peds exam 2

Question 1

Which statement best describes the infants physical development?

Answer 1

Birth weight doubles by age 5 months and triples by age 1 year

Question 2

The parents of a 9-month-old infant tell the nurse that they have noticed foods such as peas and corn are not
completely digested and can be seen in their infants stool. The nurse bases her explanation on knowing that:

Answer 2

This is normal because of the immaturity of digestive processes at this age

Question 3

A 3-month-old infant, born at 38 weeks of gestation, will hold a rattle if it is put in her hands; however, she
will not voluntarily grasp it. The nurse should interpret this as:

Answer 3

normal developement

Question 4

In terms of fine motor development, the infant of 7 months should be able to:

Answer 4

Transfer objects from one hand to the other

Question 5

In terms of gross motor development, what would the nurse expect a 5-month-old infant to do?

Answer 5

Roll from abdomen to back.

Question 6

By what age should the nurse expect that an infant will be able to pull to a standing position?

Answer 6

9 months

Question 7

According to Piaget, the 6-month-old infant would be in what stage of the sensorimotor phase?

Answer 7

Secondary circular reactions

Question 8

Which behavior indicates that an infant has developed object permanence?

Answer 8

Actively searches for a hidden object

Question 9

A parent asks the nurse At what age do most babies begin to fear strangers? The nurse responds that most
infants begin to fear strangers at age:

Answer 9

6 months.

Question 10

The nurse is interviewing the father of 10-month-old Megan. She is playing on the floor when she notices
an electrical outlet and reaches up to touch it. Her father says No firmly and removes her from near the outlet.
The nurse should use this opportunity to teach the father that Megan

Answer 10

Is old enough to understand the word no

Question 11

Which information could be given to the parents of a 12-month-old child regarding appropriate play
activities for this age?

Answer 11

Give large push-pull toys for kinesthetic stimulation.

Question 12

At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?

Answer 12

2 months

Question 13

A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. The nurse should
recommend that the infant be given:

Answer 13

Commercial iron-fortified formula

Question 14

When is the best age for solid food to be introduced into the infants diet?

Answer 14

4 to 6 months

Question 15

The parent of 2-week-old Sarah asks the nurse if Sarah needs fluoride supplements because she is
exclusively breastfed. The nurses best response is:

Answer 15

She may need to begin taking them at age 6 months

Question 16

The clinic is lending a federally approved car seat to an infants family. The nurse should explain that the
safest place to put the car seat is:

Answer 16

Rear facing in back seat.

Question 17

Clinical manifestations of failure to thrive caused by behavioral problems resulting in inadequate intake of
calories include:

Answer 17

Avoidance of eye contact.

Question 18

Which is an important nursing consideration when caring for an infant with failure to thrive?

Answer 18

Establish a structured routine and follow it consistently

Question 19

An important nursing responsibility when dealing with a family experiencing the loss of an infant from
sudden infant death syndrome (SIDS) is to:

Answer 19

Make a follow-up home visit to parents as soon as possible after the infants death.

Question 20

Which is the most appropriate action when an infant becomes apneic?

Answer 20

Gently stimulate trunk by patting or rubbing.

Question 21

The nurse should teach parents that which age is safe to give infants whole milk instead of commercial
infant formula?

Answer 21

12 months

Question 22

Pacifiers can be extremely dangerous because of the frequency of use and the intensity of the infants suck.
In teaching parents about appropriate pacifier selection, the nurse should explain that a pacifier should have
which characteristics (select all that apply)?
a. Easily grasped handle
b. One-piece construction
c. Ribbon or string to secure to clothing
d. Soft, pliable material
e. Sturdy, flexible material

Answer 22

A,B,E

Question 23

In terms of gross motor development, what would the nurse expect a 5-month-old infant to do (select all
that apply)?
a. Roll from abdomen to back.
b. Put feet in mouth when supine.
c. Roll from back to abdomen.
d. Sit erect without support.
e. Move from prone to sitting position.

Answer 23

A,B

Question 24

A nurse is preparing to administer routine immunizations to a 4-month-old infant. The infant is currently up
to date on all previously recommended immunizations. Which immunizations will the nurse prepare to
administer (select all that apply)?
a. Measles, mumps, and rubella (MMR)
b. Rotavirus (RV)
c. Diphtheria, tetanus, and acellular pertussis (DTaP)
d. Varicella
e. Haemophilus influenzae type b (HIB)
f. Inactivated poliovirus (IPV)

Answer 24

B,C,E,F

Question 25

A nurse has completed a teaching session for parents about baby-proofing the home. Which statements made by the parents indicate an understanding of the teaching (select all that apply)? a. We will put plastic fillers in all electrical plugs. b. We will place poisonous substances in a high cupboard. c. We will place a gate at the top and bottom of stairways. d. We will keep our household hot water heater at 130 degrees. e. We will remove front knobs from the stove.

Answer 25

A,C,E

Question 26

When caring for a newborn with Down syndrome, the nurse should be aware that the most common congenital anomaly associated with Down syndrome is:

Answer 26

Congenital heart disease.

Question 27

A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of:

Answer 27

Down Syndrome

Question 28

What represents the major stressor of hospitalization for children from middle infancy throughout the preschool years?

Answer 28

seperation anxiety

Question 29

Nurses must be alert for increased fluid requirements when a child has:

Answer 29

fever

Question 30

An infant is brought to the emergency department with poor skin turgor, weight loss, lethargy, and tachycardia. This is suggestive of:

Answer 30

Dehydration.

Question 31

The viral pathogen that frequently causes acute diarrhea in young children is:

Answer 31

Rotavirus.

Question 32

A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results. However, the mother refuses to see or hold her baby. Initial therapeutic approach to the mother should be to:

Answer 32

Encourage her to express her feelings

Question 33

Caring for the newborn with a cleft lip and palate before surgical repair includes:

Answer 33

Providing satisfaction of sucking needs.

Question 34

The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infants postoperative care include:

Answer 34

Cleansing of suture line, supine and side-lying positions, and arm restraints.

Question 35

The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include:

Answer 35

Elevating the head but giving nothing by mouth.

Question 36

An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN) and gastrostomy feedings. Nursing care should include:

Answer 36

Teaching the family signs of central venous catheter infection.

Question 37

For what clinical manifestation should a nurse be alert when suspecting a diagnosis of esophageal atresia?

Answer 37

A nasogastric tube fails to pass at birth.

Question 38

Which vaccine is now recommended for the immunization of all newborns?

Answer 38

Hepatitis B vaccine

Question 39

Which statements regarding hepatitis B are correct (Select all that apply)? a. Hepatitis B cannot exist in a carrier state. b. Hepatitis B can be prevented by hepatitis B virus vaccine. c. Hepatitis B can be transferred to an infant of a breastfeeding mother. d. The onset of hepatitis B is insidious. e. Immunity to hepatitis B occurs after one attack.

Answer 39

B,C,D,E

Question 40

Which interventions should a nurse implement when caring for a child with hepatitis (Select all that apply) ? a. Provide a well-balanced, low-fat diet. b. Schedule playtime in the playroom with other children c. Teach parents not to administer any over-the-counter medications. d. Arrange for home schooling because the child will not be able to return to school. e. Instruct parents on the importance of good hand washing.

Answer 40

A,C,E

Question 41

A mother who intended to breastfeed has given birth to an infant with a cleft palate. Nursing interventions should include (Select all that apply): a. Giving medication to suppress lactation. b. Encouraging and helping mother to breastfeed. c. Teaching mother to feed breast milk by gavage. d. Recommending use of a breast pump to maintain lactation until infant can suck.

Answer 41

B,D

Question 42

When caring for an infant with an upper respiratory tract infection and elevated temperature, an appropriate nursing intervention is to:

Answer 42

Give small amounts of favorite fluids frequently to prevent dehydration

Question 43

The parent of an infant with nasopharyngitis should be instructed to notify the health care professional if the infant:

Answer 43

Shows signs of an earache

Question 44

An infants parents ask the nurse about preventing otitis media (OM). What should the nurse recommend?

Answer 44

Avoid tobacco smoke

Question 45

Asthma in infants is usually triggered by:

Answer 45

A viral infection

Question 46

Why do infants and young children quickly have respiratory distress in acute and chronic alterations of the respiratory system?

Answer 46

Mucus and edema obstruct small airways

Question 47

An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which of the following? (Select all that apply). a. Cluster care to conserve energy b. Round-the-clock administration of antitussive agents c. Strict intake and output to avoid congestive heart failure d. Administration of antibiotics e. Placement in a mist tent

Answer 47

,A,D

Question 48

The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the childs care (Select all that apply)? a. Administer antibiotics. b. Administer cough syrup. c. Encourage infant to drink 8 ounces of formula every 4 hours. d. Institute cluster care to encourage adequate rest. e. Place on noninvasive oxygen monitoring.

Answer 48

C,D,E

Question 49

The mother of a 1-month-old infant tells the nurse that she worries that her baby will get meningitis like her oldest son did when he was an infant. The nurse should base her response on knowing that:

Answer 49

Vaccination to prevent Haemophilus influenzae type b meningitis has decreased the frequency of this disease in children

Question 50

Which clinical manifestations would suggest hydrocephalus in a neonate?

Answer 50

Bulging fontanel and dilated scalp veins

Question 51

Clinical manifestations of increased intracranial pressure (ICP) in infants are (Select all that apply): a. Low-pitched cry. b. Sunken fontanel. c. Diplopia and blurred vision. d. Irritability. e. Distended scalp veins. f. Increased blood pressure.

Answer 51

C,D,E

Question 52

An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Which interventions should be included in the childs postoperative care (Select all that apply)? a. Observe closely for signs of infection. b. Pump the shunt reservoir to maintain patency. c. Administer sedation to decrease irritability. d. Maintain Trendelenburg position to decrease pressure on the shunt. e. Maintain an accurate record of intake and output. f. Monitor for abdominal distention.

Answer 52

A,E,F

Question 53

``` The nurse is caring for a neonate with suspected meningitis. Which clinical manifestations should the nurse prepare to assess if meningitis is confirmed (Select all that apply)? a. Headache b. Photophobia c. Bulging anterior fontanel d. Weak cry e. Poor muscle tone ANS: ```

Answer 53

C,D,E

Question 54

The nurse is monitoring an infant for signs of increased intracranial pressure (ICP). Which are late signs of increased ICP in an infant (Select all that apply)? a. Tachycardia b. Alteration in pupil size and reactivity c. Increased motor response d. Extension or flexion posturing e. Cheyne-Stokes respirations

Answer 54

B,D,E

Question 55

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. What should be included?

Answer 55

Return to the clinic every 1 to 2 weeks

Question 56

When infants are seen for fractures, which nursing intervention is a priority?

Answer 56

Assess for child abuse. Fractures in infants are often nonaccidental

Question 57

A nurse is conducting discharge teaching for parents of an infant with osteogenesis imperfecta (OI). Further teaching is indicated if the parents make which statement?

Answer 57

Were glad there is a cure for this disorder

Question 58

``` The nurse is caring for an infant with developmental dysplasia of the hip. Which clinical manifestations should the nurse expect to observe (Select all that apply)? a. Positive Ortolani sign b. Unequal gluteal folds c. Negative Babinskis sign d. Trendelenburgs sign e. Telescoping of the affected limb f. Lordosis ANS: ```

Answer 58

A,B

Question 59

The most common problem of children born with a myelomeningocele is:

Answer 59

Neurogenic bladder.

Question 60

Which problem is most often associated with myelomeningocele?

Answer 60

Hydrocephalus

Question 61

What is the most appropriate nursing response to the father of a newborn infant with myelomeningocele who asks about the cause of this condition?

Answer 61

There may be no definitive cause identified.

Question 62

The nurse is preparing to admit a newborn with myelomeningocele to the neonatal intensive care nursery. Which describes this newborns defect?

Answer 62

Visible defect with an external saclike protrusion containing meninges, spinal fluid, and nerves

Question 63

The nurse is caring for an infant with myelomeningocele scheduled for surgical closure in the morning. Which interventions should the nurse plan for the care of the myelomeningocele sac?

Answer 63

Covered with a sterile, moist, nonadherent dressing

Question 64

The nurse is caring for an intubated infant with botulism in the pediatric intensive care unit. Which health care provider prescriptions should the nurse clarify with the health care provider before implementing?

Answer 64

Administer gentamicin sulfate (Garamycin) 10 mg per intravenous piggyback every 12 hours.

Question 65

The nurse in the neonatal intensive care unit is caring for an infant with myelomeningocele scheduled for surgical repair in the morning. Which early signs of infection should the nurse monitor on this infant (Select all that apply)? a. Temperature instability d. Bradycardia b. Irritability e. Hypertension c. Lethargy

Answer 65

A,B,C

Question 66

The primary method of treating osteomyelitis is:

Answer 66

Intravenous antibiotic therapy.