Pediatrics Quiz 2

1. One of the tasks of adolescence, as defined by Erikson, is: 1. finding an identity. 2. sexual latency. 3. heterosexuality. 4. concrete operations.

1. ANS: 1 The major tasks of adolescence include establishing an identity, separating from family, initiating intimacy, and developing career choices for economic independence. Erikson identifies the major task of this group as identity versus role confusion. Emancipation is a critical element in the establishment of identity. REF: General characteristics; Box 20-1

1. The pulse of the school-age child is approximately: 1. 100 to 120 beats/min. 2. 95 to 100 beats/min. 3. 85 to 100 beats/min. 4. 60 to 80 beats/min.

1. ANS: 3 The vital signs of the school-age child are near those of the adult. The pulse is 85 to 100 beats/minute. REF: Physical growth

2. A parent asks the nurse if it is healthy to allow her school-age child to play computer games after school every day. The best response of the nurse would be that computer and video games: a. interest the school-age child and they will keep him off the streets. b. can challenge the intellect but should be balanced with active play, with no more than 2 hours of screen time per day. c. should only be played on weekends and not on school days. d. some programs teach new skills and are appropriate for school-age children. 1. a and b 2. a and c 3. b and d 4. all of the above

2. ANS: 3 Computer and video games challenge intellect and skill and are healthy outlets as long as they do not completely replace active physical play. REF: Play

2. When communicating with an adolescent about safety concerns, which concept of adolescent behavior should be considered? 1. The typical adolescent understands teaching and respects and usually follows the advice of adults. 2. Growth and development are complete in the adolescent, and muscle coordination and skills lessen the risks for injury. 3. Safety concerns at this age mostly focus on sports injuries. 4. Adolescents are risk takers and tend to experiment with potentially dangerous outcomes.

2. ANS: 4 Adolescents are risk takers when it comes to sports, sexuality, and drugs, among other things. They tend to experiment with potentially dangerous outcomes. REF: Common problems of adolescence

4. The appropriate amount of time to use in a time-out period for a 3-year-old child is: 1. 1 minute. 2. 3 minutes. 3. 5 minutes. 4. 10 minutes.

4. ANSWER: 2 Time-out periods, usually lasting 1 minute per year of age, with the child sitting in a straight chair facing a corner, are considered an effective discipline technique. REF: Timing the time out

3. Puberty can most accurately be defined as the period of life characterized by the: 1. occurrence of sexual maturity and appearance of secondary sex characteristics. 2. substitution of adult interests and value systems for child interests. 3. most rapid rate of physical and mental growth and development. 4. awakening of sexual feelings and the initiation of sexual experience.

3. ANS: 1 Puberty is the stage in which the reproductive organs become functional and secondary sex characteristics develop. REF: Growth and development

3. While playing in school, a 9-year-old child suffers an injury that knocks his tooth out of his mouth. What should the teacher or school nurse do? 1. Place the tooth in a cup of clean water and send the child home. 2. Place the tooth in a cup of milk, and call the parent to take the child to the dentist. 3. Wrap the tooth in a clean cloth and call the parent to take the child to the dentist. 4. Rinse the child's mouth and place the tooth in an envelope for the child to show his parent.

3. ANS: 2 When a permanent tooth is accidentally knocked out of the socket, the tooth should be picked up by the crown to avoid damaging the root area. Place the tooth in milk until the child and tooth arrive at the dentist's office. REF: Play

4. The parent of an 8-year-old child seeks advice from the nurse because her child is overweight. What would the nurse advise the parent to do? 1. Provide a reward for the child when he avoids between-meal snacks for a full week. 2. Limit privileges when the child eats sweets or junk food. 3. Include the child in meal planning and preparation. 4. Limit party-going activities where sweets will be served.

4. ANS: 3 Eight-year-old children like to be considered important, particularly by adults. By including the child in meal planning and preparation, the parents assist the child in feeling important, as well as aid in making the school-age child a more responsible person. REF: The 8-year-old

4. A 16-year-old adolescent towers over her companions, which bothers her. She confides in the nurse, saying, "I just hate school - everyone is always staring at me." The nurse's best response would be: 1. "Don't pay any attention to it." 2. "You just don't know how lucky you are to be tall." 3. "This will resolve itself in time. Don't worry." 4. "Tell me more about how this embarrasses you."

4. ANS: 4 The nurse must open the lines of communication and share with adolescents to enable them to feel at ease before initiating care or teaching. Open-ended questions concerning common problems of adolescence may encourage the discussion of a topic that adolescents may not initiate by themselves. REF: Health promotion and guidance

5. Which action is most important when planning nutrition management for the adolescent? 1. Planning a low-calorie diet 2. Incorporating favorite or fad foods into the diet 3. Encouraging a positive attitude toward obesity 4. Skipping a meal to reduce caloric intake

5. ANS: 2 Foods for the adolescent should be selected from the basic food pyramid. Foods and eating fads are often a conflict between adolescents and their parents. Incorporating favorite or fad foods into the diet will increase the chances of compliance. Adolescents grow rapidly and expend large amounts of energy. The nurse attempts to involve the adolescent in selecting foods that are nutritious and appetizing. This may be done by reviewing choices made on the daily menu. REF: Sports and nutrition

5. A 9-year-old practicing the piano continues to have difficulty playing the theme song from a popular movie. She starts to pound on the piano keys in frustration. The best response would be to enter the room and say: 1. "Just what do you think you're doing? That piano cost money!" 2. "That's not difficult. Pull yourself together or you'll never amount to anything." 3. "That piece sounds hard. I can see how you could be discouraged." 4. "Here, let me show you how to play that."

5. ANS: 3 A warm, ongoing relationship between the parents and child helps to provide a safe atmosphere of caring. Mutual respect involves accepting the child's feelings. REF: The 9-year-old

5. A 4-year-old child is in Erikson's stage of: 1. autonomy. 2. industry. 3. initiative. 4. identity.

5. ANSWER: 3 Erikson's stage for the preschool years is initiative versus guilt. REF: Table 18-1

6. During the administration of medications, a 17-year-old patient tells the nurse that he has never had that particular pill before. The best nursing action would be: a. check the patient's ID band again.b. assure the patient that the medication packet has his name on it.c. ask the patient to take the medication since the ID band and the medication administration record match.d. check the health care provider's written orders to confirm if this medication is newly prescribed.1. a and b2. c only3. a and d4. all of the above

6. ANS: 3 Adolescent is capable of knowing and understanding the care he is given and communication with an adolescent should be treated with respect. It is a nursing responsibility to assure the right medication is given to the right patient, therefore the medication administration record must be reassessed. REF: The Nursing approach to adolescence

6. A parent asks the nurse if her preschool child can be allowed to have screen time since her older brother uses the electronic tablet. An appropriate response of the nurse would be: a. Noneducational screen time should be limited to 1 hour per day of quality programs. b. Parents should be present when the child is using the electronic tablet. c. Screen time should be balanced with active play during the day. d. Noneducational screen time should be limited. e. Offering screen time is one way a parent can rest or get some work done in the home. 1. a, b, c and d 2. c and e 3. a and d 4. b, c and e

6. ANSWER: 1 All suggestions are strongly recommended when young children experiencing screen time as part of their play. REF: Types of play

A 4-year-old girl is outside playing and tells her father that the "flowers are talking and having a tea party." This is an example of what? a. Animism b. Artificialism c. Egocentrism d. Centering

a. Animism Animism is a misconception that can arise during the preschool years. It is a tendency to attribute life to inanimate objects.REF: p. 424

Which of the following would be the most likely playmate choice for an 8-year-old girl? a. Another 8-year-old girl b. An 8-year-old boy c. Either an 8-year-old boy or an 8-year-old girl d. Her mother

a. Another 8-year-old girl The 8-year-old wants to do everything and can play alone for a longer period than previously. These children enjoy group activities and prefer companions of the same sex.REF: p. 439

Which is considered a sign of depression in the adolescent? a. Change in school performance b. Experimenting with members of the same sex c. Becoming secretive about activities with peer groups d. Decrease in appetite during the school day

a. Change in school performance Adolescents may experience with members of the opposite sex while identifying their role. Adolescents may also become secretive with peer groups, but it would be concerning if they started withdrawing from peer groups. Adolescents typically have decreased appetites during the day because of their level of activity.

What is the best food choice for the nurse to recommend an adolescent eat before an important exam? a. Fish and rice b. Eggs and bacon c. Pancakes and sausage d. A peanut butter sandwich and grapefruit

a. Fish and rice For an adolescent scheduled to take an important school examination, the nurse can offer nutritional guidance as part of the examination preparation. Fish, soy, peanuts, and rice increase choline and acetylcholine in the brain, which results in increased memory.REF: p. 473

What is the most appropriate activity for a 5-year-old child? a. Riding a tricycle b. Playing a soccer game c. Watching television d. Stacking colorful blocks

a. Riding a tricycle Five-year-olds can ride a tricycle around the playground with speed and dexterity. Adults should encourage them to develop motor skills. The number and types of television or computer programs that parents allow the preschool child to watch are topics for discussion. The 5-year-old may want to spend a great deal of time watching television or playing computer games. Television and computer games should not be allowed to interfere with good health habits.REF: p. 429

Which intervention would be appropriate when dealing with a preschooler's sexual curiosity? a. Use correct terminology to prevent misunderstanding. b. Defer questions about sexuality until the child is older. c. Allow a sibling to share basic information. d. Both parents should be present for any question/answer sessions.

a. Use correct terminology to prevent misunderstanding. The recommendation is to deal with a child's curiosity when it occurs, using appropriate terminology when talking with preschooler. This curiosity is normal in this age group. Siblings should not provide education when questions are addressed to parents. Parents don't necessarily have to do this task together.REF: p. 425

3. The nurse is guiding a parent concerning techniques of handling a child with enuresis. The most appropriate suggestion by the nurse would be to: 1. wake the child often during the night and take him to the bathroom to void. 2. limit liquids after dinner and have the child void before going to bed. 3. use a consistent technique of discipline whenever the bed is wet. 4. keep the child in diapers until bed wetting is no longer a problem.

answer 2 it is essential that the child with enuresis be the center of the management program. the positive approach of rewarding dry night and charting progress is very helpful. Liquids after dinner should be limited, and the child should routinely void before going to bed

2. An example of a therapeutic play activity for a preschool child who is recovering from an appendectomy would be: 1. a Wii game of bowling. 2. blowing bubbles. 3. reading a storybook. 4. coloring with crayons.

answer 2 play and toys can be of therapeutic value in retraining muscles, improving eye-hand coordination, and helping children crawl and walk (push-pull toys). Blowing is an excellent prerequisite for speech therapy and blowing out the light of flashlight as if it were a candle is therapeutic play for the postoperative child. blowing bubbles after an appendectomy can help with lung expansion

1. When selecting play activities for a healthy 4-year-old, the parent should be guided to understand that the 4-year-old enjoys: 1. solitary play, sitting next to a friend. 2. cooperative play with friends. 3. competitive play with teams. 4. observing rather than participating.

answer 2 the preschool child gradually moves from parallel and associative play to cooperative play with playmates. The play of preschool children should be noncompetitive. One of the major task of the preschool child includes development of cooperative

What is the most appropriate intervention to instruct parents to implement when a child gets his or her tooth knocked out? a. "Your child will need a tetanus shot ASAP." b. "Please put the tooth in milk and call the dentist." c. "Place ice on the jaw and go to the emergency room." d. "If it is bleeding, apply pressure. If not, make an appointment with e. the dentist."

b. "Please put the tooth in milk and call the dentist." The recommendation is to place the tooth in milk and call the dentist. REF: p. 443

A child is 25 pounds at his 1-year well visit. The nurse would expect him to be approximately _____ pounds at his 5-year well visit. a. 45 b. 50 c. 60 d. 75

b. 50 The healthy infant should double the 1-year weight by 5 years of age.REF: p. 423

Which actions can help to prevent obesity? (Select all that apply.) a. Occasionally skipping a meal b. Eating breakfast every day c. Increasing physical activity d. Encouraging computer time e. Eating family meals

b. Eating breakfast every day c. Increasing physical activity e. Eating family meals Tips to help prevent obesity include using appropriate serving sizes, limiting soda and juice intake, replacing whole milk with skim milk, eating breakfast every day, eating family meals, parents role modeling healthy eating and activity, encouraging physical activity, and decreasing computer and TV time.REF: p. 451

What are the benefits to assigning chores to a 12-year-old? (Select all that apply.) a. Helps get the work done b. Helps the child take responsibility c. Helps the child burn energy d. Helps the child develop self-esteem

b. Helps the child take responsibility d. Helps the child develop self-esteem Chores help a child to gain self-esteem and see the relationship of working to earn money and make the child feel like an important member of the family.REF: p. 447

Which stage of adolescent development is considered the time of greatest turmoil for most families? a. Early adolescence b. Middle adolescence c. Late adolescence d. Transitional adolescence

b. Middle adolescence Middle adolescence appears to be the time of greatest turmoil for most families.REF: p. 459

A physical exam of an adolescent female reveals projection of the areola and papilla to form a secondary mound on the breast. According to Tanner, which stage of sexual maturity is this considered? a. 2 b. 3 c. 4 d. 5

c. 4 The papilla and areola project during stage 4.REF: p. 463

Which intervention is considered inappropriate when disciplining a preschool child? a. Provide discipline at time of incident b. Provide warning about poor choices, but not too many c. Provide timeouts lasting 1 minute per year of age d. Administer spanking for dangerous behaviors

d. Administer spanking for dangerous behaviors Research shows that spanking is not an effective tool for discipline.REF: p. 429

A 3-year-old child's mother reports that she "seems to understand what is said, but when she wants something just points." What does the nurse suspect this child is displaying? a. A normal occurrence for a preschool child b. Language loss c. An articulation disorder d. An expressive language delay

d. An expressive language delay Typically, during the preschool period between 2 and 5 years of age, the number of words in the child's sentence should equal the child's age. A child who understands what is being said but just points to what he or she wants most likely has an expressive language delay.REF: p. 427

Which theorist stated that the school-age child is in a time of sexual latency? a. Piaget b. Kohlberg c. Erikson d. Freud

d. Freud Freud refers to the school-age period as a time of sexual latency.

A child with an allergy to animal dander has asked his parents for a pet. What would be the best response from the nurse? a. Children with allergies should not have pets. b. A cat would be the best choice. c. Desensitization of the child will be necessary. d. Having an allergy to animal dander does not rule out pet ownership.

d. Having an allergy to animal dander does not rule out pet ownership. Having an allergy to animal dander does not always rule out having a pet. Parent education concerning pet selection and hygiene can assist the family in making a decision that is best for all family members.REF: p. 452

A group of preschool children sit on chairs they have arranged in two lines to pretend they are riding a bus. What type of play is this an example of? a. Centering b. Parallel play c. Artificialism d. Symbolic functioning

d. Symbolic functioning Symbolic functioning is seen in the play of children who pretend that an empty box is a fort; they create a mental image to stand for something that is not there.REF: p. 424

The mother of a 15-year-old girl states that her daughter always believes people are looking at her. What is the best education the nurse can provide at this time? a. This is unusual behavior and may require counseling. b. This may begin to interfere with the girl's development. c. This is behavior that should be discussed with the physician. d. This is normal behavior for an adolescent.

d. This is normal behavior for an adolescent. Adolescents create what has been termed an imaginary audience, which means they believe everyone is looking at them. This preoccupation with self is normal and accounts for the constant hair combing and makeup repairing often observed in a group of adolescents.REF: p. 466