Exam 1 Flashcards
(274 cards)
1
Q
What are two possible complications of the oxygen therapy and mechanical ventilation a
premature infant often requires?
A
Bronchopulmonary dysplasia (BPD) or Retinopathy of Prematurity (ROP)
2
Q
Two hospitalized adolescents are playing pool in the activity room. Neither of them seems enthusiastic about the game. How should the nurse interpret this situation?
A
The adolescents may be enjoying themselves but have lower energy levels than healthy children.
3
Q
A 10-year-old girl needs to have another intravenous (IV) line started. She keeps telling the nurse, “Wait a minute,” and, “I’m not ready.” How should the nurse interpret this behavior?
A
This is expected behavior for a school-age child
4
Q
What behavior should most likely be manifested in an infant experiencing the protest phase of separation anxiety?
A
inconsolable and crying, clings to parent
5
Q
An occlusive dressing, Acu-derm, is applied to a large abrasion. This is advantageous because the dressing will:
A
Maintain a moist environment for healing.
6
Q
The nurse is interviewing the parents of a 4-month-old male infant brought to the hospital emergency department. The infant is dead on arrival, and no attempt at resuscitation is made. The parents state that the baby was found in his crib with a blanket over his head, lying face down in bloody fluid from his nose and mouth. They say he was “just fine” & “when they put him in his crib already asleep.” The nurse should suspect his death was caused by:
A
Sudden infant death syndrome (SIDS).
7
Q
The parents of a 4-month-old infant cannot visit except on weekends. What action by the nurse indicates an understanding of the emotional needs of a young infant?
A
Assign her to the same nurse as much as possible
8
Q
A cancer patient is experiencing neuropathic cancer pain. Which prescription should the nurse expect to be ordered to control anxiety?
A
Gabapentin (Neurontin)
9
Q
An 8-year-old child is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. Which of the following will most help her adjust to the hospital?
A
Explain hospital routines such as meal times to her.
10
Q
Which is the leading cause of death in infants younger than 1 year in the United States?
A
Congenital anomalies
11
Q
The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should the nurse include in the session with regard to deaths caused by injuries?
A
More deaths occur in males.
12
Q
What do mortality statistics describe?
A
The number of individuals who have died over a specific period
13
Q
The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning?
A
Purposeful and goal directed
14
Q
The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care?
A
Allow the child to choose the type of juice to drink with the administration of oral medications.
15
Q
The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which?
A
95th percentile
16
Q
The nurse is teaching parents about the types of behaviors children exhibit when living with chronic violence. Which statement made by the parents indicates further teaching is needed?
A
“We know that our child will show caring behaviors.”
17
Q
An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions?
A
Autonomy
18
Q
Children are taught the values of their culture through observation and feedback relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may be culturally determined?
A
Status
19
Q
The nurse is aware that if patients’ different cultures are implied to be inferior, the emotional attitude the nurse is displaying is what?
A
Ethnocentrism
20
Q
Which term best describes the sharing of common characteristics that differentiates one group from other groups in a society?
A
Ethnicity
21
Q
The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child’s mother says she has rubbed the edge of a coin on her child’s oiled skin. The nurse should recognize this as what?
A
Cultural practice to rid the body of disease
22
Q
How is family systems theory best described?
A
When the family system is disrupted, change can occur at any point in the system.
23
Q
Which family theory is described as a series of tasks for the family throughout its life span?
A
Developmental theory
24
Q
The nurse is teaching a group of new nursing graduates about identifiable qualities of strong families that help them function effectively. Which quality should be included in the teaching?
A
Clear set of family values, rules, and beliefs
25
When assessing a family, the nurse determines that the parents exert little or no control over their children. This style of parenting is called which?
Permissive
26
When discussing discipline with the mother of a 4-year-old child, which should the nurse include?
Parental control should be consistent
27
Which is a consequence of the physical punishment of children, such as spanking?
Misbehavior is likely to occur when parents are not present.
28
The parents of a young child ask the nurse for suggestions about discipline. When discussing the use of time-outs, which should the nurse include?
Select an area that is safe and nonstimulating, such as a hallway.
29
Children may believe that they are responsible for their parents’ divorce and interpret the separation as punishment. At which age is this most likely to occur?
4 years
30
A parent of a school-age child tells the school nurse that the parents 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 what?
A common reaction to divorce
31
The nurse is planning to counsel family members as a group to assess the family’s group dynamics. Which theoretic family model is the nurse using as a framework?
Family systems theory
32
The nurse is explaining different parenting styles to a group of parents. The nurse explains that an authoritative parenting style can lead to which child behavior?
Self-reliance
33
The nurse is discussing issues that are important with parents considering a cross-racial adoption. Which statement made by the parents indicates further teaching is needed?
“We are glad we will be getting full medical information when we adopt our child.”
34
The school nurse understands that children are impacted by divorce. Which has the most impact on the positive outcome of a divorce?
Family characteristics
35
The nurse is assessing a neonate who was born 1 hour ago to healthy white parents in their early forties. Which finding should be most suggestive of Down syndrome?
Low-set ears
36
Turner syndrome is suspected in an adolescent girl with short stature. What causes this?
Absence of one of the X chromosomes
37
Parents ask the nurse about the characteristics of autosomal dominant inheritance. Which statement is characteristic of autosomal dominant inheritance?
Each child of a heterozygous affected parent has a 50% chance of being affected.
38
Parents ask the nurse about the characteristics of autosomal recessive inheritance. Which is characteristic of autosomal recessive inheritance?
Affected individuals have unaffected parents.
39
Which is characteristic of X-linked recessive inheritance?
Affected individuals are principally males.
40
A woman, age 43 years, is 6 weeks pregnant. It is important that she be informed of which?
Increased risk for Down syndrome
41
A couple expecting their first child has a positive family history for several congenital defects and disorders. The couple tells the nurse that they are opposed to abortion for religious reasons. Which should the nurse consider when counseling the couple?
The couple should be encouraged to have recommended diagnostic testing.
42
Parents ask the nurse if there was something that should have been done during the pregnancy to prevent their child’s cleft lip. Which statement should the nurse give as a response?
“The malformation occurs at approximately 5 weeks of gestation; there is no known way to prevent this.”
43
A child with Prader-Willi syndrome has been hospitalized. Which assessment findings does the nurse expect with this syndrome?
Insatiable hunger
44
Which ethnic group is at risk for Tay-Sachs disease?
Ashkenazi Jewish
45
The nurse is seeing an adolescent and the parents in the clinic for the first time. Which should the nurse do first?
Introduce him- or herself.
46
Which is considered a block to effective communication?
Using clichés
47
Which is the single most important factor to consider when communicating with children?
Child’s developmental level
48
Because children younger than 5 years are egocentric, the nurse should do which when communicating with them?
Focus communication on the child.
49
The nurse is taking a health history of an adolescent. Which best describes how the chief complaint should be determined?
Ask the adolescent, “Why did you come here today?”
50
Where in the health history does a record of immunizations belong?
History
51
When doing a nutritional assessment on a Hispanic family, the nurse learns that their diet consists mainly of vegetables, legumes, and starches. The nurse should recognize that this diet is which?
Providing sufficient amino acids
52
Rectal temperatures are indicated in which situation?
Whenever accuracy is essential
53
The nurse needs to take the blood pressure of a small child. Of the cuffs available, one is too large and one is too small. The best nursing action is which?
Use the large cuff.
54
During a routine health assessment, the nurse notes that an 8-month-old infant has a significant head lag. Which is the most appropriate action?
Schedule the child for further evaluation.
55
Which explains the importance of detecting strabismus in young children?
Amblyopia, a type of blindness, may result.
56
During an otoscopic examination on an infant, in which direction is the pinna pulled?
Down and back
57
What is an appropriate screening test for hearing that the nurse can administer to a 5-year-old child?
Pure tone audiometry
58
What is the appropriate placement of a tongue blade for assessment of the mouth and throat?
Side of the tongue
59
When assessing a preschooler’s chest, what should the nurse expect?
Movement of the chest wall to be symmetric bilaterally and coordinated with breathing
60
When auscultating an infant’s lungs, the nurse detects diminished breath sounds. What should the nurse interpret this as?
An abnormal finding warranting investigation
61
The nurse is assessing a child’s capillary refill time. This can be accomplished by doing what?
Palpate the nail bed with pressure to produce a slight blanching.
62
During examination of a toddler’s extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is which?
Normal because the lower back and leg muscles are not yet well developed
63
The nurse is caring for a non–English-speaking child and family. Which should the nurse consider when using an interpreter?
Communicate directly with family members when asking questions.
64
Which is the most consistent and commonly used data for assessment of pain in infants?
Behavioral
65
What is an important consideration when using the FACES pain rating scale with children?
The scale can be used with most children as young as 3 years.
66
Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain?
Oral sucrose and nonnutritive sucking
67
A 6-year-old child has patient-controlled analgesia (PCA) for pain management after orthopedic surgery. The parents are worried that their child will be in pain. What should your explanation to the parents include?
The pump can deliver baseline and bolus dosages.
68
Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?
Morphine (Roxanol)
69
A child is in the intensive care unit after a motor vehicle collision. The child has numerous fractures and is in pain that is rated 9 or 10 on a 10-point scale. In planning care, the nurse recognizes that the indicated action is which?
Plan a preventive schedule of pain medication around the clock.
70
A bone marrow aspiration and biopsy are needed on a school-age child. The most appropriate action to provide analgesia during the procedure is which?
Use a combination of fentanyl and midazolam for conscious sedation.
71
What is a significant common side effect that occurs with opioid administration?
Constipation
72
The nurse is planning pain control for a child. Which is the advantage of administering pain medication by the intravenous (IV) bolus route?
Provides most rapid onset of effect, usually in about 5 minutes
73
Which is a complication that can occur after abdominal surgery if pain is not managed?
Atelectasis
74
A cancer patient is experiencing neuropathic cancer pain. Which prescription should the nurse expect to be ordered to control anxiety?
Gabapentin (Neurontin)
75
Pertussis vaccination should begin at which age?
2 months
76
A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain?
A topical anesthetic can be applied before injections are given.
77
Which muscle is contraindicated for the administration of immunizations in infants and young children?
Dorsogluteal
78
Which is described as an elevated, circumscribed skin lesion that is less than 1 cm in diameter and filled with serous fluid?
Vesicle
79
What often causes cellulitis?
Streptococci or staphylococci
80
What is most important in the management of cellulitis?
Oral or parenteral antibiotics
81
What is the primary treatment for warts?
Local destruction
82
Herpes zoster is caused by the varicella virus and has an affinity for which?
Posterior root ganglia and posterior horn of the spinal cord
83
Treatment for herpes simplex virus (type 1 or 2) includes which?
Oral antiviral agent
84
What should the nurse explain about ringworm?
It is spread by both direct and indirect contact.
85
When giving instructions to a parent whose child has scabies, what should the nurse include?
Be prepared for symptoms to last 2 to 3 weeks.
86
Which is usually the only symptom of pediculosis capitis (head lice)?
Itching
87
The school reviewed the pediculosis capitis (head lice) policy and removed the “no nit” requirement. The nurse explains that now, when a child is found to have nits, the parents must do which before the child can return to school?
The child can remain in school with treatment done at home.
88
The nurse should know what about Lyme disease?
Caused by a spirochete that enters the skin through a tick bite
89
The nurse is teaching a nursing student about standard precautions. Which statement made by the student indicates a need for further teaching?
“I will use precautions when administering oral medications to a school-age child.”
90
The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine?
The child has a disorder that causes a deficient immune system.
91
An immunocompromised child has been exposed to chickenpox. What should the nurse anticipate to be prescribed to the exposed child?
Varicella-zoster immune globulin
92
The clinic nurse is instructing parents about caring for a toddler with ascariasis (common roundworm). Which statement made by the parents indicates a need for further teaching?
“We know that roundworm can be transmitted from person to person.”
93
A child has been diagnosed with giardiasis. Which prescribed medication should the nurse expect to administer?
Metronidazole (Flagyl)
94
Which characteristic is representative of a full-term newborn’s gastrointestinal tract?
Stomach capacity is very limited.
95
Which is true regarding an infant’s kidney function?
The ability to concentrate urine is less than that of adults.
96
Which statement reflects accurate information about patterns of sleep and wakefulness in the newborn?
The quiet alert stage is the best stage for newborn stimulation.
97
What is the grayish white, cheeselike substance that covers the newborn’s skin?
Vernix caseosa
98
What is most descriptive of the shape of the anterior fontanel in a newborn?
Diamond
99
Which term describes irregular areas of deep blue pigmentation seen predominantly in infants of African, Asian, Native American, or Hispanic descent?
Mongolian spots
100
The nurse should expect the apical heart rate of a stabilized newborn to be in which range?
120 to 140 beats/min
101
Which finding in the newborn is considered abnormal?
Profuse drooling
102
The nurse observes flaring of nares in a newborn. What should this be interpreted as?
Sign of respiratory distress
103
Which is most important in the immediate care of the newborn?
Maintain a patent airway.
104
What should nursing interventions to maintain a patent airway in a newborn include?
Positioning the newborn supine after feedings.
105
The nurse quickly dries the newborn after delivery. This is to conserve the newborn’s body heat by preventing heat loss through which method?
Evaporation
106
The parents of an infant plan to have him circumcised. They ask the nurse about pain associated with this procedure. The nurse’s response should be based on which?
That infants experience pain with circumcision
107
The nurse is teaching a class on breastfeeding to expectant parents. Which is a contraindication for breastfeeding?
Maternal cancer therapy
108
Successful breastfeeding is most dependent on which?
Mother’s desire to breastfeed
109
A mother who breastfeeds her 6-week-old infant every 4 hours tells the nurse that he seems “hungry all the time.” The nurse should recommend which?
More frequent feedings
110
What should a nursing intervention to promote parent–infant attachment include?
Explaining individual differences among infants to the parents
111
The parents of a newborn ask the nurse what caused the baby’s facial nerve paralysis. The nurse’s response is based on remembering that this is caused by what?
Birth injury
112
A mother brings her 6-week-old infant in with complaints of poor feeding, lethargy, fever, irritability, and a vesicular rash. What does the nurse suspect?
Neonatal herpes
113
Which is a bright red, rubbery nodule with a rough surface and a well-defined margin that may be present at birth?
Strawberry hemangioma
114
When should the nurse expect breastfeeding-associated jaundice to first appear in a normal infant?
2 to 4 days
115
Which intervention may decrease the incidence of physiologic jaundice in a healthy full-term infant?
Institute early and frequent feedings.
116
Rh hemolytic disease is suspected in a mother’s second baby, a son. Which factor is important in understanding how this could develop?
The first child was Rh positive.
117
When should the nurse expect jaundice to be present in a full-term infant with hemolytic disease?
Within 24 hours after birth
118
A woman who is Rh-negative is pregnant with her first child, and her husband is Rh positive. During her 12-week prenatal visit, she tells the nurse that she has been told that this is dangerous. What should the nurse tell her?
That administration of Rh immunoglobulin is indicated at 26 to 28 weeks of gestation
119
A mother has just given birth to a newborn with a cleft lip. Sensing that something is wrong, she starts to cry and asks the nurse, “What is wrong with my baby?” What is the most appropriate nursing action?
Explain in simple language that the baby has a cleft lip.
120
The nurse is caring for an infant with hemolytic disease. Which medication should the nurse anticipate to be prescribed to decrease the bilirubin level?
Phenobarbital (Phenobarbital)
121
A 4-month-old infant is discharged home after surgery for the repair of a cleft lip. What should instructions to the parents include?
Give pain medication to the infant to minimize crying
122
Which refers to an infant whose rate of intrauterine growth has slowed and whose birth weight falls below the 10th percentile on intrauterine growth charts?
Small for gestational age
123
What explains why a neutral thermal environment is essential for a high-risk neonate?
It permits the neonate to maintain a normal core temperature with minimum oxygen consumption.
124
The nurse is caring for a high-risk neonate who has an umbilical catheter and is in a radiant warmer. The nurse notes blanching of the feet. Which is the most appropriate nursing action?
Report the findings immediately to the practitioner.
125
Which statement is true concerning the nutritional needs of preterm infants?
The secretion of lactase is low
126
A preterm infant who is being fed commercial formula by gavage has had an increase in gastric residuals, abdominal distention, and apneic episodes. Which is the most appropriate nursing action?
Notify the practitioner.
127
A mother planned to breastfeed her infant before giving birth at 33 weeks of gestation. The infant is stable and receiving oxygen. What is the most appropriate nursing action related to this?
Assess the infant’s readiness to breastfeed.
128
A preterm infant is being fed by gavage. What is an important consideration for this infant?
Provide a pacifier for nonnutritive sucking during bolus feeding.
129
The nurse is caring for a 3-week-old boy born at 29 weeks of gestation. While taking vital signs and changing his diaper after stooling, the nurse observes his color is pink but slightly mottled, his arms and legs are limp and extended, he has the hiccups, his respirations are deep and rapid, and his heart rate is regular and rapid. The nurse should recognize these behaviors as signs of what?
Stress
130
Which is a central factor responsible for respiratory distress syndrome in a newborn?
Deficient surfactant production
131
A preterm infant of 33 weeks of gestation is admitted to the neonatal intensive care unit. Approximately 2 hours after birth, the neonate begins having difficulty breathing, with grunting, tachypnea, and nasal flaring. What should the nurse recognize?
Further evaluation is needed.
132
The nurse is caring for a preterm neonate who requires mechanical ventilation for treatment of respiratory distress syndrome. Because of the mechanical ventilation, the nurse should recognize an increased risk of what?
Pneumothorax
133
What are possible premature infant complications from oxygen therapy and mechanical ventilation?
Bronchopulmonary dysplasia and retinopathy of prematurity
134
A preterm infant with respiratory distress syndrome is receiving inhaled nitric oxide (NO). What is the reason for administering the inhaled nitric oxide?
To reduce pulmonary vasoconstriction and pulmonary hypertension
135
What signs should the nurse expect when a pneumothorax occurs in an infant on mechanical ventilation?
Abrupt duskiness or cyanosis
136
A newborn is diagnosed with retinopathy of prematurity. What should the nurse know about this condition?
Cryotherapy and laser therapy are effective treatments
137
What is a priority of care for an infant with an intraventricular hemorrhage?
Minimize interventions that cause crying.
138
What is a characteristic of most neonatal seizures?
Subtle and barely discernible
139
Women who smoke during pregnancy are most likely to have infants who are what?
Growth restricted in weight, length, and chest and head circumference
140
An infant of a mother with herpes simplex infection has just been born. What should nursing considerations include?
The mother and infant should be together in a private room.
141
The nurse is caring for a newborn who was born at 35 weeks of gestation and is considered a late preterm infant. What intervention should be included in the infant’s care plan?
Promote skin-to-skin care in the immediate postpartum period.
142
Parents of an infant born at 36 weeks’ gestation ask the nurse, “Will our infant need a car seat trial before being discharged?” What is the nurse’s best response?
“Yes, to monitor for possible apnea and bradycardia while in the seat.”
143
The health care provider has prescribed surfactant, beractant (Survanta), to be administered to an infant with respiratory distress syndrome (RDS). The nurse understands that the beractant will be administered by which route?
Via the ET tube
144
The nurse is checking reflexes on a 7-month-old infant. When the infant is suspended in a horizontal prone position, the head is raised and the legs and spine are extended. Which reflex is this?
Landau
145
By which age should the nurse expect that an infant will be able to pull to a standing position?
11 to 12 months
146
According to Piaget, a 6-month-old infant should be in which developmental stage?
Secondary circular reactions
147
At which age should the nurse expect most infants to begin to say “mama” and “dada” with meaning?
10 months
148
What is an appropriate play activity for a 7-month-old infant to encourage visual stimulation?
Playing peek-a-boo
149
At a well-child visit, parents ask the nurse how to know if a daycare facility is a good choice for their infant. Which observation should the nurse stress as especially important to consider when making the selection?
Handwashing by providers after diaper changes
150
A breastfed infant is being seen in the clinic for a 6-month checkup. The mother tells the nurse that the infant recently began to suck her thumb. Which is the best nursing intervention?
Reassure the mother that this is normal at this age.
151
Which intervention is the most appropriate recommendation for relief of teething pain?
Give the infant a frozen teething ring to relieve inflammation.
152
The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the baby’s formula faster. What should the nurse recommend?
Leave the bottle top uncovered to allow heat to escape.
153
The parent of an 8.2-kg (18-lb) 9-month-old infant is borrowing a federally approved car seat from the clinic. The nurse should explain that the safest way to put in the car seat is what?
Rear facing in back seat
154
At an 8-month-old well-baby visit, the parent tells the nurse that her infant falls asleep at night during the last bottle feeding but wakes up when moved to the infant’s crib. What is the most appropriate response for the nurse to make?
“You could increase daytime feeding intervals to every 4 hours and put your baby in the crib while the baby is still awake.”
155
The nurse is performing an assessment on a 12-month-old infant. Which fine or gross motor developmental skill demonstrates the proximodistal acquisition of skills?
Fully developed pincer grasp
156
The nurse is performing an assessment on a 10-week-old infant. The nurse understands that the developmental characteristic of hearing at this age is which?
The infant turns his head to the side when sound is made at the level of the ear.
157
Rickets is caused by a deficiency in what?
Vitamin D and calcium
158
Which factors will decrease iron absorption and should not be given at the same time as an iron supplement?
Milk
159
The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their children. Which is most likely lacking in their particular diet?
Iron and calcium
160
What is marasmus?
Not confined to geographic areas where food supplies are inadequate
161
Lactose intolerance is diagnosed in an 11-month-old infant. Which should the nurse recommend as a milk substitute?
Yogurt
162
Which statement best describes colic?
A paroxysmal abdominal pain or cramping manifested by episodes of loud crying
163
Where do eczematous lesions most commonly occur in an infant?
Cheeks and extensor surfaces of the arms and legs
164
The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. The nurse’s response should be based on remembering what?
This is acceptable to encourage head control and turning over.
165
The nurse is interviewing the parents of a 4-month-old boy brought to the hospital emergency department. The infant is dead, and no attempt at resuscitation is made. The parents state that the baby was found in his crib with a blanket over his head, lying face down in bloody fluid from his nose and mouth. The nurse might initially suspect his death was caused by what?
Sudden infant death syndrome (SIDS)
166
What is an appropriate action when an infant becomes apneic?
Gently stimulate the trunk by patting or rubbing.
167
A parent brings a 12-month-old infant into the emergency department and tells the nurse that the infant is allergic to peanuts and was accidentally given a cookie with peanuts in it. The infant is dyspneic, wheezing, and cyanotic. The health care provider has prescribed a dose of epinephrine to be administered. The infant weighs 24 lb. How many milligrams of epinephrine should be administered?
0.011 to 0.3 mg
168
An infant has been diagnosed with failure to thrive (FTT) classified according to the pathophysiology of inadequate caloric intake. The nurse understands that the reason for the FTT is most likely related to what?
Incorrect formula preparation
169
The nurse is teaching parents guidelines for feeding their 8-month-old infant with failure to thrive (FTT). Which statement by the parents indicates a need for further teaching?
“We will be sure to give our infant at least 8 oz of juice every day.”
170
The nurse is teaching parents about caring for their infant with seborrheic dermatitis (cradle cap). Which statement by the parents indicates understanding of the teaching?
“We will use a fine-tooth comb to help remove the loosened crusts from the strands of hair.”
171
The nurse is administering an oral antihistamine at bedtime to a child with atopic dermatitis (eczema). Which antihistamine should the nurse expect to be prescribed at bedtime?
Diphenhydramine (Benadryl)
172
What do the psychosocial developmental tasks of toddlerhood include?
Ability to delay gratification
173
Which characteristic best describes the gross motor skills of a 24-month-old child?
Walks up and down stairs
174
What developmental characteristic does not occur until a child reaches age 2 1/2 years?
Primary dentition is complete.
175
Which statement is correct about toilet training?
Wanting to please the parent helps motivate the child to use the toilet.
176
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.” What is the nurse’s best reply?
“That is a normal response to the birth of a sibling. Let’s look at ways to deal with this.”
177
A father tells the nurse that his daughter wants the same plate and cup used at every meal, even if they go to a restaurant. The nurse should explain that this is what?
Ritualism, an expected behavior at this age
178
Which is an appropriate recommendation in preventing tooth decay in young children?
Substitute sugarless gum for regular gum.
179
What is the leading cause of death during the toddler period?
Injuries
180
A nurse is observing children playing in the playroom. What describes parallel play?
A child playing with blocks next to a child playing with trucks
181
Parents ask the nurse for strategies to help their toddler adjust to a new baby. What should the nurse suggest?
Alert visitors to the new baby to include the toddler in the visit.
182
The nurse understands that which guideline should be followed to determine serving sizes for toddlers?
1 tbsp of solid food per year of age
183
The nurse is teaching parents about avoiding accidental burns with their toddler. What water heater setting should the nurse recommend to the parents?
120° F
184
To avoid a fall from a crib, the nurse recommends to parents that their toddler should sleep in a bed rather than a crib when reaching what height?
35 in
185
In terms of fine motor development, what should the 3-year-old child be expected to do?
Copy (draw) a circle.
186
According to Piaget, magical thinking is the belief of which?
Thoughts are all powerful.
187
The nurse is caring for a hospitalized 4-year-old boy. His parents tell the nurse they will be back to visit at 6 PM. When he asks the nurse when his parents are coming, what would the nurse’s best response be?
“They will come after dinner.”
188
A 4-year-old child tells the nurse that she doesn’t want another blood sample drawn because “I need all of my insides and I don’t want anyone taking them out.” What is the nurse’s best interpretation of this?
Preschoolers have poorly defined body boundaries.
189
What characteristic best describes the language skills of a 3-year-old child?
Talks incessantly regardless of whether anyone is listening
190
During a well-child visit, the father of a 4-year-old boy tells the nurse that he is not sure if his son is ready for kindergarten. The boy’s birthday is close to the cut-off date, and he has not attended preschool. What is the nurse’s best recommendation?
Perform a developmental screening.
191
A boy age 4 1/2 years has been having increasingly frequent angry outbursts in preschool. He is aggressive toward the other children and the teachers. This behavior has been a problem for approximately 8 to 10 weeks. His parent asks the nurse for advice. What is the most appropriate intervention?
Refer the child for a professional psychosocial assessment.
192
What dysfunctional speech pattern is a normal characteristic of the language development of a preschool child?
Stammering
193
A child age 4 1/2 years sometimes wakes her parents up at night screaming, thrashing, sweating, and apparently frightened, yet she is not aware of her parents’ presence when they check on her. She lies down and sleeps without any parental intervention. This is most likely what?
Sleep terror
194
During the preschool period, the emphasis of injury prevention should be placed on what?
Teaching about safety and potential hazards
195
The nurse is planning to bring a preschool child a toy from the playroom. What toy is appropriate for this age group?
Farm animals and equipment
196
The nurse is conducting an assessment of fine motor development in a 3-year-old child. Which is the expected drawing skill for this age?
Can copy a circle and imitate a cross
197
The nurse is explaining the preconventional stage of moral development to a group of nursing students. What characterizes this stage?
Children in this stage have little, if any, concern for why something is wrong.
198
The nurse is teaching parents about instilling a positive body image for the preschool age. What statement made by the parents indicates the teaching is understood?
“We will make sure our child is praised about his or her looks.”
199
The nurse has just given a subcutaneous injection to a preschool child, and the child asks for a Band-Aid over the site. Which action should the nurse implement?
Place a Band-Aid over the site.
200
What should the nurse suggest to parents of preschoolers about sensitive questions regarding sex?
Find out what your child knows or thinks.
201
The nurse suspects that a child has ingested some type of poison. What clinical manifestation would be most suggestive that the poison was a corrosive product?
Edema of the lips, tongue, and pharynx
202
An awake, alert 4-year-old child has just arrived at the emergency department after an ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in which manner?
Mixing with a flavorful beverage in an opaque container with a straw
203
What is the most common form of child maltreatment?
Child neglect
204
A child is admitted with a suspected diagnosis of Munchausen syndrome by proxy (MSBP). What is an important consideration in the care of this child?
Monitoring the parents whenever they are with the child
205
When only one child is abused in a family, the abuse is usually a result of what?
The parent is unable to deal with the child’s behavioral style.
206
What is probably the most important criterion on which to base the decision to report suspected child abuse?
Incompatibility between the history and injury observed
207
The nurse is caring for a child with suspected ingestion of some type of poison. What action should the nurse take next after initiating cardiopulmonary resuscitation (CPR)?
Empty the mouth of pills, plants, or other material.
208
A child is admitted to the hospital with lesions on his abdomen that appear like cigarette burns. What should accurate documentation by the nurse include?
Two round 4-mm lesions are on the child’s lower abdomen.
209
What do inflicted immersion burns often appear as?
Sharply demarcated, symmetrical burns
210
A child has been admitted to the hospital with a blood lead level of 72 mcg/dL. What treatment should the nurse anticipate?
Initiation of chelation therapy
211
The nurse is teaching parents of preschoolers about plants that are poisonous. What plant should the nurse include in the teaching session?
Azalea
212
A child with cyanide poisoning has been admitted to the emergency department. What antidote does the nurse anticipate being prescribed for the child?
Amyl nitrate
213
The parents of 9-year-old twin children tell the nurse, “They have filled up their bedroom with collections of rocks, shells, stamps, and bird nests.” The nurse should recognize that this is which?
Characteristic of cognitive development at this age
214
What statement characterizes moral development in the older school-age child?
The child is able to judge an act by the intentions that prompted it rather than just by the consequences.
215
An 8-year-old girl tells the nurse that she has cancer because God is punishing her for “being bad.” What should the nurse interpret this as?
A common belief at this age
216
What is the role of the peer group in the life of school-age children?
Provides them with security as they gain independence from their parents
217
The school nurse has been asked to begin teaching sex education in the fifth grade. What should the nurse recognize?
Sexuality is presented as a normal part of growth and development.
218
The school nurse is providing guidance to families of children who are entering elementary school. What is essential information to include?
Encourage growth of a sense of responsibility in children.
219
What is an important consideration for the school nurse who is planning a class on bicycle safety?
Head injuries are the major causes of bicycle-related fatalities.
220
The nurse is teaching a class on nutrition to a group of parents of 10- and 11-year-old children. What statement by one of the parents indicates a correct understanding of the teaching?
“I will serve foods that are low in saturated fat and cholesterol.”
221
A male school-age student asks the school nurse, “How much with my height increase in a year?” The nurse should give which response?
“Your height will increase on average 2 inches a year.”
222
What does the nurse understand about caloric needs for school-age children?
The caloric needs for school-age children are lower than they were in the preschool years.
223
The school nurse is teaching female school-age children about the average age of puberty. What is the average age of puberty for girls?
12 years
224
A female school-age child asks the school nurse, “How many pounds should I expect to gain in a year?” The nurse should give which response?
“You will gain about 4.4 to 6.6 lb per year.”
225
The nurse is explaining about the developmental sequence in children’s capacity to conserve matter to a group of parents. What type of matter is last in the sequence for a child to develop?
Volume
226
The parents of a 5-year-old child ask the nurse, “How many hours of sleep a night does our child need?” The nurse should give which response?
“A 5-year-old child requires 11.5 hours of sleep.”
227
An occlusive dressing is applied to a large abrasion. This is advantageous because the dressing will accomplish what?
Maintain a moist environment for healing.
228
A toddler has a deep laceration contaminated with dirt and sand. Before closing the wound, the nurse should irrigate with what solution?
Normal saline
229
The nurse should know what about Lyme disease?
Caused by a spirochete that enters the skin through a tick bite
230
The school nurse is seeing a child who collected some poison ivy leaves during recess. He says only his hands touched it. What is the most appropriate nursing action?
Rinse his hands in cold running water.
231
The management of a child who has just been stung by a bee or wasp should include applying what?
Cool compresses
232
The nurse is assisting the family of a child with a history of encopresis. What should be included in the nurse’s discussion with the family?
Reassure the family that most problems are resolved successfully, with some relapses during periods of stress.
233
What is an important consideration in the diagnosis of attention deficit hyperactivity disorder (ADHD)?
It must be determined whether the child’s behavior is age appropriate or problematic.
234
A 9-year-old child has just been diagnosed with recurrent abdominal pain (RAP). In preparing for discharge, the nurse should include what in the home care instructions to the parents?
Following a high-fiber diet
235
The school nurse is reviewing the process of wound healing. What is the initial response at the site of injury?
Inflammation
236
An older school-age child asks the nurse, “What is the reason for this topical corticosteroid cream?” What rationale should the nurse give?
The cream is used for an anti-inflammatory effect.
237
The nurse is explaining the purpose of using a vacuum-assisted closure (VAC) device to assist in the healing of a wound. What should the nurse explain as the purpose of using a VAC device?
The device applies gentle continuous suction.
238
A child has had contact with some poison ivy. The school nurse understands that the full-blown reaction should be evident after how many days?
2 days
239
The nurse is admitting a child with frostbite. What health care prescription should the nurse question and verify?
Massage the injured tissue.
240
Girls experience an increase in weight and fat deposition during puberty. What do nursing considerations related to this include?
Give reassurance that these changes are normal.
241
In boys, what is the initial indication of puberty?
Testicular enlargement
242
What aspects of cognition develop during adolescence?
Capability of using a future time perspective
243
Adolescents often do not use reasoned decision making when issues such as substance abuse and sexual behavior are involved. What is this because of?
They are dealing with issues that are stressful and emotionally laden.
244
What is most descriptive of the spiritual development of older adolescents?
Beliefs become more abstract.
245
According to Erikson, the psychosocial task of adolescence is developing what?
Identity
246
What is true concerning the development of autonomy during adolescence?
Conformity to both parents and peers gradually declines toward the end of adolescence.
247
The development of sexual orientation during adolescence is what?
A developmental process
248
The school nurse is teaching a class on injury prevention. What should be included when discussing firearms?
Adolescence is the peak age for being a victim or offender in the case of injury involving a firearm.
249
The school nurse recognizes that pubertal delay in girls is considered if breast development has not occurred by which age?
13 years
250
The school nurse is teaching an adolescent about social networking and texting on phones. What statement by the adolescent indicates a need for further teaching?
“My text messaging during class time in school will not cause any disruption.”
251
The school nurse recognizes that adolescents should get how many hours of sleep each night?
9 hours
252
The nurse is assessing the Tanner stage in an adolescent male. The nurse recognizes that the stages are based on what?
Size and shape of the penis and scrotum and distribution of pubic hair
253
Tretinoin (Retin-A) is a commonly used topical agent for the treatment of acne. What do nursing considerations with this drug include?
Applying of the medication occurs at least 20 to 30 minutes after washing.
254
The nurse’s role in facilitating successful childrearing in unmarried teenage mothers includes what?
Providing information and feedback about positive parenting skills
255
What is a priority goal in the postpartum care of an adolescent mother?
Prevention of subsequent pregnancies
256
A pregnant 15-year-old adolescent tells the nurse that she did not use any form of contraception because she was afraid her parents would find out. The nurse should recognize what?
This is a frequent reason given by adolescents.
257
An adolescent girl is brought to the hospital emergency department by her parents after being raped. The girl is calm and controlled throughout the interview and examination. The nurse should recognize this behavior is what?
One of a variety of behaviors normally seen in rape victims
258
The nurse has determined that an adolescent’s body mass index (BMI) is in the 90th percentile. What information should the nurse convey to the adolescent?
The adolescent is at risk for becoming overweight
259
During a well-child visit, the nurse plots the child’s BMI on the health record. What is the purpose of the BMI?
To provide a consistent measure of obesity
260
During a well-child visit, the nurse practitioner provides guidance about promoting healthy eating in a child who is overweight. What does the nurse advise?
Slow down eating meals.
261
What goal is most important when caring for a child with anorexia nervosa (AN)?
Correct malnutrition.
262
What do nursing responsibilities regarding weight gain for an adolescent with anorexia nervosa include?
Restore body weight to within 10% of the adolescent’s ideal weight.
263
Many adolescents use alcohol for self-medication. How does an adolescent view the benefit of alcohol?
Provides a defense against depression
264
What best describes central nervous system (CNS) stimulants?
They can result in strong psychologic dependence
265
The nurse is caring for an adolescent brought to the hospital with acute drug toxicity. Cocaine is believed to be the drug involved. Data collection by the nurse should include what information?
Mode of administration
266
What is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?
Social isolation
267
An adolescent girl tells the nurse that she is very suicidal. The nurse asks her if she has a specific plan. How should asking about a specific plan be viewed?
An appropriate part of the assessment
268
After a treatment plan for acne has been initiated, which time period should the nurse explain to an adolescent before improvement will be seen?
6 to 8 weeks
269
The clinic nurse is evaluating an adolescent with menses that have stopped occurring. The nurse understands that which minimum amount of time should the menses be absent after a period of menstruation to be diagnosed as secondary amenorrhea?
6 months
270
A sexually active adolescent asks the school nurse about prevention of sexually transmitted infections (STIs). What should the nurse recommend?
Use of condoms
271
What statement is true about gonorrhea?
Treatment of all sexual contacts is essential.
272
What statement regarding chlamydial infections is correct?
Both men and women may have asymptomatic infections.
273
What is true about pelvic inflammatory disease (PID)?
It may have devastating effects on the reproductive tract of affected adolescents.
274
The clinic nurse is evaluating a patient with a vaginal infection. The nurse knows that the normal vaginal pH is in which range?
4.0 to 5.0
