Exam 1

Ways to integrate spiritual practices into nursing care include: A. Explaining the religious practices you personally take part in B. Realizing that young children have little understanding regarding their spirituality C. Agreeing with children and their families when they explain their religious beliefs so they are not offended D. Becoming knowledgeable about the religious worldviews of cultural groups found in the patients you care for

D. Becoming knowledgeable about the religious worldviews of cultural groups found in the patients you care for

Identify the anatomic changes that occur shortly after birth that affect the newborn's adaptation to extrauterine existence. SATA a. Closure of the foramen ovale b. Closure of the ductus arteriosus c. Increase in pulmonary vascular resistance d. Closure of the ductus venous e. Decrease in pulmonary vascular resistance

a. Closure of the foramen ovale b. Closure of the ductus arteriosus d. Closure of the ductus venous e. Decrease in pulmonary vascular resistance

Which of the following best describes a 4-year-old child's concept of death? a. Death is temporary. b. Death is permanent. c. Death is inevitable at some age. d. Death is personified in various forms.

a. Death is temporary.

Which of the following hormones have the most impact on the development of puberty in females and males? SATA a. FSH b. Insulin c. LH d. Estrogen e. Testosterone

a. FSH c. LH

Which one of the following approaches would be best to use to ensure a receptive response from a toddler? a. Focus communication on the child and tell him or her how a procedure will feel. b. Call the toddler's name while picking up him or her. c. Call the toddler's name and say, "I am your nurse." d. Stand by the toddler, addressing him or her by name.

a. Focus communication on the child and tell him or her how a procedure will feel.

A couple has given birth to their first child, a boy with a recessive disorder. The genetic counselor tells them that the risk of recurrence is one in four. Which of the following statements is a correct interpretation of this information? a. The risk factor remains the same for each pregnancy. b. The risk factor will change when they have a second child. c. Because the parents have one affected child, the next three children should be unaffected. d. Because the parents have one affected child, the next child is four times more likely to be affected.

a. The risk factor remains the same for each pregnancy.

Which of the following statements is true concerning folk remedies? a. They may be used to reinforce the treatment plan. b. They are incompatible with modern medical regimens. c. They are a leading cause of death in some cultural groups. d. They are not a part of the culture in large, developed countries.

a. They may be used to reinforce the treatment plan.

A healthy infant is born to a mother with known high risk behaviors whose HIV status is undetermined. The mother states that she wishes to breastfeed her infant. The nurse's response to the mother's request should be based on which of the following information? a. HIV is rarely transmitted to the newborn through maternal milk b. Breastfeeding should be withheld until HIV (maternal) is determined c. Breastfeeding should be avoided completely in mothers with high risk factors d. In such infants antiretroviral medication should be started within 12 hours of birth

b. Breastfeeding should be withheld until HIV (maternal) is determined

An adolescent girl dies in the emergency department after a car accident. Her family arrives at the hospital shortly after the death. They request to see her body. Because she is disfigured from the accident, the most appropriate nursing action is which of the following? a. Contact a clergyperson to discuss this problem with them. b. Explain that their daughter is disfigured and it would be best not to see her. c. Encourage them to wait for viewing until the funeral home has prepared her body. d. Inform them of what to expect and then let them see their daughter.

d. Inform them of what to expect and then let them see their daughter.

What do morbidity rates measure? a. Life span statistics b. Acute illness, chronic disease, or disability c. Cost-effective treatment for the general population d. Prevalence of a specific illness in a population

d. Prevalence of a specific illness in a population

Which of the following findings would the nurse consider normal in assessing the anterior fontanel of a neonate? a. Closed anterior fontanel b. Sunken anterior fontanel c. Bulging anterior fontanel d. Pulsating anterior fontanel

d. Pulsating anterior fontanel

The parent of a 10-week-old infant tells the nurse, "She cries sometimes when nothing is wrong—for example, when she is dry and has recently been fed." The most appropriate nursing intervention is which of the following? a. Reassure the parent that nothing is wrong. b. Explain how to better interpret infant cues. c. Evaluate for failure of the parent to bond with the infant. d. Reassure the parent that periods of "unexplained fussiness" are normal.

d. Reassure the parent that periods of "unexplained fussiness" are normal.

Which of the following statements explains why it can be difficult to assess a child's dietary intake? a. No systematic assessment tool has been developed. b. Biochemical analysis for assessing nutrition is expensive. c. Families usually do not understand much about nutrition. d. Recall of food consumption is frequently unreliable.

d. Recall of food consumption is frequently unreliable.

A toddler's parent asks the nurse for suggestions on dealing with temper tantrums. Which one of the following is the most appropriate recommendation? a. Punish the child. b. Explain to the child why the tantrum is wrong. c. Leave the child alone until the tantrum is over. d. Remain close by the child but ignore the behaviors.

d. Remain close by the child but ignore the behaviors.

In the newborn, intramuscular vitamin K is administered into which muscle? a. Deltoid b. Dorsogluteal c. Rectus femoris d. Vastus lateralis

d. Vastus lateralis

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

d. commercial iron-fortified formula.

A family you are caring for on the Pediatric unit asks you about nutrition for their baby. What facts will you want to include in this nutritional information? SATA a. Breastfeeding provides micronutrients and immunologic properties b. Eating preferences and attitudes related to food are established by family influences and culture c. Most children establish lifelong eating habits by age 18 months d. During adolescence, parental influence diminishes and adolescents make food choices related to peer acceptability and sociability e. Due to the stress of returning to work, most mothers use this as a time to stop breastfeeding

a. b. d.

Preschoolers' fears can best be dealt with by which of the following interventions? a. Actively involving them in finding practical methods to deal with the frightening experience b. Forcing them to confront the frightening object or experience in the presence of their parents c. Using logical persuasion to explain away their fears and help them recognize how unrealistic the fears are d. Ridiculing their fears so that they understand that there is no need to be afraid

a. Actively involving them in finding practical methods to deal with the frightening experience

These general approaches can be helpful when performing a physical exam. Select all that apply. a. With toddlers, restraint may be necessary, and requesting a parent's assistance is appropriate. b. When examining a preschooler, giving a choice of which parts to examine may be helpful in gaining the child's cooperation. c. With a school-age child, it is always best to have the parents present when examining. d. Giving explanations about body systems can make adolescents nervous due to their egocentricities. e. An infant physical exam is done head to toe, similarly to the adult.

a. With toddlers, restraint may be necessary, and requesting a parent's assistance is appropriate. b. When examining a preschooler, giving a choice of which parts to examine may be helpful in gaining the child's cooperation.

Bullying can be common during the school-age years. The nurse should recognize that bullying a. can have a lasting effect on children. b. is not a significant threat to self-concept. c. is rarely based on anything that is concrete. d. is usually ignored by the child who is being teased.

a. can have a lasting effect on children.

It is important to consider the child's developmental understanding of death when working with that child. Which option is the preschool child's developmental stage? a. children of this age believe their thoughts are sufficient to cause death b. They are still very much influenced by remnants of magical thinking and are subject to feelings of guilt and shame c. They have a deeper understanding of death in a concrete sense d. They can perceive the events only in terms of their own frame of reference; living

a. children of this age believe their thoughts are sufficient to cause death

Nonpharmacologic strategies for pain management a. may reduce pain perception. b. make pharmacologic strategies unnecessary. c. usually take too long to implement. d. trick children into believing they do not have pain.

a. may reduce pain perception.

Physiologic measurements in children's pain assessment are a. not useful as the sole indicator for pain. b. the best indicator of pain in children of all ages. c. of most value when children also report having pain. d. essential to determine whether a child is telling the truth about pain.

a. not useful as the sole indicator for pain.

The nurse is beginning to administer the Denver II to a small child when his mother asks, "Can you tell me again what this Denver II is?" The nurse's best response is which of the following? a. "It's a simple intelligence test for young children." b. "It tells us what a child can do at a particular age." c. "It's a test we give to measure a child's development." d. "It's an excellent way to see if a child's development is normal."

b. "It tells us what a child can do at a particular age."

As the nurse is getting Nathan ready for surgery, his doctor asked you to explain preemptive analgesic to Nathan's mother. Which response leads you to believe his mother needs more teaching? a. "I understand that preemptive analgesia is giving Nathan pain medication before he has pain and could be given before surgery." b. "This medication will control Nathan's pain so he doesn't feel anything." c. "Giving this medicine early may help prevent complications after surgery." d. "By controlling Nathan's pain, he will be more comfortable and may be able to go home sooner."

b. "This medication will control Nathan's pain so he doesn't feel anything."

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

b. 3 to 4 months

When taking a child's blood pressure, the nurse should select a cuff with a bladder width that is large enough to cover what percentage of the upper arm? a. 20% b. 40% c. 60% d. 80%

b. 40%

The nurse is assessing a 6-month-old healthy infant who weighed 3.2 kg at birth. The nurse should expect the infant to now weigh approximately how many kilograms? a. 5.2 b. 6.3 c. 8.7 d. 9.6

b. 6.3

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

b. Actively searches for a hidden object

Home care is being considered for a young child who is ventilator dependent. Which of the following factors is most important in deciding whether home care is appropriate? a. Level of education of parents b. Adequate family training c. Presence of two parents in the home d. Family's ability to assume all health care costs

b. Adequate family training

Chromosome analysis of the fetus is usually accomplished through the testing of which of the following? a. Fetal serum b. Amniotic fluid c. Maternal urine d. Maternal serum

b. Amniotic fluid

Which of the following is descriptive of a preschooler's concept of time? a. Has no understanding of time b. Associates time with events c. Can tell time on a clock d. Uses terms such as "yesterday" appropriately

b. Associates time with events

Which of the following reflexes appear at about 7 to 9 months of age? a. Moro b. Parachute c. Neck righting d. Labyrinth righting

b. Parachute

An important nutritional supplement recommended to prevent rickets in infants who are exclusively breastfeeding is a. Vitamin A b. Fluoride c. Vitamin D d. Folic acid

c. Vitamin D

A parent has a 2-year-old child in the clinic for a well-child checkup. Which of the following statements by the parent would indicate to the nurse that the parent needs more instruction regarding accident prevention? a. "We locked all the medicines in the bathroom cabinet." b. "We turned the thermostat down on our hot water heater." c. "We placed gates at the top and bottom of the basement steps." d. "We stopped using the car seat now that our child is older."

d. "We stopped using the car seat now that our child is older."

A family wants to begin oral feeding of their 4-year-old son, who is ventilator dependent and currently tube fed. They ask the home health nurse to feed him the baby food orally. The nurse recognizes a high risk of aspiration and an already compromised respiratory status. The most appropriate nursing action is which of the following? a. Refuse to feed the child orally because the risk is too high. b. Explain the risks involved and then let the family decide what should be done. c. Feed the child orally because the family has the right to make this decision for him. d. Acknowledge their request, explain the risks, and explore with the family the available options.

d. Acknowledge their request, explain the risks, and explore with the family the available options.

When caring for their infant, a parent asks you is Emily in a lot of pain? How would you know since she can't really tell you? The best answer to this question is a. Infants don't feel pain as we do because their pain receptors are not fully developed yet b. The nurse gives pain medication before she really feels the pain c. We assess her pain using an infant pain assessment tool and give the medicine as needed. d. Although we try to give her medicine before she feels pain, we watch her very closely and use different techniques to help relieve the pain

d. Although we try to give her medicine before she feels pain, we watch her very closely and use different techniques to help relieve the pain

The home health nurse is caring for a child who requires complex care. The family expresses frustration related to obtaining accurate information about their child's illness and its management. Which of the following is the best action for the nurse? a. Determine why the family is easily frustrated. b. Refer the family to the child's primary care practitioner. c. Provide the information the family requests, being confident that every question can be answered by the nurse. d. Answer questions in a straightforward manner and get professional assistance when an answer is unknown.

d. Answer questions in a straightforward manner and get professional assistance when an answer is unknown.

When parents consider genetic testing, especially after having a child born with an anomaly, which information could the nurse use to further instruct the family? Select all that apply. A. Genetic screening can provide early recognition of a disease, before signs and symptoms occur, for which effective intervention and therapy exists. B. Screening can occur at different times in a person's life: preconceptual, newborn screening, or maternal screening after delivery, depending on the circumstances. C. Genetic testing can help identify carriers of a genetic disease for the purpose of maximizing parenthood planning options. D. A thorough history by the nurse will include the parents' siblings, the parents, and the grandparents. E. Recognizing a genetic disorder can further facilitate a genetic evaluation by collecting pregnancy, labor and delivery, perinatal, medical, and developmental histories.

A. Genetic screening can provide early recognition of a disease, before signs and symptoms occur, for which effective intervention and therapy exists. B. Screening can occur at different times in a person's life: preconceptual, newborn screening, or maternal screening after delivery, depending on the circumstances. C. Genetic testing can help identify carriers of a genetic disease for the purpose of maximizing parenthood planning options. E. Recognizing a genetic disorder can further facilitate a genetic evaluation by collecting pregnancy, labor and delivery, perinatal, medical, and developmental histories.

At the clinic appointment, a 4-year-old's mother wants to discuss several concerns. Which statements require more teaching by the nurse? Select all that apply. A. My husband feels that TV is okay as long as it is educational. B. I think it is okay for my son to play dress-up along with the girls. C. I told my son that his imaginary playmate moved away because it did not seem normal. D. My mother-in-law thinks I should be working around the house all the time, but I believe playing with my son is very important. E. My neighbor gave me some flash cards with letters and numbers for my son to use, but I said, "What's the rush? He's only 4."

A. My husband feels that TV is okay as long as it is educational. C. I told my son that his imaginary playmate moved away because it did not seem normal. E. My neighbor gave me some flash cards with letters and numbers for my son to use, but I said, "What's the rush? He's only 4."

A nurse looks over her assignment for the day that includes an infant, a preschool-age child, a third-grader, and a sophomore in high school. Which techniques take into consideration developmental stages when working with pediatric patients? A Being aware that infants will become agitated due to stranger anxiety around age 4 months B When a preschooler is getting blood drawn, giving a detailed explanation will be helpful C Explaining and demonstrating what the blood pressure machine does to the third-grader before taking her blood pressure D Using a single consistent approach with the adolescent will help allay anger and hostility

C Explaining and demonstrating what the blood pressure machine does to the third-grader before taking her blood pressure

A 3-year-old child is being admitted for about 1 week of hospitalization. Her parents tell the nurse that they are going to buy her "a lot of new toys because she will be in the hospital." The nurse's reply should be based on an understanding of which of the following? a. New toys make hospitalization easier. b. New toys are usually better than older ones for children of this age. c. At this age, children often need the comfort and reassurance of familiar toys from home. d. Buying new toys for a hospitalized child is a maladaptive way to cope with parental guilt.

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A 6-year-old child needs to be hospitalized again because of a chronic illness. The clinic nurse overhears her school-age siblings tell her that they are "sick of Mom always sitting with her in the hospital and playing with her. . . . It isn't fair that you get everything and we have to stay with the neighbors." Which of the following is the nurse's best assessment of this situation? a. The siblings are immature and probably spoiled. b. The siblings need to better understand their sister's illness and needs. c. Jealousy and resentment are common reactions to the illness and hospitalization of a sibling. d. The family has ineffective coping mechanisms to deal with chronic illness.

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A common initial reaction of parents to illness or injury and hospitalization in their child is which of the following? a. Relief b. Anger c. Frustration d. Depression

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A young woman who has recently become engaged to be married asks the nurse when genetic counseling is advisable. The couple does not plan to have children for several years. Which of the following should be the nurse's recommendation? a. As soon as the woman suspects that she may be pregnant b. Whenever the couple is ready to start their family c. Now if one of them has a family history of congenital heart disease d. Now if they are members of a population at risk for certain diseases

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An appropriate nursing intervention to minimize separation anxiety in a hospitalized toddler would be which of the following? a. Provide for privacy. b. Encourage parents to room-in. c. Explain procedures and routines. d. Encourage contact with children of the same age.

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Elevation of triple marker screening results indicates the need for which of the following? a. Termination of pregnancy b. Further diagnostic testing c. Repeating the triple marker screening test d. Counseling to prepare for the birth of a child with a defect

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The nurse working in an outpatient surgery center for children should understand that a. children's anxiety is minimal in such a center. b. waiting is not stressful for parents in such a center. c. families need to be prepared for what to expect after discharge. d. accurate and complete discharge teaching is the responsibility of the surgeon.

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Trisomy 13, trisomy 18, and trisomy 21 have which of the following in common? a. Viability is rare. b. They are considered deletion syndromes. c. The diagnosis is difficult, time consuming, and expensive. d. The diagnosis can be made early based on physical characteristics.

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Which of the following is usually the greatest threat to a hospitalized adolescent? a. Fear of pain b. Fear of altered body image c. Restricted motor activity d. Separation from home and family

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Which of the following represents the major stressor of hospitalization for children from middle infancy throughout the preschool years? a. Fear of pain b. Loss of control c. Separation anxiety d. Fear of bodily injury

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Which of the following statements best represents the risk of recurrence in autosomal dominant inheritance? a. Unaffected children of affected individuals will have affected children. b. Each child of a heterozygous affected parent has a 50% chance of inheriting the mutated allele. c. Males are affected with greater frequency than females. d. Any child of two unaffected heterozygous parents has a 25% chance of being affected.

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The nurse may be called upon to have knowledge about sex chromosome aneuploidies. In answering families' questions, the nurse can report: A. "Some of the most common genetic disorders caused by sex chromosome aneuploidies are Klinefelter, XXY, triple X female, and Turner syndromes." B. "Klinefelter's syndrome is the most common of all sex chromosome aneuploidies, and mental development is normal in most cases." C. "Triple X females have premature menarche and delayed menopause." D. "Turner's syndrome girls have a prepubertal growth spurt and then mostly stop growing."

B. "Klinefelter's syndrome is the most common of all sex chromosome aneuploidies, and mental development is normal in most cases."

The typical play activity in which toddlers engage is called: A. Solitary B. Parallel C. Associative D. Cooperative

B. Parallel

When her preschool son is in the hospital, the parent tells the nurse, "I think there is something wrong with him because he is so skinny." The most appropriate answer by the nurse is: A. Most preschoolers weigh between 10 and 14 kilograms. B. The legs of a preschooler, rather than the trunk, increase in length, which may make him look slimmer. C. Preschoolers usually keep that pot-bellied appearance until about 4 years old. D. Most preschoolers gain 2 to 3 pounds per year.

B. The legs of a preschooler, rather than the trunk, increase in length, which may make him look slimmer.

One of the concerns of the preschool period is adequate nutrition. What can the nurse say to give anticipatory guidance to parents? A. Preschoolers are growing during this period and need to increase their caloric intake to 110 kcal/kg, for an average daily intake of 2200 calories. B. There is some evidence that children self-regulate their caloric intake. If they eat less at one meal, they compensate at another meal or snack. C. To monitor fat intake, dairy and meat should be limited to twice a day. D. For children who do not like milk, consumption of fruit juices is a healthy alternative.

B. There is some evidence that children self-regulate their caloric intake. If they eat less at one meal, they compensate at another meal or snack.

Growth measurement is a key element in children of their health status. One measurement for height is linear growth measurement. What should the nurse do to perfect this technique? Select all that apply. A Understand the difference in measurement for children who can stand alone and for those who must lie recumbent. B Use a length board and footboard or a standiometer, which is the best technique, or use a tape measure. C Two measurers are usually required for a recumbent child, although one measurer may be sufficient for a cooperative child. D Reposition the child and repeat the procedure. Measure at least twice (ideally three times). Average the measurements for the final value. E Demonstrate competency when measuring the growth of infants, children, and adolescents. Refresher sessions should be taken when a lack of standardization occurs.

A Understand the difference in measurement for children who can stand alone and for those who must lie recumbent. D Reposition the child and repeat the procedure. Measure at least twice (ideally three times). Average the measurements for the final value. E Demonstrate competency when measuring the growth of infants, children, and adolescents. Refresher sessions should be taken when a lack of standardization occurs.

A school nurse in middle school (grades 6, 7, and 8) is preparing an outline for a sex education class. Which of these statements represent important concepts to be covered in discussing this topic with this age group? Select all that apply. A. Consider separating the boys and girls into same-sex groups with a leader of the same sex. B. Answer questions matter-of-factly and honestly and appropriate to the children's level of understanding. C. Use vernacular or slang terms to describe human physiologic functions. D. Avoid discussing sexually transmitted diseases in this age group. E. Discuss common myths and misconceptions associated with sex and the reproductive process. F. Avoid controversial topics such as birth control.

A. Consider separating the boys and girls into same-sex groups with a leader of the same sex. B. Answer questions matter-of-factly and honestly and appropriate to the children's level of understanding. E. Discuss common myths and misconceptions associated with sex and the reproductive process.

You tell the parent of a 4-year-old patient being admitted that you need to ask some questions. She asks, "Why do you have to ask so many questions?" Which explanations should you offer? Select all that apply. a. "It is something we are required to do for every child who is hospitalized." b. "By learning about your child's routines, we can try to minimize some of the changes he will be going through." c. "Knowing more about your child can help predict how the hospital stay will go and will also help us choose a good roommate for him when more children arrive at the hospital." d. "Gaining more information about your child, such as current medications she is taking, will help us provide the best care." e. "This will give you an opportunity to ask questions as well."

a. "It is something we are required to do for every child who is hospitalized." b. "By learning about your child's routines, we can try to minimize some of the changes he will be going through." e. "This will give you an opportunity to ask questions as well."

Toddlers are often known to be finicky eaters and may exhibit abnormal eating patterns that may concern parents. Which of the following actions for feeding toddlers should be suggested so adequate amounts of nutrients for growth and development are consumed? (Select all that apply) a. Avoid placing large amounts of food portions on the toddlers plate. b. Allow the child to graze on nutritious (not "junk" food) snacks during the day c. Insist that the child sit at the table until all persons have completed their meals. d. Allow the child to make certain food choices (with reasonable limits)- for example, would you like a half peanut butter or ham sandwich? e. Provide meals at the same time of day as much as possible so the toddler has a sense of consistency f. Make the child eat all of the food provided, and provide disciplinary actions such as a "time out" if the plate is not cleaned

a. Avoid placing large amounts of food portions on the toddlers plate. b. Allow the child to graze on nutritious (not "junk" food) snacks during the day d. Allow the child to make certain food choices (with reasonable limits)- for example, would you like a half peanut butter or ham sandwich? e. Provide meals at the same time of day as much as possible so the toddler has a sense of consistency

The nurse is providing support to a family who is experiencing anticipatory grief related to their child's imminent death. Which of the following is an appropriate nursing intervention? a. Be available to the family. b. Attempt to "lighten the mood." c. Suggest activities to cheer up the family. d. Discourage crying until the actual time of death.

a. Be available to the family.

In terms of social development, the school age child does which of the following? SATA a. Begins to explore the environment beyond the family b. Has an increased interest in persons of the opposite sex c. May actively participate in same sex groups or clubs d. Strives to be different from those in the peer group e. Begins to form strong relationships with persons of the same sex

a. Begins to explore the environment beyond the family c. May actively participate in same sex groups or clubs e. Begins to form strong relationships with persons of the same sex

One indication that the toddler is ready to begin toilet training is a. Child recognizes urge to let go and hold on and is able to communicate this sensation to the parent b. Child is able to stay dry all night c. Child demonstrates mastery of dressing and undressing self d. Child asks parent to have wet or soiled diaper changed

a. Child recognizes urge to let go and hold on and is able to communicate this sensation to the parent

An 18-month-old child has just been admitted with croup. His parent is tearful and tells the nurse, "This is all my fault. I should have taken him to the doctor sooner so he wouldn't have to be here." Which of the following is appropriate in the care plan for this parent? a. Clarify misconception about the illness. b. Explain to the parent that the illness is not serious. c. Encourage the parent to maintain a sense of control. d. Assess further why the parent has excessive guilt feelings.

a. Clarify misconception about the illness.

The home health nurse is planning care for a 3-year-old boy who has Down syndrome and is on continuous oxygen. He recently began walking around furniture. He is spoon fed by his parents and eats some finger foods. Which of the following is the most appropriate goal to promote normal development? a. Encourage mobility. b. Encourage assistance in self-care. c. Promote oral-motor development. d. Provide opportunities for socialization.

a. Encourage mobility.

The American Academy of Pediatrics recommends that the best form of infant nutrition is what? a. Exclusive breastfeeding until 1 year of age b. Exclusive breastfeeding until 6 months of age c. Commercially prepared infant formula until 1 year of age d. Commercially prepared infant formula until 4 to 6 months of age

a. Exclusive breastfeeding until 1 year of age

Currently, the fastest-growing segment of the homeless population in the United States consists of which of the following? a. Families b. "Runaway" adolescents c. Migrant farm workers d. Individuals with mental disorders

a. Families

Where would nonpathologic cyanosis normally be present in the newborn shortly after birth? a. Feet and hands b. Bridge of nose c. Circumoral area d. Mucous membranes

a. Feet and hands

Which statement characterizes toddlers' eating behavior? a. Food fads are common. b. They have increased appetite. c. They have few food preferences. d. Their table manners are predictable.

a. Food fads are common.

The nurse is caring for a child who has just died. The parents ask to be left alone so that they can rock their child one more time. Which of the following should the nurse do? a. Grant their request. b. Assess why they think this is necessary. c. Discourage this because it will only prolong their grief. d. Kindly explain that they need to say good-bye to their child now and leave.

a. Grant their request.

The nurse is guiding parents in selecting a daycare facility for their child. Which of the following is especially important to consider when making the selection? a. Health practices of the facility b. Structured learning environment c. Socioeconomic status of the children d. Cultural similarities of the children

a. Health practices of the facility

The newest nurse on the Pediatric unit is concerned about maintaining a professional distance in her relationship with a patient and the patient's family. Which comment indicates that she needs more mentoring regarding her patient-nurse relationship? a. I realize that caring for the child means I can visit them on my days off if they ask me b. When the mother asks if I will care for her daughter every day, I explain that the assignments change based on the needs of the unit c. When the mother asks me questions about my family, I answer politely, but I offer only pertinent information d. I engage in multidisciplinary rounds and listen to the family's concerns

a. I realize that caring for the child means I can visit them on my days off if they ask me

When working with a new nurse on the pediatric oncology unit, the nurse should recognize that the new nurse needs further teaching about understanding the family's needs and coming to terms with her own feelings about a dying child when she says which of the following? SATA a. I understand that when a child dies, it is God's will and I can help the parents with spiritual support b. I realize that I need some therapeutic ways to relieve my stress when I deal with these terminally ill children c. I believe that parents are too emotionally distressed to make these decisions alone and should consult their extended family d. I should be able to explain my thoughts and feelings to the parents as a sounding board for them to make decisions e. The multidisciplinary team should be involved to look at all aspects for the family of the dying child

a. I understand that when a child dies, it is God's will and I can help the parents with spiritual support c. I believe that parents are too emotionally distressed to make these decisions alone and should consult their extended family d. I should be able to explain my thoughts and feelings to the parents as a sounding board for them to make decisions

Which of the following are the primary causes of mortality among adolescents in the United States? SATA a. Injuries b. Suicide c. Congenital anomalies d. Homicide e. Chronic illness

a. Injuries b. Suicide d. Homicide

The nurse has a 2-year-old boy sit in "tailor" position while palpating for the presence of the testes. What is the rationale for this position? a. It prevents the cremasteric reflex. b. Undescended testes can be palpated. c. The child has an inguinal hernia. d. The child does not yet have a need for privacy.

a. It prevents the cremasteric reflex.

When assessing blood pressure in a child: a. Knowledge of normal mean is important: newborn 65/41; 1 month to 2 years, 95/58; and 2 to 5 years, 101/57 b. Cuff size is the most important variable and should be measured using limb length c. The child is considered normotensive if the blood pressure is below the 95th percentile d. Check upper and lower extremity blood pressure to look for abnormalities such as aortic stenosis, which causes lower extremity blood pressure to be higher than upper

a. Knowledge of normal mean is important: newborn 65/41; 1 month to 2 years, 95/58; and 2 to 5 years, 101/57

When working with a child with a disability, one of the most important tasks is to promote normal development. The nurse has a role in promotion of meeting these developmental milestones. Which tasks related to development are most important to be aware of in hospitalization or illness of the child with a disability? SATA a. Nurses should work with the parents of a newborn to promote attachment in spite of the disability b. It is important that school age children understand that this disruption of their daily activities and hospitalization should not be considered a type of punishement c. One of the more crucial effects of chronic illness or disability on preschoolers is the feeling of guilt that they caused the illness through an imagined or real misdeed d. Nurses should respond to the school age child's questions in a simple, direct manner e. nurses can facilitate the adolescent's striving for autonomy by allowing and encouraging the adolescent's participation in medical decisions

a. Nurses should work with the parents of a newborn to promote attachment in spite of the disability c. One of the more crucial effects of chronic illness or disability on preschoolers is the feeling of guilt that they caused the illness through an imagined or real misdeed d. Nurses should respond to the school age child's questions in a simple, direct manner e. nurses can facilitate the adolescent's striving for autonomy by allowing and encouraging the adolescent's participation in medical decisions

For case management to be most effective, who is the most appropriate case manager? a. One nurse b. A panel of experts c. The insurance company d. A multidisciplinary team

a. One nurse

Which of the following is the most critical physiologic change required of newborns at birth? a. Onset of breathing b. Body temperature maintenance c. Stabilization of fluid and electrolytes d. Closure of fetal shunts in the heart

a. Onset of breathing

The father of a hospitalized child tells the nurse, "He can't have meat. We are Buddhist and vegetarians." What is the nurse's best intervention? a. Order the child a meatless tray as requested. b. Ask a Buddhist priest to visit the family. c. Explain that hospital patients are exempt from dietary rules. d. Help the parent understand that meat provides protein needed for healing.

a. Order the child a meatless tray as requested.

Which of the following factors should a nurse consider when managing the pain of a terminally ill child? SATA a. Pain medications are given on an as needed schedule, and extra doses for breakthrough pain are amiable to maintain comfort b. Opioid drugs such as morphine are given for severe pain, and the dosage is increased as necessary to maintain optimum pain relief c. Addiction is a factor in managing terminal pain in a child, and the nurse plays an important role in educating parents that their child may become addicted d. There is concern that administering dosages of opioids that exceed normal doses will hasten the child's death; in the principle of double effect e. in addition to pain medication, techniques such as music therapy, distraction, and guided imagery should be combined with medications to provide the child and family strategies to control pain

a. Pain medications are given on an as needed schedule, and extra doses for breakthrough pain are amiable to maintain comfort b. Opioid drugs such as morphine are given for severe pain, and the dosage is increased as necessary to maintain optimum pain relief d. There is concern that administering dosages of opioids that exceed normal doses will hasten the child's death; in the principle of double effect e. in addition to pain medication, techniques such as music therapy, distraction, and guided imagery should be combined with medications to provide the child and family strategies to control pain

When preparing parents to teach their children about human sexuality, the nurse should emphasize which of the following? a. Parents should determine exactly what the child knows and wants to know before answering a question about sex. b. A parent's words may have a greater influence on the child's understanding than the parent's actions. c. Parents should avoid using correct anatomic terms because they are confusing to preschoolers. d. Parents should allow children to satisfy their sexual curiosity by "playing doctor."

a. Parents should determine exactly what the child knows and wants to know before answering a question about sex.

School-age children are prone to accidental injury primarily because of a. Peer pressure and risk taking behaviors b. Physical awkwardness and clumsiness c. Parents lack of supervision d. Attempts to impress members of the opposite sex

a. Peer pressure and risk taking behaviors

A common cause of accidental death in children aged 1 to 19 years involves motor vehicle crashes. Evidence from test crashes indicates that the safest action to prevent accidental deaths in toddlers includes a. Placing the child in a rear facing weight appropriate care restraint seat until age 24 months b. Allowing the child to ride in the front seat with a lap shoulder seat restraint to avoid emotional outbursts c. Allowing the child to ride in a forward facing booster restraint seat after 12 months of age d. Allowing the child in the regular seat using the lap shoulder belt as long as the child weighs at least 45 pounds

a. Placing the child in a rear facing weight appropriate care restraint seat until age 24 months

What nursing intervention is most descriptive of atraumatic care of children? a. Preparing a child before any unfamiliar treatment or procedure b. Preparing a child for separation from parents during hospitalization c. Helping a child accept pain that is associated with a treatment or procedure d. Helping a child accept the loss of control associated with hospitalization

a. Preparing a child before any unfamiliar treatment or procedure

The nurse caring for a preschool child understands which of the following developmental concepts? SATA a. Preschoolers have egocentric thought and believe that everyone thinks as they do b. Play can be therapeutic and enlightening into a child's level of understanding c. Explanations are helpful when using detail to allay the preschooler's stress d. Preschoolers understand inferences and can relate to others' feelings with empathy e. Preschoolers have magical thinking and believe their thoughts have power

a. Preschoolers have egocentric thought and believe that everyone thinks as they do b. Play can be therapeutic and enlightening into a child's level of understanding e. Preschoolers have magical thinking and believe their thoughts have power

One of the key factors in addressing the health concerns and needs of the adolescent in a clinic or primary care office setting is to a. Provide confidentiality b. Include the parents in a discussion about the adolescent's sexual health c. Ask the adolescent if she or he is sexually active d. Discuss the negative effects of tobacco use

a. Provide confidentiality

Play is children's work, even in the hospital. Which of the following are functions of play? Select all that apply. a. Provides diversion and brings about relaxation b. Keeps the child occupied and directs concerns away from himself or herself c. Helps the child feel more secure in a strange environment d. Lessens the stress of separation and the feeling of homesickness e. Provides a means for release of tension and expression of feelings f. Allows the parents to have a break from the unit for a respite period

a. Provides diversion and brings about relaxation c. Helps the child feel more secure in a strange environment d. Lessens the stress of separation and the feeling of homesickness e. Provides a means for release of tension and expression of feelings

When a preschool child is hospitalized without adequate preparation, the nurse should recognize that the child may likely see hospitalization as which of the following? a. Punishment b. Loss of parental love c. Threat to child's self-image d. Loss of companionship with friends

a. Punishment

Which of the following is characteristic of a neonate's vision? a. Pupils react to light. b. Tear glands function. c. Blink reflex is absent. d. Ciliary muscles are mature.

a. Pupils react to light.

Which of the following is descriptive of toddlers' cognitive development at age 20 months? a. Realize that "out of sight" is not out of reach. b. Search for an object only if they see it hidden. c. Put objects into a container but cannot take them out. d. Understand the passage of time, such as "just a minute" and "in an

a. Realize that "out of sight" is not out of reach.

Which of the following are principles of palliative care? SATA a. Seek to relieve the physical, emotional, social, and spiritual distress produced by life limiting conditions; to assist in complex decision making; and to enhance the quality of life b. Establish a goal of care on which the health care team can work together to achieve, and rarely stray from that goal c. Establish goals of care that address the physical, emotional, social, and spiritual distress experienced by patients and their families d. Show expertise and clinical education in the principles of making the transition with children from curative to palliative care or methods of adequately managing children's and families pain and suffering during the dying process e. Evaluate suffering and the impact of the goals of care because nurses spend much more time with patients and their families compared to other medical team members

a. Seek to relieve the physical, emotional, social, and spiritual distress produced by life limiting conditions; to assist in complex decision making; and to enhance the quality of life c. Establish goals of care that address the physical, emotional, social, and spiritual distress experienced by patients and their families e. Evaluate suffering and the impact of the goals of care because nurses spend much more time with patients and their families compared to other medical team members

The type of play in which infants engage is called? a. Solitary b. Parallel c. Associative d. Cooperative

a. Solitary

Which of the following is most suggestive that a nurse has a nontherapeutic relationship with a patient or family? a. Staff members are concerned about the nurse's actions with the patient or family. b. Staff assignments allow the nurse to care for the same patient or family over an extended time. c. The nurse uses teaching skills to instruct the patient or family rather than doing everything for them. d. The nurse is able to withdraw emotionally when emotional overload occurs but still remain committed.

a. Staff members are concerned about the nurse's actions with the patient or family.

Which of the following genetic terms refers to a recognized pattern of malformations with a single specific cause? a. Syndrome b. Polygenic c. Aberration d. Association

a. Syndrome

A cure is no longer possible for a young child with cancer. The nursing staff recognizes that the goal of treatment must shift from cure to palliation. Which of the following is an important consideration at this time? a. The family is included in the decision to shift the goals of treatment. b. The family needs to understand that palliative care takes place in the home. c. The decision must be made by the health professionals involved in the child's care. d. The decision should not be communicated to the family because it will encourage a sense of hopelessness.

a. The family is included in the decision to shift the goals of treatment.

When discharging the pediatric patient from the outpatient setting, the nurse knows which of the following responses indicate a need for more teaching? SATA a. The physician said my son can have clear liquids when we return home, which would include jello, pudding, and apple juice b. The other nurse explained that I can use other things to help with the pain, such as distraction after the pain medication is given c. I can get my child's prescription tomorrow, so I can go to my regular pharmacy where they can explain the medication to me d. I am waiting for my husband to come so he can drive us and I can watch my son in the care on the way home e. I understand that I will be contacted tomorrow for follow up on my child but that I should not hesitate to call if i have any concerns before then

a. The physician said my son can have clear liquids when we return home, which would include jello, pudding, and apple juice c. I can get my child's prescription tomorrow, so I can go to my regular pharmacy where they can explain the medication to me

The nurse is talking with the parents of a child who died 6 months ago. They sometimes still "hear" the child's voice and have trouble sleeping. They describe feeling empty and depressed. The nurse should recognize which of the following? a. These are normal grief responses. b. The pain of the loss is usually less by this time. c. These grief responses are more typical of the early stages of grief. d. This grieving is essential until the pain is gone and the child is gradually forgotten.

a. These are normal grief responses.

Which of the following is descriptive of nursing diagnoses? a. They provide the basis for the selection of nursing interventions. b. They should describe everything for which nursing is responsible. c. The cause of the problem must be identified before a nursing diagnosis can be made. d. The cause of the problem implies a cause-and-effect relationship in the nursing diagnosis

a. They provide the basis for the selection of nursing interventions.

The nurses caring for a child are concerned about the child's frequent requests for pain medication. During a team conference, a nurse suggests they consider administering a placebo instead of the usual pain medication. The decision should be based on knowledge of which of the following? a. This practice is unjustified and unethical. b. This practice is effective to determine whether a child's pain is real. c. The absence of a response to a placebo means the child's pain has an organic basis. d. A positive response to a placebo will not occur if the child's pain has an organic basis.

a. This practice is unjustified and unethical.

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

a. Transfer objects from one hand to the other.

According to Erikson, infancy is concerned with acquiring a sense of which of the following? a. Trust b. Industry c. Initiative d. Autonomy

a. Trust

Caring for a child with a developmental disability or chronic illness is best accomplished using a team approach. What are some ways the nurse can facilitate this teamwork? SATA a. Understanding as parents become knowledgable about their child's special health needs, they frequently become experts in providing care b. In the absence of the child's family during hospitalization, the nurse should take this opportunity to establish new routines to enhance the child's care c. Although the families of the child with a disability are well used int he care of their child at home, it is unrealistic to ask parents to take part in the hospitalized care d. The best predictors of the well being of children with special health needs include how well the child can function in the presence of the health care team e. The nurse's role in collaborating, informing, and encouraging an open relationship with the family while caring for the child in the hospital

a. Understanding as parents become knowledgable about their child's special health needs, they frequently become experts in providing care e. The nurse's role in collaborating, informing, and encouraging an open relationship with the family while caring for the child in the hospital

A hallmark of cognitive development in the school age child is in what Piaget describes as concrete operations. In this stage the child. a. Uses thought processes to experience events and actions b. Is unable to see things from another's point of view c. Has a limited perspective of how others' interpretations of a given event differ d. Makes judgments based on what he or she sees

a. Uses thought processes to experience events and actions

In the newly born infant thermogenesis is achieved by a. Shivering b. Brown fat metabolism c. Overhead warming unit d. Skin to skin contact with mother

b. Brown fat metabolism

Kimberly is having a checkup before starting kindergarten. The nurse asks her to do the "finger-to-nose test." The nurse is testing for which of the following? a. Deep tendon reflexes b. Cerebellar function c. Sensory discrimination d. Ability to follow directions

b. Cerebellar function

The nurse is caring for a child dying from cancer. The parents ask how they will know that the child is approaching death. The nurse's answer should include which of the following? a. Rapid pulse b. Change in respiratory pattern c. Sensation of cold although body feels hot d. Loss of hearing followed by loss of other senses

b. Change in respiratory pattern

The nurse is taking a health history on a child. At the beginning of the interview, a parent says, "I brought him here because he always has diarrhea." This should be recorded under which of the following headings? a. History b. Chief complaint c. Review of systems d. Nutritional assessment

b. Chief complaint

Mandatory requests for organ and tissue donation have been instituted in several states. The nurse recognizes that which of the following children would most likely be acceptable as a transplant donor? a. Infant with sepsis b. Child who died from a motor vehicle collision c. Adolescent with leukemia d. Child who had prolonged cardiac arrest

b. Child who died from a motor vehicle collision

When teaching the adolescent about the management of acne, the nurse should include which of the following interventions? a. Clean face with an antibacterial soap twice a day. b. Clean face gently with a mild soap once or twice a day. c. Avoid foods with a high fat content such as French fries and chocolate. d. Express comedones by gentle squeezing them followed by cleansing with alcohol.

b. Clean face gently with a mild soap once or twice a day.

The nurse is using a bulb syringe to suction a neonate after delivery. Which of the following is an important consideration? a. Compress the bulb after insertion. b. Clear the pharynx before the nasal passages. c. Use two bulb syringes, one for the pharynx and one for the nares. d. Use a bulb syringe until secretions are removed because mechanical suction is contraindicated.

b. Clear the pharynx before the nasal passages.

Culture includes which of the following? SATA a. Cultural competence, which includes building skills in the health care provider, such as offering lists of common foods, health care beliefs, and important rituals b. Cultural humility, which requires that health care providers participate in a continual process of self-reflection and self-critique c. Recognizing the power of the health care provider role that views the patient and family as members of the health care team d. A particular group with its values, beliefs, norms, patterns, and practices that are learned, shared, and transmitted from one generation to another e. A complex whole in which each part is interrelated, including beliefs, tradition, life ways, and heritage

b. Cultural humility, which requires that health care providers participate in a continual process of self-reflection and self-critique c. Recognizing the power of the health care provider role that views the patient and family as members of the health care team d. A particular group with its values, beliefs, norms, patterns, and practices that are learned, shared, and transmitted from one generation to another e. A complex whole in which each part is interrelated, including beliefs, tradition, life ways, and heritage

Which of the following terms best describes a group of people who share a set of values, beliefs, practices, social relationships, laws, politics, economics, and norms of behavior? a. Race b. Culture c. Ethnicity d. Social group

b. Culture

Children with disabilities or chronic illness and their families may have different methods of coping than those of healthy children. Often they have a resilience that is to be admired. Which of these statements reflect ways that they foster this resilience? SATA a. Protect the child form having to learn about his or her disability or illness on a repeated basis b. Develop relationships with other children and their families with similar circumstances to build support c. The parents set long term goal to create a sense of hope d. Focus on the child's strengths and encourage independence e. Accept that chronic illness is part of living

b. Develop relationships with other children and their families with similar circumstances to build support d. Focus on the child's strengths and encourage independence e. Accept that chronic illness is part of living

When the nurse interviews an adolescent, which of the following is especially important? a. Focus the discussion on the peer group. b. Display a genuine interest in the adolescent. c. Emphasize that confidentiality will always be maintained. d. Use the same type of language as the adolescent.

b. Display a genuine interest in the adolescent.

The overriding goal of atraumatic care is: a. Prevent or minimize the child's separation from the family b. Do no harm c. Promote a sense of control d. Prevent or minimize bodily injury and pain

b. Do no harma.

The nurse is assessing a 3-day-old breastfed newborn who weighed 3400 g (7 lb, 8 oz) at birth. The infant's mother is now concerned because the infant weighs 3147 g (6 lb, 15 oz). The most appropriate nursing intervention is which of the following? a. Recommend supplemental feedings of formula. b. Explain that this weight loss is within normal limits. c. Assess the child further to determine the cause of excessive weight loss. d. Encourage the mother to express breast milk for bottle feeding the infant.

b. Explain that this weight loss is within normal limits.

When caring for a 4-year-old child with a disability, the nurse notes that while encouraging the child to take part in his care, the mother constantly gives in to the child, allowing him to have his own way. What anticipatory guidance can the nurse give to promote normalization in this relationship a. Giving in is not a detriment to the child when he or she has a disability and limitations b. Explain that when parents establish reasonable limits, children are likely to develop independence that is appropriate for their age and achievement equal to their limitations c. Advise the parent to wait to explain any procedure to the child until they are at the health care setting or just before the procedure to avoid unduly upsetting the child d. Have the parent realize that it would be unfair to the siblings to expect similar rules to apply to all of the children in the family

b. Explain that when parents establish reasonable limits, children are likely to develop independence that is appropriate for their age and achievement equal to their limitations

Pain scales for infants and their uses include but are not limited to a. CRIES: Crying, Requiring increased oxygen, Inability to console, Expression, and Sleeplessness b. FLACC: child's face, legs, activity, cry, and consolability c. NCCPC: parent and health care giver questionnaire assessing acute and chronic pain d. NPASS: neonatal pain, agitation, and sedation scale for infants from 3 to 6 months

b. FLACC: child's face, legs, activity, cry, and consolability

What information should the nurse give a mother regarding the introduction of solid foods during infancy? a. Fruits and vegetables should be introduced into the diet first. b. Foods should be introduced one at a time at intervals of 5 to 7 days. c. Solid foods can be mixed in a bottle to make the transition easier for the infant. d. Solid foods should not be introduced until 8 to 10 months when the extrusion reflex begins to disappear.

b. Foods should be introduced one at a time at intervals of 5 to 7 days.

A child who has been receiving morphine intravenously will now start receiving it orally. The nurse should anticipate that to achieve equianalgesia (equal analgesic effect), the oral dose will be which of the following? a. Same as the intravenous dose b. Greater than the intravenous dose c. One half of the intravenous dose d. One fourth of the intravenous dose

b. Greater than the intravenous dose

Which of the following vaccines is recommended for administration at birth? a. MMR (measles, mumps, and rubella) b. Hepatitis B c. Hepatitis A d. Haemophilus influenzae type b (Hib)

b. Hepatitis B

How can the nurse prepare a child for a painful procedure? SATA a. Be honest and use correct terms so that the child trusts the nurse. b. Involve the child in the use of distraction, such as using bubbles, music, or playing a game c. Kindly ask parents to leave the room so they don't have to watch the painful procedure d. Use positive self talk such as when I go home, I will feel better and be able to see my friends e. Use guided imagery that involves recalling a previous pleasurable event

b. Involve the child in the use of distraction, such as using bubbles, music, or playing a game d. Use positive self talk such as when I go home, I will feel better and be able to see my friends e. Use guided imagery that involves recalling a previous pleasurable event

A 4-month-old infant is brought to the well-child clinic for immunizations. The mother indicates that the infant often strains to have a bowel movement, so she has been giving him honey and has stopped feeding him iron-fortified formula, based on her sister's recommendations. The nurse recognizes that the infant is at risk for the development of which of the following? SATA a. Obesity b. Iron deficiency anemia c. Rickets d. Infant botulism e. Cow's milk allergy

b. Iron deficiency anemia d. Infant botulism

When teaching a 6-year-old child with sickle cell disease and his family about pain management, which of the following should the nurse discuss? Select all that apply. a. When pain medications are used, all pain will be eliminated. b. Nonpharmacologic methods of pain relief, including heat, massage, physical therapy, humor, and distraction. c. It is helpful to use a "passport card" that includes information about the diagnosis, any previous complications, and the pain regimen. d. Only the physician can decide the best course of treatment, and the other health care providers follow that plan. e. Long-term medication use considers many factors.

b. Nonpharmacologic methods of pain relief, including heat, massage, physical therapy, humor, and distraction. c. It is helpful to use a "passport card" that includes information about the diagnosis, any previous complications, and the pain regimen. e. Long-term medication use considers many factors.

The National Children's Study is the largest prospective, long term study of children's health and development in the United States. Which of these options are the goals of this study? SATA a. Ensure that every child is immunized at the appropriate age b. Provide information for families to eradicate unhealthy diets, dental caries, and childhood obesity c. Enlist the help of school lunch programs to reach the goal of vegetables and fruits as 30% of each lunch d. Significantly reduce violence, substance abuse, and mental health disorders among the nation's children e. Decrease tardiness and truancy and increase the high school graduation rate in each state over the next 5 years

b. Provide information for families to eradicate unhealthy diets, dental caries, and childhood obesity d. Significantly reduce violence, substance abuse, and mental health disorders among the nation's children

An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago. She has not received any medical care. She smokes but denies any other substance use. The priority nursing action is which of the following? a. Notify her parents. b. Refer her for prenatal care. c. Explain the importance of not smoking. d. Discuss dietary needs for adequate fetal growth.

b. Refer her for prenatal care.

The pediatric nurse may be in the unique position to talk with a family about further genetic evaluation of their child. Which assessment findings by the nurse may alert the nurse to this need? SATA a. Digestive difficulties, especially after 6 months of age b. Skeletal abnormalities: limb abnormalities, asymmetry, hyper extendible joints c. Recurrent infection or immunodeficiency: ear infections, pneumonia, poor healing of the umbilicus d. Urinary tract issues: recurrent infections, delay in toilet training e. Development and speech delays or loss of developmental milestones

b. Skeletal abnormalities: limb abnormalities, asymmetry, hyper extendible joints c. Recurrent infection or immunodeficiency: ear infections, pneumonia, poor healing of the umbilicus e. Development and speech delays or loss of developmental milestones

Duvall's Developmental Stages of the Family include which of the following? SATA a. Stages an individual progresses through in their moral and spiritual development b. Stages families progress through in adulthood c. Stages that designate how parenting progresses as a child develops d. Stages that designate appropriate discipline related to developmental stages e. Stages that describe the journey a couple will take as their children mature

b. Stages families progress through in adulthood c. Stages that designate how parenting progresses as a child develops e. Stages that describe the journey a couple will take as their children mature

Which of the following immunization booster vaccines should be considered for a 13 year old adolescent who has completed all recommended routine childhood vaccinations? SATA a. DTaP vaccine b. Tdap vaccine c. Meningococcal vaccine d. Pneumococcal vaccine e. Hepatitis B vaccine f. Hib vaccine

b. Tdap vaccine c. Meningococcal vaccine

In planning sex education and contraceptive teaching for adolescents, the nurse should consider which of the following? a. Both sexual activity and contraception require planning. b. Teenagers frequently lack a fundamental understanding of fertility. c. Most teenagers today are knowledgeable about reproductive anatomy and physiology. d. Most teenagers who become pregnant do so as an act of hostility, especially toward their parents.

b. Teenagers frequently lack a fundamental understanding of fertility.

The nurse is assessing a 3-year-old African American child who is being seen in the clinic for the first time. The child's height and weight are at the 20th percentile on the commonly used growth chart from the National Center for Health Statistics (NCHS). When interpreting these data, the nurse should recognize which of the following? a. The data suggest the child requires nutritional intervention. b. The NCHS charts are accurate for U.S. African American children. c. A correction factor is used when the NCHS chart is used for nonwhite ethnic groups. d. No assessment can be made until several measurements are plotted over time.

b. The NCHS charts are accurate for U.S. African American children.

Which of the following statements accurately describes physical development during the school-age years? a. The child's weight almost triples. b. The child grows an average of 5 cm (2 inches) per year. c. Few physical differences are apparent among children of different genders at the end of middle childhood. d. Fat gradually increases, which contributes to the child's heavier appearance.

b. The child grows an average of 5 cm (2 inches) per year.

Characteristics of bullying include a. Unintentional harm inflicted upon another person that is part of the socialization process in childhood b. The infliction of repetitive physical, verbal, or emotional abuse upon another person with intent to harm c. An attempt to gain acceptance and be liked by same sex peers d. An early sign of a severely disturbed personality disorder that escalates in adulthood

b. The infliction of repetitive physical, verbal, or emotional abuse upon another person with intent to harm

because injuries are the most common cause of death and disability in children in the United States, which stage of development correctly determines the type of injury that may occur? SATA a. A newborn may roll over and fall off an elevated surface b. The need to conform and gain acceptance from his peers may make a child accept a dare c. Toddlers who can run and climb may be susceptible to burns, falls, and collisions with objects d. A preschooler may ride her two wheel bike in a reckless manner e. A crawling infant may aspirate due to the tendency to place objects in his mouth

b. The need to conform and gain acceptance from his peers may make a child accept a dare c. Toddlers who can run and climb may be susceptible to burns, falls, and collisions with objects e. A crawling infant may aspirate due to the tendency to place objects in his mouth

According to Jean Piaget, adolescent cognitive development is represented by the stage of formal operational thought that includes which of the following? SATA a. Believing that thoughts are all powerful b. Thinking in abstract terms c. Thinking about hypotheses d. Using a future time perspective e. Thinking in the here and now

b. Thinking in abstract terms c. Thinking about hypotheses d. Using a future time perspective

Two toddlers are playing in a sandbox when one child suddenly grabs a toy from the other child. Which of the following is the best interpretation of this behavior? a. This is typical behavior because toddlers are aggressive. b. This is typical behavior because toddlers are egocentric. c. Toddlers should know that sharing toys is expected of them. d. Toddlers should have the cognitive ability to know right from wrong.

b. This is typical behavior because toddlers are egocentric.

One of the primary reasons for monitoring the toddler's activities and intervening to prevent accidental injury is a. Toddler have oppositional defiant behavior and negativism b. Toddlers do not understand the concept of cause and effect, so explaining that certain actions will result in serious injury is useless c. Toddlers will often listen to reasoning about why an activity should be avoided d. Toddler enjoy making their parents worry about their safety and like to see the parents' reactions to the behavior

b. Toddlers do not understand the concept of cause and effect, so explaining that certain actions will result in serious injury is useless

While interviewing parents who have just arrived in the health care clinic, the nurse begins the interview. Which statement below involves therapeutic communication techniques? SATA a. Allowing the parents to direct the conversation so they feel comfortable and in control b. Using broad, open ended questions so that parents can feel open to discuss issues c. Redirecting by asking guided questions to keep the parents on task d. Careful listening, which relies on the use of clues and verbal leads to help move the conversation along e. Asking carefully worded, detailed questions to get accurate information

b. Using broad, open ended questions so that parents can feel open to discuss issues c. Redirecting by asking guided questions to keep the parents on task e. Asking carefully worded, detailed questions to get accurate information

While orienting a new nurse to the ICU, she asks how do these children sleep and not become frightened with all the lights and noises? How should you respond? SATA a. These children are sicker than those on the pediatric unit so the noises and lights are necessary b. We try to organize care into clusters so infants and children can sleep and we can turn down lights c. We silence alarms to allow for periods of sleep, especially at night d. When possible, we allow for uninterrupted sleep cycles-for infants 90 minutes and for older children 60 minutes e. We encourage parents to sit with and touch their child as often as possible

b. We try to organize care into clusters so infants and children can sleep and we can turn down lights e. We encourage parents to sit with and touch their child as often as possible

Children are often undermedicated for pain during the terminal phase of illness. A factor that contributes to the lack of treatment is a. lack of pain assessment tools for children. b. balancing of effective dosage with side effects. c. parents' concerns about the risk of addiction. d. the necessity of using a parenteral route for medications for this type of pain.

b. balancing of effective dosage with side effects.

Sleep problems in school-age children are often demonstrated by a. night terrors that awaken them. b. delaying tactics because they do not wish to go to bed. c. somatic illness that awakens them. d. increasing need for sleep time as they get older.

b. delaying tactics because they do not wish to go to bed.

Sara, age 4 months, was born at 35 weeks of gestation. She seems to be developing normally, but her parents are concerned because she is a "more difficult" baby than their other child, who was full term. The nurse should explain that a. infants tend to become more difficult over time. b. infants become less difficult if they are kept on scheduled feedings and structured routines. c. Sara's behavior is suggestive of failure to completely bond with her parents. d. Sara's difficult temperament is the result of painful experiences in the neonatal period.

b. infants become less difficult if they are kept on scheduled feedings and structured routines.

The clinic is loaning a federally approved car seat to a 10-lb (4.5-kg) infant's family. The nurse should explain that the safest place to put the car seat is in the a. back seat facing forward. b. middle of the back seat facing rearward. c. front seat with airbags on passenger side. d. front seat if there is no air bag on the passenger side.

b. middle of the back seat facing rearward.

Recommendations for parents of toddlers to meet fluoride requirements include all of the following except a. supervise the use of toothpaste. b. supervise the use of fluoride rinses. c. store fluoride products out of reach. d. administer fluoride supplements if water fluoride content is low.

b. supervise the use of fluoride rinses.

A school-age child with cancer is beginning to feel better now that the necessary medical procedures and treatments are not so traumatic. The child has also become very uncooperative with the parents. The nurse should explain that a. the child is denying the seriousness of the illness. b. this is a common reaction and a way to express anger. c. more discipline is needed to deal with the uncooperativeness. d. permissiveness is needed as the child copes with a life-threatening illness.

b. this is a common reaction and a way to express anger.

In relation to developmental milestones, the infant can be expected to roll over from back to abdomen at approximately: a. 2 months b. 4 months c. 6 months d. 8 months

c. 6 months

Family systems theory includes a. Direct causality, meaning each change affect the whole family b. Family systems react to changes as they take place, not initiate it c. A balance between morphogenesis and morphostasis is necessary d. Theory is used primarily for family dysfunction and pathology

c. A balance between morphogenesis and morphostasis is necessary

Neonates are predisposed to problems with thermoregulation because of which of the following factors? a. Renal function is not fully developed. b. Flexed posture favors heat loss. c. A large body surface area favors heat loss to the environment. d. A thick layer of subcutaneous fat provides excellent insulation.

c. A large body surface area favors heat loss to the environment.

Which of the following statements is true concerning the increased use of telephone triage by nurses? a. Health care costs have increased as a result. b. Emergency department visits are not recommended. c. Access to high-quality health care services has increased. d. Home care is recommended when it is not appropriate.

c. Access to high-quality health care services has increased.

Part of helping a family make a decision regarding organ donations after a child's death is having the correct information. Which statement is true when answering questions about this topic? a. The family helps defray some of the cost when a child's organs are donated b. In dire cases, organ donation can take place without family consent c. Any number of body tissues or organs can be donated and their removal does not mutilate or desecrate the body or cause any suffering d. Although organ donation can be very psotivie for the donor family, they need to know that funeral services may be delayed if they decide to allow an organ donation

c. Any number of body tissues or organs can be donated and their removal does not mutilate or desecrate the body or cause any suffering

Imaginary playmates are beneficial to the preschool child because they do which of the following? a. Take the place of social interactions. b. Take the place of pets and other toys. c. Become friends in times of loneliness. d. Accomplish what the child has already successfully accomplished.

c. Become friends in times of loneliness.

A group of boys ages 9 and 10 have formed a "boys only" club that is open to neighborhood and school friends who have skateboards. This should be interpreted as which of the following? a. Behavior that encourages bullying and sexism b. Behavior that reinforces poor peer relationships c. Characteristic of social development of this age d. Characteristic of children who are later at risk for membership in gangs

c. Characteristic of social development of this age

In 1935 Title V of the Social Security Act was passed. This was significant in the evolution of child health care in the United States because it established what? a. Medicaid b. Children's Bureau c. Child Welfare Services d. White House Conferences on Children

c. Child Welfare Services

Which of the following should the nurse include when giving parents guidelines about helping their children in school? a. Punish children who fail to perform adequately. b. Help children as much as possible with their homework. c. Communicate with teachers if there appears to be a problem. d. Accept responsibility for children's successes and failures.

c. Communicate with teachers if there appears to be a problem.

The nurse is assessing a 6-month-old infant who has head lag. The nurse should recognize which of the following? a. This is normal. b. The child is probably cognitively impaired. c. Developmental-neurologic evaluation is needed. d. The parent needs to work with the infant to stop head lag.

c. Developmental-neurologic evaluation is needed.

The school nurse is discussing dental health with some children in first grade. Which of the following should be included? a. Teach how to floss teeth properly. b. Recommend a toothbrush with hard nylon bristles. c. Emphasize the importance of brushing before bedtime. d. Recommend nonfluoridated toothpaste approved by the American Dental Association.

c. Emphasize the importance of brushing before bedtime.

At the time of a child's death, the nurse tells his mother, "We will miss him so much." The best interpretation of this is that the nurse is doing which of the following? a. Denying the mother's sense of loss b. Pretending to be experiencing grief c. Expressing personal feelings of loss d. Talking when listening would be better

c. Expressing personal feelings of loss

Which of the following self-report pain rating scales can be used in children as young as 3 years of age? a. Poker Chip Tool b. Visual Analog Scale c. FACES Pain Rating Scale d Word-Graphic Rating Scale

c. FACES Pain Rating Scale

At an appointment at the pediatrician's office, a patient's mother states My son gets rough with some of the neighborhood kids. I am worried that he is becoming a bully. Which statements by the mother need more teaching? SATA a. When my son becomes aggressive, I feel he needs to be punished b. I think it is good for him to bond with his dad, so they often watch TV together c. I am trying to get him to learn to say what he is upset about in words d. Boys will be boys, so I think this can be considered a normal stage in development e. I am thinking that a time out would be a better strategy than spanking when my son shows this behavior

c. I am trying to get him to learn to say what he is upset about in words e. I am thinking that a time out would be a better strategy than spanking when my son shows this behavior

The nurse is discharging an infant diagnosed with PKU from the hospital. Which statement made by the parents indicates a need for teaching? a. I can continue breastfeeding because breast milk is low in phenylalanine b. Since my baby will begin a reduced phenylalanine diet so early, it is very unlikely he will have little cognitive impairment c. I will bring my baby back to the doctor to obtain another blood sample by 4 weeks of age, since the first sample was drawn before he was 24 hours old d. My child should remain on the special diet, which is a diet restricted in protein and close monitoring of the phenylalineine levels

c. I will bring my baby back to the doctor to obtain another blood sample by 4 weeks of age, since the first sample was drawn before he was 24 hours old

Separation anxiety is something that affects children when they are hospitalized. Each developmental stage has a somewhat different reaction as they deal with this difficulty. Which stage corresponds to the adolescent stage? a. May demonstrate separation anxiety by refusing to eat, experiencing difficulty in sleeping, crying quietly for their parents, continually asking when the parents will visit, or withdrawing from others b. Separation anxiety comes in stages: protest, despair, detachment c. Loss of peer group contact may pose a severe emotional threat because of loss of group status, inability to exert group control or leadership, and loss of group acceptance d. May need and desire parental guidance or support form other adult figures but may be unable or unwilling to ask for it

c. Loss of peer group contact may pose a severe emotional threat because of loss of group status, inability to exert group control or leadership, and loss of group acceptance

Which of the following findings on physical assessment of a neonate would indicate the need for further evaluation? a. Nystagmus b. Epstein pearls c. Low-set ears d. Positive Babinski reflex

c. Low-set ears

What is the leading cause of death from unintentional injuries in children? a. Poisoning b. Drowning c. Motor vehicles d. Fires and burns

c. Motor vehicles

Which of the following tools would be most useful to assess maternal and newborn attachment behaviors? a. Apgar b. Ballard scale c. NCAST (Nursing Child Assessment Satellite Training) Feeding Scale d. Brazelton Neonatal Behavioral Assessment Scale

c. NCAST (Nursing Child Assessment Satellite Training) Feeding Scale

A newborn whose mother is positive for Chlamydia trachomitis should be optimally treated with which of these to prevent ophthalmia? a. Silver nitrate solution b. Tetracycline ophthalmic ointment c. Oral erythromycin d. Erythromycin ophthalmic solution

c. Oral erythromycin

Which of the following terms best describes a multidisciplinary approach to the management of a terminal illness that focuses on symptom control and support? a. Dying care b. Curative care c. Palliative care d. Restorative care

c. Palliative care

The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other trauma resulting from a motor vehicle injury. The child is experiencing severe pain. Which of the following is an important consideration in managing the child's pain? a. Give only an opioid analgesic at this time. b. Increase the dosage of analgesic until the child is adequately sedated. c. Plan a preventive schedule of pain medication around the clock. d. Give the child a clock and explain when she or he can have pain medications.

c. Plan a preventive schedule of pain medication around the clock.

Maria is a Spanish-speaking 5-year-old girl who has started kindergarten in an English-speaking school. Crying most of the time, she appears helpless and unable to function in this new situation. What is the best explanation for this behavior? a. She lacks adequate maturity for attending school. b. She lacks the knowledge needed in school. c. She is experiencing cultural shock. d. She is experiencing minority group discrimination.

c. She is experiencing cultural shock.

The parents of an 8-year-old girl tell the nurse that their daughter wants to join a soccer team. The nurse's suggestions regarding participation in sports at this age should include which of the following? a. Organized sports such as soccer are not appropriate at this age. b. Competition is detrimental to the establishment of a positive self-image. c. Sports participation is encouraged if the type of sport is appropriate to the child's abilities. d. Girls should compete only against girls because at this age boys are larger and have more muscle mass.

c. Sports participation is encouraged if the type of sport is appropriate to the child's abilities.

The parents of a 3-month-old girl complain to the nurse that they are exhausted because she still wakes up as often as every 1 to 2 hours during the night. When she awakens, they change her diaper, and her mother nurses her back to sleep. Which of the following should the nurse suggest to help them deal with this problem? a. Let her cry herself back to sleep. b.Put her in parents' bed to cuddle. c. Start putting her to bed while still awake and while the parent is present. d. Give her a bottle of formula instead of breastfeeding her so often at night.

c. Start putting her to bed while still awake and while the parent is present.

The school nurse is discussing testicular self-examination with adolescent male students. Why is this important? a. Epididymitis is common during adolescence. b. Asymptomatic sexually transmitted infections may be present. c. Testicular tumors during adolescence are generally malignant. d. Testicular tumors, although usually benign, are common during adolescence.

c. Testicular tumors during adolescence are generally malignant.

A mother brings her 3-year-old daughter to the well-child clinic and expresses concern that the child's behavior is worrisome and possibly requires therapy or medication at minimum. The mother further explains that the child constantly responds to the mother's simple requests with a no answer even though the activity has been a favorite in the recent past. Furthermore, the child has had an increase in the number of temper tantrums at bedtime and refuses to go to bed. The mother is afraid her daughter will hurt herself during a temper tantrum because she holds her breath until the mother picks her up and gives in to her request. The nurse's best response to the mother is that a. The child probably would benefit from some counseling with a trained therapist b. The mother and father should evaluate their childrearing practices c. The child's behavior is normal for a toddler and may represent frustration with control of her emotions; further exploration of events surrounding temper tantrums and possible interventions should be explored d. The child's behavior is typical of toddlers, and the parents should just wait for the child to finish this phase, since this will end soon as well

c. The child's behavior is normal for a toddler and may represent frustration with control of her emotions; further exploration of events surrounding temper tantrums and possible interventions should be explored

What are some legal and ethical issues that arise for the nurse when using an interpreter? a. Direct the questions to the interpreter. b. Ask several questions at a time. c. The family should be fully informed of all aspects of procedures before consenting. d. Discourage the interpreter and client from discussing topics not included in the interview.

c. The family should be fully informed of all aspects of procedures before consenting.

An important milestone in the infant's life is the development of object permanence. This milestone is represented by which of these statements? a. The infant smiles at the mother when she talks to him b. The infant repeatedly flexes and extends his arms and legs when the mother picks him up c. The infant turns and looks for the mother when she walks out of his view d. The infant cries when the mother hands him to a babysitter

c. The infant turns and looks for the mother when she walks out of his view

Which of the following describes moral development in younger school-age children? a. The standards of behavior now come from within themselves. b. They do not yet experience a sense of guilt when they misbehave. c. They know the rules and behaviors expected of them but do not understand the reasons behind them. d. They no longer interpret accidents and misfortunes as punishment for misdeeds.

c. They know the rules and behaviors expected of them but do not understand the reasons behind them.

The nurse is explaining the strategy of consequences to a parent he is working with. Which response by the parent indicates more teaching is needed when he describes the type of consequences? a. Natural: Those that occur without any intervention b. Logical: Those that are directly related to the rule c. Transforming: Allowing the child to come to the conclusion on his or her own d. Unrelated: Those that are imposed deliberately

c. Transforming: Allowing the child to come to the conclusion on his or her own

As the nurse caring for a culturally diverse population, it is important to understand cultural health beliefs of families. This can best be accomplished by: a. Asking the parents how their extended families feel about their child's illness b. Exploring the use of alternative medicines and therapies c. Understanding the parents' perception of the seriousness or severity of the illness or disability, as well as concerns and worries they have about the condition d. Acknowledging that language constraints may make it necessary for the health care team to make some decisions

c. Understanding the parents' perception of the seriousness or severity of the illness or disability, as well as concerns and worries they have about the condition

Which of the following approaches is the most appropriate when performing a physical assessment on a toddler? a. Demonstrate use of equipment. b. Perform traumatic procedures first. c. Use minimum physical contact initially. d. Always proceed in a head-to-toe direction.

c. Use minimum physical contact initially.

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

c. Use open-ended questions.

A significant common side effect that occurs with opioid administration is a. euphoria. b. diuresis. c. constipation. d. allergic reactions.

c. constipation.

A 5-year-old has patient-controlled analgesia (PCA) for pain management after abdominal surgery. Your explanation to the parents should include a. the child will be pain free. b. only the child is allowed to push the button for a bolus. c. the pump allows for a continuous basal rate and delivers a constant amount of medication to control pain. d. there is a high risk of overdose, so monitoring is done every 15 minutes.

c. the pump allows for a continuous basal rate and delivers a constant amount of medication to control pain.

Myelination of the spinal cord is almost complete by 2 years of age. As a result of this, which of the following can gradually be achieved? a. Visual acuity of 20/20 b. Throwing a ball without falling c. Respirations becoming diaphragmatic d. Control of anal and urethral sphincters

d. Control of anal and urethral sphincters

In terms of fine motor development, what could a 3-year-old child be expected to do? a. Tie shoelaces. b. Use scissors or a pencil very well. c. Draw a person with seven to nine parts. d. Draw single-line shapes such as circles

d. Draw single-line shapes such as circles

When caring for a child with a cleft lip, a parent asks the nurse did I cause this defect in my child? What is the best response by the nurse? a. There are many things about embryo development we do not know; it is not you b. Cleft lip is an example of a disruption and occurs early in the pregnancy, often before you eve know you are pregnant c. Is there something you took while you were pregnant? d. Early in the pregnancy there may be an abnormality in the developmental process; the reasons for this are largely still unknown

d. Early in the pregnancy there may be an abnormality in the developmental process; the reasons for this are largely still unknown

Parents tell the nurse that their 7-year-old daughter wants to see her brother's body and attend the funeral. Which of the following should the nurse do? a. Encourage the child to attend the funeral but not see the body. b. Refer the child to someone who can assess her readiness for these experiences. c. Suggest that instead of these experiences the child visit the grave site after the services are over. d. Explain that the child's parents or another significant person should provide support during these experiences.

d. Explain that the child's parents or another significant person should provide support during these experiences.

Which of the following is the most consistent and commonly used indicator of pain in infants? a. Increased respirations b. Increased heart rate c. Thrashing of arms and legs d. Facial expression of discomfort

d. Facial expression of discomfort

Which of the following is characteristic of the psychosocial development of school-age children? a. Peer approval is not yet a motivating power. b. A developing sense of initiative is very important. c. Motivation comes from extrinsic rather than intrinsic sources. d. Feelings of inferiority or lack of worth can be derived from children themselves or from the environment.

d. Feelings of inferiority or lack of worth can be derived from children themselves or from the environment.

Which of the following describes the cognitive abilities of school-age children? a. Have developed the ability to reason abstractly b. Become capable of scientific reasoning and formal logic c. Progress from making judgments based on what they reason to making judgments based on what they see d. Have the ability to place things in a logical order, to group and sort, and to hold a concept in their minds while making decisions based on that concept

d. Have the ability to place things in a logical order, to group and sort, and to hold a concept in their minds while making decisions based on that concept

An intravenous line is needed in a school-age child. The most appropriate action to provide analgesia during this procedure is to apply a. TAC (tetracaine, epinephrine [Adrenalin], cocaine) 15 minutes before the procedure. b. a transdermal fentanyl (Duragesic) patch at the site of venipuncture. c. EMLA (eutectic mixture of local anesthetics) immediately before the procedure. d. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.

d. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.

An adolescent asks the nurse what causes primary dysmenorrhea. The nurse's response should include which of the following? a. It is an inherited problem. b. Excessive estrogen production causes uterine pain. c. There is no physiologic cause; it is a psychologic reaction. d. One factor is the onset of ovulatory cycles.

d. One factor is the onset of ovulatory cycles.

The health promotion interventions that have the greatest impact on injury prevention are which of the following? a. Utilization of auditory learning strategies for all families b. Including the nutritional counseling for the food pyramid c. Integrating Maslow's hierarchy of needs in the lesson d. Using a developmental approach to safety counseling

d. Using a developmental approach to safety counseling

A school-age child with cancer is being prepared for a procedure. The child says, "I have had one of these. They hurt." The nurse's response should be based on knowledge that children a. often lie about experiencing pain. b. tolerate pain better than adults. c. become accustomed to painful procedures. d. commonly experience treatment-related moderate to severe pain when they have cancer.

d. commonly experience treatment-related moderate to severe pain when they have cancer.

An important component of hospice care is a. the child is cared for in the home. b. medical interventions are discontinued. c. supportive care is provided until the child's death. d. the needs of the family are considered as important as those of the child.

d. the needs of the family are considered as important as those of the child.