Week 6

Sequence of cephalocaudal development that the nurse expects to find in the normal infant with the appropriate step numbers. Begin with the first development expected, sequencing to the final.

1. Crawl 2. Creep 3. Stand 4. Walk

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.The nurse can gain insight into the child's feelings c.Gives the child a structured play environment d.Serves as method to assist disturbed children e.The child can deal with concerns and feelings

ANS: A, B, E

In teaching parents about appropriate pacifier selection, the nurse should explain that a pacifier should have which characteristics? (Select all that apply.) a.One-piece construction b.Sturdy, flexible material c.Ribbon or string to secure to clothing d.Easily grasped handle e.Soft, pliable material

ANS: A, D

Acyclovir is given to children with chickenpox for what purpose? a.Prevent spread of the disease b.Decrease the number of lesions c.Minimize scarring d.Prevent aplastic anemia

ANS: B

During the preschool period, what should the emphasis of injury prevention be placed on? a.Constant vigilance and protection b.Education for safety and potential hazards c.Limitation of physical activities d.Punishment for unsafe behaviors

ANS: B

Lindsey, age 5 years with a diagnosis of cerebral palsy, will be starting kindergarten next month and will be placed in a special education classroom. The parents are tearful when telling the nurse about this and state that they did not realize that their child's disability was so severe. How should the nurse interpret this parental response? a.The parents need to learn more about cerebral palsy. b.This is a normal anticipated time of parental stress. c.The parents are used to having expectations that are too high. d.This is a sign that parents are in denial.

ANS: B

A child is being discharged from an ambulatory care center after an inguinal hernia repair. Which discharge interventions should the nurse implement? (Select all that apply.) a.Hold any analgesic medications until the child is home. b.Discuss complications that may occur. c.Send a pain scale home with the family. d.Discuss dietary restrictions. e.Suggest the parents fill the prescriptions on the way home.

ANS: B, C, D

A nurse is performing an assessment on a school-age child. Which findings suggest the child is receiving an excess of vitamin A? (Select all that apply.) a.Paresthesia b.Jaundice c.Pruritus d.Edema e.Delayed sexual development

ANS: B, C, E

The mother of a school-age child tells the school nurse that she and her spouse are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as: a.suggestive of lack of adequate parenting. b.unusual response that indicates need for referral. c.common reaction to divorce. d.indicative of maladjustment.

ANS: C

A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of: a.fragile X syndrome. b.microcephaly. c.Down syndrome. d.cerebral palsy.

ANS: C Down Syndrome

The type of injury a child is especially susceptible to at a specific age is most closely related to: a.physical health of the child. b.educational level of the child. c.number of responsible adults in the home. d.developmental level of the child.

ANS: D

The earliest age at which a satisfactory radial pulse can be taken in children is: a.1 year. b.3 years. c.6 years. d.2 years.

ANS : C

A 3-month-old infant, born at 38 weeks of gestation, will hold a rattle if it is put in her hands; however, she will not voluntarily grasp it. How should the nurse interpret this behavior? a.Normal development b.Slightly delayed development caused by prematurity c.Suggestive of a neurologic disorder such as cerebral palsy d.Significant developmental lag

ANS: A

A clinic nurse is planning a teaching session about childhood obesity prevention for parents of school-age children. The nurse should include which associated risk of obesity in the teaching plan? a.Type II diabetes b.Type I diabetes c.Respiratory disease d.Celiac disease

ANS: A

A nurse is teaching parents of first-grade children general guidelines to assist their children in adapting to school. Which statement by the parents indicates they understand the teaching? a."We will plan a trip to the library as often as possible." b."We will only meet with the teacher if problems occur." c."We will expect our child to make all As in school." d."We will discourage hobbies so our child focuses on schoolwork."

ANS: A

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

ANS: A

A parent of an 18 month old tells the nurse that the child says "no" to everything and has rapid mood swings. If scolded, the child shows anger and then immediately wants to be held. What is the nurse's best interpretation of this behavior? a.This is normal behavior for the child's age. b.The child is showing the need for more attention. c.The child is not effectively coping with stress. d.This is unusual behavior for the child's age.

ANS: A

A previously "potty-trained" 30-month-old child has reverted to wearing diapers while hospitalized. The nurse should reassure the parents based on what knowledge concerning regressive behaviors? a.Regression is seen during hospitalization. b.Developmental delays occur because of the hospitalization. c.The child is experiencing urinary urgency because of hospitalization. d.The child was too young to be "potty-trained."

ANS: A

A toddler playing with sand and water would be participating in _____ play. a.sense-pleasure b.dramatic c.skill d.social-affective

ANS: A

At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli? a.3 months b.4 months c.2 months d.1 month

ANS: A

From a worldwide perspective, infant mortality in the United States: a.is the highest of the other developed nations. b.lags behind most other developed nations. c.is the lowest infant death rate of developed nations. d.lags behind five other developed nations.

ANS: A

In terms of fine motor development, what could the 3-year-old child be expected to do? a.Copy (draw) a circle. b.Tie shoelaces c.Draw a person with 7 to 9 parts d.Use scissors or a pencil very well 1 points

ANS: A

Parents tell the nurse that their toddler eats little at mealtimes, only sits at the table with the family briefly, and wants snacks "all the time." The nurse should recommend what intervention to the parents? a.Give her planned, frequent, and nutritious snacks. b.Offer rewards for eating at mealtimes. c.Explain to her in a firm manner what is expected of her. d.Avoid snacks so she is hungry at mealtimes.

ANS: A

The major cause of death for children older than 1 year is: a. unintentional injuries. b. cancer. c. congenital abnormalities. d. infection.

ANS: A

The nurse has just started assessing a young child who is febrile and appears very ill. There is hyperextension of the child's head (opisthotonos) with pain on flexion. The most appropriate action is to: a.refer for immediate medical evaluation. b.ask the parent when the child's neck was injured. c.continue the assessment to determine the cause of neck pain. d.record "head lag" on the assessment record and continue the assessment of the child.

ANS: A

Which is now referred to as the "new morbidity"? a.Behavioral, social, and educational problems that alter health b.Unintentional injuries that cause chronic health problems c.Limitations in the major activities of daily living d.Discoveries of new therapies to treat health problems

ANS: A

A child has just been unexpectedly admitted to the intensive care unit after abdominal surgery. The nursing staff has completed the admission process, and the child's condition is beginning to stabilize. When speaking with the parents, the nurses should expect which stressors to be evident? (Select all that apply.) a.Strange smells b.Inadequate knowledge of condition and routine c.Unfamiliar environment d.Usual day-night routine e.Provision of privacy

ANS: A, B, C

The nursing process is a method of problem identification and problem solving that describes what the nurse actually does. The five steps include: (Select all that apply.) a.evaluation b.diagnosis. c.implementation. d.planning. e.assessment. f.documentation

ANS: A, B, C, D, E

A nurse teaches parents that team play is important for school-age children. Which abilities can children develop by experiencing team play? (Select all that apply.) a.Learn complex rules. b.Learn about division of labor. c.Achieve personal goals over group goals. d.Experience competition.

ANS: A, B, D

Which behaviors by the nurse indicate a therapeutic relationship with children and families? (Select all that apply.) a.Asking questions if families are not participating in the care b.Spending off-duty time with children and families c.Learning about the family's religious preferences d. Buying toys for a hospitalized child e. Clarifying information for families

ANS: A, C, E

A 14-year-old boy and his parents are concerned about bilateral breast enlargement. The nurse's discussion of their concerns should be based on what understanding? a.Administration of testosterone effectively reduces gynecomastia. b.This is usually a benign and temporary condition. c.This is usually caused by Klinefelter's syndrome. d.Administration of estrogen effectively reduces gynecomastia.

ANS: B

A 2-year-old child comes to the emergency department demonstrating signs of dehydration and hypovolemic shock. Which best explains why an intraosseous infusion is started? a.Long-term central venous access is not possible. b.Rapid venous access is not possible. c.Antibiotics must be started immediately. d.It is less painful for small children

ANS: B

A 9 year old diagnosed with Down syndrome is mainstreamed into a regular third-grade class for part of the school day. His mother asks the school nurse about programs such as Cub Scouts that he might join. The nurse's recommendation should be based on what knowledge? a.Parents of children with Down syndrome encourage programs such as scouting because they deny that their children have disabilities. b.Children with Down syndrome have the same need for socialization as other children. c.Programs such as Cub Scouts are inappropriate for children who are cognitively impaired. d.Children with Down syndrome socialize better with children who have similar disabilities.

ANS: B

A child is receiving total parenteral nutrition (TPN; hyperalimentation). At the end of 8 hours, the nurse observes the solution and notes that 200 mL/8 hr is being infused rather than the ordered amount of 300 mL/8 hr. The nurse should adjust the rate so that how much will infuse during the next 8 hours? a.200 mL b.300 mL c.400 mL d.350 mL

ANS: B

A child with autism is hospitalized with asthma. The nurse should plan care so that the: a.child is supported through the autistic crisis. b.child's routine habits and preferences are maintained. c.parents need not be at the hospital. d.parents' expectations are met.

ANS: B

A nurse is caring for an adolescent hospitalized for cellulitis. The nurse notes that the adolescent experiences many "mood swings" throughout the day. The nurse interprets this behavior as: a.requiring some further laboratory testing. b.normal behavior. c.requiring a referral to a mental health counselor. d.related to feelings of depression.

ANS: B

A nurse is preparing to perform a dressing change on a 6-year-old child with mild cognitive impairment (CI) who sustained a minor burn. Which strategy should the nurse use to prepare the child for this procedure? a.Have the child watch a video on dressing changes. b.Demonstrate a dressing change on a doll. c.Verbally explain what will be done. d.Explain the importance of keeping the burn area clean.

ANS: B

During examination of a toddler's extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is: a.normal if the condition is unilateral or asymmetric. b.normal because the lower back and leg muscles are not yet well developed. c.abnormal unless it occurs in conjunction with knock-knee. d.abnormal and requires further investigation.

ANS: B

The leading cause of death from unintentional injuries in children is: a.poisoning. b.motor vehicle related fatalities. c.drowning. d.fire- and burn-related fatalities.

ANS: B

The nurse has a 2-year-old boy sit in "tailor" position during palpation for the testes. The rationale for this position is that: a.this tests the child for an inguinal hernia. b.it prevents cremasteric reflex. c.undescended testes can be palpated. d.the child does not yet have a need for privacy.

ANS: B

Which statement best describes the process of critical thinking? a.It is based on deliberate and irrational thought. b.It is purposeful and goal directed. c.It is a simple developmental process. d.It assists individuals in guessing what is most appropriate.

ANS: B

Which statement is most descriptive of pediatric family-centered care? a.It avoids expecting families to be part of the decision-making process. b.It recognizes that the family is the constant in a child's life. c.It encourages family dependence on the health care system. d.It reduces the effect of cultural diversity on the family.

ANS: B

A nurse is planning care for a 7-year-old child hospitalized with osteomyelitis. Which activities should the nurse plan to bring from the playroom for the child? (Select all that apply.) a.Jack-in-the-box b. Board games c.Computer games d.Stuffed animals e.Paper and some paints

ANS: B, C, E

16 months old, falls down a few stairs and then gets up and "scolds" the stairs as if they caused the fall. This is an example of which of the following? a.Irreversibility b.Ritualism c.Animism d.Delayed cognitive development

ANS: C

A 10 year old, who needs to have another intravenous (IV) line started, keeps telling the nurse, "Wait a minute," and, "I'm not ready." How should the nurse interpret these requests? a.This behavior is usually not seen past the preschool years. b.The child has successfully manipulated the nurse in the past. c.This is normal behavior for a school-age child. d.The child thinks the nurse is punishing her

ANS: C

A 13-year-old girl asks the nurse how much taller she will become. She has been growing about 2 inches per year but grew 4 inches this past year. Menarche recently occurred. The nurse should base her response on knowing that: a.growth cannot be predicted. b.the pubertal growth spurt lasts about 1 year. c.approximately 95% of mature height is achieved when menarche occurs. d.mature height is achieved when menarche occurs.

ANS: C

A 4 year old is hospitalized with a serious bacterial infection. The child tells the nurse that, "I am sick because I was bad." What is the nurse's best interpretation of this comment? a.It is suggestive of maladaptation. b.It is a sign of stress. c.It is common at this age. d.It is suggestive of excessive discipline at home

ANS: C

A 9 year old often comes to the school nurse complaining of stomach pains. The teacher says that the child has lately been somewhat aggressive and stubborn in the classroom. What should the school nurse recognize as the possible trigger for these behaviors? a.Lack of adjustment to the school environment b.Developmental delay c.Signs of stress d.A physical problem causing emotional stress

ANS: C

A Chinese toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items such as Jell-O, Popsicles, and juices are left. What would best explain this? a.Hispanics believe that the "evil eye" enters when a person gets cold. b.Hispanics believe that an innate energy called chi is strengthened by eating soup .c.The parent is trying to restore normal balance through appropriate "hot" remedies. d.The parent is trying to feed child only what child likes most.

ANS: C

A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. What should the nurse recommend to be used as substitute for the breastmilk? a.Commercial formula without iron b.Skim milk c.Commercial iron-fortified formula d.Whole cow's milk

ANS: C

A parent asks the nurse about how to respond to negativism in toddlers. What is the most appropriate recommendation? a.Punish the child. b.Ask child not always to say "no." c.Reduce the opportunities for a "no" answer. d.Provide more attention.

ANS: C

An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is to: a. determine why she is so anxious. b.tell her she will see how it works as it is used. c.explain in simple terms how it works. d.ask her why she wants to know.

ANS: C

An adolescent male visits his primary care provider complaining of difficulty with his vision. When the nurse asks the adolescent to explain what visual deficits he/she is experiencing, the adolescent states, "I am having difficulty seeing distant objects; they are less clear than things that are close." What disorder does the nurse suspect the adolescent has? a.Astigmatism b.Amblyopia c.Myopia d.Hyphema

ANS: C

At the time of a child's death, the nurse tells his mother, "We will miss him so much." What does this statement indicate about the nurse? a.Talking when listening would be better. b.Denying the mother's sense of loss. c.Expressing personal feelings of loss. d.Pretending to be experiencing grief

ANS: C

By what age should concerns about pubertal delay be considered in boys? a.12.5 to 13 years b.12 to 12.5 years c.13.5 to 14 years d.13 to 13.5 years

ANS: C

During a routine health assessment, the nurse notes that an 8-month-old infant has significant head lag. Which is the nurse's most appropriate action? a.Recheck head control at the next visit. b.Refer the child for further evaluation if the anterior fontanel is still open. c.Refer the child for further evaluation. d.Teach the parents appropriate exercises.

ANS: C

In what type of play are children engaged in similar or identical activity without organization, division of labor, or mutual goal? a.Parallel b.Solitary c.Associative d.Cooperative

ANS: C

Matt, aged 14 years, seems to be always eating, although his weight is appropriate for his height. What is the best explanation for this situation? a.His caloric intake would have to be excessive. b.This is abnormal and suggestive of future obesity. c.This is normal because of increase in body mass. d.He is substituting food for unfilled needs.

ANS: C

The clinic is lending a federally approved car seat to an infant's family. Where in the car should the nurse explain is the safest place to put the car seat? a.Rear facing in front seat if an air bag is on the passenger side. b.Front facing in back seat. c.Rear facing in back seat. d.Front facing in front seat if an air bag is on the passenger side.

ANS: C

The most frequently used test for measuring visual acuity is the: a.Denver Eye Screening test. b.Allen picture card test. c.Snellen letter chart. d.Ishihara vision test.

ANS: C

The nurse administering a bitter oral medication to an infant or small child should mix the medication with what substance? a.A bottle of formula or milk. b.Large amounts of water to dilute medication sufficiently. c.A teaspoon of jam or ice cream. d.Any food the child is going to eat.

ANS: C

Which action by the nurse demonstrates use of evidence-based practice (EBP)? a.Clarifying a physician's prescription for morphine b.Gathering equipment for a procedure c.Questioning the use of daily central line dressing changes d.Documenting changes in a patient's status

ANS: C

Which statement regarding childhood morbidity is the most accurate? a.Unintentional injuries do not have an effect on morbidity. b.Morbidity does not vary with age. c.Morbidity is not distributed randomly. d.Little can be done to improve morbidity.

ANS: C

Which of the following is descriptive of deaths caused by unintentional injuries? a.The pattern of deaths does not vary according to age and sex. b.The pattern of deaths varies widely in Western societies. c.More deaths occur in males. d.More deaths occur in females.

ANS: C Most deaths from unintentional injuries occur in males. - The pattern of death caused by unintentional injuries is consistent in Western societies. - Causes of unintentional deaths vary with age and gender.

A 3 year old has a 102° F fever associated with a viral illness that has not responded to acetaminophen. The nurse's action should be based on what knowledge about fevers in children? a.Fever over 102° F indicates a probable bacterial infection. b.Seizures are common in children when antipyretics are ineffective. c.Fever over 102° F indicates greater severity of illness. d.Fevers such as this are common with viral illnesses.

ANS: D

A 3-year-old girl was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guideline concerning adoption should the nurse use in planning her response? a.The best time to tell the child is between ages 7 and 10 years. b.It is not necessary to tell the child who was adopted so young. c.It is best to wait until the child asks about it. d.Telling the child is an important aspect of their parental responsibilities.

ANS: D

A nurse is gathering a history on a school-age child admitted for a migraine headache. The child states, "I have been getting a migraine every 2 or 3 months for the last year." The nurse documents this as which type of pain? a.Chronic b.Acute c.Subacute d.Recurrent

ANS: D

A nurse would suspect possible visual impairment in a child who displays: a.rapid lateral movement of the eyes. b.lack of interest in casual conversation with peers. c.delay in speech development. d.excessive rubbing of the eyes.

ANS: D

In addition to injuries, the leading causes of death in adolescents ages 15 to 19 years are: a.drowning, cancer. b.suicide, cancer. c.homicide, heart disease. d.homicide, suicide

ANS: D

In terms of language and cognitive development, which behavior is expected of a 4-year-old child? a.Understanding conservation of matter. b.Comprehending another person's perspective. c.Thinking in abstract terms. d.Following simple commands.

ANS: D

Kimberly is having a checkup before starting kindergarten. The nurse asks her to do the "finger-to-nose" test. The nurse is testing for: a.sensory discrimination. b.ability to follow directions. c.deep tendon reflexes. d.cerebellar function.

ANS: D

Parents tell the nurse that they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom. Which is the most appropriate recommendation the nurse should make? a.Allow children unrestricted permission to satisfy this curiosity. b.Get counseling for this unusual and dangerous behavior. c.Punish children so this behavior stops. d.Neither condone nor condemn the curiosity.

ANS: D

The nurse is preparing staff in-service education about atraumatic care for pediatric patients. Which intervention should the nurse include? a.Prepare the child for separation from parents during hospitalization by reviewing a video. b.Help the child accept pain that is connected with a treatment or procedure. c.Help the child accept the loss of control associated with hospitalization. d.Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal.

ANS: D

Place in order the expected sequence of fine motor developmental milestones for an infant, beginning with the first milestone achieved and ending with the last milestone achieved.

First --> Reflex Palmar Grasp Second --> Voluntary Palmar Grasp Third --> Neat Pincer Grasp Fourth --> Puts objects into a container Fifth --> Builds tower of two blocks