Flashcards in student nclex questions exam 2 Deck (50)
The 8-year-old patient started immunizations on schedule during infancy but did not continue on the recommended course after 2 years of age. Which of the following is a CORRECT statement by the nurse:
A. You will have to repeat all vaccines.
B. You do not need to worry about the missed doses, we will just start your schedule as an 8-year-old.
C. We will add additional spacing between vaccines since you are older.
D. You will start with the missed doses using the catch-up schedule provided by the CDC.
It is not necessary to repeat a series that has been started (pg 841).
Administer recommended vaccines if immunization history is incomplete or unknown. Do not restart or add doses to the vaccine series for extended intervals between doses. When a vaccine is not administered at the recommended age, administer at a subsequent visit. The use of trade names is for identification purposes only and does not imply endorsement by the ACIP or CDC (Catch-up immunization schedule. (2020, February 03). Retrieved February 08, 2021, from https://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html).
A parent of a 3-year-old tells a clinic nurse that the child is rebelling constantly and having temper tantrums. Using Erikson's psychosocial development theory, which instruction (s) should the nurse provide to the parent? Select all that apply
1. Set limits on the child's behavior
2. Ignore the child when this behavior occurs
3. Allow the behavior, because this is normal at this age period
4. Provide a simple explanation of why the behavior is unacceptable.
5. Punish the child every time the child says "no" to change the behavior.
1, 4. Rationale-According to Erikson, the child focuses on gaining some basic control over self and the environment and the environment and independence between ages 1 and 3 years. Gaining independence often means that the child has to rebel against the parents’ wishes. Saying things like "no" or "mine" and having temper tantrums are common during this period of development. Being consistent and setting limits on the child's behavior are necessary elements. Providing a simple explanation of why certain behaviors are unacceptable is an appropriate action. Options 2 and 3 do not address the child's behavior. Option 5 is likely to produce a negative response during this normal development pattern.
According to Erikson, what social developmental task is an adolescent developing throughout this age?
Rationale : (page 966-Maternal Child nursing book) Traditional psychosocial theory holds that the developmental crisis of adolescence leads to the formation of a sense of identity (Erikson, 1963). Throughout childhood, individuals have been going through the process of identification as they concentrate on various parts of the body at specific times. Adolescence begins with the onset of puberty and extends to relative physical and emotional stability at or near graduation from high school. During this time, the adolescent is faced with the crisis of group identity. Adolescents also seek individual identity.
A mother wants to take her school-aged child to do an activity for the afternoon that involves physical exercise. She understands that she should ask her child about what activities the child might want to engage in. Which of the following indicates that the mother does not have an understanding of appropriate activities for a school-aged child?
A. The mother takes the child roller skating as requested by the child.
B. The mother takes the child ice skating as requested by the child.
C. The mother takes the child to gymnastics practice as requested by the child.
D. The mother takes the child to the gym to do weight training as requested by the child.
Rationale: Roller skating, ice skating, and gymnastics are all appropriate activities for school aged children as long as equipment is maintained in a safe condition, protective apparatus is worn to prevent serious injuries, and appropriate supervision is maintained. These activities should as well include proper demonstration and practice to avoid injury. (Pages 946-947 chapter 34). Weight training is not recommended for prepubertal children until they have reached physical and skeletal maturity. This would be an activity more appropriate for a middle to late adolescent. (Page 982 Chapter 35)
What describes moral development in younger school-age children?
a. The standards of behavior now come from within themselves.
b. They do not yet experience a sense of guilt when they misbehave.
c. They know the rules and behaviors expected of them but do not understand the reasons behind them.
d. They no longer interpret accidents and misfortunes as punishment for misdeeds
Rationale: Children who are ages 6 and 7 years know the rules and behaviors expected of them but do not understand the reasons for them. Young children do not believe that standards of behavior come from within themselves but that rules are established and set down by others.
What signs would you see physically and mentally in an adolescent who is sleep-deprived? Select all that apply
B) difficulty concentrating
C) overweight and obesity
F) stomach aches
Rationale: Sleep is needed to maintain good physical and mental health. An adolescent’s mind and body grow rapidly, so when they get an inadequate amount of sleep it can affect the way they think and feel.
A nurse sees children in a clinic, which child does the nurse suspect to have abnormal physical development?
a. A 6-year-old who is 46 inches tall and weighs 47 lbs.
b. A 15-year-old boy with breast enlargement.
c. A 7 ½ -year-old girl with her first menstrual period.
d. A 7-year-old who is 47 inches tall and weighs 52 lbs.
C. The normal age is 10-15
During a Pediatric physical examination, you identify that your patient’s vision has reached maturity. What age group would your patient be placed in?
A.) Ages 8-9
B.) Middle adolescent
C.) Age 10
D.) Age 6
Although you have a huge amount of growth to do through your school-age years, your vision reaches maturity at the very young age of 6 years old. At this age is when you introduce Snellen charts as a form of assessing distance visual acuity. At this age, the eye has grown in size and your muscles surrounding your eyes have developed to accommodate ocular alignment and ocular media clarity.
Chapter 29- page 808 & Chapter 34- page 992.
What is the most effective approach to use when disciplining an infant?
b. time out
d. talking harshly
B. Is the correct answer. Time out is an effective approach to disciplining infants because they are not at the cognitive stage to understand any other means of discipline. Parents must be sure to choose a place of time out that coincides with their child’s abilities and promotes safety. (Ch. 31 pg. 837)
Which of the following is an injury prevention for suffocation or drowning of an infant?
A. Keep doors of ovens, dishwasher, refrigerators, and front-loading clothes washers open at all times.
B. When playing with balloons, leave popped balloons laying around.
C. Supervise when near any source of water, such as cleaning buckets, drainage areas, ponds, toilets.
D. Keep bathroom doors open at all times.
A. The doors on appliances need to be closed at all times. A child could climb inside and if the door closes, the child could suffocate.
B. Supervise contact when using inflated balloons. Immediately discard any popped balloons and keep uninflated balloons out of reach. A child could suffocate on the balloon.
C. Correct. An infant can drown in as little as 2 inches of water.
D. Bathroom doors need to be closed at all times to prevent a child from drowning in the toilet.
When a nurse enters the room with a 3-year-old and their mother, the toddler starts to get upset and starts crying. What can the nurse do to help calm the child down and relieve their fear, so that the nurse can give care to the child?
A. Hold the child down and give care by force.
B. Explain to the child in full detail why and how the care is given.
C. Talk in a calm voice and use a stuff animal to explain care to their level.
D. Come back later and try to give care again.
C. The toddler is afraid of the nurse because they most likely have fearful memories of a nurse, like getting a shot. So, the nurse should try to interact with the child so that they can establish more positive experiences with the nurse and other care providers.
Based upon Ericksons stage theory, infants are in which stage?
A. Trust v. mistrust
B. Autonomy v. shame
C. Initiative v. guilt
D. Identity v. confusion
A. trust v. mistrust
The student nurse is presenting a community teaching class on burns. Which information should the student include? (SATA)
A) Check bathwater temperature
B) Install smoke detectors in your home
C) Smoke detector batteries last 20 years
D) Do not pour hot liquids when infant is close by
• A- checking bathwater before placing infant in the bath ensures that the water is not too hot and won’t burn the child’s skin.
• B- Installing smoke detectors can help alert you to a fire.
• C- Test smoke detector batteries monthly, batteries should be replaced at least once a year.
• D- Hot liquids can cause burns if accidentally poured on skin.
Nurse is planning discharge for patient that is prescribed liquid iron supplement. What will you include in teaching? (select all that apply) [pg. 882]
a) iron can cause diarrhea
b) iron can stain the teeth
c) use a dropper when administering to infants
d) give child a drink of milk to help absorption
B and C
What two things happening in the adolescent body makes frequent showering important? [pg. 1025]
a) Sport-related activities make them sweat
b) Working outside gets dirt on them
c) the sebaceous glands and newly function apocrine glands are hyperactive.
d) because they sweat, their feet stink
C. The Sebaceous glands and newly function apocrine glands are hyperactive.
what is the most appropriate teaching point to include in a health promotion teaching plan for parents of children of age 12 to 19?
A) Causes of mechanical suffocation.
B) Storing firearms in locked cabinets.
C) Warning signs of violent crimes.
D) Keeping all medications out of children’s reach.
B) storing firearms in locked cabinets.
Firearms are a major cause of intentional fatal injuries in the united states. Adolescence is the peak age for being either a victim or an offender in an injury involving firearm. Homicide is the second leading cause of death among 12 to 19 years old.
Infants that are exclusively breastfed after 4 months are recommended to get what supplement?
a. Vitamin D
Answer is C, Iron
Rationale: Infants are born with a reserved of iron from which it is obtain from their mother’s blood and last for the first 5-6 months. Infants who are only breast fed after that timeframe have depleted that iron so if they do not get it through iron-fortified formulas or iron-containing complementary foods such as cereal, then they can be at risk for iron deficiency. (pg. 827 & 838)
As the maturation of systems occur, which physical maturation happen during the school age? Select all that apply.
a. Increased Stomach Capacity
b. Increased Bladder Capacity
c. Increased Heart rate
d. Caloric needs are more
Answer – A & B
Rational – The stomach grows so there is a higher capacity, the bladder grows so there is a higher capacity, the heart rate decreases, the caloric needs are less (Page 936).
In Kohlbeg developed stages of moral development where does a 6 year old fall into the levels of morality?
A. Preconventional level
B. Conventional level
C. Principal level
Answe: B- Children make small decisions based on what society is going to think of them. Behavior that meets the approval and pleases or helps others is considered good.
Which is NOT a part of a preschool aged child’s social development?
A. Overcome of most their anxiety associated with stranger and fear of separation.
B. They relate to unfamiliar people easily and tolerate brief separation from parents with little or no protests
C. They no longer need parents for security, reassurance, guidance, and approval, especially when entering preschool or elementary school.
D. They can cope with changes in daily routine much better than toddlers, although they may develop more imaginary fears.
Rationale: Preschool aged children still need their parents for security, reassurance, guidance, and approval. These factors do not begin to change until school age, and even then, they are still heavily relied on. When entering into school preschoolers tend to get overwhelmed by events or the environment around them.
Injury prevention and parent education
a. should be the parents responsibility
b. should be taught to young parents only
c. should be handled on a growth and developmental basis
d. should be prompted by the parents
maternal child nursing care pg. 853 chapter 31
rationale: a large percentage of childhood deaths continue to occur as a result of preventable injuries. Nurses must be aware of the possible causes of injury in each age-group to provide anticipatory, preventive teaching. For example, the nurse should discuss guidelines for injury prevention during infancy, before the child reaches the susceptible age-group. Preventive teaching ideally begins during pregnancy.
A sense of maleness of femaleness, or gender identity, begins by ________ of age when children are able to label their own and other’s gender.
A. 1.5 years
B. 24 months
C. 36 months
D. 2.5 years
Rationale- A sense of maleness or femaleness, or gender identity begins by 24 months of age when children are able to label their own and other’s gender (Seensma, Kreukels, de Vries, et al., 2013).
The nurse assesses a toddler and notices that the toddler pushes the boundaries of their environment and then returns to the parent for assistance in verbally articulating the meaning of there experience. What is the phenomenon called?
1. Object permanence
The answer is 2.
Rationale for Self-concept. page 871 in Maternal Child
The separation-individuation phase of the toddler encompasses the phenomenon of rapprochement. Developmentally the term rapprochement means the child moves away and returns for reassurance.
What are the reasons that a pediatric nurse should stress that health promotion activities must be ongoing? (Select all that apply).
a. To identify health risks
b. To strengthen family bonds
c. To improve nutrition
d. To encourage healthy behavior
e. To prevent accident
ANSWER: A, C, D, E
Health promotion activities must be ongoing to identify health risks, to improve nutrition, to encourage healthy behavior, and to prevent accident. There is no link between health promotion activities and strengthening family bonds.
Which fact related to childhood stress is true?
a. Children should be always be protected from stress.
b. Children under 8 years of age can not develop coping strategies.
c. Parents cannot prepare children for stress.
d. Some children are more vulnerable to stress than others.
During their school age years children best understand concept that can be seen
or illustrated. The nurse knows this type of thinking is termed as ?
A. Concrete operations
B. Formal operations
C. School-age rhetoric
Answer : A
Black and white reasoning involves a situation in which only two alternatives are
considered, when infact there are additional options.During the school age year children
deal with thoughts and learn through observation. They do not have the ability to do
abstract reasoning and learn best with illustrations . Thought at this time is dominated
by what the school age can see, hear or otherwise experience.
Betty takes her 6-month-old baby in for her developmental checkup. Betty tells the pediatrician that her daughter, Beth, has 2 of her teeth that are erupting. She asks the pediatrician, “What should I do to give her the best oral care at her age?”
a. Toothbrush with soft bristles
b. “Rice-size” drop of toothpaste on your finger
c. Swish and spit
d. Damp washcloth
Correct: D – The teeth and gums are initially cleaned by wiping with a damp cloth; toothbrushing is too harsh for the tender gingiva (pg. 841)
How would a nurse explain to a mother and father of a new child the amount of sleep their child is going to need through the next few years of development?
A) Infants only need as much sleep as adults so there is nothing they need to know
B) As your child gets older the amount of sleep they need is going to increase
C) As an infant your child is going to need 15 hours of sleep, as a toddler and all the way to preschool your child is going to need approximately 12 hours of sleep
D) Children never sleep….EVER
Rationale-The sleeping needs of a child vary but will typically need much more sleep than adults. Infants Will need 15 hours of sleep and slowly taper off to approximately 12 hours of sleep at the end of year 3. (pg.841,881,914)
Children do not need more sleep as they age and a nurse should never tell parents that babies need as much sleep as adults as sleep deprivation can/will cause harm to the child.
What fine motor development would a 3 year old child be able to perform?
A. Can tie shoelaces
B. Uses scissors to cut out an outline
C. Copies a square, cross, or diamond
D. Builds tower of 9-10 cubes
A 3 Year old can build a tower out of 9-10 cubes. Build a bridge with 3 cubes. Copy circles, imitate a cross, and name what has been drawn. A 5 year old can toe shoelaces. A 4 year old can copy squares, cross, or diamonds and use scissors to cut out an outline.
Pg. 909 Chapter 33