PEDs exam 2 set 1
The nurse is assessing a 4 year old child. Which of the following findings would cause the nurse to become alarmed? A. Doesn't have a concept of time B. Cannot tie a knot C. Cannot walk down the stairs alone D. Haven't started to lose their temporary teeth
C. Cannot walk down the stairs alone
Who is credited with discovering the first safe vaccination? He discovered that inoculation with cowpox would protect a person from small pox? A. Jonas Salk B. Albert Sabin C. Edward Jenner D. Peter Jennings
C. Edward Jenner
During a well-baby visit, Liza asks the nurse when she should start giving her infant solid foods. The nurse should instruct her to introduce which solid food first? A. Applesauce B. Egg whites C. Rice cereal D. Yogurt
C. Rice cereal
Which of the vaccines given to infants betwen birth and 12 months is administered orally? A. Polio (IPV) B. Influenza (TIV) C. Rotavirus D. Polio (IPV) & Rotavirus (RV)
C. Rotavirus
The nurse understands that unless contraindicated, in the United States, all newborns receive the following immunization: a. Varicella zoster b. Rubella c. DTaP d. Hepatitis B
d. Hepatitis B
When teaching parents about typical toddler eating patterns, which of the following should be included? A .Food "jags." B. Preference to eat alone C. Consistent table manners D. Increase in appetite
A .Food "jags." Toddlers become picky eaters, experiencing food jags and eating large amounts one day and very little the next. A toddler's food gags express a preference for the ritualism of eating one type of food for several days at a time.
The family member of a patient with lung cancer has asked the nurse about palliative care for the patient. Which describes when palliative care is appropriate for a patient? Select all that apply. A. When the patient has a terminal condition B. When the patient wants alternative treatment from standard medicine C. When the patient seeks spiritual comfort in addition to physical comfort D. When all other curative treatments have failed for this patient E. When the patient's family also needs support
A, C, E
What are the physiological symptoms suggesting impending death? Select all that apply. A.Loss of bowel and bladder function B. Agitation C. Anger D. Cheyne-Stokes respiration E. Decreased blood pressure
A, D, E
The nurse is caring for a terminally ill child who is receiving palliative care. When explaining the purpose of palliative care to the child's caregiver, the nurse recognizes the need for additional instruction when the caregiver makes which statement? A. "Palliative care interventions hasten death." B. "Palliative care promotes optimal functioning." C. "Palliative care will provide pain management." D. "Palliative care will provide symptom management."
A. "Palliative care interventions hasten death." Rationale: Palliative care interventions do not serve to hasten death; rather, they provide pain and symptom management, attention to issues faced by the child and family with regard to death and dying, and promotion of optimal functioning and quality of life.
Cherry, the mother of an 11-month-old girl, Elizabeth, is in the clinic for her daughter's immunizations. She expresses concern to the nurse that Elizabeth cannot yet walk. The nurse correctly replies that, according to the Denver Developmental Screen, the median age for walking is: A. 12 months. B. 15 months. C. 10 months. D. 14 months.
A. 12 months.
The parent of a 3-month-old infant asks the nurse, "At what age do infants usually begin drinking from a cup?" The nurse would reply: A. 6 months. B. 9 months. C. 1 year. D. 2 years.
A. 6 months.
A patient is hospitalized with severe depression after her divorce is finalized. Which type of loss is the patient experiencing? A. Actual B. Perceived C. Physical D. External
A. Actual Rationale: The loss of a relationship is an actual loss. An actual loss is a reality that can be identified by others, not just by the person experiencing it. Perceived loss is internal; it can only be identified by the person experiencing the loss. Physical loss includes injuries, removal of an organ or body part, or loss of function. An external loss is an actual loss of an object.
A newly diagnosed patient states, "I hate this cancer." According to Kübler-Ross, what stage of loss is being verbalized? A. Anger B. Bargaining C. Depression D. Denial
A. Anger
According to the Centers for Disease Control and Prevention, which of the following best describes the recommended ages to administer the measles, mumps, and rubella vaccine? A. At 12 months and at 4 to 6 years of age B. At 6 months and at 12 months of age C. At 3 months, 6 months, and at 12 months of age D. At birth, 3 months, 9 months, and 15 months of age
A. At 12 months and at 4 to 6 years of age
At what age does a child develop gender identity? A. By 3 years of age B. By 5 years of age C. By 6 years of age D. By 12 months of age
A. By 3 years of age
The nurse is assessing a 24 month old child. Which of the following findings would cause the nurse to become alarmed? A. Cannot build a 3 block tower B. Doesn't copy circles C. Isn't toilet trained D. Cannot lace their own shoes
A. Cannot build a 3 block tower
The nurse is assessing a 6 year old child. Which of the following findings would cause the nurse to become alarmed? A. Cannot throw a ball over head B. Cannot print C. Eye developement is not complete D. Isn't able to do activities on their own
A. Cannot throw a ball over head
Which of the following is considered a high-fat food? A. Chocolate milk. B. Broccoli. C. Apple. D. Salmon
A. Chocolate milk.
What element is the primary factor that dictates the rituals of mourning? A. Culture B. Age C. Gender D. Religion
A. Culture
Which of the following actions demonstrates that 2½-year-old Delaney's parents understand the developmental tasks of toddlers? A. Delaney picks which toy she will take to day care every day. B. One of the parents feeds Delaney at the same times each day. C. Delaney's mother chooses her daughter's clothes before she goes to bed each night. D. Delaney's parents turn the pages when reading to her, so they will not get torn.
A. Delaney picks which toy she will take to day care every day. Toddlers want to be independent and choose for themselves; choosing which toy to bring each day supports her independence.
The nurse is assessing a 5 month old baby for growth and development. What weight should this baby be? A. Double the birth weight B. Triple the birth weight C. Quadruple the birthweight D. Birth weight isn't a good measure of growth and development
A. Double the birth weight
Documentation which is required by law whenever vaccines are given is: A. Edition of the VIS provided to the client B. Needle size and length C. Client's tolerance D. Client's insurance billing information
A. Edition of the VIS provided to the client
A nurse is helping a family whose father is dying of cancer. The nurse notes that one of the grown children in the family does not want to talk about the situation and often leaves the room when the group discusses topics about their father's funeral. The mother tells the nurse, I am so hurt that my son will not talk to us! He must be angry. Which response from the nurse is most appropriate? A. Everyone grieves differently and it is probably nothing personal against you. B. He may need counseling later, but for now, we'll try to get him involved. C. He probably is hurt that everyone wants to discuss the funeral so much. D. I will tell him he needs to talk to you and that you feel bad.
A. Everyone grieves differently and it is probably nothing personal against you.
The nurse is teaching the parents of a 3 month-old infant about nutrition. What is the main source of fluids for an infant until about 12 months of age? A. Formula or breastmilk B. Dilute nonfat dry milk C. Warmed fruit juice D. Fluoridated tap water
A. Formula or breastmilk
Which of the senses is believed to be the last one lost as a person nears death? A. Hearing B. Vision C. Touch D. Smell
A. Hearing
The nurse is assessing a four-month-old infant. The nurse would anticipate finding that the infant would be able to A. Hold a rattle B. Bang two blocks C. Drink from a cup D. Wave "bye-bye"
A. Hold a rattle
Which age group would be appropriate for a child exhibiting the following characteristics?: crawl, pull themselves to a standing position, use pincer grip to pick up objects, and put actions to words such as the itsy bitsy spider and other childhood rhymes. A. Infancy (birth-1 year) B. Toddler (1-3 years) C. Preschool (3-6 years) D. School Age (6-12 years)
A. Infancy (birth-1 year)
When implementing the immunization teaching care plan which activity is part of the evaluation? A. Patient/parent will report their vaccine questions and concerns were addressed. B. Discuss vaccine concerns, clarify misconceptions. C. Assess their concerns, attitudes, and/or misconceptions about immunizations. D. Provide follow up with physician if vaccine concerns persist.
A. Patient/parent will report their vaccine questions and concerns were addressed.
Which of the following assessment findings is likely to have a negative, long-term effect on a patient's nutritional status? A. Poor dental health B. Family history of obesity C. Preference for a vegetarian lifestyle
A. Poor dental health
A couple has brought their 7-year-old child in for a routine pediatric physical. The parents are concerned because their son seems much shorter when compared to his peers. Which component of the assessment is most important to include when identifying growth problems with this patient? A. The patients nutrition status and fluid intake B. Whether the patient is exposed to secondhand smoke C. Whether the patient has a history of allergies D. The patients sleep habits
A. The patients nutrition status and fluid intake
The parents of a 2-year-old boy who died of leukemia are experiencing intense grief in the months following his death. Which of the following is a factor that would affect how these parents experience grief? A. The personality style of the grieving person B. The age of the person who died C. The gender of the deceased person D. The life history of the person who died
A. The personality style of the grieving person
A clinic nurse assesses the communication patterns of a 5-month-old infant. The nurse determines that the infant is demonstrating the highest level of developmental achievement expected if the infant: A) Uses simple words such as "mama" B) Uses monosyllabic babbling C) Links syllables together D) Coos when comforted
B) Uses monosyllabic babbling Rationale: Using monosyllabic babbling occurs between 3 and 6 months of age. Using simple words such as "mama" occurs between 9 and 12 months. Linking syllables together when communicating occurs between 6 and 9 months. Cooing begins at birth and continues until 2 months.
The nurse monitors a terminally ill client for which physical signs of approaching death? Select all that apply. A. Increased appetite B. Loss of consciousness C. Loss of bowel control D. Loss of bladder control E. Decreased blood pressure F. Decreased tactile sensation
B, C, D, E, F
The nurse knows that an infant's birth weight should be tripled by: A. 9 months. B. 1 year. C. 18 months. D. 2 years.
B. 1 year. Rationale: The infant usually triples his or her birth weight by about 12 months of age. Birth weight doubles by age 4 to 6 months
Which statement accurately describes physical development during the school-age years? A. The child's weight almost triples. B. A child grows an average of 2 inches per year. C. Few physical differences are apparent among children at the end of middle childhood. D. Fat gradually increases, which contributes to the child's heavier appearance.
B. A child grows an average of 2 inches per year.
A 6-month-old child has just received her scheduled immunizations. Which type of immunity does this process best describe? A. Passive immunity B. Active immunity C. Natural immunity D. Exposure specific immunity
B. Active immunity
The parents of a 10-month-old baby have started feeding their child solid foods from baby food jars. The parents want to feed their child more table foods and they ask the nurse about this. Which response from the nurse is accurate? A. The child can start drinking cow's milk now that he is over 6 months old B. Allow the child to eat soft table foods such as moist crackers or noodles C. Do not feed the child honey until he is at least 4 years old D. Start by feeding the child small pieces of food he can chew, such as hot dogs
B. Allow the child to eat soft table foods such as moist crackers or noodles Children start to make the transition to table foods between 9 and 12 months of age. During these months, the parents must be careful to keep the child safe by feeding appropriate foods, such as soft crackers or pasta, which will decrease the risk of choking. Parents should not feed their young child pieces of food that could cause choking, such as hot dog chunks or grapes. A baby should not have cow's milk until at least 1 year of age and should not eat honey until he is 2 years of age.
The nurse is caring for a client who is terminally ill. When assessing the client, the nurse recognizes which as the most common distress symptom near the end of life? A. Pain B. Anxiety C. Depression D. Withdrawal
B. Anxiety
Which car safety device should be used for a child who is 8 years old and is 4 feet tall? A. Seat belt B. Booster seat C. Rear facing convertible seat D. Front-facing convertible seat
B. Booster seat Rationale: All children whose weight or height is above the forward-facing limit for their car safety seat should use a belt-positioning booster seat until the vehicle seat belt fits properly, typically when they have reached 4 feet 9 inches in height and are between 8 and 12 years of age. Infants should ride in a car in a semireclined, rear-facing position in an infant-only seat or a convertible swat until they weigh at least 20 pounds and are at least 1 year of age. The transition point for switching to the forward-facing position is defined by the manufacturer of the convertible car safety seat but is generally at a body weight of 9 kg (20 pounds) and 1 year of age.
Over time as vaccines have become available, the rate of disease incidence for vaccine-preventable diseases has: A. Stayed the same B. Decreased C. Increased D. Made no difference
B. Decreased
When providing therapeutic play, which of the following toys would best promote imaginative play in a 4-year-old? A. Large blocks B. Dress-up clothes C. Wooden puzzle D. Big wheels
B. Dress-up clothes
When developing a plan of care for a male adolescent, the nurse considers the child's psychosocial needs. During adolescence, psychosocial development focuses on: A. Becoming industrious B. Establishing an identity C. Achieving intimacy D. Developing initiative
B. Establishing an identity
Jeremy and Gwen are planning a birthday party for their 4-year-old son Nicholas. Which of the following games/activities would be most appropriate for his age group? A. Twelve-item simple crossword puzzle with names of summer toys B. Four tricycles to use in relay races C. Rental of a ten-foot climbing wall D. Four bicycles (two-wheelers) to use in relay races
B. Four tricycles to use in relay races
Which is the source people most often reply upon to answer questions about immunizations? A. Nurses B. Friends and relatives C. The internet D. Physicians
B. Friends and relatives
A nurse is working at the health department and has been asked to put away a leftover multi-dose influenza vial that has not expired but was used in today's clinic. Temperature of the vial has been safely maintained. Where should the nurse place this vaccine? A. The nurse should discard the vial since it has been opened and used even though the vaccine has not expired. B. In the refrigerator, in a centrally located area far away from vents. C. On the refrigerator's bottom shelf since the vaccine needs to be stored at a very low temperature. D. In the refrigerator door since the temperature is more stable here.
B. In the refrigerator, in a centrally located area far away from vents.
A severe allergic reaction to eggs is a contraindication for which vaccine? A. Inactivated Poliovirus (IPV) B. Influenza (TIV) C. Hep B D. Rotavirus (RV)
B. Influenza (TIV)
You recognize which of the following as relating to the nutritional needs of an older adult patient? A.Vitamin supplementation becomes increasingly essential in advancing age. B. Older adults require fewer calories per day than younger adults do. C. Dairy products become more difficult to digest as age advances.
B. Older adults require fewer calories per day than younger adults do.
The nurse is teaching a client who has iron deficiency anemia about foods she should include in her diet. The nurse determines that the client understands the dietary instructions if she selects which of the following from her menu? A. Nuts and fish. B. Oranges and dark green leafy vegetables. C. Butter and margarine. D. Sugar and candy
B. Oranges and dark green leafy vegetables Rationale: Dark green leafy vegetables are rich in iron while oranges are a good source of vitamin C, which enhances iron absorption.
Which of the following vaccine-preventable diseases is a common cause of serious illness in children and adults: A. Influenza B. Pneumococcal C. Shingles D. Meningitis
B. Pneumococcal
When developing a plan care for a hospitalized child, nurse Mica knows that children in which age group is most likely to view illness as a punishment for misdeeds? A. Infancy B. Preschool age C. School age D. Adolescence
B. Preschool age
New parents to a 3 month old are asking the nurse what toys are appropriate for their child. The best response by the nurse is which of the following? A. Mobiles that are hung about 8 inches from babys face B. Rattles C. Large bright toys D. Toys with noisemakers
B. Rattles
A client tells the nurse that he is very anxious about getting this flu shot. To help prevent vasovagal response in this client during injection, the nurse should have the client: A. Lay down while receiving the injection B. Sit down while receiving the injection C. Hold their breath while receiving the injection D. Stand while receiving the injection
B. Sit down while receiving the injection
The nurse is assessing a six-month-old child. Which developmental skills are normal and should be expected? A. Speaks in short sentences. B. Sits alone. C. Can feed self with a spoon. D. Pulling up to a standing position.
B. Sits alone.
What is an important factor in the successful resolution of grief? A. Social isolation B. Support systems C. Triggers of grief D. Loss acknowledgement
B. Support systems
Which age group would be appropriate for a child exhibiting the following characteristics?: build block towers that are 7-8 blocks high, play with other children, and begin toilet training. A. Infancy (birth-1 year) B. Toddler (1-3 years) C. Preschool (3-6 years) D. School Age (6-12 years)
B. Toddler (1-3 years)
The nurse is assessing a 12 month old baby for growth and development. What weight should this baby be? A. Double the birth weight B. Triple the birth weight C. Quadruple the birthweight D. Birth weight isn't a good measure of growth and development
B. Triple the birth weight
A patient with Alzheimer's disease has had difficulties eating and is not getting enough nutrients in his diet. The patients daughter asks the nurse if there is anything that can be done to improve his nutrition intake. Which recommendation should the nurse give? A. Help the patient choose his own eating utensils B. Use less salt when cooking and serving food C. Provide stand-by-assistance when the patient eats to offer support D. Limit calories to have better control on behavior
B. Use less salt when cooking and serving food
After an older adult patient emphasizes his need to remain as independent as possible, you appropriately suggest that he ensure maintenance of his nutritional status by A. Cooking ample amounts of nutritious foods. B. Using local resources for delivering meals to his home. C. Asking neighbors to share their meals with him.
B. Using local resources for delivering meals to his home.
Parents have voiced concerns about the number of reported adverse events in the VAERS. A critical element of understanding VAERS reporting is that: A. VAERS only accepts reports from health professionals and vaccine manufacturers who are qualified to determine casualty. B. VAERS captures all medical events occurring post-vaccination, even if the reporter is not certain that the incident is vaccine related. C. The primary purpose of VAERS is to determine the actual rate of side effects and adverse events associated with each vaccine. D. VAERS only contains reports of adverse events that are related to the vaccine administration.
B. VAERS captures all medical events occurring post-vaccination, even if the reporter is not certain that the incident is vaccine related.
The best site to give an IM vaccine to an infant is: A. Deltoid B. Vastus Lateralis C. The fatty tissue behind the arm D. Dorsogluteal
B. Vastus Lateralis
The nurses assesses a patient like to learn by watching videos, viewing internet sites, and reading charts and graphs. This would indicate the patient's preferred learning style is: A. Auditory B. Visual C. Kinesthetic D. Verbal
B. Visual
Pain tolerance in an elderly patient with cancer would: A. stay the same. B. be lowered. C. be increased. D. no effect on pain tolerance.
B. be lowered.
The nurse should recognize that all of the following physical changes of the head and face are associated with the aging client except: A. pronounced wrinkles on the face. B. decreased size of the nose and ears. C. increased growth of facial hair. D. neck wrinkles.
B. decreased size of the nose and ears. The nose and ears of the aging client actually become longer and broader. The chin line is also altered. Wrinkles on the face become more pronounced and tend to take on the general mood of the client over the years. For example laugh or frown wrinkles about the eyebrows, lips, cheeks, and outer edges of the eye orbit. The change in the androgen-estrogen ratio causes an increase in growth of facial hair in most older adults. The aging process shortens the platysma muscle, which contributes to neck wrinkles.
The nurse is preparing to care for a dying client, and several family members are at the client's bedside. Which therapeutic techniques should the nurse use when communicating with the family? Select all that apply. A. Discourage reminiscing. B. Make the decisions for the family. C. Encourage expression of feelings, concerns, and fears. D. Explain everything that is happening to all family members. E. Touch and hold the client's or family member's hand if appropriate. F. Be honest and let the client and family know that they will not be abandoned by the nurse.
C, E, F Rationale: The nurse must determine whether there is a spokesperson for the family and how much the client and family want to know. The nurse needs to allow the family and client the opportunity for informed choices and assist with the decision-making process if asked. The nurse should encourage expression of feelings, concerns, and fears and reminiscing. The nurse needs to be honest and let the client and family know that they will not be abandoned. The nurse should touch and hold the client's or family member's hand, if appropriate.
After teaching a group of parents about accident prevention for school agers, which of the following statements by the group would indicate the need for more teaching? A. "Schoolagers are more active and adventurous than are younger children." B. "Schoolagers are more susceptible to home hazards than are younger children." C. "Schoolagers are unable to understand potential dangers around them." D. "Schoolargers are less subject to parental control than are younger children."
C. "Schoolagers are unable to understand potential dangers around them."
A one-year old is being seen for his immunizations. His mother states, "I am concerned about the MMR because my sister had a reaction to it." When communicating with the parent, an example of reflection is: A. "What are your concerns about the MMR?" B. "What happened after she took the MMR?" C. "Your sister had a reaction to the MMR?" D. "The MMR is much safer today than when your sister had it."
C. "Your sister had a reaction to the MMR?"
An appropriate needle length for an IM injection for a man who weighs 290 pounds is: A. 5/8 inch B. 1 inch C. 1.5 inches D. 2 inches
C. 1.5 inches
Children are in a high-risk group for seasonal flu, and should be vaccinated yearly, starting at what age? A. Birth B. 3 months C. 6 months D. 1 year
C. 6 months
At what age should older adults receive a pneumococcal vaccine? A. 60 years B. 55 years C. 65 years D. 62 years
C. 65 years
A 58-year-old patient is feeling sadness and loss after his mother died. Which best describes the difference between grief and depression? A. A grieving person may suffer mild delusions in their grief, but a depressed person never has this type of thought pattern B. A grieving person may have feelings of hopelessness but a depressed person would act on those feelings C. A grieving person may have sadness but also some times of joy, while a depressed person's feelings are constant D. A grieving person experiences sadness and loss but a depressed person experiences guilt and anger
C. A grieving person may have sadness but also some times of joy, while a depressed person's feelings are constant
Which of the following best describes a dying patients transcendence? A. A patient asks for forgiveness from family members before dying B. A patient tells the nurse that she has hope that she will recover C. A patient believes she has overcome her fear of death to move forward D. A patient asks for the hospital chaplain to come and pray with her
C. A patient believes she has overcome her fear of death to move forward
Getting an annual flu vaccine is a professional responsibility of nurses because A. Nurses who refuse the flu vaccine are role models for the public for healthy behaviors. B. Patients are less likely to take the flu vaccine if the doctor's office nurse has received it. C. An annual flu shot helps protect the nurse, patients, co-workers and the nurse's family D. Nurses can show they are more responsible than other health care workers
C. An annual flu shot helps protect the nurse, patients, co-workers and the nurse's family
Which type of play is most typical of the preschool period? A. Solitary B. Parallel C. Associative D. Team
C. Associative Rationale: Associative play is group play in similar or identical activities but without rigid organization or rules. Play is not highly organized, and preschoolers do not cooperate during play. Solitary play is that of infants. Parallel play is that of toddlers. School-age children play in teams.
The hospice nurse visits a client who is dying of ovarian cancer. During the visit, the client says, "If I can just live long enough to celebrate my daughter's 'sweet 16' birthday party, I'll be ready to die." Which phase of coping is this client experiencing? A. Anger B. Denial C. Bargaining D. Depression
C. Bargaining
What is the recommended immunization schedule for children age 0-6 years for Hep B? A. 2 months, 3 months, and 5 months B. Birth dose, 4-6 months, and 12-15 months C. Birth dose, 1-2 months, and 6-18 months D. Birth dose, 1 month, and 3 months
C. Birth dose, 1-2 months, and 6-18 months
Which of the following demonstrates a negative outcome for the growth and development needs of 9-year-old Brandon? A. Brandon plays center guard on the youth football league. B. Brandon likes to organize his collection of baseball cards. C. Brandon seldom holds his hand up to read because the children make fun of him. D. Brandon plays organized board games with other students during recess on a rainy day
C. Brandon seldom holds his hand up to read because the children make fun of him.
A 15-month-old has a febrile seizure one month following administration of the varicella (chicken pox) vaccine. The nurse should: A. Advise the parents to stop all vaccinations B. Report an adverse reaction to the vaccine manufacturer C. File a report on the unusual event through the Vaccine Adverse Event Reporting System (VAERS) D. Recognize these two events are likely unrelated, and continue to monitor the child for further seizures
C. File a report on the unusual event through the Vaccine Adverse Event Reporting System (VAERS)
Which best describes disenfranchised grief? A. Grieving over something that has yet to happen B. Grief that is accompanied with physical complaints C. Grief over a loss that cannot be publicly shared D. Grieving in a manner that does not follow normal patterns
C. Grief over a loss that cannot be publicly shared
Which of the following is the most commonly sexually transmitted vaccine-presentable disease: A. Pneumococcal B. Influenza C. HPV D. HIV
C. HPV
At a community flu clinic at a local church an adult client reports he is having difficulty breathing after receiving the flu vaccine. The priority action the nurse should take is: A. Administer medications B. Tell the patient to be calm and the symptoms will disappear C. Have someone call 911 D. Notify the supervisor
C. Have someone call 911
Fears about the ingredients in vaccines, a belief that diseases are no longer a threat and mistrust of vaccine supply are all examples of: A. Social Inequality Barriers B. Healthcare System Barriers C. Health Knowledge Barriers D. Practitioner Barriers
C. Health Knowledge Barriers
The absence of Saturday or evening clinic hours; long waiting times and an inefficient reminder system are all examples of: A. Social Inequality Barriers B. Health Knowledge Barriers C. Healthcare System Barriers D. Practitioner Barriers
C. Healthcare System Barriers
A nurse is caring for a patient whose death is imminent. The family is at the bedside and are very upset and crying over the patient. The nurse wants to say something to comfort the family. Which of the following statements is most appropriate? A. Be strong. You can get through this. B. She's going to a better place. C. I'm here to listen if you need me. D. It will be okay.
C. I'm here to listen if you need me.
Which of the following statements best describes loss? A. It is determined by one's cultural values. B. It is largely dependent on support of family and friends. C. It can be determined only by the person who experiences it. D. It is the same as grief and mourning.
C. It can be determined only by the person who experiences it.
When discussing normal infant growth and development with parents, which of the following toys would the nurse suggest as most appropriate for an 8-month-old? A. Push-pull toys B. Rattle C. Large blocks D. Mobile
C. Large blocks
Which is a live attenuated viral vaccine? A. Human Papillomavirus (HPV) B. Diptheria, Tetanus (Td) C. Measles, Mumps, Rubella (MMR) D. Hep B
C. Measles, Mumps, Rubella (MMR)
Which of the following vaccine-preventable diseases is characterized by this whooping cough: A. Tetanus B. Chicken Pox C. Pertussis D. Hepatitis
C. Pertussis
The nurse notices that when he goes to place the vaccine in the refrigerator, the door has been left open and the temperature of the refrigerator and its contents are warm. He should: A. Place the vaccine in the refrigerator but leave the door open since someone is defrosting the refrigerator. B. Check the vials and if no change has occurred in the medication he should shut the door. C. Place the vaccine in an emergency backup refrigerator and immediately notify the supervisor. D. Place the vaccine in the refrigerator and shut the door.
C. Place the vaccine in an emergency backup refrigerator and immediately notify the supervisor.
Although relatively few died from this disease or even had symptoms of it, for a small percent of the population this disease was serious causing lifelong complete or partial paralysis: A. Smallpox B. HIV C. Polio D. Spanish Influenza
C. Polio
The best approach for discussing vaccine risks is: A. Only discuss risks when parents ask about them B. Downplay risks so the vaccines are more acceptable C. Provide accurate information about both benefits and risks of vaccines D. Provide detailed statistics related to risks to back up safety of vaccines
C. Provide accurate information about both benefits and risks of vaccines
The nurse is caring for residents in a long term care setting for the elderly. Which of the following activities will be MOST effective in meeting the growth and development needs for persons in this age group? A. Aerobic exercise classes B. Transportation for shopping trips C. Reminiscence groups D. Regularly scheduled social activities
C. Reminiscence groups
A mother of a 3-year-old tells a clinic nurse that the child is rebelling constantly and having temper tantrums. The nurse most appropriately tells the mother to: A. Punish the child every time the child says "no", to change the behavior B. Allow the behavior because this is normal at this age period C. Set limits on the child's behavior D. Ignore the child when this behavior occurs
C. Set limits on the child's behavior Rationale: According to Erikson, the child focuses on independence between ages 1 and 3 years. Gaining independence often means that the child has to rebel against the parents' wishes. Saying things like "no" or "mine" and having temper tantrums are common during this period of development. Being consistent and setting limits on the child's behavior are the necessary elements.
Which of the following best describes parallel play between two toddlers? A. Sharing crayons to color separate pictures B. Playing a board game with a nurse C. Sitting near each other while playing with separate dolls D. Sharing their dolls with two different nurses
C. Sitting near each other while playing with separate dolls
This disease is now considered eradicated from the world due to vaccination efforts but it is still of concern since it has been posed to be used as a biological weapon: A. Spanish Influenza B. Polio C. Smallpox D. HIV
C. Smallpox
What happens when some in a community are immunized against a disease: A. Few get the disease B. Community Immunity never works C. Some get the disease D. Everyone gets the disease
C. Some get the disease When some of the community are immunized, their immunity also protects some of the community.
Nearly 3-6% of the world's entire population died from this viral disease in the early twentieth century: A. Polio B. Bubonic Plague C. Spanish Influenza D. HIV
C. Spanish Influenza
Adolescent females should be counseled to... A. Increase protein consumption from a variety of sources. B. Divide their daily caloric intake among six meals. C. Take daily calcium and iron supplements.
C. Take daily calcium and iron supplements.
The nurse arrives at a church as a volunteer for a flu clinic. The nurse observes hundreds of pre-filled syringes. She learns that there were no manufacturer pre-filled syringes available, so a pharmacist and a nurse prepared them that morning so that no one would need to fill syringes during the clinic. Which is correct? A. It is a common and acceptable practice when the flu clinic occurs at a place other than the health department. B. It is an acceptable practice to pre-fill the syringes since it was done by a nurse and a pharmacist. C. The CDC recommends only pre-filling a few syringes at a time and that the nurse who draws up the medication is the person who should give it. D. When there are no manufacturer-filled syringes available, it is acceptable to use pre-fill syringes for the entire day.
C. The CDC recommends only pre-filling a few syringes at a time and that the nurse who draws up the medication is the person who should give it.
When visiting the an older adult patient approximately 3 weeks after discharge, the home health care nurse reports her concerns about the patient's nutritional status to the provider based on which of the following findings? A. The patient has several open bags of cookies and soda cans about his living room. B. The patient has a noticeable red rash on his hands, arms, and chest. C. The patient states, "Tell me again why you are here."
C. The patient states, "Tell me again why you are here." Rationale: Altered mental status, in this case confusion and poor short-term memory, is a possible indication of poor nutrition. In addition, altered mental status can further impair the patient's ability to ingest sufficient nutrients.
Which of the following suggests poor nutrition? A. The patient has sustained a fracture. B. The patient has acne on her face and upper chest. C. The patient weighs 6 pounds less than her ideal body weight (IBW).
C. The patient weighs 6 pounds less than her ideal body weight (IBW).
When assessing an older adult. The nurse may expect an increase in: A. Nail growth B. Skin turgor C. Urine residual D. Nerve conduction
C. Urine residual
What is the CDC recommendation for influenza virus for health care personnel? A. Vaccinate health care personnel ages 50 or greater B. One time vaccination is recommended for health care personnel C. Vaccinate all health care personnel annually D. Routine annual administration of influenza
C. Vaccinate all health care personnel annually
Parents may have several vaccine concerns. Studies have demonstrated the core concept that parents are most concerned about is: A. Vaccine supply B. Vaccine development C. Vaccine safety D. Vaccine efficacy
C. Vaccine safety
Which vaccines are contraindicated for pregnant women? A. Tetanus (Td) B. Influenza C. Varicella D. Hep A
C. Varicella
The nurse would expect a 4-month-old to be able to: A. hold a cup. B. stand with assistance. C. lift head and shoulders. D. sit with back straight.
C. lift head and shoulders. Rationale: Because development is cephalocaudal, of these choices, lifting the head and shoulders is the one that the infant learns to do first. The infant can usually sit with support at about 5 months of age and can sit alone at about 8 months.
The most appropriate activity to recommend to parents to promote sensorimotor stimulation for a 1-year-old would be to: A. ride a tricycle. B. spend time in an infant swing. C. play with push-pull toys. D. read large picture books.
C. play with push-pull toys Rationale: Push-pull toys are appropriate to promote sensorimotor stimulation for a 1-year-old child.
At which of the following ages would the nurse expect to administer the varicella zoster vaccine to a child? A. At birth B. 2 months C. 6 months D. 12 months
D. 12 months
When teaching a mother about introducing solid foods to her child, which of the following indicates the earliest age at which this should be done? A. 1 month B. 2 months C. 3 months D. 4 months
D. 4 months
Which of the following toys should the nurse recommend for a 5-month-old? A. A big red balloon B. A teddy bear with button eyes C. A push-pull wooden truck D. A colorful busy box
D. A colorful busy box Rationale: A busy box facilitates the fine motor development that occurs between 4 and 6 months. Option A: Balloons are contraindicated because small children may aspirate balloons. Option B: Because the button eyes of a teddy bear may detach and be aspirated, this toy is unsafe for children younger than 3 years. Option C: A 5-month-old is too young to use a push-pull toy.
The nurse is caring for a client with cancer. The client tells the nurse that a lawyer will be arriving today to prepare a living will and asks the nurse to act as one of the witnesses for the will. What is the most appropriate nursing action? A. Agree to act as a witness. B. Call the health care provider (HCP). C. Ask another nurse to serve as a witness. D. Ask the client who might be available to serve as a witness
D. Ask the client who might be available to serve as a witness Rationale: A living will addresses the withdrawal or withholding of life-sustaining interventions that unnaturally prolong life. It identifies the client who will make care decisions if the client is unable to take action. It is witnessed and signed by two people who are unrelated to the client. Nurses or employees of a facility in which the client is receiving care and beneficiaries of the client must not serve as a witness. There is no reason to call the HCP.
A nurse is caring for a patient who is dying and is at the end of his life. The nurse is alone with the patient after the family has left to eat dinner. During this time, the patient tells the nurse that he had an affair several years ago and never told his wife. Which action should the nurse do in response? A. Speak to the patients daughter first before disclosing the information to the wife B. Tell the patient that his secret is safe with her C. Comfort the patient but talk to the wife about it when she returns D. Ask the patient if he would like to speak to a member of the clergy or make arrangements for a minister to visit
D. Ask the patient if he would like to speak to a member of the clergy or make arrangements for a minister to visit
Social factors have heightened vaccine concerns and impacted immunization coverage. Identify the two social factors that negatively impact the number of Americans immunized. A. Diminishing social inequalities and understanding the cause of autism B. Increasing prosperity for women and children, and trust in local government C. Rising employment rates and universal health insurance D. Complexity of the vaccine schedule and concerns about environmental hazards.
D. Complexity of the vaccine schedule and concerns about environmental hazards.
The nurse's FIRST step in nutritional counseling/teaching for a pregnant woman is to A. Teach her how to meet the needs of self and her family B. Explain the changes in diet necessary for pregnant women C. Question her understanding and use of the food pyramid D. Conduct a diet history to determine her normal eating routines
D. Conduct a diet history to determine her normal eating routines
The nurse is observing children playing in the hospital playroom. She would expect to see 4 year-old children playing A. Competitive board games with older children B. With their own toys along side with other children C. Alone with hand held computer games D. Cooperatively with other preschoolers
D. Cooperatively with other preschoolers
Which information is not important to collect and document prior to providing a flu vaccine? A. Medical illness B. Vaccine history C. Allergies D. Current medications
D. Current medications
While performing a physical assessment of a 12 month-old, the nurse notes that the infant's anterior fontanel is still slightly open. Which of the following is the nurse's most appropriate action? A. Notify the physician immediately because there is a problem. B. Perform an intensive neurological examination. C. Perform an intensive developmental examination. D. Do nothing because this is a normal finding for the age.
D. Do nothing because this is a normal finding for the age.
Before giving a vaccine, which information is essential to know? A. Client preference for needle size B. Client insurance number C. Client preference for site D. Emergency procedures
D. Emergency procedures
A mother said that she believes her 3-year-old child needs to go to preschool to be with other children, but that she gets too upset to think of taking her child to be with strangers. Which nursing intervention would be appropriate? A. Suggest that the mother delay preschool until the child is 4 years old. B. Refer the family to counseling to help deal with this change. C. Tell the mother that she is correct to keep her child at home if it upsets her too much. D. Explain that learning separation is a normal developmental task for the family of a preschool-age child.
D. Explain that learning separation is a normal developmental task for the family of a preschool-age child.
What happens when a critical portion of the community is immunized against a disease A. Some get the disease B. Everyone gets the disease C. Community Immunity never works D. Few get the disease
D. Few get the disease When a critical portion of the community is immunized, most members are protected from the disease.
Why do infants need repeated doses of the same vaccines at regular intervals in the first year of life? A. Live vaccines have no interference with maternal antibodies and the protection they afford does not last very long. B. The live viruses in these vaccines replicate in large numbers, but every two months the immune response kills them. C. The infant immune system has a very robust response and vaccinations at regular intervals desensitize that response. D. Inactivated vaccines have less interference from maternal antibodies, but the protection they afford does not last very long.
D. Inactivated vaccines have less interference from maternal antibodies, but the protection they afford does not last very long.
A family member asks the nurse to explain the purpose of hospice care. Which of the following is the best response? Hospice care: A. Is appropriate when the patient desires to intentionally end his life B. Focuses on minimizing the disease process as rapidly as possible C. Focuses on symptom management for patients not responding to treatment D. Is holistic care for patients dying or debilitated and not expected to improve
D. Is holistic care for patients dying or debilitated and not expected to improve Rationale: Hospice care focuses on holistic care of patients actively dying or not expected to improve. It helps patients face death with dignity and comfort. Euthanasia refers to the deliberate ending of a life. Palliative care is aggressively planned care that manages symptoms of patients whose disease process no longer responds to treatment. Aggressive medical treatment is aimed at stopping the disease process.
Fourteen-month-old Parker has been taken to the family doctor for a regular check-up. He weighed 6 pounds at birth and was 21½ inches long, has had no feeding difficulties, and sleeps through the night. Which of the following might be reason for concern relating to his growth and development? A. Parker began walking without holding on to anything for support at thirteen months. B. Parker could sit up alone at eight months. C. Parker can say three or four one-syllable words. D. Parker weighed fourteen pounds today.
D. Parker weighed fourteen pounds today. Infants normally double their weight at six months and triple their weight at one year. Parker should weigh close to eighteen pounds at fourteen months.
Which age group would be appropriate for a child exhibiting the following characteristics?: tie knots, begin growing permanent teeth and losing temporary ones, is more independant, and can begin to understand concepts like the future. A. Infancy (birth-1 year) B. Toddler (1-3 years) C. Preschool (3-6 years) D. School Age (6-12 years)
D. School Age (6-12 years)
A nurse teaches a new mother about what to do in the event the child gets a fever after receiving an immunization. The best way to evaluate whether or not a parent understands what to do is: A. The nurse gives the parent a post-test with specific questions about how to identify and treat fever to see if the parent can answer correctly. B. The nurse asks the parent to complete an evaluation form of teaching effectiveness. C. The nurse asks if the parent has any further questions about what to do in the event of a fever. D. The nurse asks the parent to teach back how to identify fever and how to treat it.
D. The nurse asks the parent to teach back how to identify fever and how to treat it.
The Vaccine Information Statement (VIS) is an important part of teaching vaccine recipients or parents about vaccines. Which statement is true about the VIS? A. The VIS is part of the chart and must be signed by the vaccine recipient or the parent of child receiving vaccines. B. If more than one vaccine is given at any time, a combined VIS must be used. C. According to federal law, the nurse must provide the VIS after giving any vaccines. D. The nurse must document in the chart which VISs were given along with the VIS production date.
D. The nurse must document in the chart which VISs were given along with the VIS production date.
A 28-year-old patient who is recovering from an emergency hysterectomy is experiencing feelings of grief about her loss of ability to get pregnant. The nurse helps the patient to identify the stages of grief. Which best explains the rationale for this? A. The patient is at high risk of dysfunctional grief B. The patient would be less likely to use defense mechanisms C. The patient can know when to expect to stop grieving D. The patient can better understand the grieving process while coping with change
D. The patient can better understand the grieving process while coping with change
A 21-year-old college student is being seen at the healthcare clinic for symptoms of a sexually transmitted infection. Which information should the nurse provide that would most likely teach this patient about the consequences of his behavior? A. The patient will most likely die earlier because of his choices to have unsafe sex B. The patient should commit to having sex with only one person at a time C. The patient should at least use condoms when having sex D. The patient is at high risk of further sexually transmitted infections if he continues to have unsafe sex
D. The patient is at high risk of further sexually transmitted infections if he continues to have unsafe sex
A nurse is caring for a family who has an 18-month-old child. The parents are concerned and tell the nurse that their son does not know how to run or kick a ball. Which of the following responses from the nurse is most appropriate? A. This is not abnormal; children usually cannot run or kick until they are 3 years old. B. Why do not we help him to try? He should be able to do this by now. C. I will call the developmental pediatrician for a referral. D. This is not abnormal. Just help him with walking and by the time he is 2 he may be closer to doing these things.
D. This is not abnormal. Just help him with walking and by the time he is 2 he may be closer to doing these things.
Which vaccines are administered via the subcu route? A. Hep B, Hep A B. Influenza, Pneumococcal C. Meningococcal, HPV D. Varicella, MMR
D. Varicella, MMR
When administering an I.M. injection to an infant, the nurse in charge should use which site? A. Deltoid B. Dorsogluteal C. Ventrogluteal D. Vastus lateralis
D. Vastus lateralis
The parents of a 4-year-old child have brought him in to the pediatric care clinic for a routine physical exam. The parents tell the nurse that their child has never had immunizations as a baby, but they would like to start giving the vaccines now. Which response from the nurse is accurate? A. We can only give him the hepatitis series this late; he will have to go without everything else. B. We cannot give him infant immunizations now that he is 4 years old, but we will give him what is appropriate for his age. C. We will start him with the standard vaccines that he should receive at 5 years and then start over later. D. We will start him at the beginning of most of the vaccines he would receive as an infant and get him caught up eventually.
D. We will start him at the beginning of most of the vaccines he would receive as an infant and get him caught up eventually.
Which is an example of the nurse acting as an immunization advocate? A. Placing handouts about vaccines in the waiting room. B. Assessing patients for vaccine teaching needs C. Assuring vaccines are stored safely at the proper temperature. D. Working for policies to make vaccines more accessible.
D. Working for policies to make vaccines more accessible.
A patient is dying and has become unconscious but is still breathing. While standing next to the patients bed, his sister says, I always wanted to tell him that I loved him, but it was so hard for me. Now it is too late. Which response of the nurse is most appropriate? A. We should talk about this somewhere else and not at the bedside. B. Next time, do not wait, and tell the person when you think of it. C. He probably already knows. D. You can still tell him if you want. Hearing is the last sense to leave so he may hear you.
D. You can still tell him if you want. Hearing is the last sense to leave so he may hear you.
Which of the following are vaccine preventable diseases: A. Bubonic Plague B. HIV C. Polio D. Bubonic plague and Influenza E. Influenza and Polio F. Influenza
E. Influenza and Polio
A mother accompanies her 12 month old child to the health clinic for his scheduled immunizations. What statement by the mother would cause the nurse to question immunization administration at this visit? a. "My child has had a runny nose for the past week." b. "Joey hates getting these shots, it makes him so mad- watch yourself." c. "Joey had a slight temperature this morning but it went away after I gave him some Tylenol." d. "Last time Joey got a shot, his little thigh was red and sore afterwards for two days!"
c. "Joey had a slight temperature this morning but it went away after I gave him some Tylenol." A child should not receive immunizations generally if he/she has been running a fever or there are signs of moderate to severe illness even without a fever. Choice "A" would not be a contraindication for the immunizations if there are no other signs and symptoms of illness. Choice "B" would not be a contraindication for the immunization, most children do not like shots and object to them. Choice "D" is not a contraindication as this is considered a mild reaction to the injection.