Pedi Self Assessments
The mother of a 3-month-old breast-fed infant asks about giving her baby water because it is summer and very warm. The nurse should tell her that: a. fluids in addition to breast milk are not needed b. water should be given if infant seems to nurse longer than usual c. clear juices would be better than water to promote adequate fluid intake d. water once or twice a day will make up for losses resulting from environmental temp
a. fluids in addition to breast milk are not needed
Girls experience an increase in weight and fat deposition during puberty. Nursing considerations related to this include which of the following? a. give reassurance that these changes are normal b. suggest dietary measures to control weight gain c. encourage lowfat diet to prevent fat deposition d. recommend increased exercise to control weight gain
a. give reassurance that these changes are normal
According to Erikson, the psychosocial task of adolescence is developing which of the following? a. identity b. intimacy c. initiative d. independence
a. identity
The nurse should anticipate that the first treatment for epiglottitis will be a. intubation b. intravenous antibiotics c. cough suppressant d. placement in a croup tent
a. intubation
A mother calls the clinic nurse about her 4-year-old son who has acute diarrhea. She has been giving him the antidiarrheal drug loperamide (Imodium A-D). The nurse's response should be based on knowledge that this drug is: a. not indicated. b. indicated because it slows intestinal motility. c. indicated because it decreases diarrhea. d. indicated because it decreases fluid and electrolyte losses.
a. not indicated.
Which of the following is an appropriate play activity for a 7-month-old infant to encourage visual stimulation? a. playing peek-a-boo b. playing pat-a-cake c. imitating animal sounds d. showing how to clap hands
a. playing peek-a-boo
Three friends arrive at the camp infirmary with lesions they said were oozing and painful at first and now are terribly itchy, swollen, red blisters. What should the nurse do initially? a. put on a pair of unsterile gloves b. ask where the campers have been c. rub the lesions with alcohol wipes d. scrub the area with antibacterial soap
a. put on a pair of unsterile gloves
A parent of an 18-month-old boy tells the nurse that he says "no" to everything and has rapid mood swings. If he is scolded, he shows anger and then immediately wants to be held. The nurse's best interpretation of this behavior is which of the following? a. this is normal behavior for his age b. this is unusual behavior for his age c. he is not effectively coping with stress d. he is showing he needs more attention
a. this is normal behavior for his age
A toddler's parent asks the nurse for suggestions on dealing with temper tantrums. Which of the following is the most appropriate recommendation? a. punish the child b. explain to child that this is wrong c. leave the child alone until the tantrum is over d. remain close by the child but without eye contact
d. remain close by the child but without eye contact
Parents tell the nurse they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom. Which of the following is the most appropriate recommendation for the nurse to make? a. Punish children so this behavior stops b. Neither condone nor condemn the curiosity c. Get counseling for this unusual and dangerous behavior d. Allow children unrestricted permission to satisfy this curiosity
b. Neither condone nor condemn the curiosity
The newborn is being discharged home and the parents want to know how to care for their child. What information should the nurse share with the parents? a. Gently lift the newborn by the ankles when changing the diaper. b. Support the infant during a diaper change by lifting the buttocks. c. Use two people when changing diapers for the first few months. d. Put two diapers on the infant to provide extra padding for his lower back.
b. Support the infant during a diaper change by lifting the buttocks.
The patient is in the acute stage, and his paralysis is continuing to ascend. What actions by the nurse should be taken to monitor for respiratory complications of GBS? Select all that apply. a. stay with the child while he is eating or drinking b. check lung sounds with vital signs c. continually monitor his oxygen saturation d. maintain the patient in the supine position e. reposition the child every 4 hours
a, b, c
The parents are totally shocked about the diagnosis until they begin remembering that when their son got his immunizations, he would have bleeding and a bruise afterward for several weeks. What anticipatory guidance would be most appropriate in order to help the parents promote their son's growth and development? Select all that apply. a. put a gate at the top of the stairs b. put a gate at the bottom of the stairs c. pad the corners of hard tables d. limit the toddler's activities e. make certain that the child is supervised f. delay using a helmet until the child is riding a bike
a, b, c, e
The mother of the infant with the visual impairment asks the nurse how she will know if her daughter is really responding to what the mother is doing when she is holding her and playing with her. Which response by the nurse would best describe indications that the infant is responding to the mother? Select all that apply. a. The infant makes sounds when spoken to or laughs when her tummy is tickled. b. The infant falls asleep when cuddled and rocked at night. c. The infant becomes less active when the parents approach her crib in the morning. d. The respiratory patterns change, either becoming faster or slower. e. The infant's cries increase when she hears the parents' voices.
a, b, d
What supportive measures would be appropriate for the nurse to use and/or to monitor to prevent contractures and maintain as much neuromuscular function as possible while the child is still paralyzed? Select all that apply. a. Using neuropathic pain medications with other pain medications b. Doing active range-of-motion exercises every day c. Doing isometric exercises whenever the child wants them d. Using orthotic devices to maintain correct position e. Doing passive range-of-motion exercises several times daily
a, d, e
The mother asks about what she will need to do when her son begins losing his baby teeth because bleeding will occur. What response by the nurse is best? a. "Call the hematologist when his first tooth begins to loosen so you can plan when he'll need additional AHF." b. "Keep ice packs in the freezer and in the car so you'll always have them whenever he loses a tooth." c. "It's too soon to talk about that happening because it's several years away." d. "That's something that's best to ask your son's hematologist."
a. "Call the hematologist when his first tooth begins to loosen so you can plan when he'll need additional AHF."
The parents ask the nurse caring for their daughter what could have caused this sudden terrible illness. What information would be most appropriate for the nurse to share with the parents? a. "How children get Reye syndrome is not well understood, but there is a connection between having a viral illness such as chickenpox or the flu and treating the fever with aspirin or a medication with aspirin in it." b. "There is a direct correlation between bacterial infections and the use of acetaminophen (Tylenol) in children who acquire Reye syndrome, because Tylenol can harm the liver even in healthy children." c. "When a child gets immunizations and then gets a viral infection, regardless of how slight, the immune system cannot handle it, and because the liver is used to purify toxins, the liver function becomes impaired." d. "The measles virus can lie dormant in the body for a period of time. When a child gets the measles-mumps-rubella vaccine, it can awaken the sleeping virus, which can then attack the liver and the brain."
a. "How children get Reye syndrome is not well understood, but there is a connection between having a viral illness such as chickenpox or the flu and treating the fever with aspirin or a medication with aspirin in it."
The parents are concerned that their son will become crippled as a result of his hemophilia. What response by the nurse is most accurate as well as therapeutic? a. "With today's treatments, many children reach adulthood without joint damage." b. "As long as he gets his AHF weekly, there will never be joint damage." c. "As long as he doesn't get hurt, his joints will be fine." d. "There are worse problems than your son being crippled."
a. "With today's treatments, many children reach adulthood without joint damage."
Plasmapheresis has been done on this child, and he is experiencing chills, a fever of 102.8 degrees, urticaria, and a heart rate of 74 beats per minute. What nursing intervention is indicated for what the child is currently experiencing? a. Acetaminophen for fever b. A laxative or stool softener c. Gabapentin (Neurontin) to decrease inflammation d. Low-molecular-weight heparin to prevent deep vein thrombosis (DVT)
a. Acetaminophen for fever
The newborn with severe jaundice is at risk for developing which of the following? a. Brain damage b. Bullous impetigo c. Respiratory distress d. Blood incompatibility
a. Brain damage
The nurse is caring for a full-term infant who was born after an uneventful pregnancy and delivery. The infant's blood glucose level is 36 mg/dl. Which of the following interventions should the nurse take? a. Bring the infant to the mother and initiate breast-feeding. b. Place a nasogastric tube and administer 5% dextrose water. c. Start a peripheral intravenous line and administer 10% dextrose. d. Monitor the infant in the nursery and obtain a blood glucose level in 4 hours.
a. Bring the infant to the mother and initiate breast-feeding.
The child has patient-controlled analgesia (PCA) of morphine with an 8-minute lockout. Teaching by the nurse has been effective if what behavior is seen in this child? a. He pushes the button on the PCA whenever he wants. b. He waits 8 minutes until pushing the button again. c. The nurse pushes the PCA button whenever she is turning him. d. The mother pushes the PCA button whenever the child moans or makes a strange face.
a. He pushes the button on the PCA whenever he wants.
Which of the following interventions may decrease the incidence of physiologic jaundice in a healthy full-term infant? a. Institute early and frequent feedings. b. Bathe infant when axillary temperature is 36.3° C (97.5° F). c. Place infant's crib near window for exposure to sunlight. d. Suggest that mother initiate breast-feeding when danger of jaundice is past.
a. Institute early and frequent feedings.
The parents with the infant who is visually impaired ask what things they can do so she can be like other infants her age. What suggestion by the nurse would best meet the needs of the family as a whole? a. Sit the infant in a swing or seat so she can play with appropriate toys easily and safely. b. Leave the infant in the crib for long periods of time so she feels very safe and secure. c. Talk with the infant using adult words and in detail about what the infant is doing. d. Crawl next to the infant so she is not alone and knows the parent is nearby.
a. Sit the infant in a swing or seat so she can play with appropriate toys easily and safely.
The mother of the hearing-impaired infant is describing the signs that caused her to suspect that her daughter had a severe deficit. What characteristics would the nurse expect the mother to mention? a. The infant slept no matter how loud a noise was, including the vacuum cleaner. b. The infant startled whenever there was a very loud sound. c. The infant's babbling sounds were delayed. d. The infant turned to look in the direction from which a sound was coming.
a. The infant slept no matter how loud a noise was, including the vacuum cleaner.
The charge nurse is assessing some of the information obtained during the hourly routine. Which assessment data would provide some indications of a good outcome? a. The pupils react sluggishly but equally, and the child's toes move when tickled. b. The heart rate is regular, and the child lies quietly when his endotracheal tube is suctioned. c. The body temperature has been 97 to 98 degrees, and the lung sounds are clear. d. The oxygen saturation level is 98%, and the blood gases are within normal limits.
a. The pupils react sluggishly but equally, and the child's toes move when tickled.
The parents ask the nurse to explain the initial treatment for a child with hemophilia when the child gets hurt and has a bleeding episode. Which response by the nurse is most appropriate? a. "If there is blood in the joint, the blood is aspirated and aspirin is used for pain control." b. "Administration of antihemophilic factor (AHF) is done, followed by treatment of the specific injury." c. "Ibuprofen is given; intravenous fluids are started; and rest, ice, compression, and elevation (RICE) are utilized immediately." d. "Corticosteroids and passive range-of-motion exercises are instituted within 24 hours of the injury."
b. "Administration of antihemophilic factor (AHF) is done, followed by treatment of the specific injury."
At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli? a. 1 month b. 2 months c. 3 months d. 4 months
b. 2 months
The second patient is a 4-year-old girl with suspected Reye syndrome who is almost comatose since admission during the night. The nurse caring for this child is preparing to assist with the primary diagnostic test for this disease. What equipment and supplies should the nurse have available? a. A lumbar puncture tray and betadine b. A liver biopsy tray and abdominal x-ray c. Several blood tubes of various colors and a butterfly needle d. A bone marrow tray and the hollow-core needle
b. A liver biopsy tray and abdominal x-ray
The mother asks if there is a form of communication that her daughter can learn as an infant. What response by the nurse is most accurate? a. Lipreading b. American Sign Language c. Lipreading with cued speech d. Cued speech
b. American Sign Language
A mother is upset because her newborn has erythema toxicum neonatorum. The nurse should reassure her that this is which of the following? a. Easily treated b. Benign and transient c. Usually not contagious d. Usually not disfiguring
b. Benign and transient
The parents ask the nurse how they can help their daughter deal with the disruption in the family. What suggestion by the nurse is best? a. Spend extra time with their daughter and use verbal praise or provide for a special privilege. b. Encourage their daughter to talk with the parents about how is she is feeling. c. Decrease the amount of discipline used with their daughter to give her some freedom. d. Watch how their daughter interacts with her brother and then decide what to say.
b. Encourage their daughter to talk with the parents about how is she is feeling.
Rh hemolytic disease is suspected in a mother's second baby, a son. Which of the following factors is important in understanding how this could develop? a. The first child was a girl. b. Her first child was Rh positive. c. Both parents have type O blood. d. She was not immunized against hemolysis.
b. Her first child was Rh positive.
The child's respiratory center has been affected, so that a tracheostomy and ventilator assistance are required. He has been transferred to the intensive care unit. Nursing care to prevent further respiratory complications would include which set of nursing interventions? a. Daily mouth care and elevation of the head of the bed at least 15 degrees b. Strict asepsis when suctioning and postural changes every 2 hours c. Frequent use of a clean Yankauer suctioning device and continual pulse oximetry d. Meticulous oral care after eating and elevation of the head of the bed at least 30 degrees
b. Strict asepsis when suctioning and postural changes every 2 hours
In about 1 week a stable preterm infant will be discharged. The nurse should place the infant in which of the following positions for sleep? a. Prone b. Supine c. Position of comfort d. Abdomen with head elevated
b. Supine
The mother is afraid her son will ask why he cannot run as well as he did before. What anticipatory guidance can the nurse provide the parents? a. Tell the son that he is too young to totally understand. b. Use simple language to explain what is not working in his body. c. Draw a picture of his body, diagramming what is not working. d. Have the child state what he thinks is wrong with him.
b. Use simple language to explain what is not working in his body.
Instructions for using the MDI include to a. avoid breathing too deeply. b. breathe medication in slowly. c. hold inhaler at about a 45-degree angle to the mouth. d. breathe in through nose and out through mouth.
b. breathe medication in slowly.
The parents ask about the treatment for their son's OI. What information should the nurse explain to them? a. "There are surgeries that will be done early to prevent any deformity of your infant's lower legs." b. "There are a few treatments that help with maintaining bone density, but it's too soon to discuss that." c. "There are medications that can help promote increased bone density and prevent fractures as well as surgeries if needed." d. "If you can get him through the first year with no additional fractures, then the chance of his fracturing again decreases greatly."
c. "There are medications that can help promote increased bone density and prevent fractures as well as surgeries if needed."
At what age is it safe to give infants whole milk instead of commercial infant formula? a. 6 months b. 9 months c. 12 months d. 18 months
c. 12 months
The nurse should expect the apical heart rate of a stabilized neonate to be in which of the following ranges? a. 60 to 80 beats/min b. 80 to 100 beats/min c. 120 to 140 beats/min d. 160 to 180 beats/min
c. 120 to 140 beats/min
The nurse determines that the parents are still having problems coping with their changing world several months after the diagnosis. What suggestion by the nurse would provide the best resource to help the parents cope? a. Suggest the parents seek professional counseling because they should be coping with all the changes that have occurred in their lives. b. Ask the parents why they are continuing to have problems coping with their son's condition. c. Link the parents with another family who is coping with their child with a similar problem. d. Encourage the parents to write down their thoughts and feelings so they can be shared.
c. Link the parents with another family who is coping with their child with a similar problem.
Which of the following terms is used to describe the newborn's first stool? a. Milia b. Milk stool c. Meconium d. Transitional
c. Meconium
Which statement best characterizes hepatitis A? a. Incubation period is 6 weeks to 6 months. b. Principal mode of transmission is through the parenteral route. c. Onset is usually rapid and acute. d. There is a persistent carrier state.
c. Onset is usually rapid and acute.
A nurse case manager is beginning to work with the family as part of coordinating the child's care. What information will best help the nurse to know if the parents are hearing what is being told to them during the period after diagnosis? a. The parents are able to cope better with their children. b. The parents are able to get their usual amount of sleep. c. The parents can repeat what the nurse has told them. d. The parents spend more quality time with their daughter.
c. The parents can repeat what the nurse has told them.
An infant is brought to the emergency department with dehydration. Which physical assessment finding does the nurse expect? a. weight gain b. bradycardia c. poor skin turgor d. brisk capillary refill
c. poor skin turgor
The physician has mentioned that the child should see a dentist once the first baby teeth come in. The parents don't understand the reason for an infant to see a dentist. What explanation by the nurse can best help the parents understand? a. "Children with OI usually have more dental decay than children without the condition." b. "Your child's teeth will need braces when the adult teeth come in and this gives time for your son to get used to the dentist." c. "You can have your son sit on your lap in the dentist's chair during the dental examination." d. "When the baby teeth erupt, the dentist can examine them and determine whether they are also brittle."
d. "When the baby teeth erupt, the dentist can examine them and determine whether they are also brittle."
Which of the following is a central factor responsible for respiratory distress syndrome in the newborn? a. Absence of alveoli b. Immature bronchioles c. Overdeveloped alveoli d. Deficient surfactant production
d. Deficient surfactant production
A 3 ½-year-old child in the neurologic intensive care unit has had years of severe seizures and is being treated with a ketogenic diet. Which dinner tray would be appropriate for the nurse to serve to the child? a. Cheeseburger on a bun, French fries, and a vanilla milkshake b. Pepperoni pizza, watermelon cubes, and lemonade c. Chopped hotdogs in baked beans, a biscuit, and fruit punch d. Fried eggs with bacon, cheese cubes, and iced tea
d. Fried eggs with bacon, cheese cubes, and iced tea
The grayish white, cheeselike substance that covers the newborn's skin is: a. Milia b. Meconium c. Amniotic fluid d. Vernix caseosa
d. Vernix caseosa
According to piaget, the 6-month old infant would be in what developmental stage? a. use of reflexes b. primary circular reactions c. secondary circular reactions d. coordination of secondary schemata
c. secondary circular reactions
Which one of the following dysfunctional speech patterns is a normal characteristic of the language development of a preschool child? a. lisp b. echolalia c. stammering d. repetition without meaning
c. stammering
A 17-month-old child would be expected to be in what stage, according to Piaget? a. preoperations b. concrete operations c. tertiary circular reaction d. secondary circular reaction
c. tertiary circular reaction
In boys the initial indication of puberty is which of the following? a. Voice changes b. Growth of pubic hair c. Testicular enlargement d. Increased size of penis
c. testicular enlargement
According to Piaget, adolescents tend to be in which stage of cognitive development? a. concrete operations b. conventional thought c. post conventional thought d. formal operational thought
d. formal operational thought
A nurse is admitting an infant with dehydration caused from water loss in excess of electrolyte loss. Which type of dehydration is this infant experiencing? a. isotonic b. isomotic c. hypotonic d. hypertonic
d. hypetonic
Invagination of one segment of bowel within another is called: a. atresia. b. stenosis. c. herniation. d. intussusception.
d. intussusception.
The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include: a. elevating the head but give nothing by mouth. b. elevating the head for feedings. c. feeding glucose water only. d. avoiding suctioning unless infant is cyanotic.
a. elevating the head but give nothing by mouth.
Check all that apply what condition in a child would alert a nurse for increased fluid requirements? a. fever b. pneumonia c. congestive heart failure d. increased intracranial pressure e. hemorrhage f. vomiting and diarrhea
a, b, e, f
A child who has just had definitive repair of a high rectal malformation is to be discharged. Which should the nurse address in the discharge preparation of this family? (Select all that apply.) a. Perineal and wound care b. Necessity of firm stools to keep suture line clean c. Bowel training beginning as soon as child returns home d. Reporting any changes in stooling patterns to practitioner e. Use of diet modification to prevent constipation
a, d, e
A nurse is planning preoperative care for a newborn with tracheoesophageal fistula (TEF). Which interventions should the nurse plan to implement? (Select all that apply.) a. Positioning with head elevated on a 30-degree plane b. Feedings through a gastrostomy tube c. Nasogastric tube to continuous low wall suction d. Suctioning with a Replogle tube passed orally to the end of the pouch e. Gastrostomy tube to gravity drainage
a, d, e
The parents ask what they should do about his upcoming measles, mumps, and rubella (MMR) vaccine. Which response from the nurse is correct? a. "Postpone the immunization for at least 11 months." b. "Have your son receive the MMR immunization as scheduled." c. "Postpone the immunization for another 6 months." d. "Have your son get his MMR vaccination before he leaves the hospital."
a. "Postpone the immunization for at least 11 months."
The parents ask what they can do to calm their infant because he is very irritable while the fever is high. What explanation by the nurse is most accurate? a. "The irritability is part of the disease, and we'll try to keep him as comfortable as possible." b. "The irritability indicates he is beginning to develop some mild cardiac involvement." c. "We can keep him sedated during the acute phase so he can basically sleep right through the worst part of the illness." d. "The irritability he is experiencing is in relation to the amount of attachment he has to you both."
a. "The irritability is part of the disease, and we'll try to keep him as comfortable as possible."
The child's mother asks about her son's dependence on large doses of pain medication and whether it will cause addiction later in life. What response by the nurse is most appropriate? a. "The risk for addiction is extremely low. The child would not want to take this medication if there was no pain." b. "As long as he uses the pain medication for less than 2 weeks, there shouldn't be any problem." c. "It will be easier for him to become dependent upon this medication if he needs it later in life." d. "This is something you really need to address with his surgeon because she ordered the pain medication dosage."
a. "The risk for addiction is extremely low. The child would not want to take this medication if there was no pain."
Which of the following is most descriptive of the spiritual development of the older adolescent? a. Beliefs become more abstract b. Rituals and practices become increasingly important c. Strict observance of religious customs is common d. Emphasis is placed on external manifestations, such as whether a person goes to church
a. Beliefs become more abstract
What information should be given to the parents of a 12-month-old child regarding appropriate play activities for this age? a. Give large push-pull toys for kinetic stimulation b. Place cradle gym across crib to help develop fine motor skills c. Provide child with finger paints to enhance fine motor skills d. Provide stick horse to develop gross motor coordination
a. Give large push-pull toys for kinetic stimulation
A nurse is admitting an infant with biliary atresia. Which is the earliest clinical manifestation of biliary atresia the nurse should expect to assess? a. Jaundice b. Vomiting c. Hepatomegaly d. Absence of stooling
a. Jaundice
The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool. Which nursing action is the most appropriate? a. Notify practitioner. b. Measure abdominal girth. c. Auscultate for bowel sounds. d. Take vital signs, including blood pressure.
a. Notify practitioner.
A boy age 4 1/2 years has been having increasingly frequent angry outbursts in preschool. He is aggressive toward the other children and the teachers. This behavior has been a problem for approximately 8 to 10 weeks. His parent asks the nurse for advice. Which of the following is the most appropriate intervention? a. Refer the child for a professional psychosocial assessment b. Explain that this is normal in preschoolers, especially boys c. Encourage the parent to try more consistent and firm discipline d. Talk to the preschool teacher to obtain validation for behavior parent reports
a. Refer the child for a professional psychosocial assessment
Which is an important nursing consideration in the care of a child with celiac disease? a. Refer to a nutritionist for detailed dietary instructions and education. b. Help child and family understand that diet restrictions are usually only temporary. c. Teach proper hand washing and standard precautions to prevent disease transmission. d. Suggest ways to cope more effectively with stress to minimize symptoms.
a. Refer to a nutritionist for detailed dietary instructions and education.
What pain scale would be most appropriate for the nurse to use for a four year old child? a. The FLACC Pain Assessment Tool b. The Comfort Scale c. The Wong-Baker FACES Pain Scale d. The Oucher Pain Scale
a. The FLACC Pain Assessment Tool
The parents are told to make certain that anyone caring for their child knows about his condition. When he is ready to go to school, school officials should know he has OI, as well. What two reasons should the nurse discuss with the parents as major reasons for letting others know? a. This alerts caregivers and teachers about the child's brittle bone condition. Because the injuries can occur unusually often, the parents could be suspected of child abuse. b. This prevents any damage to his self-esteem because of his short stature and limited mobility and allows his classmates to accept him more easily. c. This is so the caregivers can realign a fracture and prevent complications when providing initial first aid. d. This provides for opportunities for early socialization of the child so he can get along with children his own age and help teachers adjust to his condition.
a. This alerts caregivers and teachers about the child's brittle bone condition. Because the injuries can occur unusually often, the parents could be suspected of child abuse.
The child is started on hemodialysis and is given a transfusion of packed red blood cells. What monitoring by the nurse is critical to evaluate the effectiveness of treatment? a. Vital signs, lung sounds, and level of consciousness b. Abdominal circumference, pupil checks, and capillary refill c. Bowel sounds, skin turgor, and mucous membrane moisture d. Pallor, lethargy, and heart rate
a. Vital signs, lung sounds, and level of consciousness
The parents keep wondering how their otherwise healthy daughter could have gotten this illness. What question by the nurse would help uncover the source of the contamination? a. What did she eat or drink at the fair? b. Has she gone swimming in the family pool? c. Does she have a pet at home? d. Do you pack her lunch?
a. What did she eat or drink at the fair?
A toddler, age 16 months, falls down a few stairs. He gets up and "scolds" the stairs as if they caused him to fall. This is an example of which of the following? a. Animism b. Ritualism c. Irreversibility d. Delayed cognitive development
a. animism
The parents of a 2-month-old boy are concerned about spoiling their son by picking him up when he cries. The nurse's best response is which of the following? a. Allow him to cry for no longer than 15 minutes, then pick him up b. Babies need comforting and cuddling. Meeting these needs will not spoil him c. Babies this young cry when they are hungry. Try feeding him when he cries d. If he isn't soiled or wet, leave him and he'll cry himself to sleep
b. Babies need comforting and cuddling. Meeting these needs will not spoil him
The child's pain management is of great concern to his mother. What information about this child should the nurse take into account when providing medication for pain? a. Children with autism do not perceive pain as do regular children. b. Children with neurologic disorders, such as autism, are at greater risk than other children for undertreatment of pain. c. EMLA cream would be contraindicated for use prior to restarting the child's intravenous line. d. Distraction and guided imagery can be used to help make this child comfortable.
b. Children with neurologic disorders, such as autism, are at greater risk than other children for undertreatment of pain.
When discussing development and play activities with the parent of a 2-month-old boy. Which of the following statements by the parent would indicate a correct understanding of the teaching? a. I can give my baby a ball of yarn to pull apart or different textured fabrics to feel b. I can use a music box and soft mobiles as appropriate play activities for my baby c. I should introduce a cup and spoon or push pull toys for my baby at this age d. I do not have to worry about appropriate play activities at this age
b. I can use a music box and soft mobiles as appropriate play activities for my baby
The infant has not responded to the initial therapy and continues to have a high fever. What therapy would the nurse expect to administer to this infant? a. A transfusion of packed red cells b. Intravenous gamma globulin (IVIG) c. High doses of salicylates (aspirin) d. High doses of acetaminophen (Tylenol)
b. Intravenous gamma globulin (IVIG)
Initial treatment with intravenous antibiotics has not decreased the fever. What therapy would the nurse expect to administer? a. Ceftriaxone (Rocephin) and ibuprofen (Motrin) b. Intravenous gamma globulin (IVIG) and aspirin therapy c. Acyclovir (Zovirax) and calamine lotion d. Packed red blood cells and ketorolac (Toradol)
b. Intravenous gamma globulin (IVIG) and aspirin therapy
The parents still cannot understand why the tumor cannot be removed through tiny incisions in the abdomen. What reinforcement information can the nurse provide to explain this as simply as possible? a. The healing process takes longer with the small multiple incisions. b. The surgeon wants to remove the tumor with as little handling as possible. c. Anesthesia must be done for the shortest time because of the age of the child. d. The child will not understand why he has all of these "boo-boos" on his belly.
b. The surgeon wants to remove the tumor with as little handling as possible.
A 4-month-old infant has gastroesophageal reflux (GER) but is thriving without other complications. Which should the nurse suggest to minimize reflux? a. Place in Trendelenburg position after eating. b. Thicken formula with rice cereal. c. Give continuous nasogastric tube feedings. d. Give larger, less frequent feedings.
b. Thicken formula with rice cereal.
Which of the following statements is correct about toilet training? a. Bladder training is usually accomplished before bowel training b. Wanting to please the parent helps motivate the child to use the toilet c. Watching older siblings use the toilet confuses the child d. Children must be forced to sit on the toilet when first learning
b. Wanting to please the parent helps motivate the child to use the toilet
A 12-year-old comes to the infirmary 4 days after returning from sleeping out in the woods with the rest of his group. A small, red rash has appeared near an area where he may have been bitten. He denies seeing anything bite him. What would the nurse expect to do for the patient after the physician sees him? a. wash off the affected area with an antibacterial soap b. administer an initial dose of doxycycline c. apply an antiseptic cream to the area with the rash d. monitor the boy for signs and symptoms of tick-borne diseases
b. administer an initial dose of doxycycline
Which of the following is the most common form of child maltreatment? a. sexual abuse b. child neglect c. physical abuse d. emotional abuse
b. child neglect
A 4-year-old boy is hospitalized with a serious bacterial infection. He tells the nurse that he is sick because he was "bad." Which of the following is the nurse's best interpretation of this comment? a. sign of stress b. common at this age c. suggestive of maladaptation d. suggestive of excessive discipline at home
b. common at this age
A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results. However, the mother refuses to see or hold her baby. Initial therapeutic approach to the mother should be: a. restating what the physician has told her about plastic surgery. b. encouraging her to express her feelings. c. emphasizing the normalcy of her baby and the baby's need for mothering. d. recognizing that negative feelings toward the child continue throughout childhood.
b. encouraging her to express her feelings.
Pyloric stenosis can best be described as: a. dilation of the pylorus. b. hypertrophy of the pyloric muscle. c. hypotonicity of the pyloric muscle. d. reduction of tone in the pyloric muscle.
b. hypertrophy of the pyloric muscle.
The nurse is interviewing the father of a 10-month-old. The child is playing on the floor when she notices an electrical outlet and reaches up to touch it. Her father says "no" firmly and moves her away from the outlet. The nurse should use this opportunity to teach the father that the child: a. should be given a time-out b. is old enough to understand the word "no." c. will learn safety issues better if she is spanked d. should already know that electrical outlets are dangerous
b. is old enough to understand the word "no."
The parent of a 4-year-old boy tells the nurse that the child believes "monsters and bogeymen" are in his bedroom at night. The nurse's best suggestion for coping with this problem is which of the following? a. let the child sleep with his parents b. keep a night light on in the child's bedroom c. help the child understand that these fears are illogical d. tell the child that monsters and bogeyman do not exist e. sleep terror f. sleep apnea g. seizure activity
b. keep a night light on in the child's bedroom e. sleep terror
The mother of a 6-month-old infant has returned to work and is expressing breast milk to be frozen. She asks for directions on how to safely thaw the breast milk in the microwave. The nurse should recommend which of the following? a. heat only 10 oz or more b. never thaw or heat breast milk in a microwave oven c. always leave bottle top uncovered to allow heat to escape d. shake bottle vigorously for at least 30 seconds after heating
b. never thaw or heat breast milk in a microwave oven
The physician orders a lateral neck x-ray film. The most important nursing action related to this is to a. ask parents to remain with steven during xray exams b. request portable xray film to be taken in the ED c. transport steven in a sitting position to radiography d. transport steven in a supine position to radiology
b. request portable xray film to be taken in the ED
In terms of cognitive development, the 5-year-old child would be expected to do which of the following? a. thick abstractly b. use magical thinking c. understand conservation of matter d. understand another person's perspective
b. use magical thinking
The parents of a 7-year-old boy tell the nurse that lately he has been cruel to their family pets and actually caused physical harm. The nurse's recommendations should be based on knowledge that this is: a. expected behavior at this age. b. warning sign of a serious problem. c. harmless venting of anger and frustration. d. common in children who are physically abused.
b. warning sign of a serious problem.
A school-age child with diarrhea has been rehydrated. The nurse is discussing the child's diet with the family. Which statement by the parent would indicate a correct understanding of the teaching? a. "I will keep my child on a clear liquid diet for the next 24 hours." b. "I should encourage my child to drink carbonated drinks but avoid food for the next 24 hours." c. "I will offer my child bananas, rice, applesauce, and toast for the next 48 hours." d. "I should have my child eat a normal diet with easily digested foods for the next 48 hours."
c. "I will offer my child bananas, rice, applesauce, and toast for the next 48 hours."
At what age would the nurse expect an infant to be able to say "mama" and "dada" with meaning? a. 4 months b. 6 months c. 10 months d. 14 months
c. 10 months
By what age should the nurse expect that an infant will be able to pull to a standing position? a. 6 months b. 8 months c. 11 to 12 months d. 14 to 15 months
c. 11 to 12 months
At about what age does an infant start to recognize familiar faces and objects, such as own hand? a. 1 month b. 2 months c. 3 months d. 4 months
c. 3 months
at what age do most infants begin to fear strangers? a. 2 months b. 4 months c. 6 months d. 12 months
c. 6 months
At what age can most infants sit steadily unsupported? a. 4 months b. 6 months c. 8 months d. 12 months
c. 8 months
The child is treated with vincristine as part of the postoperative chemotherapy. What assessment by the nurse is critical to identify a potentially serious side effect from this specific therapy? a. Lung sounds, blood glucose levels, and intake measurements b. Laboratory work focusing on red blood cells, level of consciousness, and appetite c. Bowel sounds, vomiting, and abdominal distention d. Urinary output, skin integrity, activity level
c. Bowel sounds, vomiting, and abdominal distention
Which is used to treat moderate to severe inflammatory bowel disease? a. Antacids b. Antibiotics c. Corticosteroids d. Antidiarrheal medications
c. Corticosteroids
The nurse conducts a briefing for the camp on the prevention of Lyme disease. What information should be included in the presentation? a. Wear dark clothing, tightly tucked in, with dark socks and dark shoes. b. Apply insect repellents containing diethyltoluamide (DEET) to the face and hands. c. Dress in light-colored clothing so that any ticks can be spotted fairly easily. d. Scrub vigorously in the shower immediately after returning from the woods.
c. Dress in light-colored clothing so that any ticks can be spotted fairly easily.
Which is a parasite that causes acute diarrhea? a. Shigella organisms b. Salmonella organisms c. Giardia lamblia d. Escherichia coli
c. Giardia lamblia
Which therapeutic management should the nurse prepare to initiate first for a child with acute diarrhea and moderate dehydration? a. Milk of Magnesia b. Adsorbents, such as kaolin and pectin c. Oral rehydration Therapy or Oral rehydration solution (ORS) d. Antidiarrheal medications such as paregoric
c. Oral rehydration Therapy or Oral rehydration solution (ORS)
Which observation made of the exposed abdomen is most indicative of pyloric stenosis? a. Abdominal rigidity b. Substernal retraction c. Palpable olive-like mass d. Marked distention of lower abdomen
c. Palpable olive-like mass
The nurse is explaining to a parent how to care for a school-age child with vomiting associated with a viral illness. Which action should the nurse include? a. Coke or other soda containing liquids. b. Give nothing by mouth for 24 hours. c. Small amount of Oral rehydration therapy. d. Give plain water until vomiting ceases for at least 24 hours.
c. Small amount of Oral rehydration therapy.
Constipation has recently become a problem for a school-age girl. She is healthy except for seasonal allergies that are being treated with antihistamines. The nurse should suspect that the constipation is most likely caused by: a. diet b. allergies c. antihistamines d. emotional factors
c. antihistamines
Steven's parents ask what causes epiglottitis. Based on the nurse's knowledge of epiglottitis, the most appropriate response is a. viral b. bacterial, staphylococcus aureus c. bacterial, heamophilus influenzae d. bacterial, B-hemolytic streptococci
c. bacterial, heamophilus influenzae
In girls the initial indication of puberty is which of the following? a. menarche b. growth spurt c. breast development d. growth of pubic hair
c. breast development
Kimberly needs instructions about using a metered-dose inhaler (MDI). The nurse should explain that the MDI is used to a. improve oxygenation. assess b. severity of symptoms. c. distribute prescribed medication directly to airways. d. distribute prescribed medication systemically without the need for injection
c. distribute prescribed medication directly to airways.
Which of the following is the most appropriate recommendation for relief of teething pain? a. rub gums with aspirin to relieve inflammation b. apply hydrogen peroxide to gums to relieve irritation c. give child a frozen teething ring to relieve inflammation d. have child chew on a warm teething ring to encourage tooth eruption
c. give child a frozen teething ring to relieve inflammation
During a well-child visit the father of a 4-year-old boy tells the nurse that he is not sure if his son is ready for kindergarten. The boy's birthday is close to the cut-off date, and he has not attended preschool. Which of the following is the nurse's best recommendation? a. start kindergarten b. observe a kindergarten class c. perform developmental screening d. postpone kindergarten and go to preschool
c. perform developmental screening
A four year old child tells the nurse that she doesn't want another blood sample drawn because "I need all of my insides and I don't want anyone taking them out". Which of the following is the nurses's best interpretation of this? a. child is being overly dramatic b. child has a disturbed body image c. preschoolers have poorly defined sense of skin properties d. preschoolers normally have a good understanding of their bodies
c. preschoolers have poorly defined sense of skin properties
Epinephrine is ordered to be given subcutaneously. The purpose of epinephrine is to a. promote relaxation b. reduce inflammation c. relieve bronchospasm d. correct respiratory acidosis
c. relieve bronchospasm
Although a 14-month old received a shock from an electrical outlet recently, her parent finds her about to place a paper clip in another outlet. Which of the following is the best interpretation of this behavior. a. her cognitive development is delayed b. this is typical behavior because toddlers are not very developed c. this is typical behavior because of inability to transfer knowledge to new situations d. this it not typical behavior because toddlers should know better than to repeat an act that caused pain
c. this is typical behavior because of inability to transfer knowledge to new situations
In terms of gross motor development, what would the nurse expect an infant age 5 months to do? a. sit erect without support b. roll from back to abdomen c. turn from abdomen to back d. move from prone to sitting position
c. turn from abdomen to back
During the 2-month well-child check-up the nurse expects the infant to respond to sound in the following manner: a. responds to name b. reacts to loud noise with moro reflex c. turns head to side when sound it at ear level d. locates sound by turning head in a curving sac
c. turns head to side when sound it at ear level
A nurse is conducting an in-service on gastrointestinal disorders. The nurse includes that melena, the passage of black, tarry stools, suggests bleeding from which area? a. perianal or rectal area b. hemorrhoids or anal fissures c. upper GI tract d. lower GI tract
c. upper GI tract
Which clinical manifestation would be the most suggestive of acute appendicitis? a. Rebound tenderness in left upper quadrant b. Bright red or dark red rectal bleeding c. Abdominal pain that is relieved by eating d. Abdominal pain that is most intense at McBurney point
d. Abdominal pain that is most intense at McBurney point
The psychosocial developmental tasks of toddlerhood include which of the following? a. Development of a conscience b. Recognition of sex differences c. Ability to get along with age-mates d. Ability to delay gratification
d. Ability to delay gratification
Which of the following is true concerning the development of autonomy during adolescence? a. Development of autonomy typically involves rebellion b. Development of autonomy typically involves parent-child conflicts c. Parent and peer influences are opposing forces in the development of autonomy d. Conformity to both parents and peers gradually declines toward the end of adolescence
d. Conformity to both parents and peers gradually declines toward the end of adolescence
An infant, age 6 months, has six teeth. The nurse should recognize that this is which of the following? a. Normal tooth eruption b. Delayed tooth eruption c. Unusual and dangerous d. Earlier than expected tooth eruption
d. Earlier than expected tooth eruption
Which should the nurse do first? a. Assess for dehydration b. Obtain a throat culture c. Have Steven lie down to ease respirations d. Have a pediatric tracheostomy set available
d. Have a pediatric tracheostomy set available
Which of the following characteristics best describes the fine motor skills of an infant at age 5 months? a. neat pincer grasp b. strong grasp reflex c. builds a tower of two cubes d. able to grasp object voluntary
d. able to grasp object voluntary
Adolescents often do not use reasoned decision making when issues such as substance abuse and sexual behavior are involved. This is because they: a. tend to be immature b. do not need to use reasoned decision making c. lack cognitive skills to use reasoned decision making d. are dealing with issues that are stressful and emotionally laden
d. are dealing with issues that are stressful and emotionally laden
Which of the following types of play is most typical of the preschool period? a. team b. parallel c. solitary d. associative
d. associative
The developmental task with which the child of 15-30 months is likely to be struggling is a sense of what? a. trust b. initiative c. intimacy d. autonomy
d. autonomy
Prevention of sunburn is one of the major information sessions the nurse presents to the campers as well as the counselors. What information is most important for the nurse to stress during these sessions? a. Once sunscreens are applied, they are effective for 2 to 3 hours. b. Sunscreens without p-aminobenzoic acid (PABA) prevent fewer allergic reactions in children. c. A sunscreen with a sun protection factor (SPF) of 20 provides protection for approximately 200 minutes. d. sunscreen must be reapplied at frequent intervals and in liberal amounts
d. sunscreen must be reapplied at frequent intervals and in liberal amounts
Which therapeutic management treatment is implemented for children with Hirschsprung disease? a. daily enemas b. low fiber diet c. permanent colostomy d. surgical removal of affected section of bowel
d. surgical removal of affected section of bowel
Which of the following characteristics best describes the language skills of a 3-year-old child? a. asks meanings of words b. follows directional commands c. can describe an object according to its composition d. talks incessantly regardless of whether anyone is listening
d. talks incessantly regardless of whether anyone is listening
The parents of a newborn say that their toddler "hates the baby. . . . He suggested that we put him in the trash can so the trash truck could take him away." The nurse's best reply is which of the following? a. let's see if we can figure out why he hates the new baby b. that's a strong statement to come from such a small boy c. let's refer him to counseling to work this hatred out. It's not a normal response d. that is a normal response to the birth of a sibling. let's look at ways to deal with this
d. that is a normal response to the birth of a sibling. let's look at ways to deal with this
Which of the following characteristics best describes the gross motor skills of a 24 month old child? a. skips b. broad jumps c. rides tricycle d. walks up and down stairs e. binocularity may be established
d. walks up and down stairs
