Growth & Development
The clinic nurse is preparing to explain the concepts of Kohlberg's theory of moral development with a parent. The nurse would tell the parent that which factor motivates good and bad actions for the child at the preconventional level?
Peer pressure
Social pressure
Parents' behavior
Punishment and reward
Punishment and reward
An infant receives a diphtheria, tetanus, and acellular pertussis (DTaP) immunization at a well-baby clinic. The parent returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which intervention would the nurse suggest to the parent?
Monitor the infant for a fever.
Bring the infant back to the clinic.
Apply a hot pack to the injection site.
Apply a cold pack to the injection site.
Apply a cold pack to the injection site.
The nurse is teaching a group of parents about communicable diseases. Which information about chickenpox would the nurse include?
A. "Chickenpox is communicable until the vesicles have dried."
B. "As long as dry scabs remain, chickenpox is still communicable."
C. "After the high fever has subsided, chickenpox is no longer communicable."
D. "Chickenpox is no longer communicable when the vesicles are intact with a red areola."
A. "Chickenpox is communicable until the vesicles have dried."
A 30-month-old toddler is brought to the emergency department in acute respiratory distress, and a diagnosis of laryngotracheobronchitis (viral croup) is made. Which is the most important equipment for the nurse to have available when the child is admitted to the pediatric unit?
A. Intravenous set
B. Tracheotomy set
C. Nasal cannula for oxygen
D. Crib with padded side rails
B. Tracheotomy set
Which treatment would the nurse anticipate when caring for a preschooler with Kawasaki disease?
A. Restricting fluids, especially fruit juices
B. Ensuring bright lighting in the room during assessments
C. Administering penicillin G benzathine (Bicillin) as prescribed
D. Administering intravenous immune globulin (IVIG) as prescribed
D. Administering intravenous immune globulin (IVIG) as prescribed
A 12-year-old child with sickle cell anemia is admitted during a vaso-occlusive crisis. Which is the priority of care for this child?
A. Relieving pain
B. Exercising joints
C. Increasing urine output
D. Improving respirations
A. Relieving pain
Which is the most reliable indicator of a 2.5-year-old child’s pain?
A. Crying and sobbing
B. Changes in behavior
C. Verbal exclamations of pain
D. Changes in pulse and resp rate
B. Changes in behavior
The maternity nurse is providing instructions to a new parent regarding the psychosocial development of the newborn infant. Using Erikson's psychosocial development theory, the nurse instructs the parent to take which measure?
Allow the newborn infant to signal a need.
Anticipate all needs of the newborn infant.
Attend to the newborn infant immediately when crying.
Avoid the newborn infant during the first 10 minutes of crying.
Allow the newborn infant to signal a need.
A parent brings a 4-month-old infant to a well-baby clinic for immunizations. The child is up to date with the immunization schedule. The nurse would prepare to administer which immunizations to this infant?
Varicella, hepatitis B vaccine (HepB)
MMR, Haemophilus influenzae type b (Hib), DTaP
DTaP, Hib, IPV, pneumococcal vaccine (PCV), rotavirus vaccine (RV)
Diphtheria, tetanus, and acellular pertussis (DTaP); measles, mumps, and rubella (MMR); inactivated poliovirus vaccine (IPV)
DTaP, Hib, IPV, pneumococcal vaccine (PCV), rotavirus vaccine (RV)
An unimmunized toddler has had fever, runny nose, cough, and white spots in the mouth for 3 days. A rash has also started on the face and spread to the whole body. Which communicable disease would the nurse suspect based upon the child's symptoms?
A. Rubella
B. Rubeola
C. Pertussis
D. Varicella
A. Rubeola
Which physiological alteration would the nurse expect when assessing a 6-month-old infant with bronchiolitis (respiratory syncytial virus)?
A. Decreased heart rate
B. Inspiratory stridor
C. Increased breath sounds
D. Prolonged expiratory phase
D. Prolonged expiratory phase
After the nurse feeds and burps an infant with a cardiac defect, the infant has a bowel movement and almost immediately becomes cyanotic, diaphoretic, and limp. Which activity most likely caused the infant’s response?
A.Burping
B.Feeding
C.Position change
D.Bowel movement
D.Bowel movement
Which child is the best roommate option for child admitted in a vasoocclusive sickle cell crisis?
A.Child with thalassemia
B.Child with osteomyelitis
C.Child with viral pneumonia
D.Child with acute pharyngitis
A.Child with thalassemia
A mother arrives at the hospital emergency department with her child, in whom a diagnosis of epiglottitis is documented. Which prescription, if written by the primary health care provider, would the nurse question?
Obtain a throat culture.
Obtain axillary temperatures.
Administer humidified oxygen.
Administer acetaminophen for fever.
Obtain a throat culture.
Which activity would the nurse recommend for a 9-year-old child who is undergoing intravenous antibiotic therapy? Select all that apply. One, some, or all responses may be correct.
qWatching a movie on a tablet
qPlaying solitaire
qPlaying games on a cell phone
qMaking a model airplane
qDoing arithmetic puzzles
qWatching soap operas on television
qObserving videos on a media device
qPlaying a motion-based video game
qWatching a movie on a tablet
qPlaying games on a cell phone
qMaking a model airplane
qObserving videos on a media device
The nursing student is assigned to administer immunizations to children in a clinic. The student would question whether to administer immunizations to a child with which condition?
A cold
Otitis media
Mild diarrhea
A severe febrile illness
A severe febrile illness
Which infection is caused by droplets larger than 5 microns and typically affects children between 3 to 6 years of age?
A.Rubella
B.Scabies
C.Measles
D.Chickenpox
A.Rubella
The nurse is providing discharge teaching for the parent of a child with acute laryngotracheobronchitis. Which would the nurse instruct the parent to do to control symptoms at home?
A. Mechanically induce vomiting.
B. Call a community emergency service.
C. Administer the prescribed antihistamine.
D. Start a cool-mist humidifier close to the child.
D. Start a cool-mist humidifier close to the child.
Which nursing care would the nurse provide an 8-month-old infant with tetralogy of Fallot?
A. Restriction of fluid intake to conserve energy
B. Provision of iron-fortified formula to prevent anemia
C. Administration of coagulants to control bleeding tendencies
D. Prevention of increased respiratory effort to promote oxygenation
D. Prevention of increased respiratory effort to promote oxygenation
The nurse is providing home care instructions to the parents of a 10-year-old child with hemophilia. Which sport activity would the nurse suggest for this child?
Soccer
Basketball
Swimming
Field hockey
Swimming
A child in whom sickle cell anemia is suspected is seen in a clinic, and laboratory studies are performed. The nurse checks the laboratory results, knowing that which value would be increased in this disease?
Platelet count
Hematocrit level
Hemoglobin level
Reticulocyte count
Reticulocyte count
The nurse notes that a 6-year-old child does not recognize that objects exist even when the objects are outside of the visual field. Based on this observation, which action would the nurse take?
Report the observation to the pediatrician.
Move the objects in the child's direct field of vision.
Teach the child how to visually scan the environment.
Provide additional lighting for the child during play activities.
Report the observation to the pediatrician.
The nurse is providing anticipatory guidance to the parent of a 10-month-old child. The parent asks how soon the child will be able to receive the chicken pox (varicella) vaccine. What is the best nursing response?
"Your child will receive it today."
"Your child can receive it at the age of 12 months old."
"Your child can receive it any time before the first birthday."
"Your child will receive it before entry into kindergarten, at 4 to 6 years of age."
"Your child can receive it at the age of 12 months old."
The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instruction?
"We need to encourage our child to drink fluids."
"Coughing spells may be triggered by dust or smoke."
"Vomiting may occur when our child has coughing episodes."
"We need to maintain droplet precautions and a quiet environment for at least 2 weeks."
"We need to maintain droplet precautions and a quiet environment for at least 2 weeks."
A 6-month-old infant with cystic fibrosis had an order for cupping, percussion, and postural drainage every 4 hours. Which is the best time to schedule chest physiotherapy?
A.During each feeding
B.Just before feedings
C.2 hours after feedings
D.Immediately after every feeding
C.2 hours after feedings
A 1-year-old infant with a diagnosis of heart failure is prescribed digoxin. The nurse takes the apical pulse for 1 minute before administering the medication and obtains a result of 102 beats/minute. What is the nurse's best action?
Retake the apical pulse.
Withhold the medication.
Administer the medication.
Notify the primary health care provider.
Administer the medication.
The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instruction?
Stress
Trauma
Infection
Fluid overload
Fluid overload
The nurse is caring for an infant with congenital heart disease. Which, if noted in the infant, would alert the nurse to the early development of heart failure?
Paleness of the skin
Strong sucking reflex
Diaphoresis during feeding
Slow and shallow breathing
Diaphoresis during feeding
The nurse is describing Piaget's cognitive developmental theory to pediatric nursing staff. The nurse would tell the staff that which child behavior is characteristic of the formal operations stage?
The child has the ability to think abstractly.
The child begins to understand the environment.
The child is able to classify, order, and sort facts.
The child learns to think in terms of past, present, and future.
The child has the ability to think abstractly.
An infant is brought to the clinic for a third diphtheria, tetanus toxoid, and acellular pertussis vaccination (DTaP). The parent reports that the infant developed a 99.4° F (37.4° C) temperature after the last DTaP. Which action is most appropriate?
Withhold the vaccination.
Administer the vaccination.
Draw blood for a pertussis titer.
Notify the primary health care provider.
Administer the vaccination.
A child with rubeola (measles) is being admitted to the hospital. In preparing for the admission of the child, the nurse would plan to place the child on which precautions?
Enteric
Airborne
Protective
Neutropenic
Airborne
Which is the priority action in the immediate postoperative period of a child who has undergone a tonsillectomy?
A.Assisting with coughing and deep breathing
B.Encouraging frequent intake of cool liquids
C. Ensuring airway patency by placing the child in a side-lying position
D.Promoting consciousness by encouraging caregivers to interact with the child
C. Ensuring airway patency by placing the child in a side-lying position
The nurse is assigned to care for an infant with tetralogy of Fallot. The parent of the infant calls the nurse to the room because the infant suddenly seems to be having difficulty breathing. The nurse enters the room and notes that the infant is experiencing a hypercyanotic episode. What is the priority action by the nurse?
Notify the nursing supervisor.
Contact the respiratory therapist.
Place the infant in a prone position.
Place the infant in a knee-chest position.
Place the infant in a knee-chest position.
A 10-year-old child with hemophilia A has slipped on the ice and bumped the knee. The nurse would prepare to administer which prescription?
Injection of factor X
Intravenous infusion of iron
Intravenous infusion of factor VIII
Intramuscular injection of iron using the Z-track method
Intravenous infusion of factor VIII
A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The parents become concerned because the child is frightened, consistently crying and trying to climb out of the tent. Which is the most appropriate nursing action?
Tell the parents that the child must stay in the tent.
Place a toy in the tent to make the child feel more comfortable.
Call the primary health care provider and obtain a prescription for a mild sedative.
Let one parent hold the child and direct the cool mist over the child's face.
Let one parent hold the child and direct the cool mist over the child's face.
The parent of an 8-year-old child tells the clinic nurse that they are concerned about the child because the child seems to be more attentive to friends than anything else. Using Erikson's psychosocial development theory, the nurse would make which response?
"You need to be concerned."
"You need to monitor the child's behavior closely."
"At this age, the child is developing his own personality."
"You need to provide more praise to the child to stop this behavior."
"At this age, the child is developing his own personality."
The nurse assesses the vital signs of a 12-month-old infant with a respiratory infection and notes that the respiratory rate is 35 breaths per minute. On the basis of this finding, which action is most appropriate?
Administer oxygen.
Document the findings.
Notify the pediatrician.
Reassess the respiratory rate in 15 minutes.
Document the findings.
Several children have contracted rubeola (measles) in a local school, and the school nurse conducts a teaching session for the parents of the schoolchildren. Which statement made by a parent indicates a need for further teaching regarding this communicable disease?
"Small blue-white spots with a red base may appear in the mouth."
"The rash usually begins on the face and spreads downward toward the feet."
"The disease can be spread to others from 10 days before any sign of the disease appears to 15 days after the rash appears."
"Respiratory symptoms such as a profuse runny nose, cough, and fever occur before the development of a rash."
"The disease can be spread to others from 10 days before any sign of the disease appears to 15 days after the rash appears."
**4-5 days**
During the respiratory assessment of an 8-month-old infant, the nurse notes bronchial breath sounds over areas of consolidation, mild substernal retractions, profuse nasal mucus production, pallor, and a temperature of 102°F (38.9°C). Which action would the nurse take?
A.Suction the nasopharynx so a patent airway can be maintained
B.Start an intravenous infusion to provide necessary fluids and electrolytes.
C.Call the respiratory therapist to start preparations for oxygen administration.
D.Administer an antipyretic for the fever.
A.Suction the nasopharynx so a patent airway can be maintained
The nurse is caring for a child diagnosed with Kawasaki disease. Keeping the pathophysiology in mind, the nurse carefully monitors the child for which complication?
Fever
Paralytic ileus
Myocardial infarction
Arthralgic joint involvement
Myocardial infarction
The nurse is instructing the parents of a child with iron-deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction would the nurse tell the parents?
Administer the iron at mealtimes.
Administer the iron through a straw.
Mix the iron with cereal to administer.
Add the iron to milk for easy administration.
Administer the iron through a straw.
A child is scheduled for a tonsillectomy. The nurse plans care, knowing that which condition would be a priority because it presents the highest risk of aspiration during surgery?
Presence of loose teeth
Bleeding during surgery
Difficulty in swallowing
Exudate in the throat area
Presence of loose teeth
The nurse is evaluating the developmental level of a 2-year-old. Which does the nurse expect to observe in this child?
Uses a fork to eat
Uses a cup to drink
Pours own milk into a cup
Uses a knife for cutting food
Uses a cup to drink
A child is receiving a series of the hepatitis B vaccine and arrives at the clinic with a parent for the second dose. Before administering the vaccine, the nurse would ask the child and parent about a history of a severe allergy to which substance?
Eggs
Penicillin
Sulfonamides
A previous dose of hepatitis B vaccine or component
A previous dose of hepatitis B vaccine or component
The nurse provides instructions to the parent of a child with mumps regarding respiratory precautions, and the parent asks the nurse about the length of time required for the respiratory precautions. The nurse would make which statement to the parent?
"Precautions are not necessary once the swelling appears."
"Precautions are not necessary before the swelling begins."
"Precautions are indicated during the period of communicability."
"Precautions are indicated for 20 days following the onset of parotid swelling."
"Precautions are indicated during the period of communicability."
A parent calls the primary health care provider's office, requesting an appointment for an 8-year-old child. The parent states that the child has asthma and that the child reports having trouble breathing last night and does not want to go to school. In triaging this child, which is the most important question to initially ask the parent?
"Is your child crying and irritable?"
"Does your child have a productive cough?"
"Did your child have a temperature last night of greater than 100° F (37.8° C)?"
"Is your child telling you at this time about having trouble breathing?"
"Is your child telling you at this time about having trouble breathing?"
The nurse is assessing a newborn with heart failure before administering the prescribed digoxin. In reviewing the laboratory data, the nurse notes that the newborn has a digoxin blood level of 1.6 ng/mL (2.05 mmol/L) and an apical heart rate of 90 beats/min. The parent also tells the nurse that the newborn just vomited formula. Which intervention would the nurse take?
Retake the apical pulse.
Administer the medication.
Withhold the medication for 1 hour.
Withhold the medication and notify the primary health care provider.
Withhold the medication and notify the primary health care provider.
The home care nurse is providing safety instructions to the parent of a child with hemophilia. Which instruction would the nurse include to promote a safe environment for the child?
Eliminate any toys with sharp edges from the child's play area.
Allow the child to use play equipment only when a parent is present.
Allow the child to play indoors only, and avoid any outdoor play or playgrounds.
Place a helmet and elbow pads on the child every day as soon as the child awakens.
Eliminate any toys with sharp edges from the child's play area.
An ambulatory care nurse is preparing a list of instructions for the parents of a child who is being discharged after a tonsillectomy. The nurse would place which instructions on the list? Select all that apply.
Avoid hot fluids.
Avoid raw vegetables.
Consume pudding products.
Rest in bed or on a couch for 24 hours.
Drink cold milkshakes to soothe the throat.
Avoid hot fluids.
Avoid raw vegetables.
Rest in bed or on a couch for 24 hours.