Peds midterm practice questions from Bb

While hospitalized, a school-age child began sleepwalking. The nurse teaches the parents how to handle sleepwalking once the child is discharged. Which statement indicates that this teaching has been effective? A. "We should shake the child to wake up immediately." B. "We should keep the child awake in the living room to play before going to bed." C. "We should wake the child up gently and return the child to bed." D. "We should not wake up the child."

C. "We should wake the child up gently and return the child to bed."

A 3-year-old girl is admitted to the hospital for eye surgery. You provide her with a doll and syringe for therapeutic play. She sticks the doll in the eye with the syringe and says, "You won't watch TV again when I tell you not to!" What is your best response to this? A. Pretend that you are the doll and say, "Ouch!" B. Ask her if she ever accidentally stuck herself in the eye. C. Ask her if she thinks having surgery is punishing her. D. Explain that nurses never give injections into eyes.

C. Ask her if she thinks having surgery is punishing her.

A school-aged child's parents are very upset about having to leave her alone in the hospital. How would you respond to their concern? A. "Don't worry. Your child will be just fine." B. "If you can't stay, then not visiting at all is best." C. "Just sneak out; that will make it easier." D. "If you can't stay, visiting as often as possible is the next best thing."

D. "If you can't stay, visiting as often as possible is the next best thing."

A 9-year-old boy who is blind is admitted to the hospital. When serving him a meal in bed, which statement would be most appropriate to increase his self-esteem? A. "I have cut your meat for you. Do you need any other help?" B. "I'll have to feed you lunch; spaghetti is very messy." C. "Here is your tray; if you need help just call me." D. "You have a sandwich on your plate, a glass of milk to your right, and an apple to your left."

D. "You have a sandwich on your plate, a glass of milk to your right, and an apple to your left."

The intravenous infusion line infiltrates on a child who is terminally ill, and his mother tells you that the nursing care in this hospital is the worst she has ever seen. What is your best response to her? A. "I think you should talk to a nursing supervisor." B. "You're right, but we're trying to improve." C. "Tell me with what you are comparing the care here." D. "You seem angrier today than before. Is something going on?"

D. "You seem angrier today than before. Is something going on?"

Which statement by a parent about a child's conjunctivitis indicates that further teaching is needed? a. "When the eye drainage improves, we'll stop giving the antibiotic ointment." b. "After taking the antibiotic for 24 hours, my child can return to school." c. "I'll have separate towels and washcloths for each family member." d. "I'll notify my doctor if the eye gets redder or the drainage increases."

a. "When the eye drainage improves, we'll stop giving the antibiotic ointment." The antibiotic should be continued for the full prescription. Maintaining separate towels and washcloths will prevent the other family members from acquiring the infection. If the infection proliferates, the physician should be contacted. The child should be kept home from school or day care until the child receives the antibiotic for 24 hours.

What would be most effective in helping promote initiative and nutritional health for a preschooler? a. Allowing the child to spread soft cheese on crackers. b. Praising the child for cleaning his large plate of food. c. Giving the child a high carbohydrate snack after preschool. d. Encouraging the child to cut up small pieces of apple for a snack.

a. Allowing the child to spread soft cheese on crackers. Allowing a child to do things such as spreading cheese on crackers helps to foster initiative and nutrition. High carbohydrate snacks should be avoided. Cutting an apple into pieces would be a safety issue. Apples are hard and difficult to cut, placing the child at risk for cutting himself. Small servings of food would be more appropriate because preschoolers do not have ravenous appetites. Praising the child for cleaning his plate which contains a small serving of food, not large, would be appropriate.

A school-age child, admitted for intravenous antibiotic therapy for osteomyelitis, reports difficulty in going to sleep at night. Which intervention should the nurse implement to assist the child in going to sleep at bedtime? a. Allow the child to stay up late and sleep late in the morning. b. Create a schedule similar to the one the child follows at home. c. Request a prescription for a sleeping pill. d. Plan passive activities in the morning and interactive activities right before bedtime.

b. Create a schedule similar to the one the child follows at home.

The nurse is assessing a preschool-age child who is being hospitalized for the first time for a surgical procedure. The child expresses the desire to go home and is scared. Which nursing diagnosis should the nurse identify as appropriate for the child at this time? A. Anxiety related to pending hospital admission B. Health-seeking behaviors related to lack of knowledge regarding illness C. Fear related to being away from home for first time D. Risk for social isolation related to hospitalization

C. Fear related to being away from home for first time

Conscious sedation is a pain-management technique that is used with children. During conscious sedation for a preschooler, which action would be most important? A. Assessing vital signs frequently, because they can become depressed B. Keeping the child's head in a dependent position C. Asking the child to periodically count from 1 to 10 D. Keeping the room absolutely quiet so the child can sleep

A. Assessing vital signs frequently, because they can become depressed

The nurse is using a postoperative pain management scale to determine if a newborn recovering from emergency surgery is experiencing pain. Which observations indicate that the child is experiencing level 3 pain this time? (Select all that apply.) A. Baby has not fallen asleep B. Baby falls asleep for short periods and then wakes up crying C. Heart rate elevated to greater than 20% over the baseline D. Baby is grimacing E. High-pitched cry

A. Baby has not fallen asleep C. Heart rate elevated to greater than 20% over the baseline E. High-pitched cry

The nurse working in pediatrics is aware of the special needs of children related to pain assessment. What is the highest priority for the nurse to consider when completing a pain assessment? A. Developmental age of child B. Chronological age of child C. Pain medication used and last dose administered D. Reason for the pain

A. Developmental age of child

A terminally ill child is awake at 2 AM and continues to put on the call light. What should the nurse do regarding this child's behavior? A. Provide with a sleeping aid. B. Encourage the child to sleep. C. Put on the television and dim the lights. D. Sit with the child until sleep comes.

D. Sit with the child until sleep comes

When teaching a mother about amblyopia, it would be most important to explain that: A. amblyopia is correctable if the child is properly treated before 6 years of age. B. amblyopia can result from a refractive error in one eye. C. amblyopia is a rapid irregular movement of the eye. D. if the child is not treated, he or she is likely to resent it later on.

A. amblyopia is correctable if the child is properly treated before 6 years of age.

A 10-year-old boy develops bacterial conjunctivitis of the right eye. The eye is inflamed and drains a thick, yellow discharge. An important measure you would want to teach him is: A. to clean the discharge away from the inner to outer canthus. B. not to attend school for 2 weeks. C. not to apply ophthalmic drops for more than 3 days. D. to keep his eye covered at all times.

A. to clean the discharge away from the inner to outer canthus.

A 5-year-old is diagnosed with acute otitis media. Which nursing intervention would be a priority? A. Relief of pain B. Cautioning the child not to pull on the ear C. Administration of a mydriatic D. Cautioning the child not to blow the nose

A. Relief of pain

he nurse is preparing to conduct a health history with the parents of a preschool-age child admitted for an appendectomy. Which questions should the nurse plan to use to learn more about the child's ability to manage pain? (Select all that apply.) A. "What do you do for your child when your child is hurting?" B. "How does your child usually react to pain?" C. "Does your child use pain as a control mechanism?" D. "Are you concerned about addiction to pain medication?" E. "How do you know when your child is in pain?"

A. "What do you do for your child when your child is hurting?" B. "How does your child usually react to pain?" E. "How do you know when your child is in pain?"

The nurse is completing the teaching for parents of a toddler recovering from a fracture. Which outcome should the nurse identify to help determine if teaching has been effective? A. The child resumes normal activity level at home. B. The parents place a locked gate at the top of the stairs. C. The parents encourage the child to be independent. D. The child waits for the parent to assist before walking down a set of stairs.

D. The child waits for the parent to assist before walking down a set of stairs.

A mother asks the nurse if there is any way to prevent acute otitis media. What would the nurse state to the mother? A. Prophylactic acetic acid instillations may be helpful. B. Prophylactic myringotomy tubes can be inserted at birth. C. Starting immunizations at birth rather than age 2 months might help. D. The frequency of otitis media is reduced in breast-fed infants.

D. The frequency of otitis media is reduced in breast-fed infants.

The nurse plans to apply EMLA cream to decrease the pain of an injection. What would be the best technique? A. Apply it at least 1 hour before the procedure. B. Apply it immediately prior to the painful procedure. C. Wipe it off at least 15 minutes before the procedure. D. Do not cover it after application to prevent it from discoloring.

Apply it at least 1 hour before the procedure.

The nurse is caring for an infant born with a congenital anomaly. Which of the following factors is likely to have the most influence on the mother's ability to cope with the infant's handicap? A. The mother's age B. The gender of the infant C. The fact that this is a mental and not a physical challenge D. The parents' amount of support

D. The parents' amount of support

The nurse is caring for a 5-year-old who is receiving daily antibiotic injections due to a wound infection. Which toy provides the most therapeutic play? A. A stuffed bear with Band-Aids B. A play syringe and doll C. A doll who is in a patient gown D. An anatomically correct puppet

B. A play syringe and doll

The nurse is helping the parents explain to a toddler the need to go to the hospital for a tonsillectomy. When explaining the procedure to the child, which phrase should the nurse and parents avoid using? A. "You will get medicine so that you feel better." B. "Your mommy and daddy will be with you." C. "The bad tissue will be cut out of your throat." D. "You will be able to eat popsicles."

C. "The bad tissue will be cut out of your throat."

A school-aged child needs 5 units of regular insulin administered. She is in the playroom when you are ready to give the injection. Your best action would be to A. tell her to come outside the playroom for the injection. B. inject it in the playroom; insulin injections do not hurt. C. ask the other children if they would mind if you gave the injection in the playroom. D. ask the girl if she would mind if you gave the injection in the playroom.

A. tell her to come outside the playroom for the injection.

A child having myringotomy tubes placed asks, "How and when will the tubes be removed?" What is your best response? A. "The tubes remain in place for 6 months and then are dissolved by vinegar." B. "The tubes remain in place for 6 to 12 months until they come out by themselves." C. "The tubes are not removed; they grow permanently into place." D. "You will have them replaced every 2 months until you reach age 18."

B. "The tubes remain in place for 6 to 12 months until they come out by themselves."

The nurse is using blowing bubbles during a procedure with a child as an alternative pain-management technique. What type of alternative pain management is this considered? A. Imagery B. Distraction C. Thought stopping D. Hypnosis

B. Distraction

The nurse is caring for an infant who will have surgery. What type of pain assessment would the nurse use? A. None, because infants do not remember pain B. Observation of facial and body actions C. A self-pain rating scale from 1 to 10 D. None, because infants do not feel pain

B. Observation of facial and body actions

A 6-year-old girl has a fractured left leg and has been crying. She denies having any pain while continuing to lie still without movement of the extremity. What should the nurse anticipate as the reason for this behavior? A. She is afraid of the nurse. B. She received an injection last time she was in the emergency room. C. She is not feeling any pain, just scared. D. She thinks she is in trouble for her broken leg.

B. She received an injection last time she was in the emergency room.

The nurse is planning care for a school-age child being admitted to the hospital for a chronic illness. Which hazards of hospitalization for children will the nurse use to plan this patient's care? (Select all that apply.) A. Meeting new people B. Unsure of acceptable behavior C. Losing control over the environment D. Being separated from family, school, and friends E. Experiencing physical discomfort and pain

B. Unsure of acceptable behavior C. Losing control over the environment D. Being separated from family, school, and friends E. Experiencing physical discomfort and pain

An infant's mother does not visit her in the hospital for 3 days. The infant cries relentlessly for her during this time and then becomes extremely quiet and withdrawn. This reaction best indicates A. beginning fatigue from illness. B. development of a sense of despair. C. the infant's temperament is resistant. D. the infant is denying she is hospitalized.

B. development of a sense of despair.

To be an effective nurse with a female child who is dying, it is first necessary to: A. explain the stages of grief to her parents. B. identify your own reactions and feelings about death. C. help the child understand the grieving process. D. assess at which stage of grief the parents are.

B. identify your own reactions and feelings about death.

A 3-year-old girl is admitted to the hospital for treatment of cellulitis of the right thigh. She is accompanied by her parents, who appear to be upset and frightened. Which question would be most effective in eliciting information concerning the parents' understanding of why their daughter is being admitted to the hospital? A. "Has the doctor told you why your daughter requires hospitalization?" B. "Are you worried? I'll tell you everything you need to know." C. "Why are you so concerned? We take good care of children here." D. "You seem concerned; do you have questions about your child's admission?"

D. "You seem concerned; do you have questions about your child's admission?"

The nurse is caring for a preschooler who knows she is dying. Her reaction to her impending death is most likely to be demonstrated through: A. verbalization of her feelings. B. outbreaks of anger. C. bargaining for another chance. D. fear of being separated from her parents.

D. fear of being separated from her parents.

A nurse plans therapeutic play time for a hospitalized child. Which are the benefits of therapeutic play (select all that apply)? a. Allows the child to express feelings b. Serves as method to assist disturbed children c. The child can deal with concerns and feelings d. Gives the child a structured play environment e. The nurse can gain insight into the child's feelings

a. Allows the child to express feelings c. The child can deal with concerns and feelings e. The nurse can gain insight into the child's feelings Therapeutic play is an effective, nondirective modality for helping children deal with their concerns and fears, and at the same time, it often helps the nurse gain insights into children's needs and feelings. Play and other expressive activities provide one of the best opportunities for encouraging emotional expression, including the safe release of anger and hostility. Nondirective play that allows children freedom for expression can be tremendously therapeutic. Play therapy is a structured therapy that helps disturbed children. It should not be confused with therapeutic play.

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

a. Have the ability to classify, group and sort, and hold a concept in their minds while making decisions based on that concept In Piaget's stage of concrete operations, children have the ability to group and sort and make conceptual decisions. Children cannot reason abstractly until late adolescence. Scientific reasoning and formal logic are skills of adolescents. Making judgments on what the child sees versus what he or she reasons is not a developmental skill.

A toddler's parent asks the nurse for suggestions on dealing with temper tantrums. The most appropriate recommendation is to: a. Ignore the behavior, provided that it is not injurious. b. Explain to child that this is wrong. c. Punish the child. d. Leave the child alone until the tantrum is over.

a. Ignore the behavior, provided that it is not injurious. The parent should be told that the best way to deal with temper tantrums is to ignore the behaviors, provided that the actions are not dangerous to the child. Tantrums are common during this age-group as the child becomes more independent and increasingly complex tasks overwhelm him or her. The parents and caregivers need to have consistent and developmentally appropriate expectations. Punishment and explanations will not be beneficial.

A nurse places some x-ray contrast the toddler is to drink in a small cup instead of a large cup. Which concept of a toddler's preoperational thinking is the nurse using? a. Inability to conserve b. Magical thinking c. Centration d. Irreversibility

a. Inability to conserve The nurse is using the toddler's inability to conserve. This is when the toddler is unable to understand the idea that a mass can be changed in size, shape, volume, or length without losing or adding to the original mass. Instead, toddlers judge what they see by the immediate perceptual clues given to them. A small glass means less amount of contrast. Magical thinking is believing that thoughts are all-powerful and can cause events. Centration is focusing on one aspect rather than considering all possible alternatives. Irreversibility is the inability to undo or reverse the actions initiated, such as being unable to stop doing an action when told.

The feeling of guilt that the child "caused" the disability or illness is especially critical in which child? a. Preschooler b. School-age child c. Adolescent d. Toddler

a. Preschooler Preschoolers are most likely to be affected by feelings of guilt that they caused the illness/disability or are being punished for wrongdoings. Toddlers are focused on establishing their autonomy. The illness will foster dependency. The school-age child will have limited opportunities for achievement and may not be able to understand limitations. Adolescents are faced with the task of incorporating their disabilities into their changing self-concept.

A nurse is instructing a nursing assistant on techniques to facilitate lipreading with a hearing-impaired child who lip-reads. Which techniques should the nurse include (select all that apply)? a. Speak at eye level. b. Keep sentences short. c. Speak words in a loud tone. d. Stand at a distance from the child. e. Use facial expressions while speaking.

a. Speak at eye level. b. Keep sentences short. c. Use facial expressions while speaking. To facilitate lipreading for a hearing-impaired child who can lip-read, the speaker should be at eye level, facing the child directly or at a 45-degree angle. Facial expressions should be used to assist in conveying messages, and the sentences should be kept short. The speaker should stand close to the child, not at a distance. Using a loud tone while speaking will not facilitate lipreading.

The parent of a 4-year-old son tells the nurse that the child believes "monsters and the boogeyman" are in his bedroom at night. The nurse's best suggestion for coping with this problem is to: a. Suggest involving the child to find a practical solution such as a night-light. b. Help the child understand that these fears are illogical. c. Tell the child frequently that monsters and the boogeyman do not exist. d. Insist that the child sleep with his parents until the fearful phase passes.

a. Suggest involving the child to find a practical solution such as a night-light A night-light shows a child that imaginary creatures do not lurk in the darkness. Letting the child sleep with parents or telling the child that these creatures do not exist will not get rid of the fears. A 4-year-old is in the preconceptual age and cannot understand logical thought.

Which interventions should the nurse plan when caring for a child with a visual impairment (select all that apply)? a.Always use color to describe something to a child who has been blind since birth. b. Keep items in the room in the same location. c.Describe the placement of the eating utensils on the meal tray. d. Identify noises for the child. e.Touch the child upon entering the room before speaking.

b. Keep items in the room in the same location. c. Describe the placement of the eating utensils on the meal tray. d. Identify noises for the child. Keep all items in the room in the same location and order. Describing how many steps away something is or the placement of eating utensils on a tray are both useful tactics. Identify noises for the child because children who are visually impaired or blind often have difficulty establishing the source of a noise. Never touch the child without identifying yourself and explaining what you plan to do. When describing objects or the environment to a child who is blind or visually impaired, use familiar terms. If the child has been blind since birth, color has no meaning.

The nurse comes into the room of a child who was just diagnosed with a chronic disability. The child's parents begin to yell at the nurse about a variety of concerns. The nurse's best response is: a. "I will come back when you settle down." b. "Being angry is only natural." c. "What is really wrong?" d. "Yelling at me will not change things."

b. "Being angry is only natural." Parental anger after the diagnosis of a child with a chronic disability is a common response. One of the most common targets for parental anger is members of the staff. The nurse should recognize the common response of anger to the diagnosis and allow the family to ventilate. "What is really wrong?" "Yelling at me will not change things," and "I will come back when you settle down" are all possible responses, but they are not the likely reasons for this anger.

A nurse planning care for a school-age child should take into account that which thought process is seen at this age? a. Animism b. Ability to conserve c. Magical thinking d. Thoughts are all-powerful

b. Ability to conserve One cognitive task of school-age children is mastering the concept of conservation. At an early age (5 to 7 years), children grasp the concept of reversibility of numbers as a basis for simple mathematics problems (e.g., 2 + 4 = 6 and 6 - 4 = 2). They learn that simply altering their arrangement in space does not change certain properties of the environment, and they are able to resist perceptual cues that suggest alterations in the physical state of an object. Animism, magical thinking, and believing that thoughts are all-powerful are thought processes seen in preschool children.

Which intervention will encourage a sense of autonomy in a toddler with disabilities? a. Help parents learn special care needs of their child. b. Encourage independence in as many areas as possible. c. Avoid separation from family during hospitalizations. d. Expose child to pleasurable experiences as much as possible.

b. Encourage independence in as many areas as possible. Encouraging the toddler to be independent encourages a sense of autonomy. The child can be given choices about feeding, dressing, and diversional activities, which will provide a sense of control. Avoiding separation from family during hospitalizations, and helping parents learn special care needs of their child should be practiced as part of family-centered care. It does not necessarily foster autonomy. Exposing the child to pleasurable experiences, especially sensory ones, is a supportive intervention. It does not promote autonomy.

Nursing students are reviewing information about preschooler growth and development. The students demonstrate understanding of the information when they identify which of the following as a common fear during this period? Select all that apply. a. Fear pf independence b. Fear of mutilation c. Fear of the dark d. Fear pf abandonment e. fear of separation

b. Fear of mutilation c. Fear of the dark d. Fear pf abandonment e. fear of separation

The nurse is talking to the parent of a 13-month-old child. The mother states, "My child does not make noises like 'da' or 'na' like my sister's baby, who is only 9 months old." Which statement by the nurse would be most appropriate to make? a. "You should not compare your child to your sister's child." b. "I think your child is fine, but we will check again in 3 months." c. "I am going to request a referral to a hearing specialist." d. "You should ask other parents what noises their children made at this age."

c. "I am going to request a referral to a hearing specialist." By 11 months of age, a child should be making well-formed syllables such as "da" or "na" and should be referred to a specialist if not. "You should not compare your child to your sister's child," "I think your child is fine, but we will check again in 3 months," and "You should ask other parents what noises their children made at this age" are not appropriate statements to make to the parent. Question

Kimberly's parents have been using a rearward-facing, convertible car seat since she was born. The parents should be taught that most car seats can be safely switched to the forward-facing position when the child reaches which age? a. 3 years b. 1 year c. 2 years d. 4 years

c. 2 years It is now recommended that all infants and toddlers ride in rear-facing car safety seats until they reach the age of 2 years or the height or weight recommended by the car seat manufacturer. Children 2 years old and older who have outgrown the rear-facing height or weight limit for their car safety seat should use a forward-facing car safety seat with a harness up to the maximum height or weight recommended by the manufacturer. One year is too young to switch to a forward-facing position.

An adolescent girl tells the nurse that she has suicidal thoughts. The nurse asks her if she has a specific plan. Asking this should be considered: a. Encouraging the adolescent to devise a plan. b. Not a critical part of the assessment. c. An appropriate part of the assessment. d. Suggesting that the adolescent needs a plan.

c. An appropriate part of the assessment. Routine health assessments of adolescents should include questions that assess the presence of suicidal ideation or intent. Questions such as "Have you ever developed a plan to hurt yourself or kill yourself?" should be part of that assessment. Threats of suicide should always be taken seriously and evaluated. Suggesting that the adolescent needs a plan and encouraging her to devise this plan would be inappropriate statements by the nurse.

The nurse is doing a prehospitalization orientation for Kayla, age 7, who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that Kayla will not be able to talk because of an endotracheal tube but that she will be able to talk when it is removed. This explanation is: a. Unnecessary. b. Too stressful for a young child. c. An appropriate part of the child's preparation. d. The surgeon's responsibility.

c. An appropriate part of the child's preparation. This is a necessary part of preoperative preparation that will help reduce the anxiety associated with surgery. If the child wakes and is not prepared for the inability to speak, she will be even more anxious. It is a joint responsibility of nursing, medical staff, and child life personnel. This is a necessary component of preparation that will help reduce the anxiety associated with surgery.

A child is playing in the playroom. The nurse needs to take a blood pressure on the child. Which is the appropriate procedure for obtaining the blood pressure? a. Document that the blood pressure was not obtained because the child was in the playroom. b. Ask the child to come to the exam room to obtain the blood pressure. c. Ask the child to return to his or her room for the blood pressure, then escort the child back to the playroom. d. Take the blood pressure in the playroom.

c. Ask the child to return to his or her room for the blood pressure, then escort the child back to the playroom. The playroom is a safe haven for children, free from medical or nursing procedures. The child can be returned to his or her room for the blood pressure and then escorted back to the playroom. The exam room is reserved for painful procedures that should not be performed in the child's hospital bed. Documenting that the blood pressure was not obtained because the child was in the playroom is inappropriate.

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

c. Characteristic of social development of this age. One of the outstanding characteristics of middle childhood is the creation of formalized groups or clubs. Peer-group identification and association are essential to a child's socialization. Poor relationships with peers and a lack of group identification can contribute to bullying. A boys-only club does not have a direct correlation with later gang activity.

A nurse is preparing a teaching session for parents on prevention of childhood hearing loss. The nurse should include that the most common cause of hearing impairment in children is: a. Congenital ear defects. b. Congenital rubella. c. Chronic otitis media. d. Auditory nerve damage.

c. Chronic otitis media. Chronic otitis media is the most common cause of hearing impairment in children. It is essential that appropriate measures be instituted to treat existing infections and prevent recurrences. Auditory nerve damage, congenital ear defects, and congenital rubella are rarer causes of hearing impairment.

The most common type of hearing loss, which results from interference of transmission of sound to the middle ear, is called: a. Central auditory imperceptive. b. Mixed conductive-sensorineural. c. Conductive. d. Sensorineural.

c. Conductive. Conductive or middle-ear hearing loss is the most common type. It results from interference of transmission of sound to the middle ear, most often from recurrent otitis media. Sensorineural, mixed conductive-sensorineural, and central auditory imperceptive are less common types of hearing loss.

An important consideration for the school nurse who is planning a class on bicycle safety is: a. Children should not ride double unless the bicycle has an extra-large seat. b. Children should wear bicycle helmets if they ride on paved streets. c. Head injuries are the major causes of bicycle-related fatalities. d. Most bicycle injuries involve collision with an automobile.

c. Head injuries are the major causes of bicycle-related fatalities. The most important aspect of bicycle safety is to encourage the rider to use a protective helmet. Head injuries are the major cause of bicycle-related fatalities. Although motor vehicle collisions do cause injuries to bicyclists, most injuries result from falls. The child should always wear a properly fitted helmet approved by the U.S. Consumer Product Safety Commission. Children should not ride double.

What should the nurse identify as major fears in the preschool child who is hospitalized with a chronic illness (select all that apply)? a. Separation from peer group b. Altered body image c. Mutilation d. Bodily injury e. Being left alone

c. Mutilation d. Bodily injury e. Being left alone Bodily injury, mutilation, and being left alone are all major fears of the preschooler. Altered body image and separation from peers are major fears in the adolescent.

A 9-year-old girl often comes to the school nurse complaining of stomach pains. Her teacher says that she is completing her schoolwork satisfactorily, but lately she has been somewhat aggressive and stubborn in the classroom. The school nurse should recognize this as: a. Lack of adjustment to the school environment. b. Developmental delay. c. Signs of stress. d. A physical problem causing emotional stress.

c. Signs of stress. Signs of stress include stomach pains or headache, sleep problems, bed-wetting, changes in eating habits, aggressive or stubborn behavior, reluctance to participate, or regression to early behaviors. This child is exhibiting signs of stress, not developmental delay, a physical problem, or lack of adjustment.

The mother of a 14-month-old child is concerned because the child's appetite has decreased. The best response for the nurse to make to the mother is: a. "Giving your child a multivitamin supplement daily will increase your toddler's appetite." b. "It is important for your toddler to eat three meals a day and nothing in between." c. "Be sure to increase your child's milk consumption, which will improve nutrition." d. "It is not unusual for toddlers to eat less."

d. "It is not unusual for toddlers to eat less." Toddlers need small, frequent meals. Nutritious selection throughout the day, rather than quantity, is more important with this age-group. Physiologically, growth slows and appetite decreases during the toddler period. Milk consumption should not exceed 16 to 24 oz daily. Juice should be limited to 4 to 6 oz per day. Increasing the amount of milk will only further decrease solid food intake. Supplemental vitamins are important for all children, but they do not increase appetite.

The nurse is discussing nutritional issues and concerns with the caregivers of preschoolers. Which statement made by the caregivers best indicates a common aspect of the diet and nutrition of the preschool child? a. "Our child gets into food jags where she will only one food all day long." b. "My 4-year-old east as much as my adolescent does every day." c. "My husband is insistent that our 5-year-old not eat any snacks so that he will eat all of his meals at mealtime." d. "My child is so picky and eats the same thing every day for days of end!"

d. "My child is so picky and eats the same thing every day for days of end!" The preschooler's appetite is erratic; at one sitting the preschooler may devour everything on the plate, and at the next meal he or she may be satisfied with just a few bites. Portions are smaller than adult-sized portions, so the child may need to have meals supplemented with nutritious snacks.

The parents of a newborn say that their toddler "hates the baby . . . he suggested that we put him in the trash can so the trash truck could take him away." The nurse's best reply is: a. "Let's refer him to counseling to work this hatred out. It's not a normal response." b. "That's a strong statement to come from such a small boy." c. "Let's see if we can figure out why he hates the new baby." d. "That is a normal response to the birth of a sibling. Let's look at ways to deal with this."

d. "That is a normal response to the birth of a sibling. Let's look at ways to deal with this." The arrival of a new infant represents a crisis for even the best-prepared toddler. Toddlers have their entire schedule and routines disrupted because of the new family member. The nurse should work with parents on ways to involve the toddler in the newborn's care and help focus attention on the toddler. The toddler does not hate the infant. This is an expected response to the changes in routines and attention that affect the toddler. This is a normal response. The toddler can be provided with a doll to tend to its needs when the parent is performing similar care for the newborn.

At what age do most children have an adult concept of death as being inevitable, universal, and irreversible? a. 4 to 5 years b. 12 to 16 years c. 6 to 8 years d. 9 to 11 years

d. 9 to 11 years By age 9 or 10 years, children have an adult concept of death. They realize that it is inevitable, universal, and irreversible. Preschoolers and young school-age children are too young to have an adult concept of death. Adolescents have a mature understanding of death.

A 4-year-old boy is hospitalized with a serious bacterial infection. He tells the nurse that he is sick because he was "bad." The nurse's best interpretation of this comment is that it is: a. Suggestive of maladaptation. b. Suggestive of excessive discipline at home. c. A sign of stress. d. Common at this age.

d. Common at this age. Preschoolers cannot understand the cause and effect of illness. Their egocentrism makes them think that they are directly responsible for events, making them feel guilt for things outside of their control. Children of this age show stress by regressing developmentally or acting out. Maladaptation is unlikely. This comment does not imply excessive discipline at home.

The nurse is discussing with a parent group the importance of fluoride for healthy teeth. The nurse should recommend that the parents: a. Give fluoride supplements to breastfed infants beginning at age 1 month. b. Have children brush teeth with fluoridated toothpaste unless fluoride content of water supply is adequate. c. Use fluoridated mouth rinses in children older than 1 year. d. Determine whether water supply is fluoridated.

d. Determine whether water supply is fluoridated. The decision about fluoride supplementation cannot be made until it is known whether the water supply contains fluoride and the amount. It is difficult to teach this age-group to spit out the mouthwash. Swallowing fluoridated mouthwashes can contribute to fluorosis. Fluoridated toothpaste is still indicated, but very small amounts are used. Fluoride supplementation is not recommended until after age 6 months.

Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability. After the shock phase, a period of adjustment usually follows. This is often characterized by: a. Acceptance of child's limitations. b. Social reintegration. c. Denial. d. Guilt and anger.

d. Guilt and anger. Response For most families, the adjustment phase is accompanied by several responses that are normally part of the adjustment process. Guilt, self-accusation, bitterness, and anger are common reactions. The initial diagnosis of a chronic illness or disability often is often met with intense emotion and characterized by shock and denial. Social reintegration and acceptance of the child's limitations is the culmination of the adjustment process.

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

d. Jealousy and resentment are common reactions to the illness or hospitalization of a sibling. Siblings experience loneliness, fear, worry, anger, resentment, jealousy, and guilt. The siblings experience stress equal to that of the hospitalized child. These are not uncommon responses by normal siblings. There is no evidence that the family has maladaptive coping or that the siblings lack understanding.

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

d. Separation anxiety The major stress for children from infancy through the preschool years is separation anxiety, also called anaclitic depression. This is a major stressor of hospitalization. Loss of control, fear of bodily injury, and fear of pain are all stressors associated with hospitalization. However, separation from family is a primary stressor in this age-group.

A nurse is assessing an older school-age child recently admitted to the hospital. Which assessment indicates that the child is in an appropriate stage of cognitive development? a. The child's play activity b. The child's addition and subtraction ability c. The child's vocabulary d. The child's ability to classify

d. The child's ability to classify The ability to classify things from simple to complex and the ability to identify differences and similarities are cognitive skills of the older school-age child; this demonstrates use of classification and logical thought processes. Subtraction and addition are appropriate cognitive activities for the young school-age child. Vocabulary is not as valid an assessment of cognitive ability as is the child's ability to classify. Play activity is not as valid an assessment of cognitive function as is the ability to classify.