Children Exam 1

Question 1

You are assessing an 8 month old infant. In
which order would you perform vital signs to
ensure obtaining the most accurate data? (Assume T =
rectal temp)
A. BP, T, RR, HR
B. RR, HR, BP, T
C. HR, RR, BP, T
D. T, RR, HR, BP

Answer 1

B. RR, HR, BP, T

Question 2

What is the growth development trends for weight and length for infant

Answer 2

– Double the birth weight by age 6 months
– Triple the birth weight by age 1 year
– Double the length by age 1 year
– Head circumference 1.5 cm/month first 6 months,
then 0.5 cm/month between 6-12 months

Question 3

At birth, Mary weighed 3.5 kg and was 49 cm in length,
which placed her in about the 50th percentile for weight
and length.
How much would you expect Mary to weigh at her 6
month appointment?
a) 15.4 lbs
b) 7.5 kg
c) 10.5 kg
d) 10.5 lbs

Answer 3

A 15.4 lbs. An infant’s weight doubles in the first 6 months. 3.5x2= 7kg
(x2.2=15.4lbs)

Question 4

Mary was at the 50th percentile at birth and is at the 10th
percentile for weight at her 6 month appointment.
Is this cause for concern? How would you advise Mary’s mother?
a) Yes, Mary’s mother should be referred to a nutrition
counselor.
b) Yes, the provider should review Mary’s diet and make
recommendations.
c) No, children go up and down on the growth chart and this
should just be monitored.
d) No, wait until Mary’s next appointment and see what
happens.

Answer 4

B – review Mary’s diet and make recommendations. The trend is what’s
important, but the change in percentile shouldn’t be ignored (making C and D
incorrect); however, it’s only one data point, so referral to a nutritionist is not
warranted yet.

Question 5

A nurse is assessing a 6 month old infant. The nurse recognizes that the posterior fontanel
usually closes at what age?
a) 6-8 weeks
b) 10-12 weeks
c) 4-6 months
d) 8-10 months

Answer 5

3. A – posterior fontanel closes first, at 6-8 weeks

Question 6

When does frontal fontanel usually closes?

Answer 6

12-18 months

Question 7

By 7 months what are the fine motor skills with grasp reflex

Answer 7

7 months Moves objects from hand to hand

Question 8

By 9 months what are the fine motor skills with grasp reflex

Answer 8

Has a crude pincer grasp
using the pads of their pointer finger and thumb and not the tips
( looks like pinching)

Question 9

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

Answer 9

C – 8 months is very late for head control (4 months is the milestone), so
referral for evaluation is warranted.

Question 10

Which of the following behaviors indicates that
an infant has developed object permanence?
a) Recognizes familiar face, such as mother
b) Recognizes familiar object, such as a bottle
c) Actively searches for a hidden object
d) Secures objects by pulling at them

Answer 10

C – active searching indicates that the infant recognizes something still exists
even when out of sight

Question 11

According to the “Talk With Me Baby” video,
what is the best predictor of 3rd grade reading
outcomes?
a. Parent income
b. Family socio-economic status
c. Parent education level
d. Number of words a child hears

Answer 11

D – the number of words a child hears is the best predictor of 3rd grade
reading outcomes

Question 12

When does babies have separation anxiety ?

Answer 12

Between ages 4-8 months

Question 13

When does babies have stranger anxiety

Answer 13

6-8 months

Question 14

A 4-month old was born at 35-weeks gestation. She seems to be
developing normally, but her parents are concerned because she
is a more “difficult” baby than their other child, who was term.
The nurse should explain that:
a) Infants’ temperaments are part of their unique characteristics
b) Infants become less difficult if they are not kept on scheduled
feedings and structured routines.
c) The infant’s behavior is suggestive of failure to bond
completely with her parents.
d) The infant’s difficult temperament is the result of painful
experiences in the neonatal period

Answer 14

A – infant’s temperaments (even difficult ones!) are part of their unique
characteristics

Question 15

What are the first thing introduced to babies?

Answer 15

Iron fortified cereal or drinks within 4-6 months

Question 16

After 6 months what types of food can be introduced?

Answer 16

egg, meat,citrus

Question 17

When do you start introducing finger food ?

Answer 17

9 months

Question 18

What information should the nurse give a mother regarding the
introduction of solid foods during infancy?
a) Solid foods should not be introduced until 8 to 10 moths,
when the extrusion reflex begins to disappear.
b) Foods should be introduced one at a time, at intervals of 4 to
7 days.
c) Solid foods can be mixed in a bottle to make the transition
easier for the infant.
d) Fruits and vegetables should be introduced to the diet first

Answer 18

B – solid foods should be introduced one at a time at intervals of 4-7 days.
This is to detect allergies

Question 19

What is nursing bottle syndrome

Answer 19

When leaving the bottle too lon g with the baby can cause decay or caries on teeth

Question 20

Which of the following is not true regarding tummy time? (Refer
to healthychildren.org reference on slide 57)
a) Some babies don’t seem to like it
b) Parents should wait till the baby can lift her head to begin
tummy time.
c) Tummy time can be done on the parent’s chest when the
parent is lying down
d) Parents can place a toy just out of reach to encourage the
baby to reach for it

Answer 20

A – tummy time, while necessary is not something all infants like 

Question 21

You are the nurse in a well child clinic. A mother who has been
exclusively breast feeding her 2 wk old infant since birth is
worried because the baby is having four to five golden-
yellow stools/day. There are no other findings. You would
advise her that:
a) This stool description is normal for a breast fed infant
b) This is most likely a sign of GI infection
c) She should switch her infant to formula feeding
d) It’s time to add infant rice cereal to the infant’s diet

Answer 21

A – golden yellow stools are normal for a breast fed infant

Question 22

A nurse is assessing a 6 month old child. What
developmental skills are normal and should be
expected?
• A. speaks in short sentences
• B. sits alone
• C. can feed self with spoon
• D. pulling up to a standing position

Answer 22

B. sit alone

Question 23

While teaching a 10 year old child about their
heart surgery the nurse should:
• A. provide a verbal explanation just prior to the
surgery
• B. provide the child with a booklet to read about the
surgery
• C. introduce the child to another child who had heart
surgery three days ago.
• D. explain the surgery using a model of the heart

Answer 23

D. explain the surgery using a model of the heart
Concrete thinking requires examples, pictures,and models to show them what is going on

Question 24

When giving care to a hospitalized adolescent,
the nurse should be aware that the major threat
felt by the hospitalized adolescent is
• A. pain management
• B. restricted physical activity
• C. altered body image
• D. separation from the family

Answer 24

c. Altered Body Image

Question 25

The nurse is planning care for the 18 month old
child. Which of the following should be included
in the child’s care?
• A. hold and cuddle the child often
• B. encourage the child to feed himself finger food
• C. allow the child to walk independently on the
nursing unit
• D. engage the child in games with the other children

Answer 25

B. encourage the child to feed himself finger food
Based on Autonomy vs Shame

Question 26

• The nurse is observing children playing in the
hospital playroom. She would expect to see
four year old children playing
• A. competitive board games with older children
• B. with their own toys along side other children
• C. alone with hand held computer games
• D. cooperatively with other preschoolers at a play
kitchen

Answer 26

• D. cooperatively with other preschoolers at a play
kitchen