Newborns/Peds Study Questions Flashcards
(134 cards)
1
Q
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?
a. Hypertonia
b. Low-set ears
c. Micrognathia
d. Long, thin fingers and toes
A
B
2
Q
The inheritance of which is X-linked recessive?
a. Hemophilia A
b. Marfan syndrome
c. Neurofibromatosis
d. Fragile X syndrome
A
A
3
Q
Chromosome analysis of the fetus is usually accomplished through the testing of which?
a. Fetal serum
b. Maternal urine
c. Amniotic fluid
d. Maternal serum
A
C
4
Q
A woman, age 43 years, is 6 weeks pregnant. It is important that she be informed of which?
a. The need for a therapeutic abortion
b. Increased risk for Down syndrome
c. Increased risk for Turner syndrome
d. The need for an immediate amniocentesis
A
B
5
Q
Parents ask the nurse if there was something that should have been done during the pregnancy to prevent their childs cleft lip. Which statement should the nurse give as a response?
a. This is a type of deformation and can sometimes be prevented.
b. Studies show that taking folic acid during pregnancy can prevent this defect.
c. This is a genetic disorder and has a 25% chance of happening with each pregnancy.
d. The malformation occurs at approximately 5 weeks of gestation; there is no known way to prevent this.
A
D
6
Q
The nurse is reviewing a clients prenatal history. Which prescribed medication does the nurse understand is not considered a teratogen and prescribed during pregnancy?
a. Phenytoin (Dilantin)
b. Warfarin (Coumadin)
c. Isotretinoin (Accutane)
d. Heparin sodium (Heparin)
A
D
7
Q
The nurse is seeing an adolescent and the parents in the clinic for the first time. Which should the nurse do first?
a. Introduce him- or herself.
b. Make the family comfortable.
c. Give assurance of privacy.
d. Explain the purpose of the interview.
A
A
8
Q
Which is considered a block to effective communication?
a. Using silence
b. Using clichs
c. Directing the focus
d. Defining the problem
A
B
9
Q
Which is the single most important factor to consider when communicating with children?
a. Presence of the childs parent
b. Childs physical condition
c. Childs developmental level
d. Childs nonverbal behaviors
A
C
10
Q
The nurses approach when introducing hospital equipment to a preschooler who seems afraid should be based on which principle?
a. The child may think the equipment is alive.
b. Explaining the equipment will only increase the childs fear.
c. One brief explanation will be enough to reduce the childs fear.
d. The child is too young to understand what the equipment does.
A
A
11
Q
When the nurse interviews an adolescent, which is especially important?
a. Focus the discussion on the peer group.
b. Allow an opportunity to express feelings.
c. Use the same type of language as the adolescent.
d. Emphasize that confidentiality will always be maintained.
A
B
12
Q
The nurse is preparing to assess a 10-month-old infant. He is sitting on his fathers lap and appears to be afraid of the nurse and of what might happen next. Which initial actions by the nurse should be most appropriate?
a. Initiate a game of peek-a-boo.
b. Ask the infants father to place the infant on the examination table.
c. Talk softly to the infant while taking him from his father.
d. Undress the infant while he is still sitting on his fathers lap.
A
A
13
Q
An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is which?
a. Ask her why she wants to know.
b. Determine why she is so anxious.
c. Explain in simple terms how it works.
d. Tell her she will see how it works as it is used.
A
ANS: C
14
Q
The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful?
a. Recommend that the child keep a diary.
b. Provide supplies for the child to draw a picture.
c. Suggest that the parent read fairy tales to the child.
d. Ask the parent if the child is always uncommunicative.
A
B
15
Q
Which data should be included in a health history?
a. Review of systems
b. Physical assessment
c. Growth measurements
d. Record of vital signs
A
ANS: A
16
Q
The nurse is taking a health history of an adolescent. Which best describes how the chief complaint should be determined?
a. Request a detailed listing of symptoms.
b. Ask the adolescent, Why did you come here today?
c. Interview the parent away from the adolescent to determine the chief complaint.
d. Use what the adolescent says to determine, in correct medical terminology, what the problem is.
A
ANS: B
17
Q
The nurse is preparing to perform a physical assessment on a 10-year-old girl. The nurse gives her the option of her mother staying in the room or leaving. This action should be considered which?
a. Appropriate because of childs age
b. Appropriate, but the mother may be uncomfortable
c. Inappropriate because of childs age
d. Inappropriate because child is same sex as mother
A
A
18
Q
With the National Center for Health Statistics criteria, which body mass index (BMI)for-age percentiles should indicate the patient is at risk for being overweight?
a. 10th percentile
b. 75th percentile
c. 85th percentile
d. 95th percentile
A
C
19
Q
Rectal temperatures are indicated in which situation?
a. In the newborn period
b. Whenever accuracy is essential
c. Rectal temperatures are never indicated
d. When rapid temperature changes are occurring
A
ANS: B
20
Q
Where is the best place to observe for the presence of petechiae in dark-skinned individuals?
a. Face
b. Buttocks
c. Oral mucosa
d. Palms and soles
A
ANS: C
21
Q
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?
a. Recheck head control at next visit.
b. Teach the parents appropriate exercises.
c. Schedule the child for further evaluation.
d. Refer the child for further evaluation if the anterior fontanel is still open.
A
ANS: C
22
Q
The nurse has just started assessing a young child who is febrile and appears ill. There is hyperextension of the childs head (opisthotonos) with pain on flexion. Which is the most appropriate action?
a. Ask the parent when the neck was injured.
b. Refer for immediate medical evaluation.
c. Continue assessment to determine the cause of the neck pain.
d. Record head lag on the assessment record and continue the assessment of the child.
A
ANS: B
Hyperextension of the childs head with pain on flexion is indicative of meningeal irritation and needs immediate evaluation. No indication of injury is present. This situation is not descriptive of head lag.
23
Q
The nurse is testing an infants visual acuity. By which age should the infant be able to fix on and follow a target?
a. 1 month
b. 1 to 2 months
c. 3 to 4 months
d. 6 months
A
C
24
Q
During an otoscopic examination on an infant, in which direction is the pinna pulled?
a. Up and back
b. Up and forward
c. Down and back
d. Down and forward
A
C
25
What is an appropriate screening test for hearing that the nurse can administer to a 5-year-old child?
a. Rinne test
b. Weber test
c. Pure tone audiometry
d. Eliciting the startle reflex
ANS: C
26
Which is the most consistent and commonly used data for assessment of pain in infants?
a. Self-report
b. Behavioral
c. Physiologic
d. Parental report
ANS: B
27
Children as young as age 3 years can use facial scales for discrimination. What are some suggested anchor words for the preschool age group?
a. No hurt.
b. Red pain.
c. Zero hurt.
d. Least pain.
A
28
What is an important consideration when using the FACES pain rating scale with children?
a. Children color the face with the color they choose to best describe their pain.
b. The scale can be used with most children as young as 3 years.
c. The scale is not appropriate for use with adolescents.
d. The FACES scale is useful in pain assessment but is not as accurate as physiologic responses.
B
29
What describes nonpharmacologic techniques for pain management?
a. They may reduce pain perception.
b. They usually take too long to implement.
c. They make pharmacologic strategies unnecessary.
d. They trick children into believing they do not have pain.
ANS: A
30
Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain?
a. Tactile stimulation
b. Commercial warm packs
c. Doing procedure during infant sleep
d. Oral sucrose and nonnutritive sucking
ANS: D
31
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?
a. The child will continue to sleep and be pain free.
b. Parents cannot administer additional medication with the button.
c. The pump can deliver baseline and bolus dosages.
d. There is a high risk of overdose, so monitoring is done every 15 minutes.
ANS: C
32
Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?
a. Codeine sulfate (Codeine)
b. Morphine (Roxanol)
c. Methadone (Dolophine)
d. Meperidine (Demerol)
ANS: B
33
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?
a. Give only an opioid analgesic at this time.
b. Increase dosage of analgesic until the child is adequately sedated.
c. Plan a preventive schedule of pain medication around the clock.
d. Give the child a clock and explain when she or he can have pain medications.
ANS: C
34
A preterm infant has just been admitted to the neonatal intensive care unit. The infants parents ask the nurse about anesthesia and analgesia when painful procedures are necessary. What should the nurses explanation be?
a. Nerve pathways of neonates are not sufficiently myelinated to transmit painful stimuli.
b. The risks accompanying anesthesia and analgesia are too great to justify any possible benefit of
pain relief.
c. Neonates do not possess sufficiently integrated cortical function to interpret or recall pain experiences.
d. Pain pathways and neurochemical systems associated with pain transmission are intact and
functional in neonates.
ANS: D
35
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?
a. Administer TAC (tetracaine, adrenalin, and cocaine) 15 minutes before the procedure.
b. Use a combination of fentanyl and midazolam for conscious sedation.
c. Apply EMLA (eutectic mixture of local anesthetics) 1 hour before the procedure.
d. Apply a transdermal fentanyl (Duragesic) patch immediately before the procedure.
B
36
What is a significant common side effect that occurs with opioid administration?
a. Euphoria
b. Diuresis
c. Constipation
d. Allergic reactions
ANS: C
37
The nurse is teaching a staff development program about levels of sedation in the pediatric population. Which statement by one of the participants should indicate a correct understanding of the teaching?
a. With minimal sedation, the patients respiratory efforts are affected, and cognitive function is not impaired.
b. With general anesthesia, the patients airway cannot be maintained, but cardiovascular function is
maintained.
c. During deep sedation, the patient can be easily aroused by loud verbal commands and tactile
stimulation.
d. During moderate sedation, the patient responds to verbal commands but may not respond to light
tactile stimulation.
ANS: D
38
What is a complication that can occur after abdominal surgery if pain is not managed?
a. Atelectasis
b. Hypoglycemia
c. Decrease in heart rate
d. Increase in cardiac output
A
39
A burn patient is experiencing anxiety over dressing changes. Which prescription should the nurse expect to be ordered to control anxiety?
a. Lorazepam (Ativan)
b. Oxycodone (OxyContin)
c. Fentanyl (Sublimaze)
d. Morphine Sulfate (Morphine)
ANS: A
40
A 4-month-old infant comes to the clinic for a well-infant checkup. Immunizations she should receive are DTaP (diphtheria, tetanus, acellular pertussis) and IPV (inactivated poliovirus vaccine). She is recovering from a cold but is otherwise healthy and afebrile. Her older sister has cancer and is receiving chemotherapy. Nursing considerations should include which?
a. DTaP and IPV can be safely given.
b. DTaP and IPV are contraindicated because she has a cold.
c. IPV is contraindicated because her sister is immunocompromised.
d. DTaP and IPV are contraindicated because her sister is immunocompromised.
ANS: A
41
Which muscle is contraindicated for the administration of immunizations in infants and young children?
a. Deltoid
b. Dorsogluteal
c. Ventrogluteal
d. Anterolateral thigh
B
42
What does impetigo ordinarily results in?
a. No scarring
b. Pigmented spots
c. Atrophic white scars
d. Slightly depressed scars
ANS: A
43
What should the nurse explain about ringworm?
a. It is not contagious.
b. It is a sign of uncleanliness.
c. It is expected to resolve spontaneously.
d. It is spread by both direct and indirect contact.
D
44
When giving instructions to a parent whose child has scabies, what should the nurse include?
a. Treat all family members if symptoms develop.
b. Be prepared for symptoms to last 2 to 3 weeks.
c. Carefully treat only areas where there is a rash.
d. Notify practitioner so an antibiotic can be prescribed.
B
45
Which is usually the only symptom of pediculosis capitis (head lice)?
a. Itching
b. V esicles
c. Scalp rash
d. Localized inflammatory response
A
46
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?
a. No treatment is necessary with the policy change.
b. Shampoo and then trim the childs hair to prevent reinfestation.
c. The child can remain in school with treatment done at home.
Treat the child with a shampoo to treat lice and comb with a fine-tooth comb every day until nits
d. are eliminated.
C
47
The Apgar score of an infant 5 minutes after birth is 8. Which is the nurses best interpretation of this?
a. Resuscitation is likely to be needed.
b. Adjustment to extrauterine life is adequate.
c. Additional scoring in 5 more minutes is needed.
d. Maternal sedation or analgesia contributed to the low score.
B
48
Which term describes irregular areas of deep blue pigmentation seen predominantly in infants of African, Asian, Native American, or Hispanic descent?
a. Acrocyanosis
b. Mongolian spots
c. Erythema toxicum
d. Harlequin color change
ANS: B
49
The nurse should expect the apical heart rate of a stabilized newborn to be in which range?
a. 60 to 80 beats/min
b. 80 to 100 beats/min
c. 120 to 140 beats/min
d. 160 to 180 beats/min
C
50
The nurse is assessing the reflexes of a newborn. Stroking the outer sole of the foot assesses which reflex?
a. Grasp
b. Perez
c. Babinski
d. Dance or step
C
51
Which term is defined as a vaguely outlined area of edematous tissue situated over the portion of the scalp that presents in a vertex delivery?
a. Hydrocephalus
b. Cephalhematoma
c. Caput succedaneum
d. Subdural hematoma
ANS: C
52
What should nursing care of an infant with oral candidiasis (thrush) include?
a. Avoid use of a pacifier.
b. Continue medication for the prescribed number of days.
c. Remove the characteristic white patches with a soft cloth.
d. Apply medication to the oral mucosa, being careful that none is ingested.
B
53
Which is a bright red, rubbery nodule with a rough surface and a well-defined margin that may be present at birth?
a. Port-wine stain
b. Juvenile melanoma
c. Cavernous hemangioma
d. Strawberry hemangioma
D
54
What is an infant with severe jaundice at risk for developing?
a. Encephalopathy
b. Bullous impetigo
c. Respiratory distress
d. Blood incompatibility
A
55
When should the nurse expect breastfeeding-associated jaundice to first appear in a normal infant?
a. 2 to 12 hours
b. 12 to 24 hours
c. 2to4days
d. After the fifth day
C
56
Which intervention may decrease the incidence of physiologic jaundice in a healthy full-term infant?
a. Institute early and frequent feedings.
b. Bathe newborn when the axillary temperature is 36.3 C (97.5 F).
c. Place the newborns crib near a window for exposure to sunlight.
d. Suggest that the mother initiate breastfeeding when the danger of jaundice has passed.
ANS: A
57
What is an important nursing intervention for a full-term infant receiving phototherapy?
a. Observing for signs of dehydration
b. Using sunscreen to protect the infants skin
c. Keeping the infant diapered to collect frequent stools
d. Informing the mother why breastfeeding must be discontinued
A
58
Rh hemolytic disease is suspected in a mothers second baby, a son. Which factor is important in understanding how this could develop?
a. The first child was a girl.
b. The first child was Rh positive.
c. Both parents have type O blood.
d. She was not immunized against hemolysis.
B
Hemolytic disease of the newborn results from an abnormally rapid rate of red blood cell (RBC) destruction. The major causes of this are maternal-fetal Rh and ABO incompatibility. If an Rh- negative mother has previously been exposed to Rh-positive blood through pregnancy or blood transfusion, antibodies to this blood group antigen may develop so that she is isoimmunized. With further exposure to Rh-positive blood, the maternal antibodies agglutinate with the RBCs of the fetus that has the antigen and destroy the cells. Hemolytic disease caused by ABO incompatibilities can be present with the first pregnancy. The gender of the first child is not a concern. Blood type is the important consideration. If both parents have type O blood, ABO incompatibility should not be a possibility.
59
When should the nurse expect jaundice to be present in a full-term infant with hemolytic disease?
a. At birth
b. Within 24 hours after birth
c. 25 to 48 hours after birth
d. 49 to 72 hours after birth
ANS: B
60
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?
a. That no treatment is necessary
b. That an exchange transfusion will be necessary at birth
c. That no treatment is available until the infant is born
d. That administration of Rh immunoglobulin is indicated at 26 to 28 weeks of gestation
D
61
The nurse is planning care for an infant receiving calcium gluconate for treatment of hypocalcemia. Which route of administration should be used?
a. Oral
b. Intramuscular
c. Intravenous
d. Intraosseous
ANS: C
Calcium gluconate is administered intravenously over 10 to 30 minutes or as a continuous infusion. If it is given more rapidly than this, cardiac dysrhythmias and circulatory collapse may occur. Early feedings are indicated, but when the ionized calcium drops below 3.0 to 4.4 mg/dL, intravenous calcium gluconate is necessary. Intramuscular or intraosseous administration is not recommended.
62
The nurse is caring for a breastfed full-term infant who was born after an uneventful pregnancy and delivery. The infants blood glucose level is 36 mg/dL. Which action should the nurse implement?
a. Bring the infant to the mother and initiate breastfeeding.
b. Place a nasogastric tube and administer 5% dextrose water.
c. Start a peripheral intravenous line and administer 10% dextrose.
d. Monitor the infant in the nursery and obtain a blood glucose level in 4 hours.
A
63
The nurse is caring for a newborn with Erb palsy. The nurse understands that which reflex is absent with this condition?
a. Root reflex
b. Suck reflex
c. Grasp reflex
d. Moro reflex
D
64
A newborn has been diagnosed with brachial nerve paralysis. The nurse should assist the breastfeeding mother to use which hold or position during feeding?
a. Reclining
b. The cradle hold
c. The football hold
d. The cross-over hold
C
65
At which age does an infant start to recognize familiar faces and objects, such as his or her own hand?
a. 1 month
b. 2 months
c. 3 months
d. 4 months
C
66
During the 2-month well-child checkup, the nurse expects the infant to respond to sound in which manner?
a. Respond to name.
b. React to loud noise with Moro reflex.
c. Turn his or her head to side when sound is at ear level.
d. Locate sound by turning his or her head in a curving arc.
C
67
Which characteristic best describes the fine motor skills of an infant at age 5 months?
a. Neat pincer grasp
b. Strong grasp reflex
c. Builds a tower of two cubes
d. Able to grasp object voluntarily
D
68
In terms of gross motor development, what should the nurse expect an infant age 5 months to do?
a. Sit erect without support.
b. Roll from the back to the abdomen.
c. Turn from the abdomen to the back.
d. Move from a prone to a sitting position.
C
69
At which age can most infants sit steadily unsupported?
a. 4 months
b. 6 months
c. 8 months
d. 12 months
C
70
By which age should the nurse expect that an infant will be able to pull to a standing position?
a. 5 to 6 months
b. 7 to 8 months
c. 11 to 12 months
d. 14 to 15 months
ANS: C
71
According to Piaget, a 6-month-old infant should be in which developmental stage? a. Use of reflexes
b. Primary circular reactions
c. Secondary circular reactions
d. Coordination of secondary schemata
C
Infants are usually in the secondary circular reaction stage from ages 4 to 8 months. This stage is characterized by a continuation of the primary circular reaction for the response that results. Shaking is performed to hear the noise of the rattle, not just for shaking. The use of reflexes stage is primarily during the first month of life. The primary circular reaction stage marks the replacement of reflexes with voluntary acts. The infant is in this stage from ages 1 to 4 months. The fourth sensorimotor stage is coordination of secondary schemata, which occurs at ages 9 to 12 months. This is a transitional stage in which increasing motor skills enable greater exploration of the environment.
72
At which age do most infants begin to fear strangers?
a. 2 months
b. 4 months
c. 6 months
d. 12 months
C
73
At which age should the nurse expect most infants to begin to say mama and dada with meaning?
a. 4 months
b. 6 months
c. 10 months
d. 14 months
C
74
At which age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?
a. 1 month
b. 2 months
c. 3 months
d. 4 months
B
75
What is an appropriate play activity for a 7-month-old infant to encourage visual stimulation?
a. Playing peek-a-boo
b. Playing pat-a-cake
c. Imitating animal sounds
d. Showing how to clap hands
A
76
What information should be given to the parents of a 12-month-old child regarding appropriate play activities for this age?
a. Give large pushpull toys for kinetic stimulation.
b. Place a cradle gym across the crib to help develop fine motor skills.
c. Provide the child with finger paints to enhance fine motor skills.
d. Provide a stick horse to develop gross motor coordination.
A
77
The parents of a 2-month-old boy are concerned about spoiling their son by picking him up when he cries. What is the nurses best response?
a. Allow him to cry for no longer than 15 minutes and then pick him up.
b. Babies need comforting and cuddling. Meeting these needs will not spoil him.
c. Babies this young cry when they are hungry. Try feeding him when he cries.
d. If he isnt soiled or wet, leave him, and hell cry himself to sleep.
B
78
An infant, age 6 months, has six teeth. The nurse should recognize that this is what?
a. Normal tooth eruption
b. Delayed tooth eruption
c. Unusual and dangerous
d. Earlier than expected tooth eruption
D
Six months is earlier than expected to have six teeth. At age 6 months, most infants have two teeth. Although unusual, having six teeth at 6 months is not dangerous.
79
At a well-child check-up, the nurse notes that an infant with a previous diagnosis of failure to thrive (FTT) is now steadily gaining weight. The nurse should recommend that fruit juice intake be limited to no more than how much?
a. 4 oz/day
b. 6 oz/day
c. 8 oz/day
d. 12 oz/day
A
80
An infant has been diagnosed with an allergy to milk. In teaching the parent how to meet the infants nutritional needs, the nurse states that
a. Most children will grow out of the allergy.
b. All dairy products must be eliminated from the childs diet.
c. It is important to have the entire family follow the special diet.
d. Antihistamines can be used so the child can have milk products.
A
Approximately 80% of children with cows milk allergy develop tolerance by the fifth birthday. The child can have eggs. Any food that has milk as a component or filler is eliminated. These foods include processed meats, salad dressings, soups, and milk chocolate. Having the entire family follow the special diet would provide support for the child, but the nutritional needs of other family members must be addressed. Antihistamines are not used for food allergies.
81
Lactose intolerance is diagnosed in an 11-month-old infant. Which should the nurse recommend as a milk substitute?
a. Yogurt
b. Ice cream
c. Fortified cereal
d. Cows milkbased formula
A
82
What may a clinical manifestations of failure to thrive (FTT) in a 13-month-old include?
a. Irregularity in activities of daily living
b. Preferring solid food to milk or formula
c. Weight that is at or below the 10th percentile
d. Appropriate achievement of developmental landmarks
A
83
Which one of the following strategies might be recommended for an infant with failure to thrive (FTT) to increase caloric intake?
a. Vary the schedule for routine activities on a daily basis.
b. Be persistent through 10 to 15 minutes of food refusal.
c. Avoid solids until after the bottle is well accepted.
d. Use developmental stimulation by a specialist during feedings.
B
84
What is most descriptive of atopic dermatitis (AD) (eczema) in an infant?
a. Easily cured
b. Worse in humid climates
c. Associated with hereditary allergies
d. Related to upper respiratory tract infections
C
85
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 nurses response should be based on remembering what?
a. This is acceptable to encourage head control and turning over.
b. This is acceptable to encourage fine motor development.
c. This is unacceptable because of the risk of sudden infant death syndrome (SIDS).
d. This is unacceptable because it does not encourage achievement of developmental milestones.
A
86
What is an important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS)?
a. Discourage the parents from making a last visit with the infant.
b. Make a follow-up home visit to the parents as soon as possible after the childs death.
c. Explain how SIDS could have been predicted and prevented.
d. Interview the parents in depth concerning the circumstances surrounding the childs death.
B
87
What do the psychosocial developmental tasks of toddlerhood include?
a. Development of a conscience
b. Recognition of sex differences
c. Ability to get along with age mates
d. Ability to delay gratification
D
88
The developmental task with which the child of 15 to 30 months is likely to be struggling is a sense of which?
a. Trust
b. Initiative
c. Intimacy
d. Autonomy
D
89
A 17-month-old child should be expected to be in which stage, according to Piaget?
a. Preoperations
b. Concrete operations
c. Tertiary circular reactions
d. Secondary circular reactions
C
90
A toddler, age 16 months, falls down a few stairs. He gets up and scolds the stairs as if they caused him to fall. What is this an example of?
a. Animism
b. Ritualism
c. Irreversibility
d. Delayed cognitive development
A
91
What is a characteristic of a toddler's language development at age 18 months?
a. Vocabulary of 25 words
b. Use of holophrases
c. Increasing level of understanding
d. Approximately one third of speech understandable
C
92
Which characteristic best describes the gross motor skills of a 24-month-old child?
a. Skips
b. Broad jumps
c. Rides tricycle
d. Walks up and down stairs
D
93
What developmental characteristic does not occur until a child reaches age 2 1/2 years?
a. Birth weight has doubled.
b. Anterior fontanel is still open.
c. Primary dentition is complete.
d. Binocularity may be established.
C
94
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?
a. A sign the child is spoiled
b. An attempt to exert unhealthy control
c. Regression, which is common at this age
d. Ritualism, an expected behavior at this age
D
95
What is the leading cause of death during the toddler period?
a. Injuries
b. Infectious diseases
c. Childhood diseases
d. Congenital disorders
A
96
In terms of fine motor development, what should the 3-year-old child be expected to do?
a. Tie shoelaces.
b. Copy (draw) a circle.
c. Use scissors or a pencil very well.
d. Draw a person with seven to nine parts.
B
97
According to Piaget, magical thinking is the belief of which?
a. Thoughts are all powerful.
b. God is an imaginary friend.
c. Events have cause and effect.
d. If the skin is broken, the insides will come out.
A
98
In terms of cognitive development, a 5-year-old child should be expected to do which?
a. Think abstractly.
b. Use magical thinking.
c. Understand conservation of matter.
d. Understand another persons perspective.
B
99
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 nurses best response be?
a. They will be here soon.
b. They will come after dinner.
c. Let me show you on the clock when 6 PM is.
d. I will tell you every time I see you how much longer it will be.
B
100
A 4-year-old boy is hospitalized with a serious bacterial infection. He tells the nurse that he is sick because he was bad. What is the nurses best interpretation of this comment?
a. Sign of stress
b. Common at this age
c. Suggestive of maladaptation
d. Suggestive of excessive discipline at home
B
101
A 4-year-old child tells the nurse that she doesnt want another blood sample drawn because I need all of my insides and I dont want anyone taking them out. What is the nurses best interpretation of this?
a. The child is being overly dramatic.
b. The child has a disturbed body image.
c. Preschoolers have poorly defined body boundaries.
d. Preschoolers normally have a good understanding of their bodies.
C
102
Which type of play is most typical of the preschool period?
a. Team
b. Parallel
c. Solitary
d. Associative
D
Associative play is group play in similar or identical activities but without rigid organization or rules. School-age children play in teams. Parallel play is that of toddlers. Solitary play is that of infants.
103
The parent of a 4-year-old boy tells the nurse that the child believes monsters and bogeymen are in his bedroom at night. What is the nurses best suggestion for coping with this problem?
a. Let the child sleep with his parents.
b. Keep a night light on in the childs bedroom.
c. Help the child understand that these fears are illogical.
d. Tell the child that monsters and bogeymen do not exist.
B
104
During the preschool period, the emphasis of injury prevention should be placed on what?
a. Limitation of physical activities
b. Punishment for unsafe behaviors
c. Constant vigilance and protection
d. Teaching about safety and potential hazards
D
105
At a seminar for parents with preschool-age children, the nurse has discussed anticipatory tasks during the preschool years. Which statement by a parent should indicate a correct understanding of the teaching?
a. I should be worried if my 4-year-old child has an increase in sexual curiosity because this is a sign of sexual abuse.
b. I should expect my 5-year-old to change from a tranquil child to an aggressive child when school
starts.
c. I should be concerned if my 4-year-old child starts telling exaggerated stories and has an
imaginary playmate, since these could be signs of stress.
d. I should expect my 3-year-old child to have a more stable appetite and an increase in food selections.
D
106
The nurse is planning to bring a preschool child a toy from the playroom. What toy is appropriate for this age group?
a. Building blocks
b. A 500-piece puzzle
c. Paint by number picture
d. Farm animals and equipment
D
107
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?
a. Can draw a complete stick figure
b. Holds the instrument with the fist
c. Can copy a triangle and diamond
d. Can copy a circle and imitate a cross
D
108
The nurse is explaining the preconventional stage of moral development to a group of nursing students. What characterizes this stage?
a. Children in this stage focus on following the rules.
b. Children in this stage live up to social expectations and roles.
c. Children in this stage have a concrete sense of justice and fairness.
d. Children in this stage have little, if any, concern for why something is wrong.
D
109
What is a significant secondary prevention nursing activity for lead poisoning?
a. Chelation therapy
b. Screening children for blood lead levels
c. Removing lead-based paint from older homes
d. Questioning parents about ethnic remedies containing lead
B
110
A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. What should the nurse suspect?
a. Unintentional injury
b. Shaken baby syndrome
c. Congenital neurologic problem
d. Sudden infant death syndrome (SIDS)
B
111
The nurse is teaching parents of a preschool child strategies to implement when the child delays going to bed. What strategy should the nurse recommend?
a. Use consistent bedtime rituals.
b. Give in to attention-seeking behavior.
c. Take the child into the parents bed for an hour.
d. Allow the child to stay up past the decided bedtime.
A
112
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?
a. Indicative of giftedness
b. Indicative of typical twin behavior
c. Characteristic of cognitive development at this age
d. Characteristic of psychosocial development at this age
C
113
What statement characterizes moral development in the older school-age child?
a. Rule violations are viewed in an isolated context.
b. Judgments and rules become more absolute and authoritarian.
c. The child remembers the rules but cannot understand the reasons behind them.
d. The child is able to judge an act by the intentions that prompted it rather than just by the consequences.
D
114
What is the role of the peer group in the life of school-age children?
a. Decreases their need to learn appropriate sex roles
b. Gives them an opportunity to learn dominance and hostility
c. Allows them to remain dependent on their parents for a longer time
d. Provides them with security as they gain independence from their parents
D
115
What is descriptive of the social development of school-age children?
a. Identification with peers is minimum.
b. Children frequently have best friends.
c. Boys and girls play equally with each other.
d. Peer approval is not yet an influence for the child to conform.
B
116
What statement best describes the relationship school-age children have with their families?
a. Ready to reject parental controls
b. Desire to spend equal time with family and peers
c. Need and want restrictions placed on their behavior by the family
d. Peer group replaces the family as the primary influence in setting standards of behavior and rules
C
117
What is descriptive of the play of school-age children?
a. They like to invent games, making up the rules as they go.
b. Individuality in play is better tolerated than at earlier ages.
c. Knowing the rules of a game gives an important sense of belonging.
d. Team play helps children learn the universal importance of competition and winning.
C
118
The school nurse is discussing after-school sports participation with parents of children age 10 years. The nurses presentation includes which important consideration?
a. Teams should be gender specific.
b. Organized sports are not appropriate at this age.
c. Competition is detrimental to the establishment of a positive self-image.
d. Sports participation is encouraged if the type of sport is appropriate to the childs abilities.
D
119
According to Piaget, adolescents tend to be in what stage of cognitive development?
a. Concrete operations
b. Conventional thought
c. Postconventional thought
d. Formal operational thought
D
120
What aspects of cognition develop during adolescence?
a. Ability to see things from the point of view of another
b. Capability of using a future time perspective
c. Capability of placing things in a sensible and logical order
B
121
According to Erikson, the psychosocial task of adolescence is developing what?
a. Identity
b. Intimacy
c. Initiative
A
122
What is an important consideration for the school nurse planning a class on injury prevention for adolescents?
a. Adolescents generally are not risk takers.
b. Adolescents can anticipate the long-term consequences of serious injuries.
c. Adolescents need to discharge energy, often at the expense of logical thinking.
d. During adolescence, participation in sports should be limited to prevent permanent injuries.
C
123
The school nurse is teaching a class on injury prevention. What should be included when discussing firearms?
a. Adolescents are too young to use guns properly for hunting.
b. Gun carrying among adolescents is on the rise, primarily among inner-city youth.
c. Nonpowder guns (air rifles, BB guns) are a relatively safe alternative to powder guns.
d. Adolescence is the peak age for being a victim or offender in the case of injury involving a firearm.
D
124
The nurse is caring for children on an adolescent-only unit. What growth and development milestones should the nurse expect from 11- and 14-year-old adolescents? (Select all that apply.)
a. Self-centered with increased narcissism
b. No major conflicts with parents
c. Established abstract thought process
d. Have a rich, idealistic fantasy life
e. Highly value conformity to group norms
f. Secondary sexual characteristics appear
B, E, F
125
The potential effects of chronic illness or disability on a childs development vary at different ages. What developmental alteration is a threat to a toddlers normal development?
a. Hindered mobility
b. Limited opportunities for socialization
c. Childs sense of guilt that he or she caused the illness or disability
d. Limited opportunities for success in mastering toilet training
A
126
A feeling of guilt that the child caused the disability or illness is especially common in which age group?
a. Toddler
b. Preschooler
c. School-age child
d. Adolescent
B
127
What intervention is most appropriate for fostering the development of a school-age child with disabilities associated with cerebral palsy?
a. Provide sensory experiences.
b. Help develop abstract thinking.
c. Encourage socialization with peers.
d. Give choices to allow for feeling of control.
C
128
A 5-year-old child will be starting kindergarten next month. She has cerebral palsy, and it has been determined that she needs to be in a special education classroom. Her parents are tearful when telling the nurse about this and state that they did not realize her disability was so severe. What is the best interpretation of this situation?
a. This is a sign the parents are in denial.
b. This is a normal anticipated time of parental stress.
c. The parents need to learn more about cerebral palsy.
d. The parents expectations are too high.
B
129
Autism is a complex developmental disorder. The diagnostic criteria for autism include delayed or abnormal functioning in which area with onset before age 3 years?
a. Parallel play
b. Gross motor development
c. Ability to maintain eye contact
d. Growth below the fifth percentile
C
130
What explanation best describes how preschoolers react to the death of a loved one?
a. Grief is acute but does not last long at this age.
b. Children this age are too young to have a concept of death.
c. Preschoolers may feel guilty and responsible for the death.
d. They express grief in the same way that the adults in the preschoolers life are expressing grief.
C
131
At which age do most children have an adult concept of death as being inevitable, universal, and irreversible?
a. 4 to 5 years
b. 6 to 8 years
c. 9 to 11 years
d. 12 to 16 years
C
132
A child in the terminal stage of cancer has frequent breakthrough pain. Nonpharmacologic methods are not helpful, and the child is exceeding the maximum safe dose for opiate administration. What approach should the nurse implement?
a. Add acetaminophen for the breakthrough pain.
b. Titrate the opioid medications to control the childs pain as specified in the protocol.
c. Notify the practitioner that immediate hospitalization is indicated for pain management.
Help the parents and child understand that no additional medication can be given because of the
d. risk of respiratory depression.
B
133
A 12-year-old boy is in the final phase of dying from leukemia. He tells the nurse who is giving him opiates for pain that his grandfather is waiting for him. How should the nurse interpret this situation?
a. The boy is experiencing side effects of the opiates.
b. The boy is making an attempt to comfort his parents.
c. He is experiencing hallucinations resulting from brain anoxia.
d. He is demonstrating readiness and acceptance that death is near.
D
134
The nurse is making a home visit 48 hours after the death of an infant from sudden infant death syndrome (SIDS). What intervention is an appropriate objective for this visit?
a. Give contraceptive information.
b. Provide information on the grief process.
c. Reassure parents that SIDS is not likely to occur again.
d. Thoroughly investigate the home situation to verify SIDS as the cause of death.
B
