PEDS - Exam 3
What finding would the nurse most likely discover in a 10 year old child in the period of concrete operational thought? A. Participation in abstract thinking B. Ability to classify similar objects C. Problem solving via the scientific method D. Ability to make independent decisions.
B. Ability to classify similar objects
After assessing a 10 year old girl, the nurse documents the appearance of breast buds, identifying this as what body change. A. menarche B. Thelarche C. Puberty D. Tanner Stage 5
B. Thelarche Thelarche is the term used to describe breast budding. Menarche refers to the first menstrual period. Puberty refers to the biologic changes that occur during adolescence. Tanner stage 5 involves maturation of the breast tissue to adult configuration.
The nurse is using the formula for bladder capacity to measure the bladder capacity of a 9 year old girl. What number would the nurse document for this measurement? A. 9oz B. 10oz C. 11oz D. 12oz
C. 11oz the formula for bladder capacity is age in years plus 2.
The nurse is assessing the gross motor skills of an 8 year old boy. which interview question would facilitate this assessment? A. Do you like to do puzzles? B. Do you play any instruments? C. Do you participate in any sports D. Do you like to construct models?
C. Do you participate in any sports? to assess the gross motor skills of school age children, the nurse should ask questions about participation in sports and after school activities. For fine motor skills, the nurse could ask questions about band membership, constructing models, and writing skills.
The nurse is providing suggestions to a female adolescent about foods to help meet her nutritional requirements for iron. Which food would the nurse suggest as a good source of iron? A. Broccoli B. Yogurt C. Peanut Butter D. White Beans
C. peanut Butter Peanut Butter is a good source of iron. Broccoli, yogurt, and white beans are good sources of calcium.
The nurse is promoting nutrition to a 13 year old boy who is overweight. Which comment should the nurse expect to include in the discussion A. "You need to go on a low-fat diet." B. "Eat what your parents eat." C. "Go out for a sport at school." D. "Keep a food diary."
D. "keep a food diary." Having the boy keep a detailed food diary for 1 week will determine current patterns of eating. This can then be used to show him how to make small changes with results, especially if eating is done before periods of inactivity such as before going to bed or when he is bored. Speaking and thinking in terms of diet are negative and can lead to poor body image. If parents have poor eating habits, telling the child to eat what his parents eat could be bad advice. The child could too easily choose the wrong sport or do poorly. It is best to offer solutions with more variety.
A 12 year old boy reports to the nurse that he is one of the shortest kids in his class. He asks the nurse if he will ever grow. What response by the nurse is most appropriate? A. At your age you are largely done growing taller B. Since you are the shortest now, you will likely always be the shortest in the class. C. Boys do not have their growth spurt until about age 17 D. There is no way to know how tall you will grow because you are still well within the window for growth.
D. There is no way to know how tall you will grow because you are still well within the window for growth. Boys' growth spurt occurs later than girls' and usually begins between the ages of 10.5 and 16 years and ends sometime between the ages of 13.5 and 17.5 years.
The nurse is teaching the parents of a 12 year old boy about appropriate approaches when raising an adolescent. Which comment should be included in the discussion? A. "Find out if his friends are worthy of him" B. "try to be open to his views" C. "Maintain a firm set of rules" D. "Remind him that he is still your little boy."
It is most important to be open to the child's views. This will encourage the child to consider parental concerns and promote communication. Being judgmental about his friends will make the child defensive about his chouce of friends. Rules need to be flexible so they can apply to new situations. Avoid condescension. The child will appreciate being treated like a young man.
During a health check up without his parents, a 17 year old tells the nurse he is gay. Which approach should the nurse take? A. "Tell me what makes you think you are gay." B. "This puts you in an at-risk category." C. "We need to talk about safe sex." D. "You're not gay, you're confused."
A. "Tell me what makes you think you are gay." The nurse needs to get more information from the teenager (assessment) before making any comment and then proceed in a sensitive and caring way. Comments about being at risk or needing to know about safe sex are negative and should be replaced with health promotion comments. Denying the statement shows the teenager that you are not an ally.
The school nurse providing school health screenings knows that the 7 -11 year old is in piagets stage of concrete operational thoughts. What should this age group accomplish when developing operations? SATA A. Ability to assimilate and coordinate information about the world from different dimensions B. Ability to see things from another person's POV and think through an action C. Ability to use stored memories of past experiences to evaluate and interpret present situations D. Ability to think
A. Ability to assimilate and coordinate information about the world from different dimensions B. Ability to see things from another persons POV and think through an action C. Ability to use stored memories of past experiences to evaluate and interpret present situations. F. Ability to understand the principle of conservation - that matter does not change when its from changes.
The nurse is performing an annual check up for an 8 year old child. compared to the previous assessment of this child, witch characteristics would most likely be observed? A. Breathing is diaphragmatic B. Pulse rate is increased C. Secondary sex characteristics are present D. Blood pressure has reached adult level
A. Breathing is diaphragmatic The childs respiratory system is maturing, so abdominal breathing has been replaced by diaphragmatic breathing. Pulse rate will decrease, rather than increase, during this time. Secondary sex characteristics will not appear until late school-age years. blood pressure will not reach the adult level until adolescence.
The mother of a 14 year old girl reports to the nurse that her daughter is moody, shuts herself in her room, and fights with her younger sister. Which comment is most valuable to the mother? A. Calmly talk to her about your concerns B. This is normal for her age C. She may be hanging with.a bad crowd D. Set some rules for family etiquette
A. Calmly talk to her about your concerns. Getting the mother and daughter talking and sharing information is the most valuable advice. telling the mother that this is normal does nothing for the family situation. Setting rules will alienate the child. Suggesting an underlying problem can cause a rift between the mother and daughter.
When assessing adolescents for health risks, the nurse must keep in mind the factors related to the prevalance of adolescent injuries. What accurately describes these factors? SATA A. increased physical growth B. Insufficient psychomotor coordination C. Tiredness, lack of energy D. Lack of impulsivity E. Peer pressure F. Inexperience
A. Increased physical growth B. Insufficient psychomotor coordination E. Peer Pressure F. Inexperience Influencing factors related to the prevalence of adolescent injuries include increased physical growth, insufficient psychomotor coordination for the task, abundance of energy, impulsivity, peer pressure, and inexperience. Impulsivity, inexperience, and peer pressure may place the teen in a vulnerable situation between knowing what is right and wanting to impress peers. On the other hand, teens have a feeling of invulnerability, which may contribute to negative outcomes.
The school nurse is teaching parents risk factors for suicide in adolescents. What would the nurse discuss? SATA A. Mental health changes B. History of previous suicide attempt C. Higher socioeconomic status D. Greater improved school performance E. Family disorganization. F. Substance abuse
A. Mental health changes B. History of previous suicide attempt E. Family disorganization F. Substance abuse
The nurse is preparing a class for a group of adolescents about promoting safety. What would the nurse plan to include as the leading cause of adolescent injuries? A. Motor vehicles B. Firearms C. Water D. Fires
A. Motor vehicles Although firearms, water, and fires all pose risk for injury for adolescents, most adolescent injuries are due to motor vehivle crashes.
The nurse teaches parents of adolescents that adolescents need the support of parents and nurses to facilitate healthy lifestyles. What should be a priority focus of this guidance? A. Reducing risk-taking behavior B. Promoting adequate physical growth C. maximizing learning potential D. Teaching personal hygiene routines
A. Reducing Risk-taking behaviors The adolescent experiences drastic changes in the physical, cognitive, and psychosocial areas. With this rapid growth during adolescence, the development of secondary sexual characteristics, and interest in the opposite sex, the adolescent needs the support and guidance of parents and nurses to facilitate healthy lifestyles and to reduce risk-taking behaviors. Promoting physical growth, maximizing learning potential, and teaching hygiene are secondary to reducing risk-taking behaviors.
the nurse is perfoming a cognitive assessment on a 16 year old client. Which behaviors demonstrated will the nurse identify as middle formal operational, according to piaget's theory? SATA A. Reporting that he smokes marijuana occasionally B. Wanting to make decisions about health care independently C. Being very concerned with implications of the affordable care act regarding healthcare benefits D. Wanting their friends to visit them in the hospital more than their parents E. Difficulty unde
A. Reporting that he smokes marijuana occasionally B. wanting to make decisions about health care independently C. Being very concerned with implications of the affordable care act regarding heatlhcare benefits During the middle years (14-17) piaget recognizes that the adolescent has increased ability to think abstractly or in more idealistic terms, thinks he or she is invincible (leading to risky behaviors), and becomes involved/concerned with society and politics. In the early stages of formal operational reasoning, the adolescents thinking is egocentric and lacks abstract thinking, as noted in the client being more concerned with peers than parents, and the adolescent does not understand the implications of his or her diagnosis.
The school nurse is conducting a seminar for parents of adolescents on how to communicate with teenagers. Which guidelines might the nurse recommend? SATA A. Talk face to face and be aware of body language B. Ask questions to see why he or she feels that way. C. Do not give praise unless the adolescent deserves it D. Speak to your child as an authority figure, not an equal E. Don't admit that you make mistakes F. Don't pretend you know all the answers.
A. Talk face to face and be aware of body language. B. Ask questions to see why he or she feels that way. F. Don't pretend you know all the answers. in order to improve communication with teenagers, the parents should talk face to face and be aware of body language, ask questions to see why the teenager feels that way, not pretend they know all the answers, give praise and approval to the teenager often, speak to him or her as an equal (not talk down to him or her), and admit that they do make mistakes.
The nurse is helping the parents and their underweight adolescent collaborate on planning a healthy menu. Of which nutritional requirement of adolescents should the nurse be aware? A. Teenagers have a need for increased calories, zinc, calcium, and iron for growth B. Teenage girls who are active require bout 1800 calories per day C. Teenage boys who are active require between 2000 and 2500 calories per day D. Adolescents require about 1000 to 1200 mg of calcium each day.
A. Teenagers have a need for increased calories, zinc, calcium, and iron for growth. Teenagers have a need for increased calories, zinc, calcium, and iron for growth. However, the number of calories needed for adolescence depends on the teen's age and activity level as well as growth patterns. Teenage girl's who are moderately active require about 2,000 calories per day. Teenage boys who are moderately active require between 2200 and 2800 per day. Adolescents require about 1300 mg of calcium per day.
The nurse knows that the school age child is in erikson;s stage of industry vs inferiority. which best examplifies a school ager working toward accomplishing this developmental task. A. the child signs up for after-school activities B. The child perfors his bedtime preperations autonomously C. the child becomes aware of the opposite sex D. The child is developing a conscience.
A. The child signs up for after-school activities Erikson describes the task of the school aged years to be a sense of industry versus inferiority. During this time, the child is developing his or her sense of self-worth by becoming involved in multiple activities at home, at school, and in the community, which develop his or her cognitive and social skills. Achieving independence is a task of the preschooler who also is developing a conscience at that age. Awareness of the opposite sex occurs in, but is not the focus of, the school-age child.
A mother brings her 6 year old son in for a check up because the child is reporting stomachaches. It is the beginning of the school year. What might mother also mention? A. The child cries before going to school B. The child made friends the first day of school C. The child fights with siblings more often D. The child loves the crowds in the lunchroom
A. the child cries before going to school.
The nurse explains to parents of school age children that according to kholberg's theory of moral development, their child is at the conventional stage of moral development. Which is the nurse's best explanation for the motivation for school-age children to follow rules. A. They follow rules out of a sense of being a "good person" B. They follow rules out of fear of being punished C. They follow rules in order to receive praise from caretakers D. They follow rules because it is in their nature
A. they follow rules out of a sense of being a "good person" During the school age years, the childs use of morality is constantly being developed. According to kholberg, the school age child is at the conventional stage of moral development. the 7-10 year old usually follows rules out of a sense of being a good person. he or she wants to be a good person to his or her parents, friends, and teachers and to themselves.
The nurse assesses the spirituality of an adolescent.What are normal moral and spiritual milestones in this age group? SATA A. Adolescents will base their actions on the avoidance of punishment and attainment of pleasure. B. Adolescents develop their own set of morals and values and question the status quo. C. Adolescents undergo the process of developing their own set of morals at different rates. D. Adolescents are more interested in the spiritualism of their religion than in the actual pra
B. Adolescents develop their own set of morals and values and question the status quo. C. Adolescents undergo the process of developing their own set of morals at different rates. D. Adolescents are more interested in spiritualism of their religion than in the actual practices of their religion it is during the adolescent years that teenagers develop their own set of values and morals at different rates. At the beginning of this stage, teenagers begin to question the status quo. The majority of their choices are based on emotions while they are questioning societal standards. Adolescents also begin to question their formal religious practices. As they progress through adolescence, teenagers become more interested in the spiritualism of their religion than in the actual practices of their religion. The toddler will base his or her actions on the avoidance of punishment and the attainment of pleasure. The preschool child can understand the concepts of right and wrong and is developin
The school nurse is preparing a program on a sexuality and birth control for a class of 14 to 16 year olds. Which behavior will have the most influence on how the information is presented? A. Teens are adjusting to new body images. B. Adolescents tend to take risks. C. Teenagers are able to think in the abstract D. Adolescents understand that actions have consequences.
B. Adolescents tend to take risks. Adolescents are risk takers. This tendency enables them to overcome sense and their own better judgement. Although adolescents are capable of abstract thinking and understand that actions have consequences, they are not yet committed to these attributes. Changing body image would not have significant influence on the presentation.
The school nurse is conducting vision screenign for a 7-year old girl and documents the condition "amblyopia: what would the nurse tell the parents about this condition? A. Amblyopia is an uncorrected refractive error of the eye B. Amblyopia is reduced vision in an eye that has or has not been adequately used during early development C. Amblyopia is a malalignment of the ey, which occurs at birth D. Amblyopia is a clouding of the lens of the eye caused by trauma to the eye.
B. Amblyopia is reduced vision in an eye that has not been adequately used during early development. Amblyopia (lazy eye)
The nurse is teaching the parents of a 9 year old girl about the socializtion that is occurring in their chil through school contacts. Which information would the nurse include in her teaching plan? A. teachers are the most influential people in the development of the school-age childs social network B. Continious peer relationships provide the most important social interaction for school age children C. Parents should establish norms and standards tha tsignify acceptance or rejection D. A cha
B. Continuous peer relationships provide the most important social interaction for school age children
The school nurse is performing a physical examination on a 13 year old boy who is on the soccer team. What is a physical quality that develops during these early adolescent years? A. Coordination B. Endurance C. Speed D. Accuracy
B. Endurance It is usually during early adolescence that teenagers begin to develop endurance. Their concentration has increased so they can follow complicated instructions. Coordination can be a problem because of the uneven growth spurts. During middle adolescence, speed and accuracy increase while coordination also improves.
The nurse is talking with a chatty 7 year old girl during her regular check uo which behaviors would the child also be expected to exhibit? A. showing no interest in what the nurse sees in her ears B. Explaining what is right and wrong C. Demonstrating independence from her mother D. SHowing no concern when the nurse hurts her own finger
B. Explaining what is right and wrong. At this age, behavior is seen by the child as either completely right or wrong. The child will almost surely want to know why the nurse looks in her ears. The child depends heavily on parents for support and encouragement at this age. This is a time when children gain empathy, so the child would show concern for the nurse's injury.
Based on Erikson's developmental theory, what is the major developmental task of the adolescent? A. Gaining independence B. Finding an identity C. Coordinating information D. Mastering motor skills
B. Finding an identity According to Erikson, it is during adolescence that teenagers acheive a sense of identity. The toddler developed a sense of trust in infancy and is ready to give up dependence and to assert his or her sense of control and autonomy. The psychosocial task of the preschool years is establishing a sense of initiative versus guilt by mastering skills. In the school-age years, the child develops concrete operations and is able to assimilate and coordinate information about the world from different dimensions.
the school nurse knows that dating is a milestone for adolescents. Which statement accurately describes a trend in teen dating? A. Most late adolescents spend more time in activities with mixed-sex groups, such as dances and parties, than they do dating as a couple. B. Most teens have been involved in at lease on romantic relationship by late adolescents. C. Teens that date frequently report slightly lower levels of self-esteem and decreased autonomy D. Homosexual behavior as a teen usually
B. Most teens have been involved in at lease one romantic relationship by late adolescence. By age 18, 70% of adolescents report being in at least one romantic relationship in the past 18 months. Most early adolescents spend more time in activities with mixed-sex groups, such as dances and parties, than they do dating as a couple. Teens who date frequently report slightly higher levels of self-esteem and increased autonomy. Homosexual behavior as a teen does not necessarily indicate that the adolescent will maintain a homosexual relationship.
The pediatric nurse is aware of the maturation of organ systems in the school-age child. What accurately describes these changes? SATA A. The brain grows very slowly during the school-age years and growth is complete by the time the child is 12 years of age. B. Respiratory rates decrease, abdominal breathing disappears, and respirations become diaphragmatic in nature. C. The school aged childs blood pressure increases and the pulse rate decreases, and the heart grows more slowly during the mid
B. Respiratory rates decrease, abdominal breathing disappears, and respirations become diaphragmatic in nature. C. The school aged childs blood pressure increases and the pulse rate decreases, and the heart grows more slowly during the middle years. E. Bladder capacity increases, but varies among individual children, and girls generally have a greater bladder capacity than boys. F. Prepubescence typically occurs in the 2 years before the beginning of puberty and is characterized by the development of secondary sexual characteristics.
The nurse knows that barriers to the adolescent's health and successful achievement of the tasks of adolescence exist. What is the major barrier to health and population? A. Cultural B. Socioeconomic C. Marital Status D. Racial
B. Socioeconomic The major barrier to the adolescent's health and successful achievement of the tasks of adolescence is socioeconomic status. Adolescents at a lower socioeconomic level are at a higher risk for developing healthcare problems and risk-taking behaviors. This may be due to their inability to access health care and obtain needed services. In caring for adolescents, the nurse should also recognize the influence of their culture, ethnicity, and race upon them.
The nurse is performing a physical examination of an 11 year old. what observations would be expected? A. The child has not gained weight since last year B. The child has grown 2.5 in since last year C. The child breathes abdominally D. The childs third molars are about to erupt
B. the child has grown 2.5 in since last year
During a health maintenance visit, a 15 year old girl mentions that she is not happy with being overweight. Which approach is best for the nurse to take? A. "Good observation. Let's talk about diet and exercise." B. Don't worry; you are within the weight and height guidelines." C. "what specifically have you been noticing?" D. "tell me about your parents. Are they overweight?"
C. "What specifically have you been noticing?" It is best to find out what caused the teenager to make the comment so that you can work with her about the issue. This is an assessment and must be done first. Launching into a lecture on diet and exercise will be of no value if the teenager watns to talk about dealing with snide comments from her peers. Telling the teenager she is statistically in the normal range for weight and height may close the conversation prematurely. The focus is on the teenager, not her parents. Obtaining that information would be important, but not at this time.
The nurse is performing a physical assessment of a 10 year old boy. The nurse notes that during last years check up the child weighted 80 lb. According to average growth for this age group, what would be his expected current weight? A. 81 lb B. 85 lb C. 87 lb D. 89 lb
C. 87 lb From 6-12 years of age, an increase of 7 lb (3-3.5 kg) per year in weight is expected.
The nurse is performing risk assessments on adolescents in the school setting. Which teen should the nurse screen for hypertension? A. An asian female B. A white male C. An African-American male D. A Jewish male
C. An African American Male It is important for the nurse to recognize the ethnic background of each adolescent. Research has shown that certain ethnic groups are at higher risk for certain diseases. For example, adolescent African Americans are at higher risk for developing hypertension.
When describing the various changes that occur in organ systems during adolescence, what would the nurse include? A. Significant increase in brain size B. Ossification completed later in girls C. Decrease in heart rate D. Decrease in activity of sebaceous glands
C. Decrease in heart rate During adolescence, the heart rate decreases while the systolic blood pressure increases. Brain growth continues, but the size of the brain does not increase significantly. Ossification is more advanced in girls and occurs at an earlier age. Sebaceous gland activity increases during adolescence.
The nurse has seen a 15-year-old girl and a 16-year-old boy during health surveillance visits. Which physical characteristics would be seen in both teenagers? A. Decreased respiratory rates of 15 to 20 BPM B. Eruption of the last four molars. C. Increased shoulder, chest, and hip widths D. Fully functioning sweat and sebaceous glands.
C. Increased shoulder, chest, and hip widths. Both teenagers are in the middle state of adolescence, which is marked by an increase in shoulder, chest, and hip widths. Decreased respiratory rate occurs in early adolescence, as do fully funtioning sweat and sebaceous glands. Eruption of the last four molars occur in late adolescence.
The nurse is discussing ways to promote discipline with parents who are becoming increasingly frustrated with their teenager. what would the nurse identify as most important? A. Establish rules and expectations. B. Collaborate to determine consequences C. Make your responses consistent D. Explain the rules to the adolescent
C. Make your responses consistent consistency and predictability are the cornerstones of discipline. Establishing rules and expectations, collaborating to determine the consequences, and explaining the rules are all important, but they are not as important as being consistent.
The school nurse is performing health assessments on students in middle school. Of what developmental milestone should the nurse be aware? A. Height in girls increases rapidly after menarche and usually ceases immediately after menarche. B. Boy's growth spurts usually begin between the ages of 8-14 and end between the ages of 13.5-17.5 years. C. Peak height velocity (PHV) occurs at approximately 12 years of age in girls or about 6-12 months after menarche D. Boys reach PHV and peak weight ve
C. Peak height velocity (PHV) occurs at approximately 12 years of age in girls or about 6-12 months after menarche. PHV occurs at approximately 12 years of age in girls or about 6-12 months after menarche. Height in girls increases rapidly after menarche and usually ceases 2-2.5 years after menarche. Boys' growth spurts occur later than girls' and usually begins between the ages of 12.5 and 16 hyears and ends sometime between the ages of 13.5 and 17.5 years. Boys reach PHV at about 14 years of age. PWV occurs about 6 months after menarche in girls and at about 14 years of age in boys.
The nurse is promoting learning and school attendance to a 13 year old girl. Which factor will affect the child's attitude the most? A. her parents' values and desires B. The dramatic changes to her body C. Peer group behaviors and attitudes D. Desire for attention from boys.
C. Peer group behaviors and attitudes. In this age group, children have a strong desire to conform to their peer group and to be accepted. it is important to know the peer group's attitude about school and learning. Early adolescence marks the beginning of separation from the family, including its values and desires. Physiologic changes and sexual attraction would not have significant or lasting influence in this matter
the nurse is performing an assessment of the reproductive system in a 17-year-old girl. What would alert the nurse to a developmental delay in this girl? A. Areola and papilla separate from the contour of the breast B. mature distribution and coarseness of pubic hair C. developed breast tissue D. Absence of first menstrual period.
D. Absence of first menstrual perio. The first menstrual period usually begins between the ages of 9 and 15 years (average 12.8). Breast budding (thelarche) occurs at approximately ages 9-11 and is followed by the growth of pubic hair.
During a well child check up the parents of a 9 year old boy tell the nurse that their sons frineds told him that soccer is a stupid game, and now he wants to play baseball. Which comment by the nurse best explains the effects of peer groups? A. the childs best friends will continue playing soccer B. The children will cheer for each other regardless of the sport being played. C. Your child will rarely talk to you about his friends. D. Acceptance by friends, especially of the same sex, is ver
D. Acceptance by friends, especially of the same sex, is very important at this age.
the adolescent continues to develop self-concept and self-esteem. What is the most important to a teen's self-esteem? A. Strong authority figures B. Spirituality C. Morals and values D. Body image
D. Body image Self-concept and self-esteem are tied to body image many times. Adolescents who perceive their body as being different than peers or as less than ideal may view themselves negatively. Sexual characteristics are important to the adolescent's self-concept and body image. Authority figures, spirituality, and morals and values play a role in development of self-concept/self-esteem.
the school nurse knows that school age children are developing metalinguistic awareness. Which is an example of this skill? A. The child enjoys reading books B. The child enjoys conversations with peers C. The child enjoys speaking on the phone D. The child enjoys telling jokes.
D. The child enjoys telling jokes.
The nurse teazching safety to teens knows that which of these is the leading cause of death among adolescents? A. Drowning B. Poisoning C. Diseases D. Unintentional injuries
D. Unintentional injuries Unintentional injuries are the leading cause of death in adolescents. Motor vehicle accidents are the leading cause of injury death followed by poisoning, primarily due to frug overdose from opioids. Males are more likely than females to die of any type of injury.
