Peds 1

Sonograms demonstrate thumb sucking as early as in utero. a) False b) True

True

The nurse is discussing development of fine motor skills in the preschool-age group with a group of nursing students. Which of the following statements is most accurate regarding the fine motor skills of a 3-year-old? a) The child can button their clothes. b) The child can use scissors. c) The child can tie their shoelaces. d) The child can print a few letters.

The child can button their clothes

Once temper tantrums have started, which of the following interventions are appropriate? a) Engage the child's behavior. b) Speak to the child during the tantrum. c) Move objects out of the way or move the child to prevent injury. d) Have a long talk with the child regarding the tantrum.

Move objects out of the way or move the child to prevent injury.

The nurse is recommending food items for an 18-month-old girl. Which ones will benefit the child's neurologic system most? a) Vegetable soup, whole wheat bread, and blueberries b) Peanut butter on crackers, cheese, and whole milk c) Oatmeal pancakes with bananas d) Ground beef, broccoli, and apple slices

Peanut butter on crackers, cheese, and whole milk

The nurse is examining an infant who is 4 days old. The nurse puts the infant in a semi-upright position and lets the head fall back (with immediate support). What infant reflex is the nurse testing for? a) Babinski b) Moro c) Palmar grasp d) Startle

Moro

A mother of a 3-year-old asks the nurse about what kinds of toys would be appropriate. The nurse would suggest which of the following? a) 100-piece jigsaw puzzles b) Pounding bench c) Memory games d) Bicycle with training wheels

Pounding bench

A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines: a) The weight assessment is blatantly inaccurate. b) The child weighs more than expected for age. c) The child weighs the expected amount for age. d) The child weighs less than expected for age.

The child weighs less than expected for age.

The nurse is admitting a 15-year-old to the pediatric unit. Which of the following does the nurse recognize as a priority for this child? a) The child's need for parental support should be discussed. b) The child should be encouraged to call friends often. c) The child's need for privacy should be respected. d) The child should be given freedom to participate in unit activities as desired.

The child's need for privacy should be respected.

Language development is rapid in the preschool years. At the age of 2 most children use about 50 to 100 words. By the time the child is 5 years of age how many additional words do most children use? a) 3,000 words b) 2,000 words c) 1,500 words d) 1,000 words

2,000 words

What is the correct amount of urine diapers a mature infant should have each day? a) An infant should have 3 to 5 wet diapers/day. b) An infant should have 6 to 8 wet diapers/day. c) An infant should have 1 to 2 wet diapers/day. d) An infant should have 9 to 10 wet diapers/day.

An infant should have 6 to 8 wet diapers/day.

Which measure would you suggest an infant's parents use to relieve teething discomfort? a) Provide her with a fluid diet for 2 days. b) Ask her pediatrician for a sedative for her. c) Give her a cold teething ring to chew. d) Offer her Aspergum to chew.

Give her a cold teething ring to chew.

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

Give her slices of cheddar cheese as a snack

The parents of a 2-year-old girl are concerned with her behavior. For which behavior would the nurse share their concern? a) Likes to change toys frequently b) Plays by herself even when other children are present c) Frequently babbles to herself when playing d) Refuses to share toys with her sister

Frequently babbles to herself when playing

What is a true statement regarding developmental milestones of the 30-month-old? a) Triples birth weight b) Anterior fontanel closes c) Head circumference equals chest circumference d) Full set of primary teeth

Full set of primary teeth

In 2007 the World Factbook published statistics that showed the United States still lagged behind other industrialized nations in the incidence of infant mortality. What is one reason that the United States has a higher infant mortality rate than other countries? a) Low adolescent delivery rates b) Early pre-natal care c) Home deliveries d) Low birth weight

Low birth weight

A nursing instructor is teaching students about changes during the preschool years. One predominant change that the teacher would emphasize is which of the following? a) Physical growth accelerates. b) Personality growth slows. c) Cognitive growth slows. d) Physical growth slows.

Physical growth slows

A mother reports her 2-year-old daughter has gradually eaten more and more poorly since her 1-year-old well-child visit. The nurse assesses the child's growth and development as normal. What concept explains the mother's concern? a) Improper snacking b) Poor role modeling c) Physiologic anorexia d) Iron-deficiency anemia

Physiologic anorexia

Which of the following actions by a preschooler would suggest that his thinking is inconsistent with normal preschooler growth and development? a) Refusal to go to bed without his friend b) Refusal to play with "real" children c) Insistence that his imaginary friend watch television with him d) Insistence that this imaginary friend have dinner with the family

Refusal to play with "real" children

Parents of a 2-year-old girl are having a conversation with the nurse about tantrums. Which of the following techniques would the nurse most likely to suggest? a) Use short "time-outs" and remain calm. b) Vary the response based on the situation. c) Promise a reward if she behaves. d) Tell her she is bad and will be punished.

Use short "time-outs" and remain calm

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) Irregular periods b) Supernumerary nipple c) Breasts of slightly different sizes d) Vulvar irritation

Vulvar irritation

The nurse enters her patient's room to find the new mom crying softly. The nurse asks what is wrong. The mom says, "I had my heart set on breast-feeding and now my baby has a cleft lip. My dreams of breast-feeding him are destroyed." What should the nurse tell her patient about breast-feeding an infant with this diagnosis? a) " You can still attempt breast-feeding; let me call a lactation consultant for you." b) "I am so sorry your infant has that problem, maybe next time." c) "I am so sorry, looks like bottle-feeding for you." d) "Sometimes dreams do not come true."

" You can still attempt breast-feeding; let me call a lactation consultant for you."

A mother of a toddler asks the nurse, "How will I know that my daughter is ready for toilet training?" Which response by the nurse would be most appropriate? a) "You'll probably notice that your daughter is uncomfortable in wet diapers." b) "Most children are ready for toilet training by the time they are 18 months old." c) "Your daughter can understand holding urine and stool by about 1 year of age." d) "Don't worry, your daughter will probably give you very definite signals."

"You'll probably notice that your daughter is uncomfortable in wet diapers."

A toddler's "no" can best be eliminated by asking a question instead of making a statement. a) True b) False

False

Which technique would you begin with to assess a child's abdomen? a) Palpation b) Inspection c) Auscultation d) Percussion

Inspection

A nurse is talking with the parents of a child who is participating in a research study evaluating drug therapy. Which statement by the parents indicates that the principle of beneficence is being addressed? a) "There is some risk that the medication could cause him to have seizures." b) "We can stop participating in the study at any time if we choose." c) "We get reimbursed for parking when we come in for the study visit." d) "All the information collected is recorded by a code number instead of his name."

"There is some risk that the medication could cause him to have seizures."

During the annual physical examination, a teenage client tells the nurse that she is anxious as well as frustrated because of the acne on her face. Which is the best response for the nurse? a) "You must be eating fried foods or sweets in large quantities." b) "It could be serious; seek consultation when your primary care physician examines you." c) "Most of us get acne during adolescence. Even some adults do. Don't worry." d) "This is one of the most common physical changes during adolescence."

"This is one of the most common physical changes during adolescence."

The nurse is preparing to see a 14-month-old child and needs to establish the chief purpose of the visit. Which approach with the parents would be best? a) "What is your chief complaint?" b) "Has your child been exposed to infectious agents?" c) "What can I help you with today?" d) "Is your child feeling sick?"

"What can I help you with today?"

Conformity is vital to school-age children. a) False b) True

True

The nurse knows that the 13-year-old girl in the exam room is in the process of developing her own set of values. Which activity will this child be experiencing according to Kohlberg's theory? a) Wondering what is the meaning of life b) Assuming everyone is interested in her favorite pop star c) Wishing her parents were more understanding d) Comparing morals with those of peers

Wondering what is the meaning of life

An important role of the nurse caring for children and their families is that of child advocate. Which one of the following interventions best reflects this role? a) Administering medications to patients on a timely basis b) Accurately documenting and reporting patient conditions c) Working to change agency policy to better serve families d) Teaching parents the proper way to administer insulin to their child

Working to change agency policy to better serve families

A toddler's mother tells you that no matter what she asks of her child, he says, "No." A suggestion you might make to help her handle this problem is for her to a) give him secondary, not primary, choices. b) ask no further questions of him. c) pretend she does not hear him. d) tell him never to say, "No" again.

give him secondary, not primary, choices

The best way for an infant's father to help his child complete the developmental task of the first year is to a) talk to her at a special time each day. b) respond to her consistently. c) expose her to many caregivers to help her learn variability. d) keep her stimulated with many toys.

respond to her consistently.

It is naptime and the caregiver of a 2-year-old says to her child, "I will help you put all of your stuffed animals in a row next to your bed just like we do every day." This statement is an example of: a) discipline. b) ritualism. c) dawdling. d) negativism.

ritualism

A 15-year-old is seen at a health care facility for facial acne. When counseling him, you would teach him that the basic cause of his acne is a) vitamin deficiency from an inadequate diet. b) thyroid-gland secretions increasing with adolescence. c) lack of showering adequately after gym class. d) activation of androgen hormones.

activation of androgen hormones

The best activity that a preschooler's parents could use to help her achieve the developmental task of the preschool period is to: a) provide her with clothes that snap rather than button. b) allow her to experiment with Play-Doh. c) teach her street-crossing safety. d) help her learn how to follow rules.

allow her to experiment with Play-Doh.

The best way for parents to aid a toddler in achieving his developmental task would be to a) allow him to make simple decisions. b) help him learn to count. c) urge him to dress himself completely alone. d) give him small household chores to do.

allow him to make simple decisions.

A mother tells you her 6-year-old has been biting his fingernails since he began first grade. After analyzing the cause of this as increased stress, the advice you would give his mother regarding this problem would be to a) allow some time every day for the child to talk about new experiences. b) distract the child by teaching him a new skill, such as whistling. c) encourage the child to drink more milk for stronger nails. d) allow the child to choose a reward for not biting his nails.

allow some time every day for the child to talk about new experiences.

The way you would advise a toddler's mother to handle temper tantrums would be to a) promise him a special activity if he will stop. b) distract him with a toy when he begins breath holding. c) appear to ignore them. d) mimic his behavior by also holding her breath.

appear to ignore them.

When caring for hospitalized teens, nurses should choose their words and actions carefully since adolescents typically are concerned about: a) separation from peers and family. b) mutilation of their body. c) appearing out of control of the situation and/or themselves. d) mobility restrictions.

appearing out of control of the situation and/or themselves.

A mother rooming-in with her 10-month-old infant appears upset following the visit of a consultant physician. The mother has questions but states, "The doctor is always so busy." The nurse will: a) ask the mother for her questions so that the nurse can relay them to the medical team. b) encourage the mother to remain at the infant's bedside so as not to miss any future consultant visits. c) assist the mother in preparing a list of questions for the physician's next visit. d) explain to the mother the limits on the consultant's time.

assist the mother in preparing a list of questions for the physician's next visit.

Parents of a 3½-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize: a) having the child wear a personal flotation device whenever near or on the water. b) enrolling the child in swimming lessons. c) using and renewing sunscreen regularly. d) adults learning infant/child cardiopulmonary resuscitation (CPR).

having the child wear a personal flotation device whenever near or on the water.

In assessing the bilingual 4-year-old's speech and language development, the nurse should find that the child will: a) be able to use each language as a separate system. b) be prone to stuttering. c) mix the two languages in the same sentence. d) avoid asking questions.

be able to use each language as a separate system.

A toddler's parents want to begin toilet training him. As a rule, the best instruction you could give them is: a) toilet training is a 12-month process. b) children can remain dry during the night before they can do so during the day. c) all children should be toilet trained by age 2 years. d) bowel training is easier than urine training.

bowel training is easier than urine training.

When teaching an infant's mother about bathing her, it would be important to instruct her that a) she should never use soap on a baby's hair. b) soap lubricates and oils an infant's skin. c) bath time provides an opportunity for play. d) infants need a daily bath.

bath time provides an opportunity for play.

Anticipatory guidance for an infant for the 4th month should include the fact that she probably will a) have many "blue" or moody periods. b) develop a fear of strangers. c) insist on things being done her way. d) be able to turn over onto the back.

be able to turn over onto the back.

The following events were milestones in the support of children's health. Place them in the correct sequence, from oldest to most recent: _____ a. Declaration of the Rights of the Child approved _____ b. WIC program established _____ c. U.S. Children's Bureau established _____ d. Sheppard-Towner Act passed _____ e. Family and Medical Leave Act passed _____ f. Education for all Handicapped Children Act passed.

c. U.S. Children's Bureau established d. Sheppard-Towner Act passed a. Declaration of the Rights of the Child approved b. WIC program established f. Education for all Handicapped Children Act passed. e. Family and Medical Leave Act passed

A 6 year old reports pain in the stomach upon eating. The nurse replies, "Let me see if I have this right. Every time you eat anything, you get a pain in your tummy?" The nurse is using which technique of therapeutic communication? a) perception checking b) open-ended questions c) clarifying d) reflecting

clarifying

A nurse is preparing to teach an 8 year old recently diagnosed with diabetes how to give an insulin injection. Which is the best technique for the nurse to use? a) demonstration b) role modeling c) video d) coloring book about diabetes

demonstration

A nurse caring for a preschooler scheduled for abdominal surgery the next day needs to teach about the dressing and drainage tube that the child will have after surgery. Which would be the best technique for the nurse to use? a) discussion b) video c) pamphlets d) dolls and puppets

dolls and puppets

To teach an adolescent about his or her disease, the best technique would be to a) help him or her understand how new information about the disease will improve health status now. b) help the child to realize that he or she is different from peers and needs teaching while they do not. c) urge him or her to listen attentively to what you want to teach. d) help him or her understand how new information about the disease will improve future health.

help him or her understand how new information about the disease will improve health status now.

Anthropometric measurements help determine: a) how well a child grows. b) how fast a child can run. c) how well a child sleeps. d) what grade a child should be in.

how well a child grows.

The developmental task of the adolescent period, according to Erikson, is to form a sense of: a) identity versus role confusion. b) decisiveness versus indecisiveness. c) initiative versus guilt. d) autonomy versus shame or doubt.

identity versus role confusion.

When planning how to respond to a child about telling stories, you would base your statement on the fact that a) preschoolers have a limited vocabulary. b) a 3-year-old knows the word two but not the concept 2. c) imagination in a 3-year-old is at its peak. d) a preschooler is in an insecure period.

imagination in a 3-year-old is at its peak.

The developmental task of the school-aged period, according to Erikson, is gaining a sense of a) industry versus inferiority. b) autonomy versus shame. c) identity versus failure. d) independence versus dependence.

industry versus inferiority

The Boy Scouts is an organization that continues to be a favorite with school-aged boys because a) hiking is a favorite school-aged activity. b) fathers participate in Boy Scouts. c) merit badges require completing small tasks for rewards. d) no girls are included in the organization.

merit badges require completing small tasks for rewards

A 9-year-old girl is newly diagnosed with asthma. The nurse plans to teach her about triggers related to her diagnosis. The best approach for this child would be to a) play an allergy trivia game with her. b) have the doctor teach her this information. c) give her a list of foods she cannot have. d) show her a video about allergic-reactions planning.

play an allergy trivia game with her.

During a well child check at the ambulatory clinic, the mother of a 10-year-old boy reports concerns about her son's frequent discussions about death and dying. Based upon knowledge of this age group the nurse understands that: a) discussing death and dying may hint at a psychological disorder. b) at this age, children are not afraid of death. c) preoccupation with death and dying is common in the school-aged child. d) consistent thoughts of death and dying at this age leads to the later development of depression.

preoccupation with death and dying is common in the school-aged child.

The nurse is taking health history for a toddler in the emergency department. The child's mother informs the nurse that the toddler has been vomiting for the last 3 days, has a history of asthma, and was hospitalized with pneumonia and a urinary tract infection 6 weeks ago. What would the nurse recognize as is the patient's chief concern/complaint? a) pneumonia b) asthma c) UTI d) vomiting

vomiting

The child and her mother are receiving discharge instructions from the nurse. Which statements by the child's mother are "red flags" that the mother may have poor literacy skills? Select all that apply. a) "The receptionist told me that we missed another appointment." b) "I'm going to take these instructions home to read them." c) "I'm going to take a few notes while you're teaching us." d) "I forgot my glasses today and can't seem to read this form." e) "I guess I just forgot to give her the medication the way you told me to."

• "I forgot my glasses today and can't seem to read this form." • "The receptionist told me that we missed another appointment." • "I guess I just forgot to give her the medication the way you told me to." • "I'm going to take these instructions home to read them."

A group of students are reviewing information about the Education for All Handicapped Children Act and its amendments. The students demonstrate understanding of this information when they identify which of the following as a service that may be provided? Select all that apply. a) Special education b) Financial assistance c) Psychological services d) Infant stimulation e) Speech therapy

• Speech therapy • Infant stimulation • Psychological services • Special education

The nurse is taking vital signs on a 6-month-old infant. The caregiver reports that over the past 12 hours, the child has had vomiting, diarrhea, and has been pulling on his ears. Which methods would be appropriate for taking this child's temperature? Select all that apply. a) Axillary b) Oral c) Temporal d) Tympanic e) Rectal

• Temporal • Tympanic • Axillary

The father of an 11-year-old boy is worried that the child spends too much time watching TV. What information should the nurse share with this father? Select all that apply. a) Limit TV time by using it as a reward. b) Use video games that are more active to offset sedentary TV viewing. c) Establish guidelines on when a child can watch TV. d) Watch programs together and discuss subject matter with the child. e) The American Academy of Pediatrics recommends 2 hours or less of TV daily.

• The American Academy of Pediatrics recommends 2 hours or less of TV daily. • Establish guidelines on when a child can watch TV. • Watch programs together and discuss subject matter with the child.

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

"All medicine in our bathroom is in childproof containers."

A mother calls the advance practice pediatric nurse practitioner about her 7-year-old daughter's dental hygiene. The daughter has had three cavities. She does not know what to do and asks the nurse for guidance. How should the nurse respond? a) "What type of toothbrush does she use?" b) "Did you teach her how to brush her teeth?" c) "Are you able to supervise her brushing?" d) "Is there fluoride toothpaste available for her use?"

"Are you able to supervise her brushing?"

By which age should the child know his/her own gender? a) 1 b) 3 c) 4 d) 2

3

When working with children and families, which is a critical strategy for promoting therapeutic communication? 1. Detailed explanations 2. Attentive listening 3. Comforting touch 4. Closed-ended questions

Attentive listening

What has the most influence in deterring an adolescent from beginning to drink alcohol? 1. Drinking habits of parents 2. Drinking habits of peers 3. Drinking philosophy of adolescent's culture 4. Drinking philosophy of adolescent's religion

Drinking habits of peers

Morbidity rates among children are most highly associated with which cause? a) Firearms at home b) Environmental factors c) Suicide and homicide d) School violence

Environmental factors

A mother tells a nurse that her child has recently established some friendships for the first time. In which age group do you expect this child to be? a) adolescence b) preschool c) school age d) toddler

preschool

The infant weighs 6 lbs. 8 oz. at birth. If the infant is following a normal pattern of growth, which of the following would be an expected weight for this child at the age of four months? a) 10 lbs. 8 oz. b) 16 lbs. c) 13 lbs. d) 15 lbs. 4 oz.

13 lbs.

The mother of a 12-year-old boy is talking with the school nurse about her son's clumsiness. She reports that he seems to fall a lot, his writing is horrible, and as much as he practices he can't play his guitar very well. How should the nurse respond to the mother? a) "Have you spoken with your pediatrician about your observations?" b) "Boys tend to refine their fine motor skills by this age." c) "Boys tend to take a bit longer than girls to mature." d) "I will make a note of your observations and talk to his teachers."

"Have you spoken with your pediatrician about your observations?"

Where would the S2 "dub" sound be the loudest? a) The fifth intercostal space b) The fourth intercostal space c) The third intercostal space d) The second intercostal space

The second intercostal space

Fear of mutilation is significant during the preschool age. a) False b) True

True

The nurse is doing an assessment of a 10-year-old girl. She whispers the girl's name from behind the girl. Which cranial nerve is the nurse assessing for? a) III b) VIII c) V d) IV

VIII

The nurse is conducting a well-child exam of a 4-year-old boy. Which statement would alert the nurse that the child is at risk for iron deficiency? a) "He loves milk and drinks it every time he is thirsty." b) "He does not like spinach, but he does like chicken and beef." c) "He eats a well-balanced diet." d) "He enjoys eggs and fortified cereal for breakfast."

"He loves milk and drinks it every time he is thirsty."

Children can become physically addicted to glue. a) False b) True

False Explanation: Children do not become physically addicted to glue but do become psychologically dependent on it.

In order to advocate for children and families, the nurse must first acknowledge that the basic system in which health behavior and care are organized, secured, and performed is the: a) Government b) Family c) Community d) Healthcare facility

Family

The school nurse is talking with a group of 11-year-old girls. One of the girls states, "I just feel like my whole body is changing and I don't know why." The best response by the nurse would be which of the following? a) " You may feel like you are changing, but you still look the same." b) "Your other friends are feeling like this too." c) "You have lots of hormone changes going on right now." d) "You will feel better about yourself as you get older."

"You have lots of hormone changes going on right now."

A parent wants to wait outside the room while a procedure is completed on his young child, saying, "I don't think I can stand to see you do this!" The nurse's best response is: a) "Come, stand by his head. You won't see much up there" b) "Stay. It will be less scary for your child." c) "This will only take a few minutes. You should be with your child." d) "Good. That is what the team doing the procedure would prefer." e) "Certainly. I will stay with your child during the procedure."

"Certainly. I will stay with your child during the procedure."

The nurse is discussing sensory development with the mother of a 2-year-old boy. Which parental comment suggests the child may have a sensory problem? a) "I dropped a pan behind him and he cried." b) "He doesn't respond if I wave to him." c) "He was licking the dishwashing soap." d) "He wasn't bothered by the paint smell."

"He doesn't respond if I wave to him."

The nursing students are learning how to perform a health assessment on a pediatric patient. The nursing instructor identifies a need for further teaching when a student makes which of the following statements? a) "I should establish good rapport with the child's parents before beginning an assessment on a child." b) "I should take blood pressure on a child beginning at age 2 years." c) "I should take blood pressure on a child beginning at age 3 years." d) "I should take a temperature using an electronic thermometer beginning at age 3 years."

"I should take blood pressure on a child beginning at age 2 years."

The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching? a) "He is allowed out of time-out when he is calm." b) "I put him in time-out when the problem occurs." c) "The time-out doesn't just have to be in his room." d) "I usually have him in time-out for about 10 minutes."

"I usually have him in time-out for about 10 minutes."

Nursing students are learning about the importance of therapeutic communication in their pediatric course. The nursing instructor identifies a need for further teaching when a student makes which of the following statements? a) "It is good to lean forward when listening." b) "It is best to stoop to a child's level when listening." c) "It is good to sit, not stand when listening." d) "It is best to stand when listening to a patient to demonstrate knowledge."

"It is best to stand when listening to a patient to demonstrate knowledge."

The nurse comes into infant Lucy's room on the pediatric floor. She is going to try and feed her for the first time since her surgery. How does the nurse know what infant state Lucy is in by what Mom says and that it is okay to try and feed Lucy? a) "Lucy has been crying every time someone picks her up." b) "Lucy is so quiet today, that is not like her." c) "Lucy is still sleeping, I guess she is worn out." d) "Lucy has been a chatterbox and smiles just like her brother."

"Lucy has been a chatterbox and smiles just like her brother."

Jerry and his mother have come to the office for a routine visit. In the hall away from Jerry, his mother confides that she is concerned because Jerry is playing games that the girls play and she has noticed that when he plays any role-playing games his character is very feminine. She tells you that she is worried about his sexual orientation. What is the best response to her concerns? a) "Close parental monitoring of his activities has been shown to decrease these behaviors." b) "Do not allow him to play any of these games, get him some manly games." c) "This is a concern; you should examine what you are exposing him to that could affect his behavior." d) "This behavior may be exploratory or reflect peer pressure, so do not make assumptions regarding sexual orientation."

"This behavior may be exploratory or reflect peer pressure, so do not make assumptions regarding sexual orientation."

Jenny is a 15-year-old who is being seen today in the clinic, and her mom comments on the fact that Jenny seems to always choose the opposite of what everyone else wants and that her mood swings are a common occurrence. What statement below shows the nurse that Jenny's mom understands these changes? a) "This is her temperament and we will have to learn how to deal with her." b) "She will never find anyone to live with her if she acts like this." c) "This is common for this age group and it will get better with time." d) "I know that she is doing this because of all the hormones."

"This is common for this age group and it will get better with time."

A 15-year-old female adolescent is seen in the office. During the examination, the client asks the nurse about having sex. Her mother states that she has been asking questions lately regarding this topic. Which should be the nurse's response? a) "That is not something we will discuss today." b) "Tell me what you know about sex." c) "Are you actively having sex at this time?" d) "We can discuss that as well as other aspects of sexuality."

"We can discuss that as well as other aspects of sexuality."

The nurse is caring for a 2-year-old in the hospital, and the mother expresses concern that the toddler will be scared. Which response by the nurse would be most appropriate? 1. "Don't worry; we practice family-centered and atraumatic care here." 2. "We will do our best to minimize the stress that your child experiences." 3. "It will probably be upsetting for you as well, so you should stay home." 4. "Our practice of atraumatic care will eliminate all pain and stress for your child."

"We will do our best to minimize the stress that your child experiences."

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

"We will make sure she shares her toys with cousins her age."

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) "What happened to my patient? Did you eat her?" b) "Oh no! I have a crocodile in my room. Please don't bite me!" c) "My dear, you are a girl, not a crocodile. Now sit still so that I can examine you." d) "What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile."

"What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile."

The nurse enters her patient's room and finds the infant on a pillow with a bottle propped up while mom is dressing. What reaction should the nurse make? a) "Are you almost ready to be discharged?" b) "Look how cute she is." c) "Is she almost done feeding?" d) "You should always hold your baby for feedings instead of propping the bottles."

"You should always hold your baby for feedings instead of propping the bottles."

The infant measures 21 ½ inches at birth. If the infant is following a normal pattern of growth, which of the following would be an expected height for this child at the age of six months? a) 30 ½ inches b) 27 ½ inches c) 29 inches d) 32 inches

27 ½ inches

As the school nurse conducting screening for vision in a 6-year-old child, you would refer the child to a specialist if the visual acuity in both eyes is: 1. 20/20 2. 20/25 3. 20/30 4. 20/50

20/50

If the child is gaining weight at an expected rate, a child who weighs 36 lbs. at 3 years of age would weigh which of the following at age 5? a) 58 lbs. b) 38 lbs. c) 50 lbs. d) 44 lbs.

44 lb

The nurse knows that children can give assent (agree) to participate in research. At what intellectual age does the American Academy of Pediatrics suggest minors may first do this? a) 7 years b) 9 years c) 12 years d) 14 years

7 years

A nurse is caring for a hospitalized 7 year old whose family members have been unable to visit for 2 days. The nurse is preparing a diversional activity for the child. Which activity would best be suited for a child in this age group? a) A jack-in-the box b) A mobile c) A board game such as monopoly d) A paint-by-numbers activity

A paint-by-numbers activity

Which of the following would be most effective in helping promote initiative and nutritional health for a preschooler? a) Praising the child for cleaning his large plate of food b) Encouraging the child to cut up small pieces of apple for a snack c) Allowing the child to spread soft cheese on crackers d) Giving the child a high carbohydrate snack after preschool

Allowing the child to spread soft cheese on crackers

The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which statement best accomplishes this? a) A sense of control can be provided through offering limited choices. b) Emotions of a 12-month-old are labile. He can move from calm to a temper tantrum rapidly. c) Aggressive behaviors such as hitting and biting are common in toddlers. d) A regular routine and rituals will provide stability and security.

A regular routine and rituals will provide stability and security.

In discussing the psychosocial development of the adolescent, it is important to understand that in order for adolescents to be in intimate relationships in which feelings are mutually shared, both persons must have which of the following? a) An ability to be autonomous b) A willingness to take initiative c) An understanding of socialization and of isolation d) A sense of trust and of identity

A sense of trust and of identity

Parents are proud of their toddler's fast-developing fine motor skills. Which skill they describe should the nurse point out as a safety risk? a) Turn book pages b) Hold crayon to write c) Ability to turn knobs d) Put shapes into matching openings

Ability to turn knobs

The school nurse is planning a screening program. What items should be included to address issues related to the "new morbidity"? 1. Academic difficulties, violence, and other mental health issues 2. The number of children with chronic illness at the school 3. Statistics related to health insurance coverage of the children 4. HIV infection, asthma, and respiratory allergy testing

Academic difficulties, violence, and other mental health issues

When discussing the growth and development of an adolescent, the nurse refers to various theories and phases of development. A nurse is discussing Erikson's theory of psychological development with an adolescent client. Based on Erikson's theory of psychosocial development, which should the nurse identify as the major priority challenge faced by adolescents? a) Helping others achieving their goals b) Developing trust c) Achieving their own identity d) Achieving independence from parental dominance

Achieving their own identity

For reasons of anticipatory guidance, nurses should be aware that menarche appears earlier in some ethnic groups than others. In which ethnic group is menarche likely to appear first? a) Mexican-American b) Caucasian c) African-American d) Indian-American

African-American

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) Be certain of the expiration date on the drug c) Avoid prolonged sun exposure d) Take the medication on an empty stomach

Avoid prolonged sun exposure

The school nurse is providing nutritional guidance during a 9th grade health class. Which foods should the nurse recommend as good sources for calcium? a) Beans, poultry, and fish b) Strawberries, watermelon, and raisins c) Peanut butter, tomato juice, and whole grain bread d) Cheese, yogurt, and white beans

Cheese, yogurt, and white beans

The parents of a school-aged child with school phobia have taken her to three different psychiatrists trying to resolve this problem. Based on this, which nursing diagnosis would be most appropriate? a) Noncompliance with expected school behavior related to school phobia b) Ineffective tissue perfusion, cerebral, related to anxiety over attending school c) Compromised parental coping related to inability to enforce school attendance d) Disturbed thought processes related to difficulty in school adjustment

Compromised parental coping related to inability to enforce school attendance

The nurse is caring for a child who is on a cardiac monitor. Which of the following nursing actions would be the most important action for the nurse? a) Check the site and skin condition every couple of hours. b) Clean the skin with alcohol before placing the electrodes. c) Check to be sure that the electrodes are secure when the alarm sounds. d) Confirm the alarms are set with maximum and minimum settings.

Confirm the alarms are set with maximum and minimum settings.

A sleeping 5-month-old girl is being held by the mother when the nurse comes in to do a physical examination. What assessment should be done initially? 1. Listening to the bowel sounds 2. Counting the heart rate 3. Checking the temperature 4. Looking in the ears

Counting the heart rate

While awaiting an appointment at the doctor's office for his 20-month-old daughter, a young father is astonished to see his daughter assume a proper stance and swing a toy golf club in the play area of the waiting room. A nurse also observes the behavior, and the father recalls that his daughter saw him practicing his golf swing in their back yard a few days ago. The nurse explains that this is an instance of which of the following? a) Autonomy b) Parallel play c) Deferred imitation d) Assimilation

Deferred imitation

The successful resolution of developmental tasks for the school-age child, according to Erikson, would be identified by: 1. Learning from repeating tasks 2. Developing a sense of worth and competence 3. Using fantasy and magical thinking to cope with problems 4. Developing a sense of trust

Developing a sense of worth and competence

Infant development is best described by which of the following statements? a) Development proceeds cephalocaudally. b) Development is not sequential but predictable. c) Development varies greatly from infant to infant. d) Development proceeds from fine to gross.

Development proceeds cephalocaudally.

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 of language development the nurse should expect in this child? a) Inability to speak in full sentences b) Difficulty understanding the concept of "half past" in reference to time c) Fascination with bathroom language d) Ability to carry on an adult conversation

Difficulty understanding the concept of "half past" in reference to time

The nurse is teaching parents of an 11-year old girl how to deal with the issues relating to peer pressure to use tobacco and alcohol. Which suggestion provides the best course of action for the parents? a) Hide alcohol out of the child's reach b) Forbid the child to have friends that smoke or drink c) Avoid smoking in the house or in front of the child d) Discuss tobacco and alcohol use with the child

Discuss tobacco and alcohol use with the child

The nurse is organizing an indoor play area for preschoolers. What play materials are least important? a) Dress-up clothes and hats and puppets b) Balls, blocks, and puzzles c) Cut, paste, drawing, and painting materials d) CD player with music and musical instruments e) Electronic teaching toys

Electronic teaching toys

When the nurse is teaching the child how to self-administer insulin, what should the final step of the process include? a) Assessing the child's willingness to learn b) Teaching the principles of insulin administration c) Recognizing the actions of the teaching process d) Evaluating the teaching that has occurred

Evaluating the teaching that has occurred

The nurse is working with a teenage patient. He has relatively straight teeth, but his lower front teeth are slightly crossed over. The nurse suggests to the child's caregiver that an orthodontist see him. What is the reason the nurse might make this suggestion? a) Even slight malocclusions make chewing and jaw function less efficient. b) The more common braces become, the more unacceptable crooked teeth are in society at large, affecting everything from dating possibilities to hiring. c) Uncorrected malocclusions lead to infection and ultimately tooth loss. d) Leaving even slightly crooked teeth will lead to more cavities later in life.

Even slight malocclusions make chewing and jaw function less efficient.

The nurse is performing a health surveillance visit with a 12-year-old boy. Which characteristic suggests the boy has entered adolescence? a) Feels secure with his body image b) Understands that actions have consequences c) Experiences frequent mood changes d) Shows growing interest in attracting girls' attention

Experiences frequent mood changes

A nurse is conducting a physical examination on a 5-year-old boy and is examining his abdomen. First she visually inspects the region. Then she auscultates it with a stethoscope. Finally, she palpates the area. What is the proper rationale for performing the auscultation before palpation? a) Auscultation is scary for small children and should thus be performed first, to get it over with b) The order does not matter; she could have performed palpation before auscultation c) Handling the abdomen may obliterate bowel sounds d) If she detects no abnormalities in auscultation, there will be no need for palpation

Handling the abdomen may obliterate bowel sounds

The nurse is observing a 3-year-old boy in a daycare center. Which behavior might suggest an emotional problem? a) Has persistent separation anxiety b) Sucks his thumb periodically c) Goes from calm to tantrum suddenly d) Is unable to share toys with others

Has persistent separation anxiety

The nurse is educating the parents of a 6-year-old boy how to manage the child's introduction into elementary school. The child has an easy temperament. Which should the nurse suggest? a) Scheduling several visits to the school before classes start b) Comforting the child when he is frustrated c) Being firm with episodes of moodiness and irritability d) Helping the child deal with minor stresses

Helping the child deal with minor stresses

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 the band-aid up 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 this situation the boy's attempt to master the primary developmental step of school age, which is what? a) Conservation b) Perfectionism c) Accommodation d) Industry

Industry

A nurse overhears a 7 year old calling her hospital roommate a vulgar name. What is the best action by the nurse? a) Inform the child that she will not be able to stay in the hospital if she is going to use that type of language. b) Inform the child that if she does not behave, she will get a shot. c) Inform the child that talking to the roommate using that language is not acceptable behavior. d) Inform the child that the nurse is going to call the parents and tell them what was said.

Inform the child that talking to the roommate using that language is not acceptable behavior.

The nurse is caring for a 14-year-old girl with terminal cancer and her family. Which intervention provides the best therapeutic communication? a) Recognizing the parents' desire to use all options b) Informing the child in terms she can understand c) Supporting the child's desires for treatment d) Presenting options for treatment

Informing the child in terms she can understand

Nursing students are reviewing information about the emotional development of the preschooler. They demonstrate understanding of the information when they identify which of the following as the task of the preschooler? a) Industry b) Initiative c) Trust d) Autonomy

Initiative

The major developmental task according to Erikson is for the preschool child to develop which of the following? a) Autonomy b) Industry c) Trust d) Initiative

Initiative

The nurse is caring for a 14-year-old boy, and his parents, who has just been diagnosed with a malignant tumor on his liver. Which intervention is most important to this child and family? a) Describing postoperative home care for the child b) Involving the child and family in decision making c) Arranging an additional meeting with the nurse practitioner d) Discussing treatment options with the child and parents

Involving the child and family in decision making

A 13-year-old girl has recently begun menstruating. She is active in 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) Vitamin D b) Iron c) Calcium d) Zinc

Iron

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

Is there a gun in your home?

When describing the State Children's Health Insurance Program (SCHIP) to a group of families, which of the following would the nurse include? a) It provides health insurance to children whose families are not eligible for Medicaid but cannot afford to purchase health insurance. b) Medicaid enrollment is necessary to receive a basic set of comprehensive services for children for health promotion and early treatment. c) The program provides monthly payments to income-eligible individuals, including children who are blind or disabled. d) States use federal funds for preventive, primary, and specialty care programs for pregnant women, mothers, infants, children, and adolescents.

It provides health insurance to children whose families are not eligible for Medicaid but cannot afford to purchase health insurance

The nurse is preparing a class for a group of students about homeless children and families. Which of the following factors contribute to homelessness? Select all that apply. a. Increase in family income b. Job loss c. Exposure to abuse or neglect d. Cutbacks in public welfare programs e. Development of community crisis centers

Job loss Exposure to abuse or neglect Cutbacks in public welfare programs

Teaching a group of caregivers about the topic of nutrition, one caregiver tells the group, "I use desserts as a reward for good behavior." A person in the group asks the nurse what she thinks about that idea. Which of the following statements by the nurse would be the most appropriate? Using dessert as a reward for good behavior may cause the child to a) Learn to use food to manipulate others' behavior b) Only behave on days when dessert is something she likes c) Cause the child to be overweight d) Learn to choose sweets over nutritious food

Learn to use food to manipulate others' behavior

What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds? a) Breast development will be complete with 12 months. b) Adult height will be reached at the time of menarche. c) The growth spurt will begin immediately with menarche. d) Menarche should follow in about 2 years.

Menarche should follow in about 2 years.

What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds? a) The growth spurt will begin immediately with menarche. b) Adult height will be reached at the time of menarche. c) Menarche should follow in about 2 years. d) Breast development will be complete with 12 months.

Menarche should follow in about 2 years.

Morbidity data indicate that support is needed from pediatric nursing groups to establish improved and additional services for children with what health issues? a) Mental health and behavioral disorders b) Illnesses due to environmental toxins c) Digestive system problems d) Poor immunization status

Mental health and behavioral disorders

The caregivers of 2 ½-year-old Frances tell the nurse that they are working hard to teach her to share and communicate with other children. The nurse recognizes and acknowledges their devotion, but explains to them that a child this age is probably not at a developmental level to play and share with other children. Of the following activities, which activity would the nurse recommend as the most appropriate activity for a 2 ½-year-old? a) Throwing a baseball sized ball b) Looking at large print magazines c) Mowing the lawn with a toy lawnmower d) Sharing finger paints and painting with the caregiver

Mowing the lawn with a toy lawnmower

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

Never spank the child for any reason.

The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age? a) 1 upper tooth b) No teeth c) 1 to 3 natal teeth d) 1 to 2 lower teeth

No teeth

Nurses should provide anticipatory guidance to males to prepare them for what particular pubertal change in late adolescence? a) Breast enlargement b) Reddening of the scrotum c) Nocturnal emissions d) Lengthening of the penis

Nocturnal emissions

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

Offering a variety of foods along with the foods the child likes

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 developmental task of the preschool-age child, according to Erikson? a) Rough-housing with his father b) Opening drawers in the room, pulling out supplies, and examining them c) Reading a book d) Singing a song he learned at preschool

Opening drawers in the room, pulling out supplies, and examining them

The nurse is providing teaching about good nondairy sources of calcium for preschoolers. Which of these fruits contains the most calcium? a) Peach b) Apple c) Orange d) Banana

Orange

The nurse is observing a playgroup of children of all ages. The school-age child in the group would most likely be doing which of the following activities? a) Playing with the plastic vaccum cleaner, pushing it around the room. b) Pretending to be mommies and daddies in the playhouse. c) Watching a movie with other children their age. d) Painting pictures in the art corner of the room.

Painting pictures in the art corner of the room.

When observing a group of toddlers playing in a child care setting it is noted that the toddlers are all playing with buckets and shovels but are not playing with each other. This type of play is referred to as which of the following? a) Onlooker play b) Associative play c) Solitary play d) Parallel play

Parallel play

When planning to teach a toddler about coughing and deep breathing, which would be most effective? a) Discussing the importance of coughing b) Demonstrating the technique c) Showing an audiovisual d) Playing a game with coughing and breathing

Playing a game with coughing and breathing

A boy and his mother are visiting the clinic so he can get his sports physical. After the exam, when the boy is not in the room his mother mentions that she worries that he is participating in risk behaviors and that his dependence on his peers is growing stronger. She asks what she as the parent can do to make sure that Caleb is safe. a) Suggest that he invite his friends over to the house and include them in family activities. b) Remind her that family connectedness is a strong factor in helping kids to remain resilient. c) Encourage the family to spend more time together playing games or watching movies. d) Remind her that this is normal behavior that Caleb will eventually outgrow.

Remind her that family connectedness is a strong factor in helping kids to remain resilient.

When doing a health assessment on a child, the nurse should include a physical assessment. What is the most important thing to assess first when performing the physical assessment? a) Blood pressure b) Respirations c) Temperature d) Lung sounds

Respirations

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) Weight gain of 5 lb in the past year c) Ectomorphic body type d) Resting pulse rate of 120

Resting pulse rate of 120

Which gross motor developmental milestone is least likely for a 2 year old? a) Rides a tricycle b) Jumps in place c) Climbs d) Stands on one foot with help

Rides a tricycle Explanation: A gross motor developmental milestone for a 2- to 3-year-old includes jumping in place. Riding a tricycle occurs at 3 to 4 years of age. Climbing occurs at occurs at 18 months to 2 years. At 12 to 18 months, the child can stand on one foot with help.

The nurse is talking with the mother of a 2-year-old girl during a scheduled visit. Which teaching subject best supports the emphasis on preventive care? a) Reminding the mother that the child will imitate her b) Discussing with the mother anticipated developmental milestones c) Describing physical changes taking place in her child d) Showing the mother how to teach hand washing to her child

Showing the mother how to teach hand washing to her child

An adolescent with multiple tattoos and piercings comes to the health center at the child's school. The child is complaining of feeling hot. In collecting further data the nurse finds the child has a new piercing. The nurse recognizes the need for the adolescent to be given information related to personal health. Which of the following topics would the nurse identify as the area that the child needs immediate information regarding? a) Signs of substance addiction b) Signs of infection c) Prevention of sexually transmitted infection d) Prevention of pregnancy

Signs of infection

The emergency department nurse is caring for a child who is showing signs of anaphylaxis. The nurse evaluates how comprehensive the history of the child should be and determines that which action takes priority? a) Stabilizing the child's physical status b) Getting the child's history from other providers c) Obtaining a complete and detailed history d) Taking a problem-focused history

Stabilizing the child's physical status

The nurse is assessing the development of a 15-month-old girl during a regular visit. Which of the following skills would the nurse expect to see? a) Stands alone b) Feeds herself with a spoon c) Runs to her mother d) Points to her nose and mouth

Stands alone

A nurse is faced with an ethical conflict involving the care of a child. The child's parents disagree with the physician about the use of a feeding tube. The nurse sees the benefits and limitations of both parties' views. Which of the following would be most appropriate? a) Take the issue to the Institutional Ethics Committee for advice. b) Contact the Institutional Review Board for guidelines as to how best to proceed. c) Support the parents' decision making for their child regardless of the outcome. d) Provide care to the child without getting involved either way.

Take the issue to the Institutional Ethics Committee for advice.

Which action would provide an indication that an adolescent's parents understand their daughter's need for increased independence? a) Saying, "We will always be here for her whenever she needs us." b) Telling you that they now understand that their daughter's chief need is for increased privacy c) Verbalizing, "We try to do everything we can to make things easier for her." d) Telling you that they are encouraging their daughter in her search for an after-school job

Telling you that they are encouraging their daughter in her search for an after-school job

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) The fact that preschoolers have a harder time sharing than toddlers b) Playing in an even-number group of children (four) c) Testing and identification of group role d) Regression

Testing and identification of group role

The nurse is examining a 2-year-old girl for speech and language development. Which finding would suggest a delay in speech development? a) The child puts together sentences of two words. b) The child does not use the names of familiar objects. c) The child repeats what the parents say out of context and at random moments. d) The child does not speak clearly but shows understanding of what is said.

The child does not use the names of familiar objects.

The nurse is assessing the learning needs for a 12-year-old boy with a chronic health condition and his parents. Which aspect would be least pertinent to a learning needs assessment? a) Finding that the mother relies on American Sign Language b) The family belongs to a mainline traditional faith community c) Concluding that the parents are emotionally distraught d) Discovering that the father is highly healthcare literate

The family belongs to a mainline traditional faith community

A group of students are reviewing information about Medicaid. The students demonstrate a need for additional study when they identify which of the following? a) The federal government is responsible for administering it. b) It is financed by state funds. c) The states determine income-eligibility criteria. d) It provides compensation for healthcare services.

The federal government is responsible for administering it.

The nurse is reviewing topics to be discussed with caregivers related to caring for infants. Which of the following statements would be the most appropriate statement for the nurse to make to this group of caregivers? a) The infant should be dressed more warmly than older children and caregivers b) The infant sleeps 10-12 hours at night and take 2-3 naps during the day c) The infant should wear hard-soled shoes in order to protect their feet from injury d) The infant should be sound asleep before being put into the crib for sleeping

The infant sleeps 10-12 hours at night and take 2-3 naps during the day

Using knowledge of normal growth and development, which of the following would be expected when observing a 12-week-old infant? a) The infant smiles at significant others b) The infant bears weight on legs when held in standing position c) The infant grasps objects and brings them to the mouth d) The infant is able to sit up and can roll over

The infant smiles at significant others

The nurse is assessing the Babinski sign in a 3-day-old infant. What is a normal response? a) The infant's foot moves back and forth. b) The infant's toes stay in the normal position and the big toe has dorsiflexion. c) The infant's toes fan and the big toe has dorsiflexion. d) The infant's toes wiggle.

The infant's toes fan and the big toe has dorsiflexion.

Which of the following is a grade II heart murmur? a) The murmur is soft but easily heard. b) The murmur is soft and hard to hear. c) The murmur is loud with an associated thrill. d) The murmur is loud without an associated thrill.

The murmur is soft but easily heard.

The nurse is observing a group of 8-year-olds who are being taught the concept of conservation of weight. Which of the following activities would best help these children understand this concept? a) Weighing and measuring each other and comparing the number of pounds to the number of inches for each person. b) Weighing a pound of oranges and a pound of bricks and counting how many of each make a pound. c) Measuring the weight of a handful of popcorn and then the weight of a handful of pennies. d) Using a balance scale to weigh a variety of objects and counting how many pennies must be used to balance the scales.

Weighing a pound of oranges and a pound of bricks and counting how many of each make a pound.

As Julie performs her head-to-toe assessment on a 2-year-old child, when would she examine the child's ears? a) When Julie is first starting so as to get it over with b) When Julie is done with all of the exam in case the child gets upset c) When Julie is examining the head and face d) When Julie is finished examining the entire head and face

When Julie is done with all of the exam in case the child gets upset

When is the best time for the nurse to count a 9-month-old's respirations? a) When he is quiet in his mother's lap b) When he is laughing c) When he is in the playroom d) When he is crying

When he is quiet in his mother's lap

All infants should have their head circumference measured at health-assessment visits. This measurement is made from a) the center of the forehead to the base of the occiput. b) the hairline in front to the hairline in back. c) just above the eyebrows through the prominent part of the occiput. d) the middle of the forehead through the parietal prominences.

just above the eyebrows through the prominent part of the occiput.

When weighing and measuring a child at her 1-year well-baby checkup, the nurse would expect to see that over the previous 6 months a baby who weighed 8 pounds and was 20 inches long at birth would have gained about a) 16 pounds and grown 4-6 inches b) 16 pounds and grown 2-3 inches c) 8 pounds and grown 4-6 inches d) 8 pounds and grown 2-3 inches

8 pounds and grown 4-6 inches

The nurse is discussing sleep and the amounts of sleep necessary for an 11-year-old child with the child's caregivers. For the child who gets up at 6:30 a.m., which bedtime would the nurse recommend the caregivers require the child to go to bed? a) 7:30 p.m. b) 10:00 p.m. c) 9:30 p.m. d) 8:00 p.m.

9:30 p.m.

The nurse is visualizing the ear canal and tympanic membrane of a 14-month-old boy. Which finding would warrant further investigation? a) A bubble behind the tympanic membrane b) A gray tympanic membrane c) A mobile tympanic membrane d) A pearly pink membrane e) Visible bony landmarks behind the membrane

A bubble behind the tympanic membrane

A hospitalized 7 year old is recovering from a head injury. Occupational therapy has been ordered to assist the child in regaining eye/hand coordination. If the child cannot master this skill, what feelings may arise? a) A sense of doubt b) A sense of mistrust c) A sense of shame d) A feeling of inferiority

A feeling of inferiority

When adolescents form relationships with members of the opposite sex, the relationship is categorized as what type of relationship? a) A heterosexual relationship b) A bisexual relationship c) A homosexual relationship d) An unhealthy relationship

A heterosexual relationship

When giving parents guidance for the adolescent years, the nurse would advise the parents to: (Choose all that apply.) 1. Accept the adolescent as a unique individual 2. Provide strict, inflexible rules 3. Listen and try to be open to the adolescent's views 4. Screen all of his or her friends 5. Respect the adolescent's privacy 6. Provide unconditional love

Accept the adolescent as a unique individual Listen and try to be open to the adolescent's views Respect the adolescent's privacy Provide unconditional love

In comparing the rate of growth in preadolescent girls and preadolescent boys, which of the following is the most accurate about growth rate? a) Boys and girls grow at the same rate. b) Boys grow at a slower, steadier rate than do girls. c) Boys grow at a rapid, sporadic rate. d) Girls grow at a slower, steadier rate than do boys.

Boys grow at a slower, steadier rate than do girls.

A nurse is explaining cognitive development in children to a client, with the help of Piaget's theory of cognitive development. What would be the best explanation by the nurse about the formal operations level of cognitive development? a) Children from ages 2 to 7 years investigate and explore the environment and look at things from their own point of view. b) Up to age 2, children learn by touching, tasting, and feeling. They learn to control body movement. c) From ages 7 to 11 years, children internalize actions and can perform them in the mind. d) After age 12 children can think in the abstract including complex problem solving.

After age 12 children can think in the abstract including complex problem solving.

When assessing for bowel sounds, which of the following is true? a) Bowel sounds should be audible by the naked ear unless distention is present. b) Bowel sounds should be heard at a rate of 80 to 90 per minute in the lower quadrants. c) The presence of high-frequency sounds at 5- to 10-second intervals is abnormal. d) All four quadrants should be auscultated in a consistent pattern.

All four quadrants should be auscultated in a consistent pattern.

The nurse is collecting data on a 9-year-old child being admitted to the pediatric unit. Which of the following is the most appropriate way to gather information from the child's caregiver? a) Ask the caregiver if they can read or if they need someone to read the questions on the admission form to them. b) Have the child read the questions to the caregiver and then write down the answers on the form. c) Ask the caregiver questions and write the answers down. d) Have the caregiver sit in a quiet room and fill out a questionnaire.

Ask the caregiver questions and write the answers down.

Which suggestion by the nurse meant to promote good dental health in the 15-month-old is inappropriate? a) Wean the child from the bottle. b) Avoid grazing (continual snacking) throughout the day. c) Arrange for your child's first dental visit as soon as possible. d) Brush your child's teeth with a pea-sized amount of fluoride-containing toothpaste.

Brush your child's teeth with a pea-sized amount of fluoride-containing toothpaste. Using fluoride toothpaste prior to age 2 years promotes development of fluorosis.

Broken fluency is a serious condition, and children who exhibit it should be referred to a speech pathologist for treatment. a) False b) True

False

A 4-year-old is hospitalized with a urinary tract infection. Based on what you know of her cognitive development, which approach would be best to prepare her for a radiograph? a) Tell her a radiograph is a picture of the dark inside her body. b) Help her pretend the x-ray machine is a camera. c) Explain that she must behave because the technician is busy. d) Tell her she must follow directions or she will be hurt.

Help her pretend the x-ray machine is a camera.

The nurse is examining the heart and peripheral perfusion of an 8-year-old. The nurse will assess the apical impulse at which location? a) The fifth intercostal space medial to the left midclavicular line b) The fourth intercostal space just medial to the child's left midclavicular line c) The fifth intercostal space lateral to the left midclavicular line d) The fourth intercostal space at the left midclavicular line

The fifth intercostal space lateral to the left midclavicular line

Which of the following shows an example of Erik Erikson's developmental task for the infant? a) The infant cries and the caregiver picks the child up. b) The infant smiles as people walk past the crib. c) The infant cries when they have a wet diaper. d) The infant plays the game peek-a-boo.

The infant cries and the caregiver picks the child up.

The nurse is collecting subjective data when doing which of the following? a) The nurse is weighing and measuring the child. b) The nurse is reinforcing teaching with the child's caregivers. c) The nurse is interviewing the child's caregiver. d) The nurse is taking the child's vital signs.

The nurse is interviewing the child's caregiver.

The nurse is weighing an 18-month-old infant who is in the clinic for a well-child visit. Which of the following actions by the nurse would be most appropriate for weighing this child? a) The nurse should lay the infant on the scale covered with a clean paper and gently hold the child flat against the scale and let go just before reading the weight. b) The nurse should weigh the mother on a standing scale and then weigh her again while the mother is holding the infant. c) The nurse should have the child sit on the scale while keeping a hand close to but not touching the child. d) The nurse should ask the mother to lightly hold the infant's hands while the infant is sitting on the scale.

The nurse should have the child sit on the scale while keeping a hand close to but not touching the child.

A nurse is assessing a 2 year old's language development. Which of the following would the nurse expect to assess? a) Verbalization of 4 to 6 words b) Knowledge of full name c) Ability to name one color d) Use of a two-word noun-verb sentence

Use of a two-word noun-verb sentence

The parents of a 5-year-old call the nurse for advice about night terrors. The child has had them nightly for almost 2 weeks. What is the most appropriate intervention? a) Wake the child up nightly 30 to 45 minutes after going to sleep. b) Tell the parents to be sure to wake the child up during the next episode. c) Encourage the parents to let the child fall asleep in a safe place such as their bed. d) Explain that this is a developmental phase that will not last.

Wake the child up nightly 30 to 45 minutes after going to sleep.

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

Wear sunglasses.

The nurse is promoting nutrition to a teen who is going through a growth spurt. Which food should the nurse recommended for its high iron content? a) Fresh orange juice b) Fat-free milk c) Whole grain bread d) Organic carrots

Whole grain bread

The mother of a 2-year-old boy has asked for some ideas for snack foods that would be less likely to cause dental caries. Which of the following items would the nurse most likely suggest? a) A handful of unsalted peanuts b) A handful of organic raisins c) Fruit strips cut into pieces d) Whole grain chips broken into pieces

Whole grain chips broken into pieces

A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is: a) pushing a spoon from her high chair tray to the floor. b) looking for a toy in her crib at the last place she saw it. c) shaking a rattle to enjoy the sound. d) smiling at herself in the mirror.

looking for a toy in her crib at the last place she saw it.

On physical examination, you discover that a 6-year-old's palatine tonsils are somewhat enlarged in the back of his throat. Your best action would be to a) give the child something for pain. b) record this as a normal early school-aged finding. c) take the child's temperature; this must be tonsillitis. d) suggest a resident examine him for breathing difficulty.

record this as a normal early school-aged finding.

Parents who just moved into their "dream home" are concerned because their toddler boy, who had achieved daytime bowel and bladder control, has begun wetting and defecating in his underwear. The nurse explains this is called: a) regression. b) egocentrism. c) autonomy. d) ritualism.

regression

A new staff member asks veteran nurses about the meaning of atraumatic care for children. These nurses explain that the concept is based on: a) peers being helped to develop empathy for the child. b) units staffed to provide one nurse for each child. c) the child's need to experience no trauma. d) the underlying premise of "do no harm."

the underlying premise of "do no harm."

The nurse is caring for a 4-year-old girl following an appendectomy. The girl becomes fearful and starts to cry as soon as the nurse walks into the room. When the nurse asks about the crying, the girl says, "Nurses who wear shirts with flowers give shots." The nurse understands that this statement is an example of: a) beginning empathy. b) magical thinking. c) animism. d) transduction.

transduction

The nurse is talking to a 13-year-old boy about choosing friends. Which function do peer groups provide that can have a negative result? a) Negotiating differences b) Sharing problems c) Following role models d) Developing loyalties

Following role models

The nurse is educating the parents of a 10-year-old girl in ways to help their child avoid tobacco. Which suggestion should be part of the nurse's advice? a) "Always go outside when you have a cigarette." b) "Keep your cigarettes where she can't get to them." c) "Tell her only losers smoke and chew tobacco." d) "As parents, you need to be good role models."

"As parents, you need to be good role models."

A 4-year-old girl has begun stuttering. Which practice by the parents will the nurse discourage? a) Enunciating clearly and slowing down parental speech b) Giving the child opportunity to speak and finish her ideas c) Asking the girl to slow down and to think before she talks d) Looking at the child while she is speaking

Asking the girl to slow down and to think before she talks

The nurse is providing anticipatory guidance for violence prevention to a group of parents with adolescents. Which parental action should the nurse include as the most effective in preventing suicide? a) Checking for signs of depression or lack of friends b) Watching for aggressive behavior or racist remarks c) Becoming acquainted with the teen's friends d) Monitoring video games, TV shows, and music

Checking for signs of depression or lack of friends

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

Chicken, whole-wheat bread, watermelon

While interviewing a mother about her infant son's illness, the nurse asks, "Why did you bring Clark to the clinic today, Ms. Donovan?" Which part of the health interview is this nurse currently in? a) Chief concern/complaint b) Health and family profile c) Day history d) Demographic data

Chief concern/complaint

Telling tall tales is harmless and should be encouraged in preschoolers because it helps them develop their imaginations. a) False b) True

False

Parents tell the nurse their 3½-year-old refuses to eat meat but are pleased she drinks "lots of milk." What risk does the nurse identify? a) Dental caries b) Obesity c) Iron deficiency d) Interference with growth

Iron deficiency

A nurse is assessing an infant's reflexes. The nurse places his or her thumb to the ball of the infant's foot to elicit which reflex? a) Parachute b) Plantar grasp c) Palmar grasp d) Babinski

Plantar grasp

The nurse is assessing the abdomen of a 3-year-old. Which finding should be reported immediately? a) Active bowel sounds b) Tympany over the abdomen c) Rounded abdomen d) Visible peristaltic waves

Visible peristaltic waves

The nurse is discussing nutrition with a group of adolescents. The nurse would encourage the adolescents to eat which foods to increase their intake of iron? Select all that apply. a) Peanuts b) Hard-boiled eggs c) Cheese sticks d) Grapes e) Dried fruits f) Milk shakes

• Dried fruits • Peanuts • Hard-boiled eggs

The child life nurse practitioner has been assigned to assist the hospitalized child and the child's parents. Which interventions are appropriate for the child life specialist to perform? Select all that apply. a) Giving the child an influenza vaccination b) Showing the child where the pediatric play room is located c) Talking to the family about a scheduled diagnostic test d) Starting the child's intravenous line e) Speaking to the physician as the child's advocate

• Showing the child where the pediatric play room is located • Talking to the family about a scheduled diagnostic test • Speaking to the physician as the child's advocate

For what reasons do nurses work to prevent tobacco use by teens? Select all that apply. a) Teens who smoke are more likely to use alcohol and drugs. b) Smoking damages the respiratory system. c) Smokeless tobacco damages gums and teeth. d) Smoking is associated with fighting and unprotected sex. e) Tobacco use is addicting (nicotine).

• Smoking damages the respiratory system. • Smokeless tobacco damages gums and teeth. • Teens who smoke are more likely to use alcohol and drugs. • Smoking is associated with fighting and unprotected sex. • Tobacco use is addicting (nicotine).

The nurse is preparing to educate the child about a procedure scheduled for the following morning. Which techniques should the nurse use when communicating with this child? Select all that apply. a) Requesting that the parents leave the room during the education b) Standing at the foot of the child's bed while teaching the child c) Using terms that the child will likely understand d) Looking for nonverbal cues e) Being patient with the child

• Using terms that the child will likely understand • Looking for nonverbal cues • Being patient with the child

A 6-month-old is admitted to the hospital because of a fever. When you obtain a health history, what data would you obtain first? a) History of past illnesses b) Details about the fever c) Family profile d) Review of systems

Details about the fever

A 13-year-old girl has grown rapidly in height over the past 2 years and is 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) 20 to 21 years old b) 18 to 19 years old c) 14 to 15 years old d) 16 to 17 years old

16 to 17 years old

The nurse is conducting a well child examination of a 4-year-old and is assessing the child's height. By how much should the nurse expect the child's height to have increased since last year's examination? a) 1 to 2 inches (2.54 to 5.07 cm) b) 2.5 to 3 inches (6.35 to 7.62 cm) c) 3.5 to 4 inches (8.89 to 10.16 cm) d) 0.5 to 1 inch (1.27 to 2.54 cm)

2.5 to 3 inches (6.35 to 7.62 cm)

A nurse is preparing to administer medication to a preschooler. What can the nurse do to ensure communication with the child is effective? a) Show the child a video about medication administration. b) Allow the child to determine if he or she wants to take the medication at that time. c) Use medical terminology when discussing the medication with the child. d) Allow the child to choose between juice, water, or soda to take the medication.

Allow the child to choose between juice, water, or soda to take the medication.

When providing atraumatic care to a child, which action would be most appropriate? 1. Applying restraints for any procedure that would be uncomfortable 2. Keeping the lights on in the child's room throughout the day and night 3. Limiting the use of topical anesthetics for painful injections 4. Allowing parents and children an informed choice about being together

Allowing parents and children an informed choice about being together

The school nurse is assessing a 16-year-old girl who was removed from class because of disruptive behavior. She arrives in the nurse's office with dilated pupils and is talking rapidly. Which drug might she be using? a) Marijuana b) Opiates c) Barbiturates d) Amphetamines

Amphetamines

The nurse is caring for a 10-year-old who has been admitted for surgery. Which of the following would be the most important for the nurse to do when caring for this child? The nurse should a) Avoid prolonged discussions about the patient's anxiety b) Answer questions the child asks regarding pain c) Offer to help the child wash her private parts when bathing d) Encourage family caregivers to frequently sing songs the child enjoys

Answer questions the child asks regarding pain

The nurse is examining the testicles of a 6-year-old boy. How can the nurse prevent a retractile testis from slipping back up the inguinal canal? a) Apply gentle pressure on the inguinal canal. b) Place one finger over the inguinal canal. c) Ask the boy to stand. d) Ask the boy to sit cross-legged.

Ask the boy to sit cross-legged.

A client has confided in a nurse that her 13-year-old daughter has recently changed dramatically in her social interactions with others. Which of the following is a social behavior most likely to be exhibited by a girl at this age? a) Hanging out with girls but maintaining her own unique style b) Banding together with boys and girls but maintaining her own unique style c) Hanging out primarily with boys her own age d) Banding together with other girls and dressing like them

Banding together with other girls and dressing like them

A child is admitted for treatment of a congenital cardiac disorder. The extremely upset parents ask, "How could this happen? Will our child die?" What can the nurse do to help the family meet the healthcare needs of the child? a) Inform them that they should wait in the waiting room while the physician examines the child. b) Inform the family that everything will be done for the child to cure them. c) Be honest with the family and allow them to express concerns and ask questions. d) Inform the family that to have the best outcome for the child, they must trust everyone involved in the care.

Be honest with the family and allow them to express concerns and ask questions.

The nurse is taking an apical pulse on an infant. The nurse should place the stethoscope at which of the following sites? a) Between the sternum and the left nipple b) Below the ribs about one half of an inch c) Above the sternum, slightly to the right d) Above the clavicle on the left side

Between the sternum and the left nipple

The parent reports the 13-month-old infant was using auditory expressive language. The vocalizations have been diminished over the last month and the child no longer says words. Select the best rationale for the infant's language behavior. a) This behavior is common in children when autism is developing. b) Biological factors such as otitis media could be causing hearing loss. c) The environment has changed since the grandparents moved in with the family. d) The parent has decreased the usual sensory stimulation for the child.

Biological factors such as otitis media could be causing hearing loss

Which of the following assessments would you expect to introduce for the first time in the physical examination of a 3-year-old child? a) Snellen vision testing b) Blood-pressure recording c) Standing height measurement d) Observation of walking gait

Blood-pressure recording

The nurse is talking to the mother of a 19-month-old girl about setting limits and supervising activities. In which of the following situations will the nurse recommend letting the child do as she pleases? a) Exploring her body b) Choosing her own foods c) Deciding her bedtime schedule d) Playing on the picnic table

Exploring her body

A toddler insists on brushing his own teeth and being left alone in the bathtub. What advice would you give his parents regarding this? a) It is unusual for 2-year-olds to have such strong opinions. b) Helping with his own tooth brushing allows him to experience autonomy. c) His mother should continue to give full care in all aspects. d) Leaving him alone in the bathtub is a good way to encourage autonomy.

Helping with his own tooth brushing allows him to experience autonomy.

The nurse is assessing the growth of a premature infant. What would be the appropriate action by the nurse to complete this assessment? a) Weigh the infant's diapers. b) Plot the infant's weight, height, and length on a growth chart. c) Ask mom if her baby eats enough. d) Take vital signs.

Plot the infant's weight, height, and length on a growth chart

A nurse is talking with a 10 year old and her parent about the current treatment plan for the child's asthma. The child stands behind the parent and does not ask questions or look at the nurse. What should the nurse consider the child's behavior could indicate? a) The child may be angry about the diagnosis of asthma. b) The child may be developmentally delayed and not understand the conversation. c) The child may not want to be treated for the asthma. d) The child may be shy and have some reluctance about communicating.

The child may be shy and have some reluctance about communicating.

In working with the preschool-age child, the nurse recognizes which of the following as a characteristic of the preschooler? a) The child takes in new information at a rapid rate and asks "why" and "how." b) The child grows and develops skills more rapidly than at any other time in their life. c) The child insists they can "do it," and the next moment they revert to being dependent. d) The child has an increased attention span and can be interested in an activity for a long length of time.

The child takes in new information at a rapid rate and asks "why" and "how."

Which of the following best describes Erikson's psychosocial development task for the school-age child? a) The child wants to successfully complete activities. b) The child is developing his or her own personal identity. c) The child understands and responds to discipline. d) The child is learning to do things on its own.

The child wants to successfully complete activities.

The nurse is conducting a physical examination of a 5-year-old girl. The nurse asks the girl to stand still with her eyes closed and arms down by her side. The girl immediately begins to lean. What does this tell the nurse? a) The child has a negative Romberg test; no further testing is necessary. b) The child has poor coordination and poor balance. c) The child warrants further testing for cerebellar dysfunction. d) The child warrants further testing for an inner ear infection.

The child warrants further testing for cerebellar dysfunction.

The nurse is caring for a 4-year-old child who is hospitalized and in traction. The child talks about an invisible friend to the nurse. Which action by the nurse is indicated? a) The nurse should explain to the child that there are no friends present. b) The nurse should recognize this behavior as normal for the child's developmental age and do nothing. c) The nurse should document the reports of hallucinations by the child. d) The nurse should discourage the child from talking about the imaginary friend.

The nurse should recognize this behavior as normal for the child's developmental age and do nothing.

Question: The experienced nurse is assessing the child's lungs. Rank the following steps in the proper order of assessment. 1 The nurse palpates the child's thorax. 2 The nurse auscultates the child's lungs. 3 The nurse percusses over the child's lungs. 4 The nurse visually inspects the child's thorax.

The nurse visually inspects the child's thorax. The nurse palpates the child's thorax. The nurse percusses over the child's lungs. The nurse auscultates the child's lungs.

The high school soccer coach asks the nurse how soft tissue ankle injuries to the players might be prevented. The nurse's main recommendation is: a) Use semi-rigid ankle orthoses. b) Wear high-top athletic shoes. c) Exercises to improve coordination and proprioception. d) Ankle conditioning and strength training.

Use semi-rigid ankle orthoses

The developmental task of preschoolers is to achieve a sense of a) initiative versus guilt. b) accomplishment versus inefficiency. c) autonomy versus shame and doubt. d) cognition versus attitude.

initiative versus guilt.

When assessing symptoms such as rashes, pain, or lesions, what would be included in the location factor of the symptom? a) amount b) quality c) localized or generalized d) color

localized or generalized

The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to: a) conclude the earlier assessments carried out fatigued the infant. b) refer the infant for developmental and/or neurologic evaluation. c) consider this a normal response for the age. d) suggest more awake tummy time for the child.

refer the infant for developmental and/or neurologic evaluation.

A 2-year-old holds his breath until he passes out when he wants something his mother does not want him to have. You would base your evaluation of whether these temper tantrums are a form of seizure on the basis that a) seizures are not provoked; temper tantrums are. b) seizures typically occur with fever; temper tantrums do not. c) seizures rarely occur in toddlers. d) with seizures, cyanosis rarely develops.

seizures are not provoked; temper tantrums are.

A 7-year-old has taken money from his brother's dresser on two occasions. When counseling his mother about this, you would advise her that a) she should talk to the child's teacher about putting less pressure on him. b) she may need to remind him of property rights. c) stealing is unusual for a 7-year-old. d) she should buy his brother a bank that cannot be opened.

she may need to remind him of property rights.

The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex: a) is a protective reflex and retained for life. b) should be pronounced and easy to elicit. c) should have disappeared. d) is expected to appear within 1 month.

should have disappeared.

The activity that would best foster the developmental task of an adolescent who is physically challenged would be a) talking to another adolescent who has a similar disorder. b) deciding whether she wants her bath before or after lunch. c) watching television on the set in her room. d) having a teacher bring her school homework in for her.

talking to another adolescent who has a similar disorder.

In counseling a group of parents regarding the development of school readiness in preschoolers, the nurse emphasizes: a) library visits and story hour. b) visiting the kindergarten. c) the home environment. d) enrollment in a preschool.

the home environment.

The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother: a) the newborn's stomach can hold between one-half to 1 ounce. b) most newborns need to eat about 4 times per day. c) the best feeding schedule offers food every 4 to 6 hours. d) demand scheduled feeding is associated with increased difficulty getting the baby to sleep through the night.

the newborn's stomach can hold between one-half to 1 ounce.

The mother of a 4-year-old girl reports her daughter has episodes of wetting her pants. The nurse questions the mother about the frequency. The nurse determines these episodes occur about once every 1 to 2 weeks. Which response by the nurse is indicated? a) "At this age it is helpful to remind children to go to the bathroom." b) "Consider restricting your daughter's fluid intake." c) "The frequency of these wetting episodes may be consistent with a low-grade urinary tract infection." d) "Discipline should be applied after these times."

"At this age it is helpful to remind children to go to the bathroom."

The nurse is providing teaching about proper dental care for the parents of a 5-year-old girl. Which response indicates a need for further teaching? a) "We should use only a pea-sized amount of toothpaste." b) "She should see a dentist every 6 months." c) "Too much fluoride can contribute to fluorosis." d) "She needs to floss her teeth before brushing."

"She needs to floss her teeth before brushing."

At birth the newborn's head and chest circumference were measured. The nurse knows that the head should be about: a) ½ inch smaller than the chest b) Equal in size to the chest c) 2 inches larger than the chest d) 1 inch larger than the chest

1 inch larger than the chest

Suicide is so common in adolescents it ranks third as a cause of death in the 10- to 24-year-old age group. a) False b) True

True

The nurse needs to calculate the child's body mass index (BMI). The child's weight is 42 kg. The child is 142 cm in height. Calculate the child's BMI using the metric method. Record your answer using a whole number. ______BMI

21 the formula is: weight in kilograms divided by height in meters squared weight (kg)/height (m)2 42 kg/1.42 squared 42/2.0164 = 20.8292 Rounded to 21

The best way for a parent to handle a temper tantrum by a toddler is to calmly express disapproval and then ignore it. a) False b) True

True

The human papillomavirus (HPV) is associated with the development of cervical cancer in women. a) False b) True

True

The toddler grows about how many inches in height per year? a) 5 inches b) 1 inch c) 7 inches d) 3 inches

3 inches

While taking care of a teenager in the late adolescence stage, what behavior of the client will the nurse most likely observe during data collection for annual physical examination? a) Introspection and fluctuations in self assurance b) Seclusion and moodiness c) True attitude of maturity d) Childish ways of appearing, thinking and behaving

True attitude of maturity

Which behavior by an 18-year-old is consistent with successful progression through the stages of Piaget's theory of development? a) Uses critical thought processes to handle a problem b) Is able to be part of a large group of peers while maintaining a sense of self c) Reflects a strong moral code d) Has a strong sense of understanding of internal identity

Uses critical thought processes to handle a problem

The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which observation points to a developmental risk? a) Uses only the left hand to grasp b) Crawls with stomach down c) Picks up small objects using entire hand d) Cannot pull self to standing

Uses only the left hand to grasp

When caring for children, how does the nurse best incorporate the concept of family-centered care? 1. Encourages the family to allow the physician to make health care decisions for the child 2. Uses the concepts of respect, family strengths, diversity, and collaboration with the family 3. Advises the family to choose a pediatric provider who is on the child's health care plan 4. Recognizes that families undergoing stress related to the child's illness cannot make good decisions

Uses the concepts of respect, family strengths, diversity, and collaboration with the family

Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay? a) Asks "why" often b) Talks about a past event c) Uses two-word sentences or phrases d) Half of speech understood by outsider

Uses two-word sentences or phrases

Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay? a) Asks "why" often b) Uses two-word sentences or phrases c) Half of speech understood by outsider d) Talks about a past event

Uses two-word sentences or phrases

How can the nurse increase communication between the family of a child with sickle-cell disease and the health care team? a) Have the physician talk to the parents about treatment. b) Using a dry erase board for updating the daily plan of care. c) Tell the child to inform the parents that of new medications for control of pain. d) Inform the family when present in the child's room about changes in the child's condition.

Using a dry erase board for updating the daily plan of care.

A 5-year-old boy visits the physician's office with an upper respiratory infection. Which approach would give the nurse the most information about the child's developmental level? 1. Playing a game with the child 2. Talking with the child about the teddy bear next to him 3. Using a screening tool during a follow-up office visit 4. Asking the 10-year-old sibling about the child

Using a screening tool during a follow-up office visit

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

• Books and stories can help preschoolers master proper behavior. • When discussing improper behavior, call the behavior "bad" or "naughty," not the child. • Anticipate situations likely to cause misbehavior and redirect the child to another activity.

Which statements regarding infant safety are accurate? Select all that apply. a) Bottle should only be propped for infants 8 months or older b) Crib and playpen bars should be no more than 2 3/8 inches apart c) Only small pillows should be used in cribs d) A safe temperature for hot water heaters in households with infants is 120 degrees e) Car seats should be placed in back seats

• Crib and playpen bars should be no more than 2 3/8 inches apart • Car seats should be placed in back seats • A safe temperature for hot water heaters in households with infants is 120 degrees

A nurse is caring for a 4-year-old girl. The parents indicate that their daughter often reports that objects in the house are her friends. They are concerned because the girl says that the grandfather clock in the hallway smiles and sings to her. Which response by the nurse is best? a) "Do you think your daughter is hallucinating? b) "Is there a family history of mental illness?" c) "Attributing life-like qualities to inanimate objects is quite normal at this age." d) "Your daughter is demonstrating animism which is common."

"Attributing life-like qualities to inanimate objects is quite normal at this age."

A 16-year-old girl has arrived for her sports physical with a new piercing in her navel. Which response by the nurse is best? a) "I hope for your sake the needle was clean." b) "This is a risk for hepatitis, tetanus, and AIDS." c) "Be sure to clean the navel several times a day." d) "This is a wound and can become infected."

"Be sure to clean the navel several times a day."

The mother of a 7-year-old girl is asking the nurse's advice about getting her daughter a 2-wheel bike. Which response by the nurse is most important? a) "Be sure to get the proper size bike." b) "Learning to ride the bike will improve her coordination." c) "Teach her where she'll land on the grass if she falls." d) "She won't need a helmet if she has training wheels."

"Be sure to get the proper size bike."

A teen mom asks the discharge nurse if it is okay to sleep in bed with the baby. She says her mom always did it with her siblings and it seemed okay. The nurse should respond how? a) "Bed sharing has positive effects on babies, let me get you information." b) "Bed sharing is okay, just make sure the infant is between two people." c) "Sure, you can do whatever you want, it is your baby." d) "Sure, you can, make sure you use a soft mattress for support."

"Bed sharing has positive effects on babies, let me get you information."

The nurse is discussing the topics of sex and sexuality and how to discuss these issues with a group of caregivers of adolescents. Which of the following statements made by the nurse is most appropriate to tell this group of caregivers? a) "Most schools have excellent programs to teach adolescents about sex and sexuality." b) "Being honest and straightforward with teenagers will encourage them to ask their parents about subjects like sexuality." c) "Internet resources, movies, and television have the most accurate and current information for your adolescent to learn about sexuality issues." d) "Teenagers spend so much time with their peers, and that is usually how they find out about sex."

"Being honest and straightforward with teenagers will encourage them to ask their parents about subjects like sexuality."

The father of a preschool boy reports concerns about the short stature of his son. The nurse reviews the child's history and notes the child is 4 years old and is presently 41 in (104 cm) tall and has grown 2.5 in (6.35 cm) in the past year. Which response by the nurse is most appropriate? a) "Both your son's height and rate of growth are within normal limits for his age." b) "Is there a reason you are concerned about your child's height?" c) "Your son is slightly below the normal height for his age but he had demonstrated a normal growth rate this year." d) "Your son is slightly below the normal height for his age group but may still grow to be a normal height in the coming year."

"Both your son's height and rate of growth are within normal limits for his age."

The nurse is collecting data from a 15-year-old boy who is being seen at the ambulatory care clinic for immunizations. During the initial assessment, he voices concerns about being shorter than his peers. What response by the nurse is indicated? a) "Being short is nothing to be ashamed of." b) "Are the other men in your family short?" c) "I am sure you are not the shortest guy in your class." d) "Boys your age will often continue growing a few more years."

"Boys your age will often continue growing a few more years."

The parents of an 8-year-old boy report their son is being bullied and teased by a group of boys in the neighborhood. Which response by the nurse is best? a) "Your son is at high risk for bullying other children as a result of this situation." b) "Perhaps teaching your son self-defense courses will help him to have a greater sense of control and safety." c) "Fortunately the scars of being picked on will fade as your son grows up." d) "Bullying can have lifelong effects on the self-esteem of a child."

"Bullying can have lifelong effects on the self-esteem of a child."

The caregiver of a 6-year-old tells the clinic nurse that he is concerned that his 5-year-old child cannot yet print his first and last name, and the caregiver is wondering if this is normal. Which response by the nurse would be most appropriate? a) "By the age of 6 most children can print some letters and maybe their first name." b) "Some children this age cannot hold a pencil or crayon well enough to write legibly." c) "Usually by the age of 6, most children can write numbers up to nine, but no letters." d) "It is not unusual for children of this age to be writing their first name in cursive."

"By the age of 6 most children can print some letters and maybe their first name."

The nurse is working with a group of caregivers of 6-year-olds. One of the mothers states her son has been lying and making up stories; she asks for some advice about how to address the issue. Which of the following would be an appropriate response by the nurse? a) "Is there any possibility he is telling the truth and you just don't know it is the truth?" b) "Your child could be in serious trouble in school if he continues to tell lies." c) "Children this age sometimes can't distinguish between fantasy and reality." d) "The child should have privileges taken away for several days each time he tells a lie."

"Children this age sometimes can't distinguish between fantasy and reality."

The nurse is promoting safe sex to a 14-year old boy who is frequently dating. Which of the following points is most likely to be made during the talk? a) "Adolescents account for 25% of sexually transmitted infection (STI) cases." b) "Girls are more susceptible to STIs than boys." c) "Be careful or you'll wind up being a teenage dad." d) "Contraception is a shared responsibility."

"Contraception is a shared responsibility."

The nurse examines a 3-year-old girl in a health maintenance setting. What is the first question the nurse would ask her mother to obtain a health history? a) "Is your daughter ill in any way?" b) "Has your daughter been ill in the past?" c) "Do you have any concerns about your daughter?" d) "Tell me about your daughter."

"Do you have any concerns about your daughter?"

A nurse is conducting a physical examination of an uncooperative preschooler. In order to encourage deep breathing during lung auscultation what could the nurse say? a) "You must breathe deeply so I can hear your lungs." b) "You may not leave until I listen to your breathing." c) "Do you want your mother to listen to your lungs?" d) "Do you think you can blow out my light bulb on this pen?"

"Do you think you can blow out my light bulb on this pen?"

The nurse is teaching a group of caregivers of school-age children on various topics. Which of the following statements made by the caregivers indicates a need for further teaching? a) "Sometimes we have to be firm, but our children wash their hands before eating." b) "Food is so expensive, we always make our children eat everything on their plate." c) "Even if the weather is cool and cloudy, our children play outside every day." d) "I make sure they have good teeth by giving them calcium and phosphorus."

"Food is so expensive, we always make our children eat everything on their plate."

The nurse is caring for an 11-year-old girl. The girl's mother complains that the girl does not want to play team sports like soccer or volleyball anymore. Her daughter insists she does not enjoy them. The mother is concerned that her daughter will not get enough physical activity and asks the nurse for guidance. How should the nurse respond? a) "Why don't you sign her up for an aerobics or dance class?" b) "Give her some options; it's important to find something she enjoys." c) "Organized sports are just a complementary activity to other physical activities." d) "Remind her of the importance of regular physical activity for good health."

"Give her some options; it's important to find something she enjoys."

The parents of an overweight 2-year-old boy admit that their child is a bit "chubby," but argue that he is a picky eater who will eat only junk food. Which response by the nurse is best to facilitate a healthier diet? a) "Calorie requirements for toddlers are less than infants." b) "You may have to serve a new food 10 or more times." c) "Give him more healthy choices with less junk food available." d) "Serve only healthy foods. He'll eat when he's hungry."

"Give him more healthy choices with less junk food available."

When questioning a 15-year-old about his or her health history, what would be an appropriate way for the nurse to ask about the child's drug history? a) "Have you heard that some teens like to smoke? Have you tried this?" b) "Have you smoked cigarettes?" c) "Have you had alcohol at parties before?" d) "Have you smoked crack before?"

"Have you heard that some teens like to smoke? Have you tried this?"

A mother is discussing her 10-month-old boy with the nurse. Which comment indicates a need for teaching? a) "He loves being in his walker and 'zips' around the house." b) "He gets a few sips of apple juice each day from a regular cup, not a sippy cup." c) "We have safety gates at the top and bottom of our stairs." d) "I wipe my son's teeth every day with a fresh washcloth."

"He loves being in his walker and 'zips' around the house."

The mother of a preschool-age child is discussing normal development of this age child with the pediatric nurse. The nurse explains the developmental milestone of initiative. The mother makes the following statements about her son. Which statement is an example of what might be this developmental milestone? a) "He broke my favorite plate but blamed it on some friend he called Paul, but we don't know anyone named Paul." b) "He tries to sweep up cereal his brother spilled but cries when he can't do it well." c) "He refuses to hold my hand while we are crossing the street." d) "When I leave him with a babysitter he gets upset, but she says he still does what she asks him to do."

"He tries to sweep up cereal his brother spilled but cries when he can't do it well."

A nurse is caring for a very shy 4-year-old girl. During the course of a well child assessment, the nurse must take the girl's blood pressure. Which approach is best? a) "May I take your blood pressure?" b) "Will you let me put this cuff on your arm?" c) "Help me take your dolls blood pressure" d) "Your sister did a great job when I took hers"

"Help me take your dolls blood pressure"

The nurse is caring for a 13-year-old girl. The child has been identified as overweight with no underlying psychological or secondary causes. The nurse is reviewing the child's weight-loss progress and nutrition at a follow-up visit. Which of the following indicates a need for further discussion and teaching? a) "Her goal is to be a size smaller by our vacation in two weeks." b) "My daughter is helping us plan our family's weekly menu." c) "We are using family outings and activities as a reward for weight loss." d) "Our whole family has changed our eating habits."

"Her goal is to be a size smaller by our vacation in two weeks."

During a routine wellness examination, the nurse is trying to determine how well a 5-year-old boy communicates and comprehends instructions. Which of the following is the best specific trigger question to determine the preschooler's linguistic and cognitive progress? a) "How well does your son communicate or follow instructions?" b) "Would you say your son has a vocabulary of about 900 words?" c) "Does your son speak in complete sentences all the time?" d) "Is your son's speech clear enough that anyone can understand it?"

"How well does your son communicate or follow instructions?"

The school nurse is the guest speaker in a classroom of fourth-grade children, and they are discussing eating habits and the number of servings from each of the food groups that is appropriate for the school-age child. Which of the following statements made by the children best indicates an appropriate intake of one of the food groups for this age child? a) "My gramma cooks for us and she lets me eat two chicken breasts for supper." b) "My dad doesn't like bread so I get my grain in the morning when I eat a bowl of cereal." c) "I love fruit so every day I eat the half of orange my mom puts in my lunch." d) "I drink three big glasses of milk each day."

"I drink three big glasses of milk each day."

The nurse is doing teaching with a group of caregivers of preschool children on various topics. The topic of sexual development is discussed. Which of the following statements made by the caregivers indicates an understanding of the sexual development of the preschool age child? a) "I feel better knowing that what she is doing is normal." b) "When I find my son masturbating, I will tell him that is unacceptable." c) "I will tell my daughter that she will have time to explore her body as she gets older." d) "I will encourage my son to ask his father any questions that are sexual in nature."

"I feel better knowing that what she is doing is normal."

The nurse suspects poor literacy skills in a child's family member when which statement is made? a) "I need you to review once more the best way to be sure he swallowed all his medicine." b) "I forgot my glasses, so I'll read this when I get home and let you know if I have questions." c) "We communicate with the special education teachers and school daily with a notebook." d) "He gets a suppository every 3 days to prevent constipation."

"I forgot my glasses, so I'll read this when I get home and let you know if I have questions."

What statement by the mother of a 20-month-old indicates a need for further teaching about nutrition? a) "She drinks three 6-ounce cups of whole milk each day." b) "I give my daughter juice at breakfast and when she is thirsty during the day." c) "When she doesn't eat well at meals we give her nutritious snacks." d) "New foods are offered along with ones she likes."

"I give my daughter juice at breakfast and when she is thirsty during the day."

The nurse is counseling an overweight, sedentary 15-year-old girl. The nurse is assisting her to make appropriate menu choices. Which statement indicates the adolescent understands how to make appropriate dietary selections? a) "Because of my age, my dairy intake is unlimited." b) "To lose weight my protein intake should be limited to 2 to 4 servings per day." c) "I avoid all fat intake." d) "I need to have 4 servings of fruit each day."

"I need to have 4 servings of fruit each day."

The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching? a) "I usually have him in time-out for about 10 minutes." b) "He is allowed out of time-out when he is calm." c) "The time-out doesn't just have to be in his room." d) "I put him in time-out when the problem occurs."

"I usually have him in time-out for about 10 minutes."

A nurse is preparing a hospitalized child for a lumbar puncture. The physician states that he will perform the procedure in the child's hospital room. What should the nurse inform the physician to advocate for the child? a) "I will have the procedure prepared in the treatment room, so that the child may view the hospital room as safe and secure." b) "We will have to have the parents hold the child down because there is not enough assistance on the floor." c) "The parents want to be present during the procedure, and I informed them that this isn't the policy of our facility." d) "I will prepare the hospital room for the child, because that room is where the child will feel most comfortable."

"I will have the procedure prepared in the treatment room, so that the child may view the hospital room as safe and secure."

The nurse is caring for a 10-year-old girl and is trying to obtain clues about the child's state of physical, emotional, and moral development. Which question is most likely to elicit the desired information? a) "Do you like your school and your teacher?" b) "Would you say that you are a good student?" c) "Tell me about your favorite activity at school?" d) "Do you have a lot of friends at school?"

"Tell me about your favorite activity at school?"

The father of a 4½-year-old boy has contacted the nurse because he is concerned that his son is frequently touching his genitals. The nurse explains that this is normal during the preschool years. Which statement by the father would indicate a need for further teaching? a) "I have heard that both boys and girls often touch themselves at this age." b) "I will need to find an appropriate punishment for him if this continues." c) "This is probably a good time to talk about safety and who can touch him." d) "I should teach him certain rules about this activity."

"I will need to find an appropriate punishment for him if this continues."

A 14-year-old boy is far quieter than usual when he visits his physician's office. The nurse asks him if anything is wrong, and the boy replies that he did not make the cut for the football team. What would be most appropriate for the nurse to say? a) "That's okay; you can try out for basketball in a few months." b) "Don't let it get you down; sports are a waste of time, anyway." c) "I'm really sorry; I know that must be a big disappointment." d) "It's not that big of a deal; a lot of kids don't make the football team."

"I'm really sorry; I know that must be a big disappointment."

The nurse is discussing the topic of nutrition with a group of caregivers of preschoolers. Which of the following statements made by the caregivers is most accurate regarding nutrition in the preschooler? a) "If I give snacks throughout the day, my child can meet her nutritional requirements." b) "It is important for me to give my child calcium so his muscles will grow." c) "It is hard for me to get my child to drink the 4 cups of milk he needs each day." d) "My child is growing so rapidly, she needs to eat three big meals a day."

"If I give snacks throughout the day, my child can meet her nutritional requirements."

Martha asks the nurse if her 2-month-old could have baby bananas yet. The nurse would respond and educate Martha on the nutrition stages of infants by which of these responses? a) "Sure, if you feel she is ready to have bananas." b) "In one month you can try bananas if you think she is ready." c) "In two months you can try bananas if you think she is ready." d) "When did you feed your other child bananas?

"In two months you can try bananas if you think she is ready."

The nurse is taking a health history for a 12-year-old boy who is seriously overweight. Which general question would the nurse direct to the child's parents? a) "Is there a family history of hypertension, heart disease, or diabetes?" b) "How important is exercise?" c) "Is breakfast eaten regularly?" d) "What beverages are preferred?"

"Is there a family history of hypertension, heart disease, or diabetes?"

Debbie asks her nurse what she thinks about giving her baby a pacifier. Debbie is struggling with this issue and is very teary-eyed about making a decision. How should the nurse respond to Debbie? a) "I always gave my kids a pacifier." b) "You should never give babies pacifiers." c) "It is a personal decision, let me give you a pamphlet from the AAP." d) "You should do whatever you want."

"It is a personal decision, let me give you a pamphlet from the AAP."

During a well-child visit, an 11-year-old girl complains to the nurse that she looks different from her friends who are wearing bras. What is an appropriate response? a) "It is normal for there to be differences in the time and rate girls your age develop." b) "You are doing well in school. Be happy with this success." c) "Remember the methods you have been taught to manage peer pressure." d) "It is common for girls your age to worry about being different."

"It is normal for there to be differences in the time and rate girls your age develop."

A mother is concerned because her 14-month-old son, who had a big appetite when breastfeeding a few months ago, seems uninterested in eating solid food. She still breastfeeds him daily, but is thinking of weaning him soon. How should the nurse respond to this mother? a) "It is not normal for toddlers to lose their appetites; have him tested for a gastrointestinal condition." b) "It is normal for toddlers to lose their appetites; try weaning him all at once so that he will be more interested in the solid food." c) "It is not normal for toddlers to lose their appetites; spoon feed him yourself to make sure he gets proper nutrition." d) "It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate."

"It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate."

An adolescent asks you what the term "puberty" means. What is your best response? a) "It denotes the beginning of secondary sex characteristics." b) "It is the time span between 12 and 18 years." c) "It is the time span that denotes the onset of maturity." d) "It is the age at which one first becomes capable of sexual reproduction."

"It is the age at which one first becomes capable of sexual reproduction."

In working with the toddler, which of the following statements would be most appropriate to say to the toddler to decrease the behavior known as negativism? a) "You love having the same food every day, do you want apples again with lunch?" b) "It is time for lunch, I am going to put your bib on." c) "Do you want help getting into your chair so we can have lunch?" d) "Are you getting hungry and ready for lunch?"

"It is time for lunch, I am going to put your bib on."

After teaching the mother of a 13-month boy old about suggestions for bathing and hygiene, the nurse determines that the teaching was successful when the mother states which of the following? a) "I'll drain the tub while he's still in it so he won't fall." b) "I'll wash his hair everyday with just plain soap." c) "It might be best to give him a bath in the evening." d) "I can use bubble baths to lure him into the tub."

"It might be best to give him a bath in the evening."

What should be the first step in developing a teaching plan for a 9 year old who needs education about a gluten-free diet for the treatment of celiac disease? a) Collecting data of current dietary likes and dislikes b) Assessing the child's current level of understanding c) Giving the child a pamphlet about the reason for a gluten-free diet d) Developing outcome standards for the nutritional aspect of the plan

Assessing the child's current level of understanding

A nurse is discussing safety measures with the parents of a toddler. Which of the following would the nurse emphasize to address the most frequent type of accident in toddlers? a) "Keep all cleaning products and drugs out of the reach of your child." b) "Turn the handles of your pots away from the edge of the stove when cooking." c) "Make sure to have your child securely fastened in a car seat." d) "Have your child wear a helmet when beginning to ride a tricycle."

"Keep all cleaning products and drugs out of the reach of your child."

Patty calls the hospital nursing hotline and asks, "My 8-week-old daughter cries 8 hours a day, and she is hard to console, is that normal?" What should the nurse's response be to this mother? a) "Yes, maybe she is just tired." b) "Yes, infants cry all the time at that age." c) "No, call your doctor." d) "Let me ask you some more questions to see if there are symptoms of colic."

"Let me ask you some more questions to see if there are symptoms of colic."

When the nurse discharges a new mom and infant, the nurses notices that the car seat is in the front seat of the car. What is the appropriate response for the nurse to make regarding the car seat? a) "Let me go over car seat safety with you, so you can install your car seat properly." b) "You should never put the car seat in the front." c) "With the car seat in front, you can keep an eye on your baby." d) "I see you have a car seat, that is great."

"Let me go over car seat safety with you, so you can install your car seat properly."

The nurse is preparing to assess the internal ear structures of a 3-year-old. The child is resistant to the otoscope. How should the nurse respond? a) "Come, sit on this pretty, little red chair." b) "May I please look inside your ears?" c) "Please sit still so I can see inside your ears." d) "Let's see if I can find some puppies or kittens."

"Let's see if I can find some puppies or kittens."

The nurse is talking with the parents of an 8-year-old boy who has been cheating at school. Which comment should be the nurse's primary message? a) "Make sure that your behavior around your son is exemplary." b) "Punishment should be severe and long lasting." c) "Resolve this by providing an opportunity for him to cheat and then dealing with it." d) "You may be putting too much pressure on him to succeed."

"Make sure that your behavior around your son is exemplary."

The nurse is reinforcing teaching related to the nutritional needs of the infant with a group of caregivers. One caregiver asks why her 6-month-old infant needs to have solid foods when breast milk is such a good source of nutrition. What would be the best response by the nurse? a) "By this age your child is ready to try new skills such as eating solid foods." b) "Breastfeeding will become painful when the child gets more teeth, so the infant needs to eat solid foods." c) "Milk does not provide adequate amounts of iron, which are found in solid foods." d) "The extrusion reflex must be developed and feeding solid foods will help the child to develop this reflex."

"Milk does not provide adequate amounts of iron, which are found in solid foods."

The nurse is discussing nutritional issues and concerns with the caregivers of preschoolers. Which of the following statements made by the caregivers best indicates a common aspect of the diet and nutrition of the preschool child? a) "My 4-year-old eats as much as my adolescent does every day." b) "My husband is insistent that our 5-year-old not eat any snacks so he will eat he all of his meals at mealtime." c) "My child is so picky and eats the same thing every day for days on end!" d) "Our child gets into food jags where she will only eat one food all day long."

"My child is so picky and eats the same thing every day for days on end!"

The nurse is teaching a group of caregivers of school-age children about the importance of setting a consistent bedtime for the school-age child. Which of the following statements made by a caregiver indicates an understanding of the sleep patterns and needs of the school-age child? a) "My son doesn't even know when he's tired." b) "She stays up late when she takes a nap after school." c) "My child sleeps between 11 and 12 hours a night." d) "My teenage child doesn't sleep as much as my 9-year-old does."

"My child sleeps between 11 and 12 hours a night."

During the toddler years, the child attempts to become autonomous. If the following statements were made by caregivers of 3-year-old children, which observation reflects that the child is developing autonomy? a) "Every night my child follows the same routine at bedtime." b) "When my child falls down, he always wants me to pick him up." c) "My child uses the potty chair and is dry all day long." d) "My child has temper tantrums when we go to the store."

"My child uses the potty chair and is dry all day long."

The nurse is caring for an 8-year-old girl. She is reviewing her nutritional requirements and describing interventions that promote healthy eating habits. Which of the following responses by the girl's mother indicates a need for further discussion? a) "My daughter must stay at the table until she has cleaned her plate." b) "My daughter likes to have a glass of milk with her meal." c) "My daughter eats one item at a time." d) "My daughter likes many different kinds of fruits and vegetables."

"My daughter must stay at the table until she has cleaned her plate."

The nurse is teaching a first-time mother with a 14-month-old boy about child safety. Which is the most effective overall safety information to provide guidance for the mother? a) "Put chemicals in a locked cabinet." b) "Place a gate at the top of each stairway." c) "Never let him out of your sight when outdoors." d) "Don't smoke in the house or car."

"Never let him out of your sight when outdoors."

The nurse is doing a well-child exam of a 5½-year-old girl. Which statement by the mother would alert the nurse that further teaching is needed about healthy eating habits? a) "We eat fast food less than once a month." b) "Our family rule is that all children clean up their plates at each meal, and we feed them a lot." c) "I try to set a good example and eat a variety of fruits and vegetables." d) "She enjoys planning meals and helping me in the kitchen." e) "Her serving sizes are about half the size of ours."

"Our family rule is that all children clean up their plates at each meal, and we feed them a lot."

Fourteen-year-old Freddy has come to his primary-care physician's office for a routine well-child visit. In reading the child's history, the nurse notes that Freddy's father suffers from alcoholism. If Freddy's mother makes the following statements, which statement would be most important for the nurse to gather further data regarding? a) "Sometimes Freddy asks me questions about his father's low tolerance for alcohol." b) "I think I know how Freddy feels about drinking. He has had substance abuse education in school." c) "Our next door neighbor is older than Freddy, and he drinks when they hang out together." d) "I wish there was a blood test for alcoholism. I know Freddy is at risk."

"Our next door neighbor is older than Freddy, and he drinks when they hang out together."

A mother reports to the nurse that her 4 year old does everything that she does. She says she is becoming somewhat frustrated with these actions. What would be the best response by the nurse to this mother? a) "I am sure there are ways to get your daughter to stop imitating you." b) "I can imagine that it would be very irritating." c) "Preschoolers imitate as a healthy behavior--it is part of their imagination and normal growth and development." d) "This is not normal behavior. I am going to get the doctor's advice."

"Preschoolers imitate as a healthy behavior--it is part of their imagination and normal growth and development."

Billy's mother is with him at a visit for a sore throat. In the interview she states that she does not know what to do with him: He is taking two or three showers a day, when not that long ago she could barely get him to take a bath at all. What should the nurse's reply be to the mother? a) "Reinforce the family rules but also allow him to develop his own routine." b) "Do not encourage multiple baths, it can be very drying to the skin." c) "Remind him that he needs to be on a schedule so that he does not disrupt the family." d) "Reevaluate his ability to do hygiene care since he is showering so frequently."

"Reinforce the family rules but also allow him to develop his own routine."

Evan, a 14-year-old, and his mother are in the office for an annual visit and his mother jokes openly in front of you about the changes in Evan's voice and the hair under his armpits. What is an appropriate response from the nurse when she is talking with the mother? a) "I remember that time in my life, it was so awkward and uncomfortable." b) "Discuss with Evan your trials with puberty and the changes you experienced." c) "Has he gone through the big change, smelly armpits and hair all over his body?" d) "Remember that he can become modest and self-conscious and teasing may cause embarrassment."

"Remember that he can become modest and self-conscious and teasing may cause embarrassment."

The parents of an 8-year-old girl with a slow-to-warm temperament are concerned about their daughter's reaction when she visits the dentist for the first time after having a cavity filled at the last visit. How should the nurse respond? a) "Remind your daughter of the importance of proper oral hygiene." b) "Remind her in simple terms what will happen in the dentist's office." c) "Wait to tell her about the visit until just before the appointment." d) "Tell your daughter that it is just like going to see the pediatrician."

"Remind her in simple terms what will happen in the dentist's office."

The nurse is providing teaching to the mother of a 4-year-old girl about bike safety. Which statement indicates a need for further teaching? a) "The balls of her feet should reach both pedals while sitting." b) "She should always ride on the sidewalk." c) "She can ride on the street if I am riding with her." d) "Pedal back brakes are better for her age group."

"She can ride on the street if I am riding with her."

The parents of a 4-year-old girl tell the nurse that their daughter is having frequent nightmares. Which statement indicates that the girl is having night terrors instead of nightmares? a) "She is scared after she wakes up." b) "She screams and thrashes when we try to touch her." c) "She comes and wakes us up after she awakens." d) "She has a hard time going back to sleep."

"She screams and thrashes when we try to touch her."

The nurse is conducting a health screening of a 5-year-old boy as required for kindergarten. The boy is fearful about going to a new school. The mother asks for the nurse's advice. Which response by the nurse is best? a) "Kindergarten is a big step for a child. Be patient with him." b) "Talk to your son's new teacher and schedule a tour with him." c) "Be aware that he may have difficulty adjusting being away from home 5 days a week." d) "Remind him that kindergarten will be a lot of fun and he'll make new friends."

"Talk to your son's new teacher and schedule a tour with him."

A 3½-year-old shouts, "Look out for Boo-ga-loo!" as the nurse enters the exam room. The father explains Boo-ga-loo is his daughter's imaginary friend. How should the nurse respond? a) "Are you kidding me?" b) "Tell me about Boo-ga-loo." c) "I don't see anyone." d) "Where did you get that funny name?"

"Tell me about Boo-ga-loo."

The nurse is conducting a physical examination of a young preschooler and detects the odor of tobacco smoke on the parents' hair and clothing. How should the nurse respond? a) "Are you aware that exposure to tobacco smoke can be associated with behavioral difficulties?" b) "Tell me about your child's exposure to tobacco smoke." c) "Tobacco smoke is linked with an increased number of ear infections." d) "You should stop smoking around your child."

"Tell me about your child's exposure to tobacco smoke."

A nurse is educating a 6 year old about the removal of a cyst on the back. What is the best explanation the nurse can give to the child? a) "The doctor is going to make a special opening on your back to take out the bump." b) "The doctor is going to cut your back open to take out the cyst." c) "The doctor is going to make an incision in your back and take out the cyst." d) "The doctor is going to make a hole in your back and take out the cyst."

"The doctor is going to make a special opening on your back to take out the bump."

A nurse is preparing a 7 year old for abdominal computed tomography (CT) scanning with intravenous contrast. What statement would be most appropriate to explain the injection of the contrast dye to the child? a) "You are going to have medicine injected into your IV so that the doctor will be able to see your internal organs better." b) "The radiologist is going to inject dye into your IV. You won't feel a thing." c) "The doctor is going to put a special medicine in your tube so that she will be able to see your stomach better." d) "The doctor is going to proceed by administering contrast medium into your vein to see what is wrong with you."

"The doctor is going to put a special medicine in your tube so that she will be able to see your stomach better."

The mother of an infant questions the nurse about her baby's teething. The nurse provides client education. Which statement by the mother indicates understanding of the information provided? a) "My baby's first tooth will likely appear between 5 and 6 months." b) "The first teeth that will likely appear are the lower incisors." c) "My baby will most likely have his upper middle teeth come in first." d) "By 1 year my baby should have about three teeth."

"The first teeth that will likely appear are the lower incisors."

The nurse is discussing psychosocial development of the adolescent with a group of family caregivers. Which of the following statements made by the caregiver is an example of the most effective way the caregiver can support the adolescent? a) "I leave pamphlets about topics such as drugs and alcohol in his room so he can read them any time." b) "Our house rules are strict and we know many of his friends are not, but they all follow the same rules at our house." c) "The hairstyles she chooses are not what I think looks good on her, but I just let her do what she wants to with her hair." d) "We discourage him from spending too much time with his school friends since we know they can be a negative influence."

"The hairstyles she chooses are not what I think looks good on her, but I just let her do what she wants to with her hair."

The nurse is conducting a health screening for a 3-year-old boy as required by his new preschool. Which statement by the parents warrants further discussion and intervention? a) "The school is quite structured and advocates corporal punishment." b) "The school requires processed foods and high sugar foods be avoided." c) "The school has a looser environment which is a good match for his temperament." d) "There is a very low student teacher ratio and they do a lot of hands on projects."

"The school is quite structured and advocates corporal punishment."

The nurse is conducting teaching with families of school-age children. Which of the following statements made by the nurse is most appropriate related to topics that would be covered with this group of individuals? a) "The school-age child should have a routine physical exam every six months." b) "The school-age child should brush their teeth at bedtime." c) "The school-age child needs 10 to 12 hours of sleep per night." d) "The school-age child should be screened for scoliosis once a year."

"The school-age child needs 10 to 12 hours of sleep per night."

The parents of a 9-year-old boy report they have been homeschooling their son and now plan to enroll him in the local public school. They voice concerns about the influence of the other children on their son's values. Which information should the nurse provide the parents? a) "Values are largely inborn and will be impacted only in a limited way by environmental influences." b) "At your son's age, values are most influenced by peers." c) "The values of the family will likely prevail for your son." d) "The teacher will begin to have the largest influence on a child's values at this age."

"The values of the family will likely prevail for your son."

A mother who is returning to work outside the home has found a daycare center close to her office and is eager to have her 15-month-old son placed there so he can be close by. The center will only take children who are potty-trained. The mother asks the nurse for advice about how to persuade her son to use the potty. Which of the following would be the most appropriate response for the nurse to make to this mother? a) "Each time you change his diaper, tell your son how important and fun it is to use the potty chair." b) "Get your son a potty chair and have him sit on it for a few minutes each day." c) "Encourage your son to watch his older siblings use the toilet." d) "Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained."

"Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained."

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

"We just got him a new bike he can grow into."

The nurse is providing teaching about child safety to the parents of a 4-year-old girl. Which statement by the parents indicates a need for further teaching? a) "We need to know the basics of CPR and first aid." b) "We need to continually remind her about safety rules." c) "She still needs a booster seat in the car." d) "We need to tell her that her vitamins are candy."

"We need to tell her that her vitamins are candy."

A nurse is providing a routine wellness examination for a 5-year-old boy. Which response by the parents indicates a need for an additional referral or follow-up? a) "We often have to translate his speech to others." b) "He can count to 30 but gets confused after that." c) "He knows his name and address." d) "He is always talking and telling detailed stories."

"We often have to translate his speech to others."

The nurse is preparing to do an altered family function risk assessment on a patient. Which question should the nurse ask first? a) "Are you able to cope with family health problems?" b) "Tell me about your family's eating habits?" c) "What are the potential sources of stress in your family?" d) "What is the general sleep pattern in your family?" e) "How would each member describe this family?"

"What are the potential sources of stress in your family?"

The nurse is gathering data from the caregiver of 3-year-old Jared who was heard complaining that he was nauseated while sitting in the waiting room. In interviewing the child's caregiver, which of the following would be the most appropriate initial question for the nurse to ask the caregiver? a) "Has Jared had anything to eat that he might be allergic to?" b) "How often does Jared complain of being nauseated?" c) "Does anyone else in the family have the same symptoms?" d) "What caused you to decide to bring Jared to the clinic today?"

"What caused you to decide to bring Jared to the clinic today?"

A nurse is interviewing a father regarding his 2-year-old daughter's recent illness. The nurse would like the father to elaborate about any symptoms of the illness that he has noticed. Which of the following would be the most effective question for the nurse to ask the father in this situation? a) "Has your daughter exhibited a fever and vomiting?" b) "Your daughter hasn't exhibited a fever, has she?" c) "What symptoms has your daughter exhibited?" d) "Has your daughter exhibited any symptoms?"

"What symptoms has your daughter exhibited?"

A group of caregivers of toddlers are discussing the form of discipline in which the child is placed in a "time-out" chair. Which of the following statements made by these caregivers is most appropriate related to this form of discipline? a) "Our 'time-out' chair is in the master bedroom so she can't see anyone else in the family." b) "She is two years old now and I put her in 'time out' for five to 10 minutes when she misbehaves." c) "We use the 'time-out' chair when our son gets tired but doesn't want to take a nap." d) "When my son starts getting frustrated and aggressive, I remind him that if he throws a fit he will have to go to 'time out.'"

"When my son starts getting frustrated and aggressive, I remind him that if he throws a fit he will have to go to 'time out.'"

The father of a 2-year-old girl tells the nurse that he and his wife would like to begin toilet training their daughter soon. He asks when the right time is to begin this process. Which of the following should the nurse say in response? a) "It is best to wait a little longer, until she is 3; only then will she be socially developed enough to understand what you are asking her to do." b) "She's well past the age to begin toilet training; most children are ready by age 1, when they have developed the needed nervous control." c) "When she starts tugging on a wet or dirty diaper, she is letting you know she's ready." d) "The best time to start toilet training is as soon as the child begins walking."

"When she starts tugging on a wet or dirty diaper, she is letting you know she's ready."

Bob and Nancy have financial issues and ask the nurse if a borrowed crib would be okay to use for their new twin boys. Which response should the nurse use in educating the parents? a) "No, you cannot use a borrowed crib." b) "You can use the crib, but there are guidelines to follow." c) "You should just buy a new crib to be on the safe side." d) "You can use any crib that you want."

"You can use the crib, but there are guidelines to follow."

The nurse is talking with the parents of a newborn who is being discharged following an uneventful delivery. The parents express their excitement about going home but have concerns about what they need to do to help their 2-year-old adjust to the new baby. Which of the following suggestions would be most appropriate for the nurse to offer these parents? a) "You should plan some time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant." b) "It would be good to have a grandparent or another special adult in the child's life take the toddler on an errand or a special visit." c) "You should plan some time for the secondary caregiver to focus on the toddler while the primary caregiver focuses on the infant." d) "It would be helpful to move the toddler to a new bedroom with a "grown-up" bed."

"You should plan some time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant."

A parent brings a 6 year old to the clinic and informs the nurse that the child is tired all the time even though the child sleeps 7 to 8 hours each night. What is the best response by the nurse? a) "Your child should be getting 8 to 9 hours of sleep per night." b) "We should ask the physician to run some tests; with that much sleep, the child should not be tired." c) "Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school." d) "Your child should be getting at least 9 hours of sleep per night."

"Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school."

The parents of a 7-year-old girl report concerns about her seemingly low self-esteem. The parents question how self-esteem is developed in a young girl. Which response by the nurse is best? a) "Several interrelated factors are to blame for low self-esteem." b) "The peers of a child at this age are the greatest influence on self-esteem." c) "Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age." d) "A child's self-esteem is greatly inborn and environmental influences guide it."

"Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age."

The father of a 4-year-old confides in the school nurse that he is concerned about his child not telling the truth. The father states, "I found a broken tool in my garage and when I asked my son about it, he said that his friend Andrew broke it, but we don't know anyone named Andrew." The best response by the nurse would be a) "Your son may have a friend named Andrew, but it could be an imaginary friend." b) "You should watch this type of behavior closely since most children this age tell the truth." c) "You need to show your child the broken tool since at this age they must see something in order to understand." d) "You should punish your son because no child should be telling lies at this age."

"Your son may have a friend named Andrew, but it could be an imaginary friend."

The nurse is assessing the nutritional needs of an 8-year-old girl who weighs 65 pounds. Which of the following amounts would provide the proper daily caloric intake for this child? a) 2,065 calories per day b) 2,385 calories per day c) 1,895 calories per day d) 2,245 calories per day

2,065 calories per day (29.5 kg x 70 calories per day per kg = 2,065 calories per day).

The nurse is meeting with a 16-year-old girl who reports being physically active on the track and basketball teams at school. The child reports a weight loss of 7 lb (3.2 kg) since she began training for the track season. When reviewing her caloric needs the nurse recognizes the diet should include how many calories? a) 1,800 calories per day b) 2,200 calories per day c) 2,000 calories per day d) 2,400 calories per day

2,200 calories per day

A 6-month-old arrives for a well-baby visit with a case of diaper rash. The baby's mother tells the nurse she is not concerned and believes this to be normal. She reports that she changes the baby's diaper when he wakes up and before she puts him in his crib for naps or bedtime. It would be important to teach this mother that she should start checking his diaper to see if it needs changing every a) 2-4 hours b) 1/2 hour c) 5 hours d) 1-1 1/2 hours

2-4 hours

The infant weighs 7 lbs. 4 oz. at birth. If the infant is following a normal pattern of growth, which of the following would be an expected weight for this child at the age of 12 months? a) 28 lbs. 4 oz. b) 25 lbs. c) 21 lbs. 12 oz. d) 14 lbs. 8 oz.

21 lbs. 12 oz.

A nurse realizes the importance of nutritional assessment during the health history. When doing so, the nurse must assess the quality as well as quantity of food eaten. The best way to assess food intake is to do which of the following? a) 24-hour recall b) 1-week recall c) 12-hour recall d) 3-day recall

24-hour recall

The infant measured 20 inches at birth. If the infant is following a normal pattern of growth, which of the following ranges would be an expected height for this child at the age of 12 months? a) 36-38 inches b) 26-28 inches c) 30-32 inches d) 40-42 inches

30-32 inches

The parents of a 30-month-old girl have brought her into the emergency department because she had a seizure. During the health history, the nurse suspects the child had a breath-holding spell. Which of the following parental reports suggests breath-holding? a) The child was lethargic afterward. b) The child became unconscious. c) The event took place during a nap. d) A tantrum preceded the event.

A tantrum preceded the event

A nurse is examining the skin of a 15-year-old girl. Which of the following findings should most warrant concern on the part of the nurse? a) A very dark mole with an uneven border b) A rash due to an allergic reaction to cosmetics c) A few acne lesions on the back d) A tattoo on the wrist, with no signs of inflammation

A very dark mole with an uneven border

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

A yellow rubber duck for the bath

An adolescent with ulcerative colitis has a temporary colostomy. What intervention can the nurse provide to allow the child to have a sense of control over the situation? a) Ask the physician to prescribe something for anxiety. b) Inform the child that he or she will not have to take care of the colostomy; a nurse will care for it when the child is discharged from the hospital. c) Have the parents stay with the child and provide all care. d) Allow the child to participate in care.

Allow the child to participate in care.

When 12-year-old Chelsie comes in for her annual check-up, the nurse must take a health history and do a physical exam. What is the most appropriate manner for the nurse to obtain a health history? a) Ask Chelsie to fill out the health form and return it herself. b) Ask Chelsie if she minds if her mother is in the room with her. c) Ask Chelsie's mom to leave the room. d) Ask Chelsie to wait outside while the nurse talks with her mother.

Ask Chelsie if she minds if her mother is in the room with her.

The nurse is educating a 15-year-old girl with Grave's disease and her family about the disease and its treatment. Which method of evaluating learning is least effective? a) Requesting the parent to teach the child skills b) Setting up a scenario for them to talk through c) Having the child and family demonstrate skills d) Asking closed-ended questions for specific facts

Asking closed-ended questions for specific facts

A nurse is providing some basic hygiene teaching to a preschooler who is continually developing upper respiratory infections from his time spent in daycare. Which of the following is an example of assessing the child's learning needs? a) Demonstrating how to wash his hands after using the bathroom b) Establishing a goal that he will be able to demonstrate proper use of a tissue for blowing his nose by the end of the teaching session c) Asking him what germs are d) Selecting a fun video for him to watch about how sicknesses are spread

Asking him what germs are

The nurse is educating the family of a 2-year-old boy with bronchiolitis about the disorder and its treatment. The family parents speak only Chinese. Which action, involving an interpreter, can jeopardize the family's trust? a) Using an older sibling to communicate with the parents b) Asking the interpreter questions not meant for the family c) Allowing too little appointment time for the translation d) Using a person who is not a professional interpreter

Asking the interpreter questions not meant for the family

A nurse is attempting to reduce pain that a child is experiencing after an emergency appendectomy. What intervention can the nurse provide to meet this goal? a) Have the child turn every 2 hours prior to administering pain medication. b) Encourage oral fluids after surgery. c) Assess the child frequently and use pharmacologic and nonpharmacologic methods of pain relief as needed. d) Provide diversional activities postoperatively so the child will not focus on the pain.

Assess the child frequently and use pharmacologic and nonpharmacologic methods of pain relief as needed.

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

Assess the child's usual intake pattern at home.

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

Assess the situation with the help of the school staff and parents.

When the nurse performs her head-to-toe assessment on a 2-year-old child, when would she examine the child's ears? a) At the start to get it over with b) At the end of the exam in case the child gets upset c) When examining the head and face d) After she is finished examining the entire head and face

At the end of the exam in case the child gets upset

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) Take the medication on an empty stomach b) Be certain of the expiration date on the drug c) If taking an oral contraceptive, switch to a different type of contraception while taking this medication d) Avoid prolonged sun exposure

Avoid prolonged sun exposure

A nurse is performing a physical examination on a newborn. Which of the following assessments should she include? a) Rectal temperature, femoral pulse, head circumference b) Oral temperature, blood pressure, head circumference c) Temporal temperature, blood pressure, reflexes d) Axillary temperature, femoral pulse, head circumference

Axillary temperature, femoral pulse, head circumference

A nurse is caring for a small child with leukemia who will be hospitalized frequently for chemotherapy. What type of referral can the nurse make that will help the child and family through this time? a) Occupational therapist b) Child life specialist c) Child psychologist d) Play therapist

Child life specialist

The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. After discussing various types of play, the following examples are given. Which is the best example of cooperative play? a) Children are playing together in an activity without organization. b) Children are playing in an organized group with each other. c) Children are playing independently and are side-by-side. d) Children are playing apart from others without being part of a group.

Children are playing in an organized group with each other

The nurse is presenting an inservice training to a group of pediatric nurses on the topic of play. After discussing various types of play, the following examples are given. Which is the best example of parallel play? a) Children are playing in an organized group with each other b) Children are playing apart from others without being part of a group c) Children are playing together in an activity without organization d) Children are playing independently and are side by side

Children are playing independently and are side by side

A nurse is talking with a 10 year old who is saying that his "stomach has been hurting for several days and is worse when he drinks milk." The nurse asks the child, "Let me be sure I understand. The pain gets worse when you drink milk?" What type of therapeutic communication technique is the nurse using? a) Clarifying b) Reflecting c) Perception checking d) Paraphrasing

Clarifying

A nurse is assigned to care for a 7 year old with cystic fibrosis. The child wants to show the nurse his collection of baseball cards. The nurse understands that the collection of objects is common in this age group and is known as what type of thinking? a) Egocentric thinking b) Classification c) Decentration d) Preoperational thinking

Classification

Question: The five levels of communication are listed below. Put them in the correct order, from first level to fifth: 1 Shared personal ideas and judgments 2 Peak communication 3 Cliché conversation 4 Shared feelings 5 Fact reporting

Cliché conversation Fact reporting Shared personal ideas and judgments Shared feelings Peak communication

Parents bring a toddler age 19 months to the clinic for a regular checkup. When palpating the toddler's fontanels, what should the nurse expect to find? a) Open anterior and posterior fontanels b) Open anterior fontanel and closed posterior fontanel c) Closed anterior fontanel and open posterior fontanel d) Closed anterior and posterior fontanels

Closed anterior and posterior fontanels

The nurse is about to see a 9-year-old girl for a well child check-up. Knowing that the child is in Piaget's period of concrete operational thought, which characteristic should the child display? a) Make generalized assumptions about groups of things b) View the world in terms of her own experience c) Know lying is bad because she gets sent to her room for it d) Consider an action and its consequences

Consider an action and its consequences

The nurse is conducting the Denver Articulation Screening with a 5-year-old girl to assess her speech. Which of the following should the nurse do while conducting this exam? a) Convey the impression that there are no right or wrong answers b) Modify the directions of the test using the nurse's own discretion c) At the end explain which words the child missed and why d) Have the child read each of the 22 words from a sheet of paper

Convey the impression that there are no right or wrong answers

A family is anxious for information about the status of their ill infant. The parents do not understand English, but the 14-year-old daughter is competent in spoken and written English. The physician is present, but an interpreter is unavailable. The nurse should: a) Support the 14-year-old while she interprets for her parents and the physician at the bedside. b) Develop a written account of the infant's status with the physician that the daughter can read and explain to her parents. c) Have the teenage daughter and physician discuss the information thoroughly and help her share this data with her parents. d) Coordinate physician and interpreter schedules and arrange an information-sharing session for later in the day.

Coordinate physician and interpreter schedules and arrange an information-sharing session for later in the day.

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

Cruises around furniture

The nurse is performing an assessment on a 12-year-old boy. Which finding is consistent with the child's age? a) No pubic hair b) Curling pubic hair c) Coarse pubic hair d) Sparse pubic hair

Curling pubic hair

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) Decentering b) Class inclusion c) Conservation d) Accommodation

Decentering

A 4-year-old tells you he has an imaginary friend. His parents are concerned because he refuses to do anything without his friend's help. Which of the following nursing diagnoses is most applicable for his family? a) Social isolation related to unwillingness to relate except through imaginary friend b) Compromised family coping related to abnormal behavior of child c) Deficient knowledge of normal preschool development d) Disturbed thought processes related to deep-set psychological need

Deficient knowledge of normal preschool development

The mother of a 2-year-old tells you she is constantly scolding him for having wet pants. She says her son was trained at 12 months, but since he started to walk, he wets all the time. Which nursing diagnosis would be most applicable? a) Total urinary incontinence related to delayed toilet training b) Excess fluid volume related to inability to control urination c) Deficient parental knowledge related to inappropriate method for toilet training d) Ineffective coping related to lack of self-control of 2-year old

Deficient parental knowledge related to inappropriate method for toilet training

You are going to teach a 9-year-old how to do active range-of-motion exercises. Which of the following techniques would be most appropriate to use? a) Demonstrate the technique by performing it consistently the same each time. b) Allow her to listen to the radio as you are teaching her. c) Tell her about different ways to perform the technique so that she can vary them as she chooses. d) Suggest she tell you how she wants her range-of-motion exercises to be done.

Demonstrate the technique by performing it consistently the same each time.

During an office visit for a sports injury, 16-year-old Derek's caregivers tell the nurse they are worried about changes in Derek's behavior. He has always been industrious in his schoolwork and very focused on sports. Now he has a girlfriend and seems to spend almost all of his time with her or on the phone with her and little or no time on his schoolwork. What information might the nurse offer these caregivers about Derek's behavior? a) Derek has chosen a girl who is overly dependent on him. They should talk to him about making sure he meets his own needs, including doing the schoolwork he enjoys, in any relationship. b) Derek has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with or talk to his girlfriend as long as he has completed his schoolwork for the day. c) Derek is not developmentally mature enough to make healthy choices about the ways in which he spends his time, so it would be helpful if they would make a schedule for him that includes about a half-hour per day to talk with his girlfriend. d) Derek is not developmentally mature enough to have an intimate relationship with one girl; they should encourage him to spend time with groups of friends rather than time alone with his girlfriend.

Derek has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with or talk to his girlfriend as long as he has completed his schoolwork for the day.

The nurse is providing anticipatory guidance to the parents of an 18-month-old girl. Which recommendation should be the most helpful to the parents? a) Giving the child time out for 1 ½ minute b) Ignoring bad behavior and praising good behavior c) Describing proper behavior when she misbehaves d) Slapping her hand using one or two fingers

Describing proper behavior when she misbehaves

When planning education for a child and parents, what is the first step the nurse should take? 1. Decide which procedures and medications the child will be discharged on. 2. Determine the child's and family's learning needs and styles. 3. Ask the family if they have ever performed this type of procedure. 4. Tell the child and family what the goals of the teaching session are.

Determine the child's and family's learning needs and styles.

During a routine physical examination of a 13 year old female the nurse notes the presence of a tender nodule just below the nipple on her right breast. Which action by the nurse is indicated? a) Request the teen have a breast ultrasound. b) Request the teen have a mammogram. c) Document the finding as normal. d) Review the teen's medical record for family history of breast cancer.

Document the finding as normal.

A type of play seen in the preschool child encourages children to act out troubling situations such as occur in the hospitalized child who must undergo an upsetting procedure. This type of play is referred to as which of the following? a) Solitary independent play b) Parallel play c) Independent play d) Dramatic play

Dramatic play

Which project or game would you anticipate that a preschooler would most enjoy while hospitalized? a) Playing an electronic, hand-held game b) Planting flower bulbs that she can watch grow next spring c) Turning out the lights to play hide and seek d) Dressing in her mother's coat to play house

Dressing in her mother's coat to play house

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

Eat slowly and place the fork down between each bite. Have the family exercise together. Refer to an adolescent weight-loss program. Keep a food and exercise diary.

A nurse is taking care of a teenager who complains about involuntary discharge of semen while sleeping. The nurse observes that the client is confused and does not know about the pubertal changes that are taking place in his body. Based on this information, what is the highest priority area that should be reviewed with the client? a) Provide information about sex and sexuality b) Educate the client about the changes that occur during adolescence c) Convince him that involuntary discharge of semen during sleeping needs immediate attention of the primary care provider d) Review about sexually transmitted diseases

Educate the client about the changes that occur during adolescence

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) Genu valgus b) Centering c) Electra complex d) Oedipus complex

Electra complex Explanation: An Electra complex is the attachment of a preschool girl to her father Oedipus complex refers to the strong emotional attachment a preschool boy demonstrates toward his mother. A daughter demonstrating an Electra complex might prefer to always sit beside her father at the table; she asks her father to tuck her in at night. She makes a point she is "Daddy's girl." `Many children at the beginning of the preschool period exhibit genu valgus (knock-knees); this disappears with increased skeletal growth at the end of the preschool period.

A 5-year-old girl tenses up when the nurse approaches to examine her. "Are you afraid?" the nurse asks her. The girl shakes her head in denial. As the nurse lifts the stethoscope to auscultate the girl's chest, however, the nurse notices that the girl tenses up again and grips the edge of the examination table tightly. "Oh—you are afraid of the stethoscope, aren't you?" the nurse replies. "It's okay—it doesn't hurt; see—reach out and touch it." Which of the following communication techniques is the nurse most demonstrating here? a) Warmth b) Genuineness c) Attentive listening d) Empathy

Empathy

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

Encourage cup drinking and give water between meals and snacks.

The nurse is caring for a 16-month-old child on the pediatric unit. The child's mother is a single mother who has two other young children at home. She must leave her 16-month-old daughter overnight in the hospital. Which of the following actions by the nurse will be most appropriate in helping the child feel secure and in reassuring this mother? a) Distract the child with a special blanket, stuffed animal, or other "lovey" from home while the mother quietly slips out b) Tell both the mother and child that the child will be carefully guarded and won't be in as much danger as she might be if she were home exploring her environment c) Remind the child and mother that by staying in the hospital now the child will get well and be home again soon, and that the other children also need their mother d) Encourage the mother to give her daughter a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return such as "when breakfast comes in the morning."

Encourage the mother to give her daughter a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return such as "when breakfast comes in the morning."

The mother of a 3-year-old child reports her son is afraid of the dark. She asks the nurse for help. Which advice is best for the nurse to offer? a) Encourage the parent to consider allowing the child to sleep with her b) Encourage the parent to leave on the television in the child's room c) Encourage the mother to check for monsters under the bed in the presence of the child d) Encourage the parent to allow a small night light

Encourage the parent to allow a small night light

The mother of a 4-year-old boy reports her son has voiced curiosity about her breasts. She asks the nurse what she should do. Which information is best for the nurse to give the parent? a) Encourage the parent to determine what the child's specific questions are and answer them briefly. b) Encourage the parent to provide a detailed discussion about human sexuality with the child. c) Advise the parent that sexual curiosity is unusual at this age. d) Advise the parent to explain to the child that he is too young to discuss such things.

Encourage the parent to determine what the child's specific questions are and answer them briefly.

An adolescent remarks rather sarcastically that she feels like a "lab rat." What is the priority nursing action? a) Enable the teen to stay in contact with peers electronically. b) Arrange for additional bedside activities of the adolescent's choice. c) Provide more physical privacy for this teenager. d) Ensure information is shared with and decisions about care are made with and not for the teen. e) Share with the adolescent that everyone on the unit enjoys working with teenagers.

Ensure information is shared with and decisions about care are made with and not for the teen.

Eight-year-old Ted's foster mother is discussing her concerns about Ted's recent dental checkup in which three cavities were found in his permanent teeth. Ted's mother is concerned because Ted eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. What would the nurse suggest to this mother is the most appropriate in regard to Ted's dental health? The nurse would suggest that the mother a) Have Ted's teeth professionally cleaned every three months b) Ensure that Ted brushes his teeth after each meal and snacks c) Accept Ted is genetically predisposed to having more cavities than most children d) Encourage Ted to abstain from eating sugary snacks at school

Ensure that Ted brushes his teeth after each meal and snacks

The nurse is providing care for a 2-year-old girl with a chronic respiratory disease present since birth. Which would be of least help in working effectively with the parents? a) Consider parents equal partners in care. b) Provide positive feedback to mother and father for care and parenting well done. c) Maintain complete honesty with the parents. d) Expect parents to perform procedures precisely as taught.

Expect parents to perform procedures precisely as taught.

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 tell 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) Explain in a calm and everyday manner how the child should stay away from strangers in cars b) Don't worry about it; the odds of your child being abducted are very low c) It is your responsibility to keep your child safe, not your child's; keep her in your sight at all times d) Wait until the child is school-aged before telling her what to do, so she will be better able to handle it

Explain in a calm and everyday manner how the child should stay away from strangers in cars

What approach by the nurse would most likely encourage a child to cooperate with an assessment of physical and developmental health? 1. Explain to the child what's going to happen when the child asks questions. 2. Explain what is going to happen in words the child can understand. 3. Force the child to cooperate by having a parent hold him or her down. 4. Give the child a sticker before beginning the examination.

Explain what is going to happen in words the child can understand.

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

Explaining to the mother the risk for infection is high due to the lack of antibodies

Eight-year-old Matt is doing well with adding and subtraction. His father asks for suggestions regarding projects that would help increase Matt's understanding of conservation of mass. Of the following projects, which would most help Matt understand conservation of mass? a) Build a doghouse. b) Build a sandcastle with a water-filled moat. c) Stack blocks in a tower. d) Form vases from blocks of clay.

Form vases from blocks of clay.

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 in this young man? a) Puberty b) Formal operational thought c) Socialization d) Role confusion

Formal operational thought

The nurse is teaching a mother of a 1-year old girl about weaning her from the bottle and breast. Which recommendation should be part of the nurse's plan? a) Wean from breast by 18 months of age at the latest. b) Wean from the bottle at 15 months of age. c) Switch the child to a no-spill sippy cup. d) Give the child an iron-fortified cereal.

Give the child an iron-fortified cereal.

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

Giving the child bowls, pot, pans, and large spoons

Anna is 4 years old and complains of ear pain. To examine Anna's ear, how should the nurse proceed? a) Grasp the pinna and look inside. b) Grasp the pinna and pull down and back. c) Grasp the pinna and pull up and back. d) Grasp the pinna and pull forward.

Grasp the pinna and pull up and back.

Jordan is coming back to the office for a follow-up visit. He is 15 years old and he shows a pattern of gaining weight, not a large amount but a little more each visit. Jordan says that he is not active in any sports but that he and his father eat out a lot. What is the best way for the nurse to assess Jordan's eating pattern? a) Ask Jordan to show you what a healthy portion looks like. b) Have Jordan guess what his calorie intake is in a 24-hour period. c) Have Jordan keep a food diary for one week. d) Ask Jordan to recall what he has had to eat in the last three days.

Have Jordan keep a food diary for one week.

The nurse is caring for a 3-year-old boy who must have a lumbar puncture. Which action provides the greatest contribution toward atraumatic care? a) Explaining the lumbar puncture procedure b) Having a child life nurse practitioner play with the child c) Letting the child take his teddy bear with him d) Keeping the parents calm in front of the child

Having a child life nurse practitioner play with the child

When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old? a) He should be able to count out loud to 20. b) He should say two words plus "ma-ma" and "da-da." c) He should say 20 nouns and 4 pronouns. d) He should speak in two-word sentences ("Me go").

He should speak in two-word sentences ("Me go").

The nurse is examining a 6-month-old girl who was born 8 weeks early. Which finding is cause for concern? a) The child measures 21 in (53 cm) in length. b) Head size has increased 5 in (12 cm) since birth. c) The child weighs 10 lb 2 oz (4.6 kg). d) The child exhibits palmar grasp reflex.

Head size has increased 5 in (12 cm) since birth.

The nurse is taking a family history of a 10-year-old with asthma. What would be a helpful tool to obtain a family history of illness and disease? a) Have the family write down any history they remember. b) Help the family design a genogram. c) Have the family fill out a health questionnaire. d) Make a family tree for tracking purposes.

Help the family design a genogram.

The nurse has completed an examination of a 32-month-old girl with normal gross and fine motor skills. Which of the following observations would suggest the child is experiencing a problem with language development? a) She asks many questions. b) She uses complete 3-to-4 word sentences. c) Her vocabulary is between 10 and 15 words. d) She talks incessantly.

Her vocabulary is between 10 and 15 words.

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

Hesitancy and dysfluency are normal during this period of development.

The school nurse is assessing the nutritional status of an overweight 12-year-old girl. Which question is appropriate for the nurse to ask? a) Does your family have rules about foods and how they are prepared? b) Have you gained weight recently? c) How often does everyone in your family eat together? d) What does your family do for exercise?

How often does everyone in your family eat together?

According to Erikson, the adolescent develops their own sense of being independent people with their own thoughts and goals. This stage is referred to as which of the following? a) Identity vs. role confusion b) Industry vs. inferiority c) Autonomy vs. doubt and shame d) Intimacy vs. isolation

Identity vs. role confusion

A nurse is describing growth and development during the preschool period. Which of the following would the nurse identify as a predominant and heightened characteristic for this age group? a) Gross motor skills b) Vocabulary c) Imagination d) Fine motor skills

Imagination

A nurse is observing a 3-year-old preschooler engaged in play. What behavior would the nurse most likely expect to observe? a) Group play b) Solitary play c) Parallel play d) Imitative play

Imitative play

Which of the following should a nurse include in her pediatric history of 8-year-old patient Rosie? a) Where Rosie lives b) How many friends Rosie has c) Immunizations d) Her favorite toys

Immunizations

Nurse Betty is beginning the examination of a 4-month-old infant. She takes the infant from the mother's arms to do the exam. Where should the nurse place the infant for the exam? a) In the nurse's own arms b) In the crib facing the mom c) In the crib on the infant's back d) In the child treatment room

In the crib facing the mom

Which of the following is appropriate with reference to enhancing a child's self-esteem? a) Utilize belittling techniques as opposed to time-outs. b) Avoid applauding for unsuccessful attempts. c) Include the child in activities that interest the adult. d) Utilize negative criticism as well as positive reinforcement.

Include the child in activities that interest the adult.

A 3-year-old wants to do everything independently, including putting on shoes. Every day, no matter how hard he tries, he puts the shoes on the wrong feet until finally he is successful. According to Erikson, what developmental task is this child trying to master? a) Initiative vs. guilt b) Trust vs. mistrust c) Industry vs. inferiority d) Autonomy vs. shame

Initiative vs. guilt

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) Have the child attend a different school b) Hold the child back a year and let him try again next year c) Insist that the child return to school d) Homeschool the child

Insist that the child return to school

Which statement indicates the best sequence for the nurse to conduct an assessment in a nonemergency situation? 1. Introduce yourself, ask about any problems, take a history, and do the physical examination. 2. Perform the physical examination and then ask the family if there are any problems in the child's life. 3. Do the physical examination while at the same time asking about the child's previous illnesses; then talk about the family's concerns. 4. Get a complete history of the family's health beliefs and practices, and then assess the child.

Introduce yourself, ask about any problems, take a history, and do the physical examination.

Question: Below are the first six (of nine total) sections of an initial health assessment interview. Put them in the correct order: 1 Introduction and explanation 2 Chief concern/complaint 3 Demographic data 4 History of chief concern/complaint 5 Health and family profile 6 Day history

Introduction and explanation Demographic data Chief concern/complaint History of chief concern/complaint Health and family profile Day history

A parent who is feeding his child formula prepared at home using evaporated milk is concerned about whether the child is receiving all necessary nutrients. Which of the following would be important for this parent to add to his child's diet to supplement the formula? a) Calcium b) Vitamins D c) Iron d) Vitamin E

Iron

Nurse Julie is doing a physical exam on a 3-year-old boy. What method would Julie use to perform the exam? a) Julie would examine the child's head and work down to the child's toes. b) Julie would examine the child's chest and then go to the head and down. c) Julie would examine different sections of the body at various times. d) Julie would examine the child's extremities first and then the chest.

Julie would examine the child's head and work down to the child's toes.

To gain cooperation from a toddler, what is the best approach by the nurse? 1. Immediately pick the toddler up from the mother's lap. 2. Kneel in front of the toddler while he or she is on the mother's lap. 3. Do the nursing tasks quickly so the toddler can play. 4. Ask the toddler if it is okay if you begin the needed task.

Kneel in front of the toddler while he or she is on the mother's lap.

According to Eric Erikson, the developmental task of the toddler is developing autonomy. Which of the following describes Erikson's psychosocial development task for the toddler? a) Learning to trust b) Learning to speak c) Learning to understand and respond to discipline d) Learning to act on one's own

Learning to act on one's own

The mother of two sons, ages 6 and 9, states they want to play on the same baseball team. As the school nurse, what advice would you give their mother? 1. Having the boys on the same team will make it more convenient for the mother. 2. Levels of coordination and concentration differ, so the boys need to be on different teams. 3. Put the boys on the same team because they are both school-age children. 4. It is best to avoid putting the boys on the same team to prevent sibling rivalry.

Levels of coordination and concentration differ, so the boys need to be on different teams.

A group of students is reviewing material about ways parents can help to foster a child's self-esteem. The students demonstrate a need for additional studying when they identify which method? a) Limiting the choices and decisions that the child makes b) Using positive reinforcement while limiting criticism c) Showing respect and support to the child d) Acting as a coach rather than a cheerleader

Limiting the choices and decisions that the child makes

What action might the nurse take to engender trust and open communication with an adolescent? a) Avoid using medical terminology altogether. b) Speak to the parents while the teen listens and observes. c) Listen actively while maintaining a relaxed, open body posture. d) While admitting the adolescent, use closed questions so only limited response is required of the reluctant teen.

Listen actively while maintaining a relaxed, open body posture.

A 9-year-old boy has arrived for a health maintenance visit. Which milestone of physical growth should the nurse expect to observe? a) Brain growth is complete and the shape of the head is longer. b) Lymphatic tissue growth is complete providing greater resistance to infections. c) All deciduous teeth are replaced by 32 permanent teeth. d) Frontal sinuses are developed while tonsils have decreased in size.

Lymphatic tissue growth is complete providing greater resistance to infections.

The nurse is providing helpful feeding tips to the mother of a 2-week-old boy. Which recommendations will best help the child feed effectively? a) Encourage the infant to latch on properly b) Maintain a feed-on-demand approach c) Apply warm compresses to the breast d) Maintain adequate diet and fluid intake

Maintain a feed-on-demand approach

A 10 year old with sickle-cell disease is frequently a patient in the pediatric center of a hospital. What intervention can the nurse provide that will allow the child a sense of control that promotes atraumatic care? a) Promote family-centered care. b) Provide appropriate pain management. c) Advocate for minimal laboratory blood draws. d) Maintain the child's home routine related to activities of daily living.

Maintain the child's home routine related to activities of daily living.

A 16-year-old uses marijuana daily. To help her do better in school, what advice would you offer that would be most important? a) Marijuana increases blood pressure; she should not run after smoking it. b) The effect of marijuana fades fastest if she eats after use. c) Marijuana causes memory gaps that interfere with learning. d) Marijuana leads to muscle laxness, so it should not be used close to gym class.

Marijuana causes memory gaps that interfere with learning.

The nurse is teaching the mother of a 2-month-old girl about the social and emotional developments that will occur in the next 8 weeks. Which behavior is most likely to occur? a) Crying when the mother is out of sight b) Becoming clingy around strangers c) Mimicking mother's facial expressions d) Participating in a game of peek-a-boo

Mimicking mother's facial expressions

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

Most 3-month-olds still have a Moro reflex.

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

Place the child in time-out for 4 minutes.

The mother of a 3-month-old is concerned because her daughter does not yet sit by herself. Which of the following statements best reflects average sitting ability? a) Most babies do not sit steadily until 8 months; she is normal. b) Most babies sit steadily at 3 months; she is slightly delayed. c) Sitting ability and the age of first tooth eruption are correlated. d) Most babies sit steadily at 4 months; she is normal.

Most babies do not sit steadily until 8 months; she is normal.

Based on the most frequent cause of death in adolescents, what preventive measure would you most want to teach an adolescent? a) Motor-vehicle safety b) Firearm safety c) Water safety d) Home safety

Motor-vehicle safety

The nurse is caring for a hospitalized 30-month-old who is resistant to care, is angry, and yells "no" all the time. The nurse identifies this toddler's behavior as 1. Problematic, as it interferes with needed nursing care. 2. Normal for this stage of growth and development. 3. Normal because the child is hospitalized and out of his routine.

Normal for this stage of growth and development.

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

Normal for this stage of growth and development.

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 the 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) A pituitary disorder b) Tonsillitis c) Normal growth of lymphatic tissue for this age d) An allergic reaction

Normal growth of lymphatic tissue for this age

While evaluating the development of 10-month-old boy, a nurse hides the boy's stuffed animal behind her back. The boy crawls around the examination table to look behind the nurse's back for the stuffed animal. Which developmental phenomena has this infant demonstrated? a) Binocular vision b) Object permanence c) Depth perception d) Hand regard

Object permanence

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

Observe the mother while she feeds and burps her infant.

The nurse is conducting a physical examination of a healthy 6-year-old. Which action should the nurse do first? a) Observe the skin for its overall color and characteristics b) Palpate the skin for texture and hydration status c) Tap with the knee with a reflex hammer to check for deep tendon reflexes d) Auscultate the heart, lungs, and the abdomen

Observe the skin for its overall color and characteristics

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) Assist the girl with using the bed pan to urinate b) Brush the girl's hair for her c) Offer to assist the girl in washing her hair and let her pick the shampoo d) Allow the girl to wear her own clothes, despite hospital policy

Offer to assist the girl in washing her hair and let her pick the shampoo

Question: Place the steps for using time-out as a disciplinary measure for a 4-year-old in proper order. 1 If the child gets up, replace the child and restart the time. 2 Parent knows the misbehavior was intentional. 3 Remove the preschooler to a boring spot. 4 Set a timer for no more than 4 minutes. 5 Warn the child there will be a time-out if the behavior does not stop.

Parent knows the misbehavior was intentional. Warn the child there will be a time-out if the behavior does not stop. Remove the preschooler to a boring spot. Set a timer for no more than 4 minutes. If the child gets up, replace the child and restart the time.

What exercise recommendation should nurses give to adolescents? a) Participate in physical activities that cause sweating and hard breathing weekly. b) Participate in 60 minutes of moderate to vigorous physical activity each day. c) Engage in aerobic exercise for 30 minutes three days per week. d) Engage in at least one competitive sport during the school year.

Participate in 60 minutes of moderate to vigorous physical activity each day.

A nurse is caring for a hospitalized 10 year old. What would be an appropriate activity for this child to meet the developmental tasks of this age group? a) Participating in a craft project b) Playing with a jack-in-the-box c) Writing letters to friends d) Playing with blocks

Participating in a craft project

The nurse is measuring the head circumference of a child. Which of the following is accurate related to this procedure? a) Place the tape measure around the head with the tape touching just below the eyes. b) Expect the head circumference and the chest circumference measurements to be equal up to the age of 6 years. c) Place the tape measure around the head just above the eyebrows. d) Measure the head circumference routinely on children up to the age of 6 years.

Place the tape measure around the head just above the eyebrows.

A 9-year-old patient with rheumatoid arthritis has difficulty moving her painful hands as well as her other joints. She refuses to participate in ordered physical therapy. What would be the best way for the nurse to make sure that the patient continues to exercise her joints? a) Show a video about exercising. b) Play a game like "Simon Says" to introduce exercises. c) Give the patient a coloring book about arthritis. d) Give the patient a pamphlet about the importance of exercise.

Play a game like "Simon Says" to introduce exercises.

The nurse is observing a play group of children of all ages. The toddlers in the group would most likely be doing which of the following activities? a) Playing with the plastic vaccum cleaner pushing it around the room b) Painting pictures in the art corner of the room c) Watching a movie with other children their age d) Pretending to be mommies and daddies in the play house

Playing with the plastic vaccum cleaner pushing it around the room

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) Caries b) Broken fluency c) Poor articulation d) Malocclusion

Poor articulation

A school-aged child learns how to do range-of-motion exercises but has been unable to perform them the same from day to day. Which approach would be best for you to take to encourage compliance? a) Impress upon her the importance of the exercises to prevent disfiguring complications. b) Reprimand her so that she sees how important the exercises are to you. c) Praise her for doing them when you see her doing them. d) Tell her parents so they can withhold privileges.

Praise her for doing them when you see her doing them.

Nursing students are reviewing information about the cognitive development of preschoolers. The students demonstrate understanding of the information when they identify that a 3 year old is in which of the following stages as identified by Piaget? a) Tertiary circular reaction b) Primary circular reaction c) Preoperational thought d) Coordination of secondary schema

Preoperational thought

A 10-year-old spends 2 hours by herself every afternoon before her parents arrive home. Which of the following would be the most appropriate safety measure to suggest that the parents teach the child? a) Wearing the house key prominently around her neck b) Lighting candles in case there is a power failure c) Preparing a no-cook snack for herself d) Telling people at school she is by herself for added safety

Preparing a no-cook snack for herself

The nurse is conducting a well child assessment of a 4-year-old. Which assessment finding warrants further investigation? a) Presence of 20 deciduous teeth b) Presence of 10 deciduous teeth c) Absence of dental caries d) Presence of 19 deciduous teeth

Presence of 10 deciduous teeth

A nurse is assessing a family and asks, "On whom does the family depend to provide the solution to problems?" What role is the nurse trying to establish? a) Problem-solver b) Nurturer c) Gatekeeper d) Financial manager

Problem-solver

A nurse is caring for a child with cystic fibrosis who is concerned about being separated from parents. What interventions can the nurse provide that will prevent or minimize child and family separation? a) In the hospital, use primary nursing. b) Encourage the child to have a security item present. c) Promote family-centered care. d) Empower the family and child by providing knowledge.

Promote family-centered care.

Linda and her mother are in the office. As Linda uses the restroom, her mother asks you about the changes that Linda is going through. She would like to talk to her about sexuality and its changes but she is unsure of how to do this. As the nurse, what reminders should you give her when she discusses sex? a) Promote open lines of communication; listen instead of lecture; and share family values. b) Discuss with the teen the experiences that you had so that she can connect on a personal level. c) Encourage her to talk to her peers and teachers in health class. d) Do not initiate any conversation; let the teen come and seek the advice of the parent.

Promote open lines of communication; listen instead of lecture; and share family values.

The nurse is promoting a healthy diet to the mother of a 6-month-old girl. What action would have the most effect on the infant's neurologic development? a) Adding fruit juice daily b) Establishing an adequate level of dietary iron intake c) Requiring more solid foods in the diet d) Promoting continuation of breastfeeding

Promoting continuation of breastfeeding

Ten-year-old Edgar is above normal weight for a child his age and height. When discussing with him what he likes to eat, he tells the nurse he doesn't eat much candy but he loves to eat fruit, pasta, potatoes, and bread. What would the nurse recommend to Edgar's caregivers as to ways to help him maintain a healthy weight? The caregiver should a) Avoid talking to Edgar about his weight. b) Feed Edgar a very low-fat and no-carbohydrate diet. c) Remind Edgar at each meal that he must not eat too much food. d) Provide activities for Edgar that will increase his physical activity.

Provide activities for Edgar that will increase his physical activity.

A client tells the nurse that she has noticed an increase in weight and fat deposits during the last year. The nurse reviews the client's chart and recognizes that the client is most likely going through puberty. Which nursing action is most appropriate at this time? a) Provide reassurance that these are normal changes. b) Share what foods can be eaten on a low fat diet to prevent fat deposits. c) Review dietary measures to assist in controlling the weight gain. d) Encourage increased exercise to control weight gain.

Provide reassurance that these are normal changes.

A 5-year-old is obviously relieved yet angry following a procedure he resisted and needed to be restrained to complete. Which nursing action may be most helpful to this kindergartner? a) Providing Play-Doh for him to manipulate b) Getting paper and markers so that he can draw and color c) Finding an age-appropriate action DVD for him to view d) Discussing the reasons for the procedure with the child and parents

Providing Play-Doh for him to manipulate

The nurse is teaching the parents of a newborn with a metabolic problem about the disorder and its treatment. What is the least effective teaching technique? a) Using the food pyramid diagram to teach necessary nutrition alterations b) Explaining the disorder in common terms c) Discussing how to handle a possible emergency situation d) Providing a print handout for the parent to read and asking for questions

Providing a print handout for the parent to read and asking for questions

The period in which physical changes relating to sexual maturation take place is called: a) Role confusion. b) Identity diffusion. c) Adolescent turmoil. d) Puberty.

Puberty

A nursing student asks the nursing instructor to explain pulse oximetry measurements in child. The nurse is accurate in telling the student: a) Pulse oximetry is done to detect respiratory retractions in the child. b) If the oximeter probe is to be left in place, the site should be checked every eight hours. c) Place the probe of the oximeter on the child's chest and secure it with tape. d) Pulse oximetry measures the oxygen saturation of arterial hemoglobin.

Pulse oximetry measures the oxygen saturation of arterial hemoglobin.

The nurse is performing an examination of the eyes of a 7-year-old girl. Which of the following findings would indicate that the third cranial nerve is intact? a) Light of an otoscope reflecting evenly off both pupils b) The eyelid blinks in response to touching the cornea with a wisp of cotton c) Pupil dilation in response to light d) Pupil constriction in response to light

Pupil constriction in response to light

The nurse is observing a 6-month-old boy for developmental progress. For which typical milestone should the nurse look? a) Puts down a little ball to pick up a stuffed toy b) Enjoys hitting a plastic bowl with a large spoon c) Picks up an object using his thumb and finger tips d) Shifts a toy to his left hand and reaches for another

Puts down a little ball to pick up a stuffed toy

Parents of a toddler describe how they handled their child's temper tantrum in a shopping mall. What action of the parents indicates need for additional teaching? a) Tried to refocus the child's attention as tantrum behavioral cues appeared b) Reasoned with the child to stop the behavior c) Made sure the child was rested and not hungry before going to the mall d) Remained relatively calm even though embarrassed

Reasoned with the child to stop the behavior

The mother of a 15-month-old is concerned about a speech delay. She describes her toddler as being able to understand what she says, sometimes following commands, but using only one or two words with any consistency. What is the nurse's best response to this information? 1. The toddler should have a developmental evaluation as soon as possible. 2. If the mother would read to the child, then speech would develop faster. 3. Receptive language normally develops earlier than expressive language. 4. The mother should ask her child's physician for a speech therapy evaluation.

Receptive language normally develops earlier than expressive language.

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

Regression

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

Reinsert the tooth into the socket.

Which milestone would you expect an infant to accomplish by 8 months of age? a) Pulling self to a standing position b) Being able to sit from a standing position c) Creeping on all fours d) Sitting without support

Sitting without support

A new mother, when asked by a nurse, explains that her 4-month-old infant has been nursing regularly every 3 to 4 hours but seems satisfied. However, the mother recently introduced solid food in the form of unbuttered popcorn to the baby as a supplement, to "get her used to eating solid food." She felt that the popcorn would be safe because it is soft on the baby's gums. Which of the following should be the primary nursing diagnosis in this situation? a) Readiness for enhanced nutrition, related to the age of the infant b) Imbalanced nutrition, more than body requirements, related to introduction of a high-calorie food c) Imbalanced nutrition, less than body requirements, related to introduction of a low nutritive food d) Risk for aspiration related to feeding the infant an inappropriate food

Risk for aspiration related to feeding the infant an inappropriate food

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

Role modeling by family Becoming active in sports Involving child in meal planning and grocery shopping

The nurse is auscultating the heart of a 6-month-old. Which finding would warrant further investigation? a) A split S2 at the apex b) Variation in heart rate during the 60 second auscultation c) Heart rate of 120 d) S1 varies in intensity.

S1 varies in intensity.

The nurse is conducting a skin assessment of a newborn. The examination reveals a light pink macule on the back of the neck. The nurse understands that this is a normal variation and is most likely which type of birthmark? a) Petechiae b) Nevus flammeus c) Purpura d) Salmon nevus

Salmon nevus

A nurse places a toy car in front of a 6-month-old girl. She swats at it, and the car flies across the examination table and lands on the floor. She squeals with surprise and delight. When the nurse puts the toy car in front of her again, she immediately swats it again and laughs as it rolls across the table and falls to the floor again. What has the girl just demonstrated? a) Binocular vision b) Primary circular reaction c) Secondary circular reaction d) Object permanence

Secondary circular reaction third month of life, a child enters a cognitive stage identified by Piaget as primary circular reaction. During this time, the infant explores objects by grasping them with the hands or by mouthing them. Infants appear to be unaware of what actions they can cause or what actions occur independently, however. At about 6 months of age infants pass into a stage Piaget called secondary circular reaction. Now when infants reach for an object, hit it, and watch it move, they realize it was their hand that initiated the motion, and so they hit it again. By 10 months, infants discover object permanence. Infants are ready for peek-a-boo once they have gained this concept. They know their parent still exists even when hiding behind a hand or blanket and wait excitedly for the parent to reappear. Binocular vision, which is the ability to fuse two images into one, is demonstrated by 2-month-olds when the follow moving objects with their eyes, although not past the midline.

The school nurse is discussing various topics with a group of adolescent girls. One of the girls states, "I just want to be pretty and to look like everyone else." The nurse recognizes that the girl's feelings about herself and her body relate to the development of which of the following? a) Self-esteem b) Shyness c) Modesty d) Independence

Self-esteem

The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice? a) Provide small portions that must be eaten b) Let the child eat only the foods she prefers c) Serve new foods several times d) Actively urge the child to eat new foods

Serve new foods several times

The nurse is teaching injection techniques to a school-aged child with type 1 diabetes and her family. Which observation would be the best evaluation as to whether learning was successful? a) She explains the importance of performing the injections. b) She returns an adequate demonstration of the injection technique. c) She shows an eagerness to learn more things. d) She consistently performs the injection correctly over time.

She consistently performs the injection correctly over time.

Sixteen-year-old Bettina has been hospitalized 100 miles from home for a week. She is recovering from surgery to repair a broken kneecap, an injury incurred while skateboarding. She was cheerful and chatty when she first arrived, but the nurse notes in recent days she has become increasingly quiet and seems lonely. Which of the following nursing interventions would be most appropriate for Bettina? The nurse should a) Suggest that she read books and magazines from the hospital bookmobile. b) Ask Bettina's caregivers to bring her siblings and friends to visit. c) Call the hospital's mental health unit to see if Bettina can get some counseling. d) Show Bettina where the teen lounge in the hospital is so she can meet other teens, use a phone, and check her e-mail.

Show Bettina where the teen lounge in the hospital is so she can meet other teens, use a phone, and check her e-mail.

A nurse is assigned to care for a 6 month old hospitalized with diarrhea and dehydration. Because a child this age does not have developed speech, what can the nurse do to communicate with the child? a) Sing to the infant. b) Write on a whiteboard. c) Use puppets to communicate with the child. d) Use a stuffed animal to tell a story.

Sing to the infant.

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? a) Sitting independently b) Walking independently c) Building a tower of four cubes d) Turning a doorknob

Sitting independently

Assessing skin in children is an important factor and good indicator of their overall condition. Which of the following describes cyanosis of the skin? a) Skin that is pink b) Skin that is bluish c) Skin that is an olive-tone d) Skin that is yellowish

Skin that is bluish

A father and his 12-month-old son are in for an office visit. The son is now walking regularly, and the father asks the nurse for recommendations on shoes. Which of the following should the nurse suggest? a) Flip-flops b) Ankle-high shoes c) Sneakers d) Shoes with much arch support

Sneakers

Lea is 3 months old. At what age would it be okay for Lea's mother to introduce carrots to her for dinner? a) Solid food can be introduced at 9 months of age. b) Solid food can be introduced at 7 to 9 months of age. c) Solid food can be introduced at 4 to 6 months of age. d) Solid food can be introduced whenever the child seems ready.

Solid food can be introduced at 4 to 6 months of age.

The nurse has worked diligently with an adolescent to meet his teaching-learning needs and make adaptations for managing his illness to suit his preferences and lifestyle. Even so, there is evidence of noncompliance. The nurse's interpretation is: a) Because the adolescent did not pay attention during his teaching sessions, he now does not know what to do. b) Some noncompliance should be expected due to the teen's desire for independence, expression of his personal values, and peer acceptance. c) More assistance from the family is needed for the teen to manage his care. d) The developmental thinking skills of the adolescent prevent him from seeing the connection between his actions and the effect on his health.

Some noncompliance should be expected due to the teen's desire for independence, expression of his personal values, and peer acceptance.

A 15-year-old patient with type 1 diabetes has been noncompliant with his dietary regimen. When educating the teen, what is the most important thing the nurse do to allow the teen to be in control and involved in the decision-making process? a) Speak directly to the teen and consider his input in the decisions about care and education. b) Offer choices whenever possible. c) Praise the patient often. d) Provide information and allow the teen to process and ask questions.

Speak directly to the teen and consider his input in the decisions about care and education.

Which assessment finding is considered normal in children? 1. Irregular respiratory rate and rhythm 2. Split S2 and sinus arrhythmia 3. Decreased heart rate with crying 4. Genu varum past the age of 5 years

Split S2 and sinus arrhythmia

A nurse conducted a health history with a 5 year old admitted with abdominal pain. The nurse stood at the bedside while talking to the mother and child. The patient was in a private room. The nurse made sure the door was closed and referred to the mother as "Mrs. Smith" whenever asking a question. Which of the following actions by the nurse was not conducive to the health history? a) Closing the door b) Conducting it in a private room c) Standing at the bedside d) Referring to the mother as Mrs. Smith

Standing at the bedside

The nurse is teaching a 6-year-old girl and her mother about home care for an eye infection. Which communication techniques would be least effective with this child? a) Asking permission to touch the child before doing so b) Talking directly to the child even though the mother makes comments c) Standing beside the child when doing the teaching d) Listening attentively to the child while giving time to finish thoughts and ideas

Standing beside the child when doing the teaching

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

Still at times wants to be dependent upon parents Is influenced by peers and values memberships in cliques

Put the following developmental milestones related to an infant's hearing in correct chronological order: 1 Stop activity in response to spoken word 2 Locate sounds made above 3 Locate & turn toward sound in any direction 4 Turn head to locate sound 5 Recognize name when spoken 6 Locate sounds downward and to side

Stop activity in response to spoken word Turn head to locate sound Locate sounds downward and to side Locate sounds made above Recognize name when spoken Locate & turn toward sound in any direction

A 4 year old is going to finger paint for the first time. Which of the following is the best action for the adult supervisor of this activity? a) Make a model for the child to follow so it will be easy to copy. b) Support whatever the child paints. c) Tell the child that it will be fun but that he or she should not make a mess. d) Draw a picture first for the child to see how to do it.

Support whatever the child paints.

The nurse is examining the genitals of a healthy newborn girl. The nurse should observe which normal finding? a) Lesions on the external genitalia b) Swollen labia minora c) Labial adhesions d) Swollen labia majora

Swollen labia minora

When performing a physical examination on a child, if there is a mirror image in shape, size, and position from one side of the body to the other, the child would have which of the following? a) Alignment b) Symmetry c) Retraction d) Accommodation

Symmetry

To obtain an accurate heart rate in an infant, which of the following would be the most important for the nurse to do? a) Take a radial pulse. b) Take the apical pulse. c) Count the pulse rate for 30 seconds. d) Use a regular stethoscope.

Take the apical pulse.

Parents of 3-year-old son ask the nurse for suggestions on how to deal with their son's nightmares. Which suggestion would be least effective? a) Talk to him that night about the details of the dreams. b) Search the room to show him that there aren't any monsters. c) Try reassuring him that it was a dream and not real. d) Try having him sleep with a nightlight on in his room.

Talk to him that night about the details of the dreams.

A nurse is teaching a child and parents about an outpatient surgical procedure the child will have the next day. The child is "shy" and does not maintain eye contact with the nurse. What is the best way for the nurse to approach the child? a) Ask the parents to step out of the room and talk with the child privately. b) Talk to the parents first to give the child a chance to "warm up." c) Ask the child questions until he or she begins talking freely. d) Give information to the parents and let them talk to the child later.

Talk to the parents first to give the child a chance to "warm up."

Jamie, an 18-year-old, comes to the clinic. In the health history she reveals that she has a nipple ring and is looking to get a tattoo in the next few months. What is the most important thing that the nurse can teach her at this time? a) Complications are more likely when they are done on your own. b) Review the safety rules for those who do the tattooing. c) It is not recommended to get the tattoo from your friend in his garage. d) Tattooing carries risks such as infection, disease, and nerve damage.

Tattooing carries risks such as infection, disease, and nerve damage.

What type of teaching would be best for a preschooler having an invasive procedure? a) Giving the child a brochure about the procedure and allowing him or her to ask any questions b) Teaching with dolls or toys c) Letting parents educate the child about the procedure d) Showing a video

Teaching with dolls or toys

The nurse is caring for a 13-year-old girl. As part of a routine health assessment the nurse needs to address areas relating to sexuality and substance use. Which statement should the nurse say first to encourage communication? a) Tell me about some of your current activities at school. b) Are you considering sexual activity? c) I promise not to tell your mother any of your responses. d) Do you smoke cigarettes or marijuana?

Tell me about some of your current activities at school.

An urgent care nurse is cleaning a forehead laceration on a 7-year-old. The mother is present. The child is crying and screaming. The nurse should: a) Have the mother speak firmly to the child to correct the crying and screaming. b) Ask the child to be less noisy because he is "scaring and bothering other children." c) Close the door tightly and reassure the child, "I am being gentle and am almost done." d) Review safety measures that could have prevented the injury. e) Tell the child, "It's OK to cry, but I need you to hold still."

Tell the child, "It's OK to cry, but I need you to hold still."

The school nurse is working with a group of 6- to 8-year-old children. Which of the following responsibilities would the school nurse most likely have for this age child? The nurse would be a) Teaching a class on sex education b) Testing the children's vision and hearing c) Giving tetanus-diphtheria booster shots d) Monitoring the children for signs of scoliosis

Testing the children's vision and hearing

A nurse is examining a 6-year-old boy. The nurse says, "Point to where it hurts the most." The boy points to his stomach. In this scenario, which of the following is the decoder? a) The nurse b) The 6-year-old boy c) The instruction to point to where it hurts d) The action of pointing to his stomach

The 6-year-old boy

Where is the point of maximal impulse (PMI) found in Lucy who is 5 years old? a) The PMI is at the third intercostal space. b) The PMI is at the fourth intercostal space. c) The PMI is at the sternum. d) The PMI is at the clavicle.

The PMI is at the fourth intercostal space.

The 18-month-old has most likely attained which of the following gross motor skills? a) The ability to walk independently. b) The ability to walk up stairs alone. c) The ability to pedal a tricycle. d) The ability to balance on one foot.

The ability to walk independently.

What is the best explanation of Erikson's theory of psychosocial development during the adolescence period? a) The adolescent develops many skills during the teen ages, which help adolescents make educational and career choices. b) The adolescent faces many different decisions during the teen years concerning the future and the adult world. c) Cognitive development is cumulative; that is, what is learned is based on what has been known before. d) The adolescent thinks in the abstract and develops skills to participate in complex problem solving.

The adolescent faces many different decisions during the teen years concerning the future and the adult world.

The nurse is assessing an infant at his 4-month well-baby check-up. The nurse notes that at birth the baby weighed 8 lb (3.6 kg)and was 20 in (50.8 cm)in length. Which finding is most consistent with the normal infant growth and development? a) The baby weighs 21 lb (9.5 kg)and is 30 in (76.2 cm) in length. b) The baby weighs 24 lb (10.9 kg) and is 26 (66.0 cm) in in length. c) The baby weighs 15 lb (6.8 kg)and is 24 in (61.0 cm) in length. d) The baby weighs 16 lb (7.3 kg) and is 26 in (66.0 cm) in length.

The baby weighs 16 lb (7.3 kg) and is 26 in (66.0 cm) in length.

The time period known as adolescence usually begins with which of the following occurrences. a) The fine motor skills fully developed. b) The child becoming self-supported c) The beginning of puberty. d) The deciduous teeth falling out.

The beginning of puberty.

A 5-year-old boy's father was recently injured in a motorcycle accident, but has fully recovered. The father confides to the school nurse that he is concerned about the child not acting the way he did before the accident. The boy is not testing boundaries as he was before the accident. Which situation best describes the reason for the behavior Jack's father is seeing? a) The boy wanted to go with his father on the motorcycle ride. When he was told he couldn't go he told his father he hoped he would crash, so he believes he caused the accident. b) The thought of losing his father was scary, and the child is trying to show his father how much he loves him. c) The child is afraid of being hurt himself and thinks being especially good will protect him from accidents. d) Everyone in the family is being nicer to each other and the boy is imitating the adults' behavior.

The boy wanted to go with his father on the motorcycle ride. When he was told he couldn't go he told his father he hoped he would crash, so he believes he caused the accident.

When obtaining a child's health history the child's biological data is assessed. What is the next thing to assess in the child's history? a) Types of medications the child is on b) The chief complaint of the child c) How the child feels school is going d) History of illness

The chief complaint of the child

The nurse is discussing development of motor skills in the preschool-age group with a group of nursing students. Which of the following statements is most accurate regarding the gross motor skills of a 4-year-old? a) The child can hop on one foot. b) The child can walk backwards with heel to toe. c) The child can jump rope. d) The child can throw and catch a ball.

The child can hop on one foot

The nurse is examining a 3-year-old girl during a regular visit. Which finding would disclose a developmental delay in this child? a) The child demonstrates separation anxiety. b) The child follows directions when made one at a time. c) The child copies a circle on a piece of paper. d) The child imitates the nurse in use of a stethoscope.

The child demonstrates separation anxiety.

A 15-month-old boy has been brought to the clinic because he is pale and listless. Which of the following findings and observations would lead the nurse to suspect iron deficiency anemia as the cause of the clinical manifestations? a) The nurse hears a grade 2 heart murmur. b) The child eats a vegetarian diet. c) The child drinks four cups of milk per day. d) The child drinks very little fruit juice.

The child drinks four cups of milk per day

The nurse has taken a health history and performed a physical exam for a 12-year-old boy. Which finding is the most likely? a) The child described a somewhat reduced appetite. b) The child has different diet preferences than his parents. c) The child's body fat has decreased since last year. d) The child has a leaner body mass than a girl at this age.

The child has a leaner body mass than a girl at this age.

The nurse is performing a physical assessment on an 11-year-old girl during a health surveillance visit. Which of the following findings would suggest the child has reached adolescence? a) The child has higher blood pressure b) Eruption of last four molars c) Increased shoulder, chest and hip widths d) A significant muscle mass increase

The child has higher blood pressure

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

The child hides behind her bedroom door when defecating.

The nurse is conducting a physical examination of a 5-month-old boy. Which observation may be cause for concern about the infant's neurologic development? a) His toes hyperextend when the bottom of the foot is stroked. b) The infant grasps a finger when it is placed in his palm. c) The infant displays an asymmetric tonic neck reflex (fencing reflex). d) The anterior fontanel is open and easily palpated.

The infant displays an asymmetric tonic neck reflex (fencing reflex). (Birth-4mos)

The nurse is assessing development of a 4-month-old boy during a well-child visit. Which observation needs further investigation? a) The infant makes babbling sounds, coos, and smiles. b) The infant shows interest in looking at near or high-contrast objects. c) The infant responds to his mother when he sees her but not at other times when she is near. d) The infant turns his head in the direction of a squeak toy.

The infant responds to his mother when he sees her but not at other times when she is near.

A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. Which of the following represents the most advanced milestone of language development that the nurse should expect to see in this child? a) The infant says "da-da" when looking at her father b) The infant coos, babbles, and gurgles c) The infant squeals with pleasure d) The infant imitates her father's cough

The infant says "da-da" when looking at her father

In teaching caregivers of preschool children, the nurse would reinforce that which of the following would be most important for this age group? a) The preschool child should cover mouth when coughing or sneezing. b) The preschool child should wear a seat belt when riding in a vehicle. c) The preschool child should be screened for amblyopia. d) The preschool child should brush and floss teeth after snacks and meals.

The preschool child should wear a seat belt when riding in a vehicle.

Puberty is said to begin when what occurs? a) The production of sperm in the male. b) The voice deepens in the male. c) The growth spurt in the female ends. d) The areola separate from the contour of the breasts in the female.

The production of sperm in the male. Adolescence begins with the onset of menstruation in the female and the production of sperm in the male.

When testing the deep tendon reflexes of a child, a four-point grading scale is used. What would a 1+ result mean for a reflex tested? a) The reflex is absent. b) The reflex is hyperactive. c) The reflex is diminished. d) The reflex is brisk.

The reflex is diminished. 1+ indicates a diminished response. 2+ as average 3+ is brisker than average 4+ is hyperactive. The reflex is absent at a grade of 0

The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide? a) The normal respiratory rate for an infant at this age is between 20 and 30 breaths per minute. b) The respirations of a 1-month-old infant are normally irregular and periodically pause. c) An infant at this age should have regular respirations. d) The irregularity of the infant's respirations are concerning; I will notify the physician.

The respirations of a 1-month-old infant are normally irregular and periodically pause.

A 2-year-old is having a temper tantrum. What advice should the nurse give the mother? 1. For safety reasons, the toddler should be restrained during the tantrum. 2. Punishment should be initiated, as tantrums should be controlled. 3. The mother should promise the toddler a reward if the tantrum stops. 4. The tantrum should be ignored as long as the toddler is safe.

The tantrum should be ignored as long as the toddler is safe.

The mother of 2-year-old triplets is anxious and worried because one of the children does not seem to be at the same developmental level as her siblings. Which finding might indicate a need for further diagnostic testing to rule out intellectual disability in this child? a) She blows her nose frequently. b) The tops of her ears are below the corners of her eyes. c) She speaks loudly when asked a question. d) The fontanels on her head are closed.

The tops of her ears are below the corners of her eyes.

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

This is a normal and expected activity best treated matter-of-factly.

A toddler's father is concerned because his son refuses to share. What is your best response concerning this? a) His son is probably reacting to some family crisis. b) This is normal toddler behavior; sharing is learned later. c) Behavior modification techniques can change the child's behavior. d) Play time with other children should be cut back until he learns to share.

This is normal toddler behavior; sharing is learned later.

The father of a 15-year-old basketball player is following a very low carbohydrate diet. He realizes his daughter should not follow the same eating plan. Which of the following would be most advisable for this father to serve his daughter so that she can perform at her optimum level in a Friday basketball game that starts at 6 p.m.? a) Boiled eggs with bacon or ham and a glass of orange juice for breakfast on Thursday and Friday mornings along with some sliced turkey and a salad at noon on Friday. b) Three daily meals that include choices from each of the food groups; Friday's lunch should be eaten around 2 p.m. and include a small amount of fat and a somewhat larger than usual portion of complex carbohydrates c) Three daily meals that include choices from each of the food groups with an additional serving of fruit and several extra glasses of water on Friday. d) Pasta with a small amount of meat sauce and two slices of bread for dinner on Wednesday and Thursday evenings and again at 2 p.m. on Friday.

Three daily meals that include choices from each of the food groups; Friday's lunch should be eaten around 2 p.m. and include a small amount of fat and a somewhat larger than usual portion of complex carbohydrates

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

To escape punishment Lack of sense of propriety Strong desire to own something

A 16-year-old girl confides in the nurse that her parents are difficult to deal with and that it stresses her out. The nurse responds by saying, "You think that's stressful, you should see some of the patients I have to deal with in here!" Which barrier to communication is this nurse demonstrating? a) Growing defensive b) Cliché advice c) Showing disapproval d) Topping up

Topping up

A father brings his 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which of the following findings should concern the nurse? a) Prominent abdomen b) Forward curve of the spine at the sacral area c) Total weight gain of 15 lb in the past year d) Increase in height of 5 inches in the past year

Total weight gain of 15 lb in the past year

The nurse at a family health clinic is teaching a group of parents about normal infant development. What patterns of communication should the nurse tell parents to expect from an infant at age 1? a) Uses speech-like rhythm when talking with an adult b) Understands "no" and other simple commands c) Squeals and makes pleasure sound d) Uses multisyllabic babbling

Understands "no" and other simple commands

The nurse is observing a 36-month-old boy during a well visit. Which motor skill has he most recently acquired? a) Kick a ball b) Undress himself c) Push a toy lawnmower d) Pull a toy while walking

Undress himself

The nurse is caring for a 6-year-old girl who will be undergoing a surgical procedure that will result in a temporary ileostomy. Which approach would be most effective in helping prepare the child for surgery? a) Show the child a teaching DVD about ileostomy care. b) Show the child photographs of another girl with her ileostomy. c) Draw a picture that explains the procedure. d) Use a doll to role-play the events surrounding the surgical experience and the procedure.

Use a doll to role-play the events surrounding the surgical experience and the procedure.

A nurse is preparing to start an intravenous (IV) line in a child with severe pneumonia. The nervous child asks the nurse to wait until later to do the procedure. What is the best option for the nurse? a) Ask the parents to hold the child down so that the procedure can be completed. b) Inform the child that the procedure will have to be done with or without cooperation. c) Use a firm, positive, confident approach when starting the IV. d) Call the physician to see if the medication can be given in liquid form by mouth.

Use a firm, positive, confident approach when starting the IV.

A new mother complains that she is exhausted and that the little sleep she gets is determined by her baby's daytime naps and the few hours the baby sleeps during the night. The nurse discusses with this mother the importance of helping the infant establish healthy sleeping patterns. Which of the following would be most helpful for this mother to do to encourage healthy sleeping patterns? The mother should a) Put the baby to bed a various times of the evening b) Let the baby cry during the night and she will eventually fall back to sleep c) Wake the baby from afternoon naps after 1 hour to ensure she is sleepy by nighttime d) Use the crib for sleeping only, not for play activities

Use the crib for sleeping only, not for play activities

A child on a cardiac monitor has been transported from the emergency room to the intensive care unit. The nurse admits the child to the unit and begins collecting data on the child. Which of the following nursing interventions would the nurse do first? a) Change the probe on the pulse oximeter. b) Verify that the alarms on the monitor are still properly set. c) Assess the neurological function using the Glasgow coma scale. d) Check the apical pulse rate using a pediatric stethoscope.

Verify that the alarms on the monitor are still properly set.

During a well-child visit, the nurse observes the child saying "no" to her mother quite frequently. The mother asks the nurse, "How do I deal with her saying no all the time?" Which of the following would be appropriate for the nurse to suggest? Select all that apply. a) "Offer her two options from which to choose." b) "Offer her something she would like, such as ice cream, to distract her." c) "Use timeout every other time she tells you no." d) "Make a statement instead of asking a question." e) "Limit the number of questions you ask of her."

• "Offer her two options from which to choose." • "Make a statement instead of asking a question." • "Limit the number of questions you ask of her."

The nurse is caring for a hospitalized 5-year old child. The child's mother has reported her child is becoming very "clingy." Which advice should the nurse provide? Select all that apply. a) "Regression is normal during hospitalization." b) "These behaviors are the result of a loss of self-control and are likely temporary." c) "The child may miss school and interaction with peers." d) "Allowing the child to have some input in the care may be helpful in managing these behaviors." e) "Be careful not to coddle the child or it will result in regressive behaviors."

• "Regression is normal during hospitalization." • "Allowing the child to have some input in the care may be helpful in managing these behaviors." • "The child may miss school and interaction with peers."

The nurse is planning to talk to a 12½-year-old boy who says, "I am too short! Girls are taller than I am. Guess I won't be playing basketball." What points of information will the nurse share? Select all that apply. a) "There are a lot of size differences in your age group now because everyone enters puberty and grows at slightly different times than others." b) "If you know how tall you were at age 3, you can double that and predict fairly well how tall you will get." c) "You are at the age now when most boys begin their growth spurt and grow very rapidly." d) "Girls begin to grow rapidly at a younger age than boys do. Boys start later and grow longer." e) "You can't control when and how much you will grow. Basketball can use some really fast guards." f) "You could add as much as 12 inches to your height before you stop growing."

• "There are a lot of size differences in your age group now because everyone enters puberty and grows at slightly different times than others." • "Girls begin to grow rapidly at a younger age than boys do. Boys start later and grow longer." • "You could add as much as 12 inches to your height before you stop growing."

Parents of a preschooler tell the nurse that their child often refuses to go to sleep at night. Which suggestion by the nurse would be helpful? Select all that apply. a) "Try reading a favorite story before bedtime." b) "Set up some familiar bedtime rituals for your child." c) "Try using a night light in the child's room." d) "Keep the door closed and the lights off so that your child can fall asleep faster." e) "Avoid having your child watch frightening shows on TV before bedtime."

• "Try reading a favorite story before bedtime." • "Set up some familiar bedtime rituals for your child." • "Try using a night light in the child's room." • "Avoid having your child watch frightening shows on TV before bedtime."

The nurse is educating a young child about what to expect during an upcoming procedure. Which statements are appropriate for the nurse to use? Select all that apply. a) "I'm going to give you this shot and it will put you to sleep." b) "When they come to get you, you'll get on a special rolling bed." c) "This little tube will go in your nose and down into your belly." d) "They're going to give you some special medicine to help the doctor see what's happening inside your belly." e) "You'll end up in 'ICU' where you'll wake up with some electrodes on your thorax."

• "When they come to get you, you'll get on a special rolling bed." • "This little tube will go in your nose and down into your belly." • "They're going to give you some special medicine to help the doctor see what's happening inside your belly."

The nurse realizes that the 5-year-old's growth chart and BMI indicate the child is at risk for obesity. What other findings reinforce this risk? Select all that apply. a) A father who is overweight b) Expectations to eat everything on plate c) Fast food eaten once a month d) Mealtimes organized and regular e) Television on during meals f) Food used as reward or punishment

• A father who is overweight • Expectations to eat everything on plate • Television on during meals • Food used as reward or punishment

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

• Adolescents need parental support and guidance as they move toward greater peer involvement. • Peers provide opportunity to learn and practice social roles. • Peers can be positive or negative influences. • Peers are needed for emotional security while stepping away from family.

The nurse is teaching the mother of a 5-month-old boy who is concerned about thumb sucking. What should be included in the teaching plan? Select all that apply. a) Telling the mother this behavior usually decreases by 6 to 9 months of age b) Informing the mother that thumb sucking occurs more often during periods of stress c) Advising the mother this behavior is a form of self-comfort d) Assuring the mother this behavior won't cause malocclusion

• Advising the mother this behavior is a form of self-comfort • Assuring the mother this behavior won't cause malocclusion • Informing the mother that thumb sucking occurs more often during periods of stress • Telling the mother this behavior usually decreases by 6 to 9 months of age

The child has been admitted to a pediatric unit in a hospital. Which nursing interventions use atraumatic care principles? Select all that apply. a) Requesting that parent assist the nurse by "holding the child down" b) Encouraging the family to bring in the child's favorite stuffed animal from home c) Showing the parent how to unfold the chair in the child's room into a bed d) Applying a numbing cream prior to starting the child's intravenous line e) Asking the child if he would like to take a bath before or after he takes his medication

• Encouraging the family to bring in the child's favorite stuffed animal from home • Showing the parent how to unfold the chair in the child's room into a bed • Applying a numbing cream prior to starting the child's intravenous line • Asking the child if he would like to take a bath before or after he takes his medication

The nurse is providing information to the parents of a 6-year-old boy who has been caught lying at home and at school. Which would the nurse share with the parents? Select all that apply. a) Indicate that the child is probably lying to impress his friends. b) Explain that children this age typically lie to avoid punishment. c) Recommend the use of immediate and firm punishment. d) Suggest reading a story with the child about the consequences of lying.

• Explain that children this age typically lie to avoid punishment. • Suggest reading a story with the child about the consequences of lying.

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

• Hard foods such as nuts, raw carrots, and popcorn • Sticky foods like peanut butter alone, gummy candies, and marshmallows • Round foods such as hot dogs, whole grapes, and cherry tomatoes

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 formal exercise classes b) Participation in a formal weight-control organization c) Preparation of a special meal just for the child d) Intake of about 1,200 calories a day e) Limiting time spent in physical inactivity f) Adherence to a high-protein diet

• Intake of about 1,200 calories a day • Limiting time spent in physical inactivity • Participation in a formal weight-control organization • Participation in formal exercise classes

Johnny exhibits the following growth pattern. How should the nurse interpret or manage this data? Select all that apply. 3 yrs: Ht. 37 inches Wt. 32 pounds 4 yrs: Ht. 39 inches Wt. 39 pounds 5 yrs: Ht. 40 inches Wt. 46 pounds a) Johnny may be at risk for overweight or obesity. b) Johnny is following a normal pattern of growth for the preschool years. c) Johnny is growing slowly in height but rapidly in weight. d) Johnny's height and weight should be plotted on a growth chart.

• Johnny is growing slowly in height but rapidly in weight. • Johnny may be at risk for overweight or obesity. • Johnny's height and weight should be plotted on a growth chart.

The nurse is providing teaching about car seat safety for a parents' meeting at the preschool their children attend. Choose the points the nurse should make. Select all that apply. a) Many car seats are installed improperly, making them unsafe. b) The back seat remains the safest place for children to ride. c) Children who weigh less than 40 pounds should use a car seat with harness and top tether. d) Booster seats should be used with both a shoulder and lap belt.

• Many car seats are installed improperly, making them unsafe. • The back seat remains the safest place for children to ride. • Children who weigh less than 40 pounds should use a car seat with harness and top tether. • Booster seats should be used with both a shoulder and lap belt.

A mother of a 2-year-old asks the nurse, "What would be a good between-meal snack?" Which of the following would be appropriate for the nurse to suggest? Select all that apply. a) Cookies b) Orange slices c) Yogurt d) Cheese e) Pieces of apples

• Orange slices • Yogurt • Cheese • Pieces of apples

A mother is concerned because her 2-year-old daughter is not speaking much. What should the nurse suggest to the mother? Select all that apply. a) Read books aloud to her. b) Name aloud the objects that she is playing with. c) Use baby talk when speaking to her. d) Have her watch educational television. e) Use pronouns when speaking to her. f) Always answer her questions.

• Read books aloud to her. • Name aloud the objects that she is playing with. • Always answer her questions.

While examining a child, the nurse notes quiet, soft sounds each time the stethoscope is moved over the child's chest. The nurse knows that these are not breath sounds. What actions should the nurse take? (Select all that apply.) a) Refer the child for further evaluation. b) Record the location and timing of the sounds. c) Conclude this is a grade 3 heart murmur. d) Auscultate with the child lying down. e) Auscultate with the child sitting up.

• Record the location and timing of the sounds. • Auscultate with the child lying down. • Auscultate with the child sitting up. • Refer the child for further evaluation.

The infant in the exam room has these signs and symptoms. Which will the nurse attribute to teething? Select all that apply. a) Fever and diarrhea b) Refusing to eat c) Irritability and awakening from sleep d) Drooling and biting e) Increased sucking on hands

• Refusing to eat • Irritability and awakening from sleep • Drooling and biting • Increased sucking on hands

The mother of a 15-year-old boy confides in the nurse that she is concerned because her son is about to turn 16 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) Require the son to wear long pants b) Require the son to wear a helmet c) Require that the son to wear a seat belt d) Require the son to wear full body covering e) Require the son to learn all relevant safety rules f) Insist on age and not emotional maturity as the qualification for obtaining a driver's license

• Require the son to wear long pants • Require the son to wear a helmet • Require the son to wear full body covering • Require the son to learn all relevant safety rules

A nurse is presenting a class on toilet training to a group of parents with toddlers. Which of the following would the nurse include in the class? Select all that apply. a) Using training pants that slide down easily and quickly b) Keeping the child on the potty chair for as long as necessary c) Putting the child on the potty chair at regular intervals during the day d) Allowing at least 6 weeks to prepare the child psychologically for the training e) Praising the child when he or she urinates or defecates

• Using training pants that slide down easily and quickly • Putting the child on the potty chair at regular intervals during the day • Praising the child when he or she urinates or defecates

The caregiver of an infant tells the nurse that her dentist told her not to let the child go to bed with a bottle of milk. The caregiver states she doesn't understand the reason for this since her baby seems to enjoy the bottle. The most appropriate response to this caregiver would be: a) "Giving a bottle of milk when the infant goes to bed can lead to obesity." b) "Giving your baby a pacifier at bedtime will satisfy the need to suck." c) "Bottles given at bedtime can cause erosion of the enamel on the teeth." d) "You could give your baby a bottle of water at bedtime occasionally."

"Bottles given at bedtime can cause erosion of the enamel on the teeth."

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

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

The father of a 2-month-old girl is expressing concern that his infant may be getting spoiled. The nurse's best response is: 1. "She just needs love and attention. Don't worry; she's too young to spoil." 2. "Consistently meeting the infant's needs helps promote a sense of trust." 3. "Infants need to be fed and cleaned; if you're sure those needs are met, just let her cry." 4. "Consistency in meeting needs is important, but you're right, holding her too much will spoil her."

"Consistently meeting the infant's needs helps promote a sense of trust."

The nurse goes in to check on Lilly and how breast-feeding is going with her new son. The nurse observes the infant is on her lap with the blanket unwrapped, and Lilly is washing his face, and gently stroking the baby. Lily has had trouble breast-feeding the last few times. What is the appropriate response from her nurse? a) "Lilly, you are doing a wonderful job attempting to waken the baby." b) "Lilly, you will never get him to eat all unwrapped like that." c) "Lilly, maybe you should watch the breast-feeding video again." d) "Lilly, that is not how you get him to eat."

"Lilly, you are doing a wonderful job attempting to waken the baby."

In an effort to control health care costs, what is the best recommendation by the nurse? 1. "Shop around to find the most inexpensive health insurance plan." 2. "Find a job that provides family health insurance at a minimal cost." 3. "Stress primary prevention, using the health care system for check-ups." 4. "Avoid seeing a physician until your child becomes ill."

"Stress primary prevention, using the health care system for check-ups."

The nurse is assessing the vital signs of a child who is being evaluated in an urgent care center. The child is to be seen by the pediatric nurse practitioner (PNP). The mother asks, "Why is my child seeing the PNP and not the doctor?" What is the best response by the nurse? 1. "The PNP functions similar to the physician's assistant, so you should be perfectly at ease." 2. "The child may be seen by the physician instead if you'd like." 3. "Seeing the PNP is just one more step in having your child evaluated in this setting." 4. "The PNP is an experienced RN with advanced education in the diagnosis and treatment of children."

"The PNP is an experienced RN with advanced education in the diagnosis and treatment of children."

A frustrated mother comes to a 9-month well-baby checkup complaining to you that her son is refusing all of the solid food she gives him. When talking with this mother, the nurse discovers that she has struggled all her life with a weight problem. She attributes this problem to being forced to eat all of the food she was served as a child, even when she was full. Because she doesn't want to cause the same problem in her child, she tells the nurse that each time her son pushes food away with his tongue she believes that he doesn't want it. Which of the following statements would be most appropriate for the nurse to say to this mother? a) "The baby might not be ready for solid food, so wait a month or so and try again." b) "Because your baby is a fussy eater, have more than one food available at each feeding so he can choose a food he likes." c) "The baby might be allergic to the particular foods you offered, so try different kinds of food." d) "The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this."

"The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this."

Nurse Betty is documenting her postpartum mother and baby. She must document the relationship between the mother and infant. Which observation would demonstrate attachment? a) "The mom is talking to the infant while breast-feeding the infant." b) "The infant remains in the nursery most of the day." c) "The father is always holding the infant." d) "The infant is in the crib every time Betty goes into the room."

"The mom is talking to the infant while breast-feeding the infant."

The mother of a 3-month-old boy asks the nurse about starting solid foods. What is the most appropriate response by the nurse? 1. "It's okay to start puréed solids at this age if fed via the bottle." 2. "Infants don't require solid food until 12 months of age." 3. "Solid foods should be delayed until age 6 months, when the infant can handle a spoon on his own." 4. "The tongue extrusion reflex disappears at age 4 to 6 months, making it a good time to start solid foods."

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

A nurse is determining whether or not informed consent has been obtained from the family of a child who is going to have abdominal surgery. Which statement by the family would lead the nurse to suspect that informed consent is lacking? a) "Although there are risks involved, our son needs the surgery to cure the problem." b) "We are amazed that he'll be up and walking around the day after surgery." c) "He might miss some school afterwards, but he'll be feeling much better." d) "We had to sign the form right away so the surgery could get scheduled."

"We had to sign the form right away so the surgery could get scheduled."

The mother of 1-week-old boy voices concerns about her baby's weight loss since birth. At birth the baby weighed 7 lb (3.2 kg); the baby currently weighs 6 lb 1 oz (2.8 kg). Which response by the nurse is most appropriate? a) "All babies lose a substantial amount of weight after birth." b) "Your baby has lost a bit more than the normal amount." c) "Your baby has lost too much weight and may need to be hospitalized." d) "Your baby's weight loss is well within the expected range."

"Your baby has lost a bit more than the normal amount."

A nurse is working as part of a research team evaluating children for participation in a research study. The nurse demonstrates respect for persons when the nurse obtains assent from children over which age? a) 12 b) 16 c) 18 d) 7

7

Which of the following would be a current trend that is influencing child care? a) Greater use of alternative treatment modalities b) Less interest in child care c) Decreased regionalization of care d) More families living in apartments

Greater use of alternative treatment modalities

A terminally ill 15-year-old tells the nurse that she wants to stop all treatments and go home despite her parents' directives to provide extraordinary means to keep their child alive. What is the best resource available to this nurse to help solve this dilemma? a) The local JCAHCO branch b) The American Association of Nurses c) A nurse mentor d) An institutional ethics committee

An institutional ethics committee

The nursery nurse is preparing a consent form for the circumcision of a newborn. The mother of the child is 16 years of age. The baby's father is not participating in the care. When planning to complete the surgical consent, which action by the nurse is most appropriate? a) Ask the grandmother of the newborn to sign the surgical consent b) Determine if the baby's father is older than 18 years, and if so ask for him to sign c) Recommend that the court appoint a guardian for the baby d) Ask the baby's mother to sign the surgical consent

Ask the baby's mother to sign the surgical consent

The nurse is caring for a 14-year-old boy with a debilitating illness who wants to attend school. Which of the following interventions addresses the child's physical health but not his quality of life? a) Adapting technologies for use outside of the home b) Helping the child modify trendy clothing to his needs c) Consulting with the school nurse at the child's school d) Assessing the child's daily oxygen supplement needs

Assessing the child's daily oxygen supplement needs

The parents of two school-age children state that they expect their children to adhere to their rules without question and that they make all the decisions. Which type of parenting style does this reflect? 1. Authoritarian 2. Democratic 3. Authoritative 4. Permissive

Authoritarian

An instructor is describing the issues of research involving children. Which of the following would the instructor include? a) Little if any issues arise when children are part of a research study. b) Children have a lesser risk for nonphysical injury than for physical injury. c) The Common Rule is rarely applicable to research involving children. d) Children are considered vulnerable subjects at high risk for injury.

Children are considered vulnerable subjects at high risk for injury.

A new mother asks for advice from the nurse about bathing her infant. Which of the following should the nurse tell her? a) Be sure to wash the infant's face, hands, and diaper area daily b) Be sure to brush the scalp with a soft toothbrush during the bath to prevent seborrhea c) Be sure to oil the scalp with mineral oil and leave it on overnight before bathing the infant the next day d) Be sure to give the baby a complete bath every day

Be sure to wash the infant's face, hands, and diaper area daily

An infant is breastfed. When assessing her stools, which of the following data would be typical? a) Breastfed infants are less likely to be constipated than bottle-fed infants. b) Breastfed infants usually have fewer stools than bottle-fed infants. c) Stools of breastfed infants are usually harder than those of bottle-fed infants. d) Stools of breastfed infants tend to have a strong odor.

Breastfed infants are less likely to be constipated than bottle-fed infants.

Which of the following would you include when teaching the parents of an infant about colic? a) Their child will need future follow-up for a "nervous" bowel. b) Formula intake should be doubled to keep her from losing weight. c) Colic symptoms will probably fade at 3 months of age. d) Symptoms will decrease if she is laid on her back after feedings.

Colic symptoms will probably fade at 3 months of age.

Which would the nurse identify as a protective factor for youth violence? 1. Exposure to family violence 2. Limited involvement in social activities 3. Inconsistency of parental support 4. Commitment to academic performance

Commitment to academic performance

A single18-year-old woman in her second trimester presents at the clinic with vaginal bleeding. She confides to the nurse in confidence that she has been using cocaine to "calm her nerves" and hopes it didn't harm her baby. What would be the nurse's best response to this situation? a) Explain the effects of cocaine on the fetus and tell the mother that she must quit for her baby's sake. b) Tell the doctor about the mother's drug use and ask him to intervene in the situation. c) Consult with the healthcare facility's institutional ethics committee for an appropriate response. d) Refer the mother to a drug and alcohol rehabilitation program and follow up with her recovery.

Consult with the healthcare facility's institutional ethics committee for an appropriate response

A 9-month-old infant's mother is questioning why cow's milk is not recommended in the first year of life as it is much cheaper than formula. What rationale does the nurse include in her response? 1. It is permissible to substitute cow's milk for formula at this age as he is so close to 1 year old. 2. Cow's milk is iron poor and does not provide the proper balance of nutrients for the infant. 3. As long as the mother provides whole milk, rather than skim, she can start cow's milk in infancy. 4. If the mother cannot afford the infant formula, she should dilute it to make it last longer.

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

The school nurse is caring for several children who witnessed an accident in which an 8-year-old girl was struck by a car on the way to school. Which is the most important first step in developing the nursing care plan for these children? a) Seeking permission from parents of children needing counseling for them to participate b) Arranging for counseling for the children who saw the accident c) Arranging for friends of the injured child to receive counseling d) Determining whether the children were traumatized by the accident

Determining whether the children were traumatized by the accident

The parents of a 12-year-old child preparing to undergo surgery explain to the nurse that their religious beliefs do not allow for blood transfusions. What initial action by the nurse is most appropriate? a) Contact the hospital attorney. b) Ask the child what their preference will be. c) Document the parents' requests. d) Explain to the parents that the surgeon will make the final decision in the event a blood transfusion is needed by the child.

Document the parents' requests.

A 16-year-old child is admitted to the hospital for treatment after a motor vehicle crash. Review of the child's record reveals that she has the legal right to consent to and make decisions for treatment. What is the term for this client's status? a) Self guardian b) Independent practitioner c) Health care surrogate by proxy d) Emancipated minor

Emancipated minor

The nurse is caring for a 16-year-old boy with injuries from a car accident. Which activity describes the nurse's manager role? a) Changing dressings covering the skin abrasions b) Teaching the mother cast care c) Discussing driving safety with the teen d) Facilitating return to school by working with the school nurse

Facilitating return to school by working with the school nurse

A single mother asks the nurse for suggestions on disciplining her 2-year-old son. Which suggestion would be most appropriate? 1. Encourage the mother to emphasize the inappropriate behavior. 2. Wait an hour or so before enforcing the discipline. 3. Have the child spend 2 minutes in time-out. 4. Withhold a privilege from the toddler for a week.

Have the child spend 2 minutes in time-out.

Mark is a 2-month-old that has inconsolable crying, is gassy, and constantly draws his legs up. It has been determined that Mark has colic. What is the best intervention to treat colic? a) He needs to try a different formula to assess for sensitivity. b) He is hungry so his mom should feed him more. c) His parents should sing and play music to comfort him. d) His mom should have a regular diet.

He needs to try a different formula to assess for sensitivity.

Which of the following is NOT a trend in child health care today? a) Health restoration is stressed over health promotion. b) Children are hospitalized for observation less often than previously. c) Nursing roles are increasing because of the decreasing centrality of families. d) Child health care is moving into regional centers.

Health restoration is stressed over health promotion

The nurse is caring for a 7-year-old boy with cystic fibrosis whose parents are intensely interested in all aspects of his condition and care. Which is the most effective way of advocating for this child and family? a) Locating the best price on a high-frequency chest compression vest b) Teaching the parents how to perform chest physiotherapy c) Assisting the parents in getting the child on a lung transplant list d) Helping parents access the area's multidisciplinary cystic fibrosis clinic

Helping parents access the area's multidisciplinary cystic fibrosis clinic

The 5-year-old in the emergency room is having glass removed from a wound. Which action constitutes ethical behavior by the nurse? a) Discussing with the physician the merits of sutures versus staples for wound closure b) Telling the child, "Stop screaming! You are scaring the other kids here!" c) Holding the child's hand in order to facilitate removal of the glass d) Asking the parent to leave the emergency room cubicle due to crowding

Holding the child's hand in order to facilitate removal of the glass

The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify? a) Increased biting and sucking b) Running a mild fever or vomiting c) Frequent loose stools d) Choosing soft foods over hard foods

Increased biting and sucking

The nurse is caring for a 2-year-old boy who needs a lumbar puncture. His mother is present. What would prevent informed consent from being obtained? a) Determining the mother cannot read the form b) Finding out the mother is younger than 18 years of age c) Establishing the mother was never married d) Learning the mother is not the custodial parent

Learning the mother is not the custodial parent

The nurse is updating the records of a 10-year-old boy who had his appendix removed. Which action could jeopardize the privacy of the child's medical records? a) Encrypting any e-mail transmissions b) Changing identification and passwords regularly and according to institutional policy c) Letting another nurse use the nurse's log-in session d) Closing files before stepping away from the computer

Letting another nurse use the nurse's log-in session

The nurse is caring for a 7-year-old boy with cystic fibrosis whose parents are intensely interested in all aspects of the child's condition and care. Which of the following interventions is LEAST important for empowering these health care consumers? a) Keeping the family apprised of all developments in care b) Teaching the parents how to perform chest physiotherapy c) Educating the parents about the lung transplant list d) Locating the best deal on a high frequency chest compression vest

Locating the best deal on a high frequency chest compression vest

The school nurse is caring for several children who witnessed an 8-year-old girl get hit by car on the way to school. Which intervention is least important to the nursing plan of care for these children? a) Making phone calls to the parents of the children counseled b) Arranging for counseling for the children who saw the accident c) Including friends of the injured child to receive counseling too d) Determining that the children were traumatized by what they saw

Making phone calls to the parents of the children counseled

The nurse is assessing a 9-year-old boy with pneumonia. Which finding is a factor for this child's morbidity? a) Child's white blood cell (WBC) count is within normal limits b) Child's height and weight plot at the 50th percentile on the growth chart c) Medical records reveal a history of asthma d) Child is active in a Boy Scout troop

Medical records reveal a history of asthma

The parent of an 11-year-old female patient with an inoperable brain tumor confides to the nurse that her daughter's physician is "pushing them" to convince their daughter to participate in a controversial treatment that has a high risk for side effects. She further states that she told him twice that they were not interested. What would be the nurse's best response to this situation? a) Tell the parents to state in writing that they will not participate in the treatment and give the letter to their physician. b) Reassure the family that the doctor is acting in their best interests and they should reconsider the treatment. c) Tell the doctor that the procedure is not in the best interests of his patient and ask him to respect the rights of the family. d) Meet with the physician and disclose the concerns of the family; refer the case to the institutional ethics committee if not resolved.

Meet with the physician and disclose the concerns of the family; refer the case to the institutional ethics committee if not resolved.

The mother of an infant asks you when to begin tooth brushing with her son. Your best response would be a) as soon as the first tooth erupts. b) as soon as he begins to eat fruit. c) when weaning is complete. d) by 12 months of age.

as soon as the first tooth erupts.

The nurse is assessing a 9-year-old boy during a back-to-school check up. Which finding is a factor for childhood injury? a) The parents adopted the boy from Guatemala. b) Records show child weighed 2,450 g at birth. c) Mother reports she has abused alcohol and drugs. d) Mother reports the child is hostile to other children.

Mother reports she has abused alcohol and drugs.

What is the number one cause for mortality among children? 1. Human immunodeficiency virus 2. Congenital anomalies 3. Motor vehicle accidents 4. Low birthweight

Motor vehicle accidents

A nurse is caring for a child. Which individual would the nurse identify as being primarily responsible for initiating and coordinating healthcare? a) Social worker b) Parents c) Case manager d) Community

Parents

More nurses are stepping into the role of the advanced practice nurse. Which of the following would be the nurse to provide care for children under the age of 18? a) Clinical nurse specialist b) Women's health nurse practitioner c) Case manager d) Pediatric nurse practitioner

Pediatric nurse practitioner

A nurse is reviewing the medical record of a terminally ill child who has a DNAR order. The nurse interprets this as refraining from which of the following? a) Administering analgesics b) Performing cardiopulmonary resuscitation c) Administering oxygen d) Suctioning the child

Performing cardiopulmonary resuscitation

The pediatric nurse knows that the state of children's health in the United States is evaluated by specific determinants and measures of health status. These determinants include: a) Prevalence of asthma episodes b) Race and ethnicity c) Causes of mortality d) Chronic health conditions

Race and ethnicity

The nurse is focusing on health promotion for a 6-year-old girl. Which intervention best supports Healthy People goals? a) Providing information about after-school child care b) Explaining proper diet in the child's terms c) Recommending a helmet for biking d) Discussing needed amount of sleep

Recommending a helmet for biking

The nurse is talking with the mother of a 2-year-old girl during a scheduled visit. Which of the following teaching subjects least supports the emphasis on preventive care? a) Describing self-care for brushing teeth b) Explaining how to toddler proof the house c) Explaining how to teach self hand washing d) Reminding that child will imitate parents

Reminding that child will imitate parents

A nurse is preparing discharge teaching for a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan? a) Restrain the baby in a car seat. b) Lock all cabinets that contain cleaning supplies. c) Keep all pots and pans in lower cabinets. d) Give warm bottles of formula to the baby.

Restrain the baby in a car seat.

Parents of an 8-month-old girl express concern that she cries when left with the babysitter. How does the nurse best explain this behavior? 1. Crying when left with the sitter may indicate difficulty with building trust. 2. Stranger anxiety should not occur until toddlerhood; this concern should be investigated. 3. Separation anxiety is normal at this age; the infant recognizes parents as separate beings. 4. Perhaps the sitter doesn't meet the infant's needs; choose a different sitter.

Separation anxiety is normal at this age; the infant recognizes parents as separate beings.

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? a) Building a tower of four cubes b) Sitting independently c) Turning a doorknob d) Walking independently

Sitting independently

Which of the following milestones would you expect an infant to accomplish by 8 months of age? a) Sitting without support b) Pulling self to a standing position c) Creeping on all fours d) Being able to sit from a standing position

Sitting without support

A nurse is looking for information about advocacy activities related to promoting literacy. Which of the following would be most appropriate for the nurse to contact? a) Society of Pediatric Nurses (SPN) b) Annie E. Casey Foundation c) National Association of School Nurses (NASN) d) National Association of Pediatric Nurse Practitioners (NAPNAP)

Society of Pediatric Nurses (SPN)

The nurse is caring for a 5-year-old girl with meningitis. What action by the nurse may be considered ethical behavior? a) Scheduling a laboratory procedure at lunchtime b) Referring to the child as "her" when she is present c) Starting intravenous fluids even though the child protests d) Telling her an intramuscular injection won't hurt

Starting intravenous fluids even though the child protests

To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups? a) Help integrate exercise practices and programs into the lifestyles of individuals and communities. b) Teach injury prevention and proper safety practices. c) Advocate for more research into control of environmental toxins. d) Provide guidance regarding proper nutrition.

Teach injury prevention and proper safety practices.

Consent for urgent treatment is needed for a minor. The parents are unable to be at the hospital. What action by the nurse constitutes informed consent? a) Treating the minor and obtaining written informed consent when the parent arrives b) Explaining the needed treatment to the minor and documenting this action c) Telephone consent with two witnesses listening simultaneously d) Contacting the institution's attorney to provide and document consent

Telephone consent with two witnesses listening simultaneously

An older couple approaches the nurse's station seeking information about their hospitalized grandchild. What should be the nurse's response? a) Ask to see identification from the two individuals. b) Answer the grandparents' questions in a less public place. c) Assume "busy-looking" behaviors and move away. d) Tell the couple to seek information directly from the child's parents.

Tell the couple to seek information directly from the child's parents.

In working with the infant age child, the nurse recognizes which of the following as a characteristic of the infant. a) The child grows and develops skills more rapidly than at any other time in their life b) The child has an increased attention span and can be interested in an activity for a long length of time c) The child takes in new information at a rapid rate and asks "why" and "how" d) The child insists they can "do it," the next moment they revert to being dependent

The child grows and develops skills more rapidly than at any other time in their life

A father asks you what symptoms he can expect with normal teething in his infant. Which of the following would you tell him? a) The child's gum line will be tender. b) The child will not play or eat for 2 days. c) He can expect his child to be constipated for 2 days. d) The child's temperature may go as high as 102°F.

The child's gum line will be tender.

The nurse is teaching a group of students about the possible effects of immigration on the health status of children. Which response by the group would indicate the need for additional teaching? 1. The children of immigrants have better access to preventive care. 2. The children of immigrants have limited involvement in activities due to the language barrier. 3. The children of immigrants lack adequate support systems. 4. The children of immigrants face increased stressors due to relocation.

The children of immigrants have better access to preventive care.

A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms? a) The development of a 3-month-old b) The growth of a 5-month-old c) The development of a 10-week-old d) The growth of a 2-month-old

The development of a 3-month-old 40weeks - birth week = months to minus from current age 40-32=8wks (2 months) [5mos-2mos=3mos]

The line at the well-child walk-in clinic is long, with closing time near. Which child does the nurse assess based on knowledge of morbidity data? a) The teen needing a sports assessment b) The foreign-born adopted child c) The toddler with a "poor appetite" d) The infant at the 25th percentile on the growth chart

The foreign-born adopted child

You are going to provide an education program to early grade-school children. Which of the following topics would address the number one cause of death for this age group? a) The importance of crossing streets safely b) The importance of immunizations c) Prevention of infection and communicable disease d) Exercise and good nutrition

The importance of crossing streets safely

After teaching a group of nursing students about major threats to children's health, the instructor determines that the teaching was successful when the students state which of the following? a) Infectious diseases continue to be prevalent. b) Infant mortality rates have dropped. c) The prevalence of chronic disease is increasing. d) Birth rates for teen moms have dramatically increased.

The prevalence of chronic disease is increasing.

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking? a) If she is safe, they lie her down and leave. b) They put her to bed when she falls asleep. c) They sing to her before she goes to sleep. d) The child has a regular, scheduled bedtime.

They put her to bed when she falls asleep.

The nurse providing care to the fifth-grade child and his family reviews the nursing care plan, noting that teaching about pubertal changes is one of the individualized interventions. The nurse chooses not to address this. How should the nurse's action be evaluated? a) Nurses make clinical decisions—this action is acceptable. b) This nurse has not met the standard of care that constitutes adequate nursing practice identified in Pediatric Nursing: Scope of Standards and Practice. c) The intervention on the nursing care plan came from the family, not the nurse—the nurse may omit it. d) Sexuality education is a function of the schools—the nurse need not assume the function.

This nurse has not met the standard of care that constitutes adequate nursing practice identified in Pediatric Nursing: Scope of Standards and Practice.

A family that makes too much money to qualify for Medicaid, but who cannot afford to purchase health insurance, should be referred to the Children's Health Insurance Program (CHIP). a) False b) True

True

When caring for an adolescent, in which case must the nurse share information with the parents no matter which state the care is provided in? 1. Pregnancy counseling 2. Depression 3. Contraception 4. Tuberculosis

Tuberculosis

The nurse is caring for the family with a 2-month-old boy with colic. The mother reports feeling very stressed by the baby's constant crying. Which intervention would provide the most help in the short term? a) Educating the parents about when colic stops b) Assessing the parents' care and feeding skills c) Urging the baby's mother to take time for herself away from the child d) Watching how the parents respond to the child

Urging the baby's mother to take time for herself away from the child

The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which observation points to a developmental risk? a) Picks up small objects using entire hand b) Cannot pull self to standing c) Uses only the left hand to grasp d) Crawls with stomach down

Uses only the left hand to grasp

Pediatric nurses are developing more home care and community-based services for children with chronic illnesses because: a) disability and chronic illness have increased with the appearance of more genetic abnormalities. b) uninsured families can access these services. c) increasing numbers of children live with chronic disabilities due to advances in healthcare that allow children with formerly fatal diseases to survive. d) there are fewer positions for nurses in institutions providing acute care. e) more disabilities are occurring in children because many women are delaying pregnancy and giving birth to babies later in life.

increasing numbers of children live with chronic disabilities due to advances in healthcare that allow children with formerly fatal diseases to survive.

A nurse is considering employment in a practice that promotes family-centered care. When considering this position, the nurse recognizes that this philosophy will: a) promote the involvement of the child and parents as members of the health care team. b) focus primarily on the use of herbal remedies to manage health concerns. c) consider the wishes of the child as the leading force in planning care. d) embrace teaching the parents to manage the health care needs of their child.

promote the involvement of the child and parents as members of the health care team.

Nurses can help to decrease the United States' mortality rate by advocating for improved access to healthcare for which ethnic groups in particular? Select all that apply. a) American Indians and Native Alaskans b) Mexican-Americans c) Puerto Rican-Americans d) Asian-Americans e) African-Americans

• African-Americans • American Indians and Native Alaskans • Puerto Rican-Americans

A nurse caring for children and their families must respect the rights of the parents and guardians and their charges relevant to child health issues. Which statement best describes these rights? Select all that apply. a) The right to educations is not viewed as an entitlement for children. b) Parents are able to raise the child according to their religion. c) What is best for the child is always considered when parents choose a course of action for their child. d) Parents and guardians can give permission for treatment. e) Court appointed guardians are usually the closest relatives of the child. f) The mother of the child assumes parental responsibility when the couple is not married.

• Parents are able to raise the child according to their religion. • Parents and guardians can give permission for treatment. • The mother of the child assumes parental responsibility when the couple is not married

The parents of a 9-year-old agree to allow their child to participate in a research project involving drug trials for a new drug for attention deficit hyperactivity disorder. Which of the following rights of the child are related to beneficence? Select all that apply. a) The parents and child are told whom to contact in the agency if they have any questions or concerns. b) The parents and child are made aware of strategies to protect their identifies. c) The parents and child are told of the direct and indirect benefits of participation. d) The parents and child are informed of the possible adverse effects of the research. e) The parents and child are told the physical and nonphysical risks associated with the research. f) The parents and child are aware they can withdraw from the study at any time without prejudice.

• The parents and child are told the physical and nonphysical risks associated with the research. • The parents and child are informed of the possible adverse effects of the research. • The parents and child are told of the direct and indirect benefits of participation.

A 15-year-old with leukemia tells the nurse that she wants to file for emancipation in order to control her own treatment plan. The nurse explains the process by stating: Select all that apply. a) The minor must live with parents or guardians. b) The process is governed by individual state laws. c) The minor must demonstrate the ability to manage financial affairs. d) The minor must be married or in the armed forces. e) The minor must be able to claim a share of the parent's income by law. f) The minor must be at least 14 years of age.

• The process is governed by individual state laws. • The minor must demonstrate the ability to manage financial affairs. • The minor must be at least 14 years of age.