year. The child, who attends a preschool program, continues to develop upper respiratory infections. The mother is frustrated with the situation and asks the nurse for advice. Which of the following would be the best recommendation for the nurse to give to the mother in this situation? A. Send the child to preschool with a healthy snack each day B. Teach the child to cover her mouth when she sneezes C. Make sure that frequent hand washing is being stressed at the preschool D. Withdraw the child from preschool and keep her at home
C
A nurse is carrying on a conversation with a 7 year old girl during an office visit. Which of the following is an example of the level on language development the nurse should expect in this child? A. Ability to carry on an adult conversation B. Inability to speak in full sentences C. Difficulty understanding the concept of half past in reference to time D. Fascination with bathroom language
C
A nurse is discussing prepubescence and preadolescence with a group of parents of school age children. Which of the following information should the nurse include in the discussion? A. Initial physiologic changes appear during early childhood B. Changes in height and weight occur slowly during this period C. Growth differences between boys and girls become evident D. Signs of sexual maturation become highly visible in boys
C
A nurse is providing teaching about age appropriate activities to the parent of a 2 year old. Which of the following statements by the parent indicates a need for further teaching? A. I send my child's favorite stuffed animals when she will be napping away from home. B. Putting large piece puzzles together is one of my child's favorite activities. C. The soccer team my child will be playing on starts practicing next week. D. My child likes to ride a straddle truck in the dining room while I am cooking.
C
The parents of a 2 year old child are concerned because their child's back seems curved. What is the nurse's best response? A. The child needs to be screened for scoliosis B. The child needs referral for a spine radiograph C. This is normal for this age D. The nurse should perform a full neurologic assessment
C
A 12 year old girl has recently begun menstruating and is well into puberty. She is visiting the doctor today for a routine physical examination. Which of the following findings should cause concern in the nurse? A. Supernumerary nipple B. Irregular periods C. Breasts of slightly different sizes D. Vulvar irritation
D
A 13 years old girl has grown rapidly in height over the past 2 years and still taller than most of the boys in her class. She wonders when she will stop growing. Which of the following should the nurse tell her as a general guideline for the ages at which most girls stop growing? A. 14-15 years old B. 18-19 years old C. 20-21 years old D. 16-17 years old
D
A nurse is providing education about sleep and rest to a group of parents of school age children. Which of the following statements by a parent indicates a need for further teaching? A. My child's age influences the number of hours of sleep he needs. B. My child's level of activity during the day influences the number of hours of sleep he needs. C. My child's health status influences the number of hours of sleep he needs. D. My child's family history of sleep apnea influences the number of hours of sleep he needs
D
A nurse is providing teaching about methods to promote sleep to the parent of a preschool age child. Which of the following statements by the parent indicates an understanding of the teaching? A. I will sleep in the bed with my child if she wakes up during the night B. I will let my child stay up an additional two hours on weekend nights C. I will let my child watch television 30 minutes just before bedtime each night D. I will keep a dim lamp on in my child's room during the night
D
True of false? Telling tall tales is harmless and should be encouraged in preschoolers because it helps them develop their imaginations.
False
True or false? Broken fluency is a serious condition, and children who exhibit it should be referred to a speech pathologist for treatment.
False
True or false? Children can become physically addicted to glue.
False
True or false? Marijuana use has no long-term side effects
False
