Peds study ch 2-4
The nurse is assessing a 2-year-old boy who has missed some developmental milestones. Which finding will point to the cause of motor skill delays?
The child is homeless and has no toys.
The parents of a 14-year-old girl complain about the amount of time she spends on the Internet. Which question would the nurse ask the parents to assess her psychosocial development?
"Does she do her homework and have fun with her peers?"
The nurse is assessing the respiratory system of a newborn. Which anatomic differences place the infant at risk for respiratory compromise? Select all that apply.
- The nasal passages are narrower. - The larynx is more funnel shaped. - There are significantly fewer alveoli.
At which age would the nurse expect to find the beginning of object permanence?
6 months
During a health history, the nurse explores the sleeping habits of a 3-year-old boy by interviewing his parents. Which statement from the parents reflects a recommended guideline for promoting healthy sleep in this age group?
'We keep a strict bedtime ritual for our son, which includes a bath and bedtime story.'
The nurse is caring for a child just admitted to the medical-surgical unit and notes that the patient records indicate the family's religion as Roman-Catholic. Which statements by the nurse are appropriate when considering the patient's religion while providing care? Select all that apply.
- "Is there anything I can do to help your family maintain any religious practices during your child's stay here?" - "If there are any religious dietary practices that we should be aware of, please don't hesitate to let our staff know."
The nurse is talking with a newly married couple who are asking questions about genetic testing. Which statement by the couple indicates the need for further teaching regarding genetics?
- "We are thankful that our child's temperament won't be anything like either of our fathers' temperaments." - "We are glad that heart disease just runs in our family and can't be a genetic disease."
The nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl. Which is the most effective anticipatory guidance?
Discouraging the addition of fruit juice to the diet
The nurse is providing guidance after observing a mother interact with her negative 2-year-old boy. For which interaction will the nurse advise the mother that she is handling the negativism properly?
Telling the child firmly that we don't scream in the office
The nurse is examining a 10-month-old boy who was born 10 weeks early. Which finding is cause for concern?
The child's head circumference is 19.5 inches.
The nurse observing toddlers in a day care center notes that they may be happy and pleasant one moment and overreact to limit setting the next minute by throwing a tantrum. What is the focus of the toddler's developmental task that is driving this behavior?
The need for separation and control
The nurse is teaching a new mother about the development of sensory skills in her newborn. What would alert the mother to a sensory deficit in her child?
The newborn does not respond to a loud noise.
The nurse is watching toddlers at play. Which normal behavior would the nurse observe?
Toddlers engage in parallel play.
The nurse is assessing a family to determine if they have access to adequate health care. Which statement accurately describes how certain families are affected by common barriers to health care?
White, non-Hispanic children overall are more likely than African American and Hispanic children to be in very good or excellent health.
What activity would the nurse expect to find in an 18-month-old?
Climbing stairs with assistance
The pediatric nurse is caring for the families of immigrant migrant workers in a small town community. For which risk factor should the nurse provide screening?
Depression
A 6-month-old girl weighs 14.7 pounds during a scheduled check-up. Her birth weight was 8 pounds. What is the priority nursing intervention?
Discussing the child's feeding patterns
The nurse is caring for a 7-month-old girl during a well-child visit. Which intervention is most appropriate for this child?
Discussing the type of sippy cup to use
The nurse is educating a first-time mother who has a 1-week-old boy. Which is the most accurate anticipatory guidance?
Explaining that the stomach holds less than 1 ounce
The school nurse is caring for a 10-year-old boy whose single mother's boyfriend is living with them. Which may be an indicator of violence in the home?
He recently started smoking.
The nurse is counseling a young couple who in 2 months are having their third baby. The nurse uses Von Bertalanffy's general system theory applied to families to analyze the family structure. Which best describes the main emphasis of this theory and its application to family dynamics?
It emphasizes the family as a system with interdependent, interacting parts that endure over time to ensure the survival, continuity, and growth of its components.
The nurse is caring for a toddler who is in Piaget's sensorimotor stage of cognitive development. Which task would the nurse expect the toddler to be able to perform?
Knowing which are his or her toys
The nurse is performing a health assessment of a 3-month-old African-American boy. For what condition should this infant be monitored based on his race?
Lactose intolerance
The nurse caring for families in crisis assesses the affective function of an immigrant family consisting of a father, mother, and two school-age children. Based on Friedman's structural functional theory, what defines this family component?
Meeting the love and belonging needs of each member
The nurse in a community clinic is caring for a 6-month-old boy and his mother. Which intervention is priority to promote adequate growth?
Monitoring the child's weight and height
The nurse is designing a nursing care plan for a toddler with lymphoma, who is hospitalized for treatment. What is a priority intervention that the nurse should include in this child's nursing plan?
Monitoring the toddler for developmental delays
The nurse is describing the maturation of various organ systems during toddlerhood to the parents. What would the nurse correctly include in this description?
Myelinization of the brain and spinal cord is complete at about 24 months.
A 10-year-old girl is living with a foster family. Which intervention is the priority for the child in this family structure?
Performing a comprehensive health assessment
The nurse is providing anticipatory guidance to a mother to help promote healthy sleep for her 3-week-old baby. Which recommended guideline might be included in the teaching plan?
Place the baby on his or her back when sleeping.
The nurse volunteering at a homeless shelter to assist families with children identifies homelessness as a risk preventing families from achieving positive outcomes in life. What family theory encompasses this approach to assessing family dynamics?
Resiliency model of family stress, adjustment, and adaptation
The nurse is assisting low-income families to access health care. The nurse is aware that, in today's society, this most accurately defines the diversity of a modern family.
A family is whatever the child and family say it is.
The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development?
The child is unable to push a toy lawnmower.
A parent of four children being interviewed by the nurse states: 'Whatever my husband and I say goes and the kids need to follow our rules without complaining about them.' What type of parenting style does this attitude represent?
Authoritarian
The nurse is assessing a 12-month-old boy with an English-speaking father and a Spanish-speaking mother. The boy does not say mama or dada yet. What is the priority intervention?
Asking the mother if the child uses Spanish words
The nurse is caring for a 2-year-old girl who is wheezing and has difficulty breathing. Which interview question would provide the most useful information related to the symptoms of the child?
Asking the parents if they smoke in the home
The nurse is caring for a child and family who just moved out of a dangerous neighborhood. Which of the following approaches is appropriate to the family stress theory?
Assessing the child's coping abilities
The parent of a 6-month-old infant asks the nurse for advice about his son's thumb sucking. What would be the nurse's best response to this parent?
'Thumb sucking is a healthy self-comforting activity.'
The mother of a 4-year-old is discussing discipline methods with the nurse. She states that she has never tried using "time-outs" with her child and wonders how and if this method works. Which responses from the nurse are appropriate? Select all that apply.
- "Time-out is a way of removing positive reinforcement of an unwanted or inappropriate behavior." -"If you decide to try this method, be sure to use time-out in a nonthreatening, safe area where no interaction occurs with you." - "Time-out is a method that is recognized by many pediatricians and experts in pediatrics."
The nurse is assessing a toddler for temperament and documents a 'difficult' temperament. Which traits are often seen in this type of personality?
- Irritability - Overly active
The neonatal nurse assesses newborns for iron-deficiency anemia. Which newborn is at highest risk for this disorder?
A premature newborn
The nurse is interviewing a 3-year-old girl who tells the nurse: 'Want go potty.' The parents tell the nurse that their daughter often speaks in this type of broken speech. What would be the nurse's appropriate response to this concern?
'This is a normal, common speech pattern in the 3-year-old and is called telegraphic speech.'
The nurse is teaching discipline strategies to the parents of a 4-year-old boy. Which response from the parents indicates a need for more teaching?
"We should let him know he makes us angry with bad behavior."
A new mother expresses concern to the nurse that her baby is crying and grunting when passing stool. What is the nurse's best response to this observation?
'This is normal behavior for infants unless the stool passed is hard and dry.'
The nurse is teaching good sleep habits for toddlers to the mother of a 3-year-old boy. Which response indicates the mother understands sleep requirements for her son?
"He needs 12 hours of sleep per day including his nap."
The nurse is caring for a child of divorced parents on the postoperative unit. Both parents are with the child upon returning from surgery. The nurse hears the parents arguing just outside the child's room. What is the best response by the nurse?
"I know this is a stressful time, but your child can hear you arguing outside the room."
A mother is concerned about her infant's spitting up. Which suggestion would be most appropriate?
"Keep the baby sitting up for about 30 minutes afterward."
A mother confides to the nurse that she is thinking of divorce. Which suggestion by the nurse would help minimize the effects on the child?
"Tell the child together using appropriate terms."
The nurse is providing anticipatory guidance to a mother of a 5-month-old boy about introducing solid foods. Which statement by the mother indicates that effective teaching has occurred?
"The cereal should be a fairly thin consistency at first."
After teaching a group of parents about language development in toddlers, what if stated by a member of the group indicates successful teaching?
"When my 3-year-old asks 'why?' all the time, this is completely normal."
The parents of a 2-year-old girl are frustrated by the frequent confrontations they have with their child. Which is the best anticipatory guidance the nurse can offer to prevent confrontations?
"You need to adhere to various routines."
The nurse is providing discharge teaching regarding formula preparation for a new mother. Which guideline would the nurse include in the teaching plan?
Do not add cereal to the formula in the bottle or sweeten the formula with honey.
The nurse is performing a health assessment of a school-age child. Based on the child's developmental level, on which problem would the nurse focus more attention?
Accidents and injuries
The nurse is developing a teaching plan for toddler safety to present at a parenting seminar. Which safety intervention should the nurse address?
Advise parents to use a forward-facing car seat with harness straps and a clip, placed in the backseat of the car.
The nurse is providing anticipatory guidance to the mother of a 9-month-old girl during a well-baby visit. Which topic would be most appropriate?
Advising how to create a toddler-safe home
The nurse is providing anticipatory guidance to the parents of an 18-month-old girl. Which guidance will be most helpful for toilet teaching?
Advising them to use praise, not scolding
A 14-year-old tells the nurse that he feels like he can never live up to his parents' standards and that they won't even discuss their rules. What parenting style do this child's parents most likely practice?
Authoritarian
The nurse is performing a cognitive assessment of a 2-year-old. Which behavior would alert the nurse to a developmental delay in this area?
The child does not point to named body parts.
The nurse who is scheduled to work in a clinic in a Hispanic neighborhood takes time to research Hispanic cultural norms to better provide culturally competent care. This behavior is an example of which cultural component?
Cultural knowledge
The nurse is caring for a 4-year-old girl of Mexican descent who is recovering in the hospital following a diagnosis of epileptic seizures. The child's mother insists on a visit from her curandera to provide healing powers to her daughter. What would be the best intervention of the nurse in this situation?
Discuss the situation with the child's physician and arrange for a visit from the curandera at the hospital if appropriate.
The nurse is teaching the parents of a 2-year-old toddler methods of dealing with their child's 'negativism.' Based on Erickson's theory of development, what would be an appropriate intervention for this child?
Encourage the child to pick out his own clothes.
The nurse is teaching parents of a 2-year-old about the extinction method of discipline. What is an example of this method of discipline?
Enforcing a 'time-out'
The nurse is teaching the parents of a 2-year-old girl how to deal with common toddler situations. Which is the best advice?
Have the child help clean up a bowel accident.
The nurse is assessing a 3-year-old boy's development during a well-child visit. Which response by the child indicates the need for further assessment?
He laughs when his brother cries getting vaccinated.
The nurse is assessing the 'resilience' of a 16-year-old boy. Which exemplifies an external protective factor that may help to promote resiliency in this child?
His caring relationship with members of his family
The nurse is counseling the mother of a newborn who is concerned about her baby's constant crying. What teaching would be appropriate for this mother?
Reducing stimulation may decrease the length of crying.
The nurse is teaching the parents of an overweight 18-month-old girl about diet. Which intervention will be most effective for promoting proportionate growth?
Remove high-calorie, low-nutrient foods from the diet.
The pediatric nurse is planning quiet activities for hospitalized 18-month-old. What would be an appropriate activity for this age group?
Stacking blocks
Which reflex, if found in a 4-month-old infant, would cause the nurse to be concerned?
Step
The nurse is teaching discipline strategies to the parents of a 14-year-old girl. Which topic is an example of positive reinforcement discipline?
Taking a chore away from her for a week
The mother of an 8-year-old girl with a broken arm is the nurturer in the family. Which nursing activity should be focused on her?
Teaching proper care procedures
The nurse is testing the sensory development of a toddler brought to the clinic for a well visit. What might alert the nurse to a potential problem with the child's sensory development?
The toddler does not respond to commands whispered in his ear.
The nurse is performing a physical assessment of a 3-year-old girl. What finding would be a concern for the nurse?
The toddler's anterior fontanel is not fully closed.
The nurse emphasizes that a toddler younger than the age of 18 months should never be spanked primarily for which reason?
There is an increased risk for physical injury in this age group.
The parents of a 1-year-old girl, both of whom have perfect teeth, are concerned about their child getting dental caries. Which is the best advice the nurse can provide?
Tell the parents to limit the child's eating to meal and snack times.
The nurse is teaching an athletic father how to stimulate his 7-year-old son who has a 'slow-to-warm-up' temperament. Which guidance will be most successful?
Telling him to read stories to the child about famous athletes
The nurse is caring for a 4-week-old girl and her mother. Which is the most appropriate subject for anticipatory guidance?
Telling how and when to introduce rice cereal
The nurse is assessing a 4-month-old boy during a scheduled visit. Which findings might suggest a developmental problem?
The child does not vocally respond to voices.
The nurse accepts an assignment that involves caring for new parents and their infants in a clinic in a predominantly African American neighborhood. In order to apply culturally competent care, the nurse investigates the common beliefs and practices that may affect the health of these parents and infants. What are some examples of these beliefs? Select all that apply.
- Strong extended family relationships; mother as head of household; elder family members valued and respected - View of health as harmony with nature, illness as disruption in harmony - View of pain and suffering as inevitable; relief achieved through prayers and laying on of hands
A new mother tells the nurse that she is having difficulty breastfeeding her baby. When observing the mother, which actions prompt the nurse to provide teaching about proper breastfeeding techniques? Select all that apply.
- The mother carefully washes her breasts prior to feeding the infant. - The mother feeds the infant every hour. - The mother supplements feedings with water.
The nurse is assessing the developmental milestones of an infant. The infant was born 8 weeks ago and was 4 weeks premature. The nurse anticipates that the infant will be meeting milestones for what age of child? Record your answer in weeks.
4
A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm. How might the nurse respond to this information?
'This is a primitive reflex known as the palmar grasp.'
The nurse is assessing the infants in the nursery for the six stages of consciousness. The nurse becomes concerned when assessing which infants? Select all that apply.
- An infant rapidly moves from deep sleep to crying - An infant moves from active alert state to drowsiness - An infant frequently skips the quiet alert state during the six stages of consciousness
The nurse observes an infant interacting with his parents. What are normal social behavioral developments for this age group? Select all that apply.
- Around 2 months the infant exhibits a first real smile. - Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. - Around 3 months the infant will mimic the parent's facial movements, such as sticking out the tongue. - Separation anxiety may also start in the last few months of infancy.
The nurse caring for newborns knows that infants exhibit phenomenal increases in their gross motor skills over the first 12 months of life. Which statements accurately describe the typical infant's achievement of these milestones? Select all answers that apply.
- At 1 month the infant lifts and turns the head to the side in the prone position. - At 7 months the infant sits alone with some use of hands for support. - At 9 months the infant crawls with the abdomen off the floor. - At 12 months the infant walks independently.
The nurse is helping parents prepare a healthy meal plan for their toddler. Which guidelines for promoting nutrition should be followed when planning meals? Select all that apply.
- Extending breastfeeding into toddlerhood is believed to be beneficial to the child. - Adequate calcium intake and appropriate exercise lay the foundation for proper bone mineralization. - The toddler requires an average intake of 500 mg calcium per day.
The nurse working in a free community clinic knows that access to health care is affected negatively by lack of health insurance. What accurately describes the effect of lack of insurance on family health? Select all that apply.
- Parents with uninsured children often delay care for their children. - Parents with uninsured children are less likely to have taken their children to a doctor or dentist in the last 2 years. - Currently, the states have improved enrollment in Medicaid and the State Children's Health Insurance Program (SCHIP). - Despite state efforts to ensure all children, nearly half of children eligible for these public programs are still uninsured.
The nurse is choosing foods for a toddler's diet that are high in vitamin A. What foods could be added to the menu? Select all that apply.
- Spinach - Sweet potatoes - carrots
The nurse is teaching a new mother the proper techniques for breastfeeding her newborn. Which is a recommended guideline that should be implemented?
Bring the baby's wide-open mouth to the breast to form a seal around all of the nipple and areola.
The nurse is teaching a new mother about the drastic growth and developmental changes her infant will experience in the first year of life. Which statement describes a developmental milestone occurring in infancy?
By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months, the brain weighs 2.5 times what it did at birth.
The nurse is teaching parents interventions appropriate to the emotional development of their toddlers. What is a recommended intervention for this age group?
Do not blame toddlers for aggressive behavior; instead, point out the results of their behavior.
