Review Questions - Pediatric Final Exam

A. animism

A hospitalized 5 year old thinks that the IV pole is a skinny monster that is going to tie her up. This is an example of: A. animism B. centration C. hallucinatory delusions D. magical thinking

B. is emotionally labile

A hospitalized adolescent has emotional highs followed by emotional lows. The nurse notes that the adolescent: A. is a substance abused B. is emotionally labile C. has access to alcohol D. none of the above

B. preventing aspiration

A newborn with a TEF is waiting for a transfer to a neonatal intensive care unit. The nurse's priority intervention is: A. arranging for transportation B. preventing aspiration C. providing psychosocial support for the parents D. providing small, frequent feedings

C. imaginary friends are not unusual during the preschool period

A parent tells the nurse that she is worried because her preschooler has an imaginary friend. The nurse explains that: A. the parent should consider enrolling in parenting classes B. the child would probably benefit from going to daycare a few days a week C. imaginary friends are not unusual during the preschool period D. the parent should try to spend more time with the child

A. an oral rehydrating solution

A preschooler with moderate diarrhea who is just admitted to the hospital and who is not nothing-by-mouth (NPO) status wants something to drink. The nurse's best choice is to offer: A. an oral rehydrating solution B. bottled water C. diluted apple juice D. low-fat milk

D. "This behavior actually shows a healthy attachment between you and your child"

A young child cries, kicks, and clings to his mother when she tries to leave. What is the nurse's best comment to the mother about this behavior? A. "This child is experiencing ineffective coping" B. "Parents should not leave their children when they are hospitalized" C. "Wait until the child falls asleep to leave" D. "This behavior actually shows a healthy attachment between you and your child"

C. allow the child to examine the stethoscope

Before auscultating a toddler's lungs, the nurse should: A. examine the child's ears and throat B. ask the parent(s) to leave the room C. allow the child to examine the stethoscope D. do none of the above

C. Consistently ignored

An infant will develop a sense of mistrust if he is: A. Adopted B. Hospitalized after birth C. Consistently ignored D. Send to daycare before 2 months of age

B. soy formula

An infant with diarrhea has tolerated clear liquids but begins having diarrhea again when she returns to regular formula. Her diet should be changed to: A. boiled skim milk B. soy formula C. IV fluids D. Pedialyte

B. lactaid

A child with lactose intolerance may be able to drink milk if it is taken with: A. colace B. lactaid C. lactulose D. lomotil

D. hypernatremia

An otherwise healthy infant is admitted to the hospital with dehydration and diarrhea. She is hyperirritable and agitated, and she has flushed skin and dry mucous membranes. The nurse suspects: A. hypercalcemia B. hypokalemia C. hyperkalemia D. hypernatremia

C. role confusion

According to Erikson, a person who has not successfully completed the developmental task of adolescence will experience: A. shame and doubt B. identity C. role confusion D. guilt

B. Initiative

According to Erikson, preschoolers who are encouraged to try new things and be creative will develop a sense of: A. Autonomy B. Initiative C. Industry D. Integrity

C. Secondary circular reactions

According to Piaget, an infant who intentionally shakes a rattle to hear the sound is in what substage? A. Reflective B. Primary circular reactions C. Secondary circular reactions D. Coordination of secondary schemata

D. formal operations

According to Piaget, most adolescents eventually achieve which stage? A. sensorimotor B. preoperational C. concrete operations D. formal operations

B. Pincer grasp

An 11 month old infant enjoys picking up pieces of banana one by one with the thumb and index finger and throwing them on the floor. This is an example of: A. Egocentrism B. Pincer grasp C. Oral activity D. Reflective activity

D. cannot appreciate another person's point of view

An 8 year old child typically: A. solves problems through random guessing B. comprehends historical time C. understands the conservation of mass D. cannot appreciate another person's point of view

D. Celiac disease

At his 1 year old checkup, you note that Jason has thin arms and legs and abdominal distention. His mother reports that he has been irritable, has lost his appetite, and has foul-smelling stools. He has fallen behind on the growth chart. Jason probably has: A. Crohn Disease B. Hirschsprung disease C. IBS D. Celiac disease

D. is all of the above

Parent-infant attachment: A. Is critical for survival B. is essential for normal development C. involves the infant as an active participant in the process D. is all of the above

C. 3 hours

Parents should limit school-age children's daily television viewing time to: A. 1 hour B. 2 hours C. 3 hours D. 4 hours

D. all of the above

Which is Healthy People 2020 objective for adolescents? A. increase high school completion B. reduce physical fighting C. reduce pregnancy D. all of the above

D. Children are magical thinkers at this age

Why might a 4 year old child think that she caused her younger sibling's illness, which necessitated hospitalization? A. Preschool age children have a beginning understanding of disease transmission B. The child feels insecure since the birth of the sibling C. The feeling of closeness to her sibling makes her feel responsible for the illness D. Children are magical thinkers at this age

D. ingests too much fluoride

During a well-child checkup, the nurse notices that a toddler's teeth are brownish and speckled with white. The nurse suspects that the child: A. does not brush her teeth B. goes to sleep with a bottle of milk C. eats too much candy D. ingests too much fluoride

A. acute pain

Postoperative pain is an example of: A. acute pain B. conscious pain C. chronic pain D. objective pain

B. fentanyl

Respiratory depression is a side effect of: A. acetaminophen B. fentanyl C. ketorolac D. naloxone

B. Pleural friction rub

Which sound occurs when parts of the lungs lose their lubricating fluid? A. High-pitched wheezing B. Pleural friction rub C. Rales D. Sonorous rhonchi

D. A child who has been physically abused

Emotional outlet play would be appropriate for which child? A. A child who does not feel well enough to play B. A child who is having a hip spica cast applied in the morning C. A child who is scheduled for surgery next week D. A child who has been physically abused

B. eliminate pain associated with bowel

For the child with encopresis, mineral oil is often prescribed to: A. facilitate the absorption of fat-soluble vitamins B. eliminate pain associated with bowel movements C. evacuate fecal impactions D. initiate normal gastrocolic reflex

D. Distract him by playing his favorite board game with him

A 7 year old child, who is going to have a puncture later today, tells the nurse, "I'm really nervous about this test". What is the best way to minimize the child's anxiety until time for the procedure? A. Review the lumbar puncture procedure with him B. Give him a relaxation tape to practice C. Read a book to him about being in the hospital D. Distract him by playing his favorite board game with him

B. occurs in the majority of adolescent males

Gynecomastia: A. is always bilateral B. occurs in the majority of adolescent males C. requires surgical intervention D. begins during late adolescence

C. call a poison control center

A 3 year old walks out of the kitchen drinking a bottle of dishwashing liquid. After taking the bottle away from her, the parents should: A. call 911 B. induce vomiting C. call a poison control center D. giver her 4 oz of milk

B. has a ruptured appendix

A 5 year old admitted to rule out appendicitis, tells the nurse, "it doesn't hurt anymore". The nurse suspects the child: A. is afraid of surgery B. has a ruptured appendix C. wants to please the nurse D. cannot accurately communicate about the pain

B. Two hours before the procedure

A 5-year old is scheduled for a computing tomography (CT) scan of her head. What is the best time for her mother to initiate a discussion about the procedure? A. Immediately before the procedure begins B. Two hours before the procedure C. The day before the procedure D. A few days before the procedure

D.a Shigella infection

A 6 year old is admitted to the hospital with severe abdominal pain, bloody diarrhea, high fever, headache, and nuchal rigidity. The child probably has: A. an intussusception B. cirrhosis C. a perforated appendix D.a Shigella infection

D. gather data about what has occurred since the last visit

A 1 year old child is at the pediatrician's office for a well interim visit. When interviewing the parents, the nurse should: A. obtain a complete history from conception to the present B. record information about the child's chief complaint C. obtain a family history D. gather data about what has occurred since the last visit

B. distraction

A 12 year old had abdominal surgery at 10am. She last received her dose of morphine at 5pm. At 8pm, the nurse enters her room and finds her playing a video game. When asked about her pain, the child rates it as a 1 on a 0 to 5 rating scale. In this situation, playing a video game is an example of: A. imagery B. distraction C. play therapy D. obsession

C. "Your wife might want to write down her questions so she won't forget anything when she comes back tomorrow."

A child has been diagnosed with diabetes. The child's father tells the nurse, "My wife will be back in the morning. Before she left, she told me that she has a lot of questions about what to do." What is the most appropriate response for the nurse to make at this time? A. "You will be meeting with the clinical specialist tomorrow. Ask her tomorrow." B. "Did the clinical specialist give you any papers to read? If not, I'll get a pamphlet for you." C. "Your wife might want to write down her questions so she won't forget anything when she comes back tomorrow." D. Why don't you tell me what information you received from the clinical specialist today?"

C. 50

A child weighing 14kg is receiving maintenance IV fluids. How many milliliters per hour the child receive? A. 14 B. 24 C. 50 D. 100

B. guilt

A child who does not successfully complete the developmental task of industry develops a sense of: A. shame and doubt B. guilt C. inferiority D. confusion

A. Face the child when speaking

A child with a hearing impairment needs to have an arm cast. What can the nurse do to facilitate communication with the child throughout the cast application process? A. Face the child when speaking B. Speak at a slower pace than usual C. Talk clearly and directly into the child's ear D. Keep gestures to a minimum

D. all of the above

A child's perception of pain is influenced by the: A. parental response to the child's pain B. child's ethnic background C. child's developmental age D. all of the above

C. " Ill take two Motrin when the pain comes back"

An adolescent has just been diagnosed with an ulcer. Which statement indicates that she requires clarification about her therapeutic regimen? A. "I wont take my ulcer medication and milk of magnesium together" B. "Ill switch to orange soda from cola" C. " Ill take two Motrin when the pain comes back" D. "Ill stay away from cigarette smoke"

D. "So, would you prefer a different room?"

An adolescent tells the nurse, "I don't like this hospital room." An active listening response to this child's statement is: A. "Don't you know this is the best room in the house?" B. "Let me see whether there are any other rooms available" C. "What's wrong with this room?" D. "So, would you prefer a different room?"

A. cheerios

An appropriate "finger food" for an 11 month old infant is: A. cheerios B. lollipops C. popcorn D. raisins

B. is courteous to children, referees, and other coaches

An appropriate coach for a child's basketball team: A. has a win-at-all-costs philosophy B. is courteous to children, referees, and other coaches C. divides the children into teams based on age D. demonstrates all of the above

D. percussion

An assessment technique of the chest and lungs normally reserved for the advanced nursing practitioner is: A. inspection B. auscultation C. palpation D. percussion

A. a short attention span

An example of a "soft" neurologic sign is: A. a short attention span B. left handedness C. non-mirroring movement of the extremities D. none of the above

D. swimming

An example of an activity that develops fine motor skills in the school-age child is: A. rollerblading B. playing the guitar C. playing tag D. swimming

A. proper hand washing technique

An infant has viral gastroenteritis. To prevent its spread to other family members, the nurse teaches the family: A. proper hand washing techniques B. how to administer antidiarrheal medication C. how to administer antibiotics D. how to calculate daily fluid requirements

B. 4 months of age

An infant should turn her eyes and head toward a sound coming from behind her at: A. Birth B. 4 months of age C. 6 months of age D. 10 months of age

B. moderate dehydration

An infant weighed 6.4kg at the pediatrician's office 2 days ago. He has had diarrhea since then. He now weights 5.9kg. His mucous membranes are dry, his fontanel is sunken, and his capillary refill is approximately 5 seconds. The infant has: A. hypotonic dehydration B. moderate dehydration C. hypernatremic dehydration D. severe dehydration

B. metabolic alkalosis

An infant who has been vomiting frequently is at risk for: A. metabolic acidosis B. metabolic alkalosis C. respiratory acidosis D. respiratory alkalosis

B. "He should continue to use the car safety seat"

During a well child checkup, a father asks the nurse whether his 3 year old son, who weighs 31 lbs, can use the car seatbelt instead of the child car safety seat. The nurse's best response is: A. "He's old enough to use a shoulder harness and lap belt" B. "He should continue to use the car safety seat" C. "It's time to switch to a booster seat" D. "He'll be safest in a rear-facing car safety seat"

A. hepatitis A

Careful hand washing before and after patient contact can prevent the spread of: A. hepatitis A B. volvulus C. ulcerative colitis D. all of the above

D. do any of the above

Children at an increased risk for dental caries include those who: A. wear braces B. do not wear mouth protectors during sports activities C. use smokeless tobacco D. do any of the above

C. classify objects into categories

Children in the intuitive thought stage: A. form hypotheses B. are able to reverse their thinking C. classify objects into categories D. exhibit egocentrism

C. increasing the proportion of children older than 2 years who consume at least 30% of their calories from fat

Healthy People 2020 objectives for school-age children include: A. increasing the proportion of children with disabilities who spend at least 40% of their time in regular education programs B. reducing the proportion of children with mental health problems C. increasing the proportion of children older than 2 years who consume at least 30% of their calories from fat D. increasing the proportion of children who receive dental sealants on their molar teeth

D. all of these reasons apply

IV fentanyl is prescribed for a child who is about to have a chest tube placed. Fentanyl is an appropriate analgesic choice for this procedure because: A. it is more potent than meperidine B. it releases less histamine than other analgesics C. it is shorter acting than morphine D. all of these reasons apply

D. all of these

In adolescence, sexual activity is usually related to: A. risk taking B. alcohol and/or substance abuse C. low self esteem D. all of these

C. 3 and 4

In boys, P HV occurs during Tanner stages: A. 1 and 2 B. 2 and 3 C. 3 and 4 D. 4 and 5

A. "restraints may be removed for sleep"

In teaching parents about the use of elbow restraints following the surgical repair of a cleft lip, which statement should the nurse not include? A. "restraints may be removed for sleep" B. "remove the restraints for 10 to 15 minutes every 2 hours" C. "apply the restraints loosely but tight enough to prevent elbow bending" D. "continue to use the restraints for 8 days"

D. thirst and specific gravity of 1.038

Indicators of dehydration in a 4 year old child include: A. a heart rate of 120 beats/min (bpm) and sunken fontanel B. a specific gravity of 1.010 and oliguria C. weight gain and absence of tears D. thirst and specific gravity of 1.038

A. decreased blood pressure

Infants with dehydration must be monitored for signs of impending shock. A late sign in the infant is: A. decreased blood pressure B. elevated heart rate C. change in skin color D. a change in sensorium

D. all of the above

Sex education for the 9 year old should include information about: A. anatomy and physiology B. bodily functions C. what to expect during puberty D. all of the above

C. Meg wonders whether she will get sick too

Ten year old Meg told the school nurse that she is worried about her twin sister, Mary, who is in the hospital. What might increase Meg's stress about this situation? A. Meg's grandparents are helping to care for her at home B. Meg's parents have explained Mary's illness to her C. Meg wonders whether she will get sick too D. Meg plans to call her sister on the phone after school

D. 7 years

The PMI is located at the fifth intercostal space in the midclavicular line after approximately age: A. 2 months B. 18 months C. 3 years D. 7 years

A. behavioral changes

The best indicator of pain in a 15 month old toddler is: A. behavioral changes B. changes in vital signs C. the child's parents' assessment of the child's pain D. the child's verbal response

B. Sequentially organize information

The developmentally appropriate strategy for the nurse to use when performing preoperative teaching with a 10-year-old is to: A. Keep explanations under 5 minutes B. Sequentially organize information C. Use puppets to explain the surgery D. Start preoperative teaching 3 hours before surgery

D. is used to reverse the sedative effects of morphine

The drug Narcan: A. causes respiratory depression in high doses B. is used as an antidote to an ibuprofen overdose C. is a topical anesthetic D. is used to reverse the sedative effects of morphine

B. RLQ

The nurse begins auscultation of the abdomen in the: A. RUQ B. RLQ C. LUQ D. LLQ

C. Assure them that they are not bad parents

The parents of a 3 month old infant with colic explain that because their daughter does not sleep through the night, they feel very frustrated. The nurse's first action is to: A. Provide information about normal sleep-wake cycles in a 3 month old infant B. Suggest that they practice relaxation techniques C. Assure them that they are not bad parents D. Demonstrate how to soothe the infant

D. all of the above

The side effects of opioid analgesics include: A. constipation B. nausea C. sedation D. all of the above

A. Have limited language ability

Toddlers have temper tantrums because they: A. Have limited language ability B. Are not getting enough attention C. Are unable to distinguish right from wrong D. Have poor parent-child attachment

C. explain that children often exhibit regressive behaviors because of the stress of hospitalization

What is the best nursing response to a father who is concerned because his 4 year old daughter has been using the bathroom independently for more than a year now but has had a few "accidents" since she has been hospitalized? A. suggest that he take his daughter to the bathroom more often B. assure him that this behavior will disappear immediately after the discharge C. explain that children often exhibit regressive behaviors because of the stress of hospitalization D. set up a reward system to motivate the child to use the bathroom

D. Ritualism

What provides a toddler with a sense of security? A. Animism B. Egocentrism C. Negativism D. Ritualism

D. a diaphragmatic hernia

When performing a newborn assessment the nurse observes the infant is cyanotic and has nasal flaring and retractions. In addition, no breath sounds can be auscultated on the left side, and an apical pulse is palpated on the right side of the sternum. The nurse immediately notifies the physician because which condition is suspected? A. a teacheoesophageal fistula B. a cleft palate C. pyloric stenosis D. a diaphragmatic hernia

D. All of these indicate readiness for school

Which action indicates that a 5 year old is ready for kindergarten? A. The child can follow three-part instructions B. The child can wait and take turns C. The child is able to independently go to the bathroom D. All of these indicate readiness for school

D. discourage visits from school friends

Which action is not developmentally appropriate for a hospitalized adolescent? A. allow the adolescent to wear her own clothing B. provide privacy when giving treatments C. suggest that the parents bring in her favorite foods D. discourage visits from school friends

B. His mother is expecting a baby in 3 weeks

Which action suggests that a 20 month old should not yet begin toilet training? A. He says "pee-pee" when his diaper is soiled B. His mother is expecting a baby in 3 weeks C. He is able to remove his pants D. He can sit and walk well

B. An 18 month old

Which child is most likely to have difficulty with separation during hospitalization? A. A 3 month old B. An 18 month old C. A 4 year old D. A 7 year old

D. all of the above are appropriate

Which dietary modification is appropriate for GER? A. an infant is given small, frequent, thickened feedings B. a toddler eats solid foods before drinking liquids C. a school-age child avoids colas and chocolates D. all of the above are appropriate

C. Ibuprofen

Which drug is classified as an NSAID? A. Acetaminophen B. Codeine C. Ibuprofen D. Midazolam

D. Talking while the hands are feeling moving

Which example describes how a nurse can display an open body procedure? A. Speaking to a child with head bowed B. Frequently shifting weight from one left to the other while speaking C. Leaning away from the child while talking D. Talking while the hands are feeling moving

A. A 10 month old whose mother crafts stained glass

Which infant is at risk for developing lead toxicity? A. A 10 month old whose mother crafts stained glass B. An 8 month old living in a recently constructed house C. A 9 month old who plays with toys that are made in the United States D. A 6 month old whose 9 month old cousin has lead toxicity

B. monitoring the rectal temperature every four hours for evidence of a fever

Which intervention is not appropriate following surgery for Hirschsprung disease? A. assessing the surgical site for swelling, redness, and drainage B. monitoring the rectal temperature every four hours for evidence of a fever C. reuniting the parents with the child as soon as possible D. keeping the child nothing by mouth (NPO) until bowl sounds return

B. Cerumen is found in the external auditory meatus

Which is a normal finding in a school age child? A. Bone conduction is greater than air conduction B. Cerumen is found in the external auditory meatus C. Discharge is present in the ear canal D. The tympanic membrane is stationary

A. Posterior fontanel is flat and soft in an 8 month old infant

Which is an abnormal finding? A. Posterior fontanel is flat and soft in an 8 month old infant B. A 7 month old sits using hands for support C. Breathing is normal in a 3 month old child D. A 5 year old pupils dilate when focusing on a distant object

B. The nurse asks the adolescent whether she can give her a hug

Which nursing action indicates that the nurse understands the components of effective communication? A. The nurse stands right next to the chair where the child is seated B. The nurse asks the adolescent whether she can give her a hug C. The nurse speaks to a child who is aphonic in a loud, clear voice D. The nurse talks with her arms folded across her chest

A. Follow the child's usual bedtime routine

Which nursing intervention might help the hospitalized toddler feel a sense of security and control? A. Follow the child's usual bedtime routine B. Place the child in a crib with a cover over it C. Tell the child what needs to be done and do not offer choices D. Suggest to the parents that they bring new toys to the child

A. Clonus

Which reflex is elicited by suddenly and briskly dorsiflexing the child's foot and applying moderate pressure? A. Clonus B. Babinski C. Cremasteric D. Patellar

C. Past pain experiences affect how a child experiences pain

Which statement about children and pain and its management is true? A. Children can easily become addicted to opioid analgesics B. Children who are playing are not in pain C. Past pain experiences affect how a child experiences pain D. Children are more likely than adults to experience respiratory depression from narcotics

B. Infants are prone to infectious diseases because of immature immune systems

Which statement about immunity and immunizations is true? A. Breastfed infants do not need immunizations until they are weaned B. Infants are prone to infectious diseases because of immature immune systems C. Transplacental passive immunity lasts through the first year of life D. Immunizations offer the infant total protection against infectious diseases

B. If the serum pH increases above normal, the kidneys conserve hydrogen ions

Which statement about the compensatory mechanisms that maintain a normal serum pH is true? A. if the serum pH increases above normal, the respiratory rate and depth increase B. If the serum pH increases above normal, the kidneys conserve hydrogen ions C. Bicarbonate is a chemical that buffers the ICF D. Respiratory compensatory mechanisms work more slowly than renal mechanisms

C. "We always put our cleaning supplies on the shelves above the sink"

Which statement indicates the parents of a toddler need more information about toddler safety? A. "We always put her in her car safety seat, even if we only drive down the street" B. "We never let her play outside alone" C. "We always put our cleaning supplies on the shelves above the sink" D. "One of use stays with her the entire time she is in the bathtub"

A. "I'll change from breast milk to whole milk at approximately 6 months"

Which statement suggest that the parent needs more information about infant nutrition? A. "I'll change from breast milk to whole milk at approximately 6 months" B. "I'll introduce soft foods at approximately 5 months" C. "I'll add new foods one at a time" D. "I'll gradually introduce drinking from a cup"

B. barium enema

Which test is not typically ordered when GER is suspected? A. fiberoptic endoscopy B. barium enema C. pH studies D. scintigraphy

C. Tanner

Which tool is used to assess sexual maturity? A. Denver Developmental Screening Test II (DDST-II) B. Dubowitx C. Tanner D. Elkind

C. Withdrawn

Which type of behavior would be expected when a child is in the despair stage of separation? A. Agitated B. Playful C. Withdrawn D. Anxious

C. vaccine for H. pylori

Which vaccine is currently being developed but is not yet available? A. vaccine for hepatitis A B. vaccine for rotavirus C. vaccine for H. pylori D. all of these vaccines are currently available

C. explain to the child why he is in the hospital

While a 5 year old is hospitalized for an appendectomy, he tells the nurse that he is in the hospital because he was bad. The nurse should: A. suspect child abuse and report it to the authorities B. question the parents about their discipline methods C. explain to the child why he is in the hospital D. ignore the comment