YOU
Which statement explains why it can be difficult to assess a child’s dietary intake?
A. No systematic assessment tool has been developed for this purpose.
B. Biochemical analysis for assessing nutrition is expensive.
C. Families usually do not understand much about nutrition.
D. Recall of children’s food consumption is frequently unreliable.
D. Recall of children’s food consumption is frequently unreliable.
The appropriate direction to pull the pinna of an infant during an otoscopic examination is
A. down and back.
B. down and forward.
C. up and forward.
D. up and back.
A. down and back.
When assessing a preschooler’s chest, the nurse would expect
A. respiratory movements to be chiefly thoracic.
B. anteroposterior diameter to be equal to the transverse diameter.
C. intercostal retractions on respiratory movement.
D. movement of the chest wall to be symmetric bilaterally and coordinated with breathing.
D. movement of the chest wall to be symmetric bilaterally and coordinated with breathing.
When interviewing a patient, which statement/action indicates that the nurse is displaying empathy?
A. The nurse offers the patient a tissue when the patient is crying after hearing some sad news before giving the patient medication.
B. The nurse and patient discuss their families and discover they each have two brothers.
C. The patient appreciates that the nurse has sat by her bedside and held her hand while they spoke about health concerns.
D. The nurse provided the patient’s family with Advanced Directive Form to fill out acknowledging that it has to be done in order to fulfill the patient’s wishes.
C. The patient appreciates that the nurse has sat by her bedside and held her hand while they spoke about health concerns.
The nurse is ready to begin a physical examination on an 8-month-old infant. The child is sitting contentedly on the mother’s lap, chewing on a toy. What should the nurse do first?
A. Elicit reflexes.
B. Auscultate the heart and lungs.
C. Examine the eyes, ears, and mouth.
D. Examine the head, systematically moving toward the feet.
B. Auscultate the heart and lungs.
The nurse is assessing skin turgor in a child. The nurse grasps the skin on the abdomen between the thumb and index finger, pulls it taut, and quickly releases it. The tissue remains suspended, or tented, for a few seconds, and then slowly falls back on the abdomen. Based on the nurse’s knowledge of assessing skin turgor, the assessment finding is that the
A. tissue shows normal elasticity.
B. child is properly hydrated.
C. assessment is done incorrectly.
D. child has poor skin turgor.
D. child has poor skin turgor.
Superficial palpation of the abdomen is often perceived by the child as tickling. Which measure by the nurse is most likely to minimize this sensation and promote relaxation?
A. Palpate another area simultaneously.
B. Have the child “help” with palpation by placing his or her hand over the palpating hand.
C. Ask the child not to laugh or move if it tickles.
D. Begin with deeper palpation and gradually progress to superficial palpation.
B. Have the child “help” with palpation by placing his or her hand over the palpating hand.
Guidelines for a nurse using an interpreter in developing a care plan for an 8-year-old admitted to rule out epilepsy include
A. explaining to the interpreter what information is necessary to obtain from the patient and family.
B. encouraging the interpreter to ask several questions at a time to make the best use of time.
C. not giving the interpreter too much information so that the interview evolves.
D. discouraging the interpreter and client from discussing topics that are deemed irrelevant to the original intent of the interview.
A. explaining to the interpreter what information is necessary to obtain from the patient and family.
The nurse is assessing a 3-year-old African-American child who is being seen in the clinic for the first time. The child’s height and weight are in the 20th percentile on the commonly used growth chart from the National Center for Health Statistics. When interpreting the data, the nurse recognizes
A. child’s growth is within normal limits.
B. child’s growth is not within normal limits.
C. growth chart is not accurate for African-American children.
D. growth chart is not useful until several measurements are plotted over time.
A. child’s growth is within normal limits.
The most appropriate method for a nurse to use to view the tonsils and oropharynx of a 6-year-old child is to
A. ask child to open mouth wide and say “Ahh.”
B. ask child to open mouth wide, and then place tongue blade in the center back area of the tongue.
C. examine mouth when child is crying to avoid use of tongue blade.
D. pinch nostrils closed until child opens mouth, then insert tongue blade.
A. ask child to open mouth wide and say “Ahh.”
Which statement is true concerning the increased use of telephone triage by nurses?
A. Telephone triage has led to an increase in health care costs.
B. Emergency department visits are not recommended by nurses, and therefore they are not a component of telephone triage.
C. Access to high-quality health care services has increased through telephone triage.
D. Home care is often recommended when it is not appropriate.
C. Access to high-quality health care services has increased through telephone triage.
What is the most accurate method of determining the length of a child younger than 12 months of age?
A. Standing height
B. Estimation of length to the nearest centimeter or 1/2 inch
C. Recumbent length measured in the prone position
D. Recumbent length measured in the supine position
D. Recumbent length measured in the supine position
The nurse needs to take the blood pressure of a small child. Of the cuffs available, one is too large and one is too small. The best nursing action is to
A. use the small cuff.
B. use the large cuff.
C. use either cuff, using palpation method.
D. locate the proper-sized cuff before taking the blood pressure.
D. locate the proper-sized cuff before taking the blood pressure.
A nursing student is discussing the technique of interviewing with his instructor and conveys that he is somewhat reluctant to talk with potential patients as he fears he may have nothing to say and there would be periods of silence. Which statement represents the best response by the nursing instructor in response to the students’ expressed concerns?
A. Telling the student that everyone feels like this at first but that the feeling and anxiety will reside during the next interview experience.
B. Encourage the student to practice interviewing technique skills with peers and family members to increase his confidence level.
C. Acknowledge that his reluctance is normal but that the utilization of silence may well eventually represent the ability of a confident interviewer in knowing that sometimes it is equally important to listen rather than to keep talking.
D. Provide the student with practice questions for interviewing and have him look at himself in the mirror while voicing the questions to increase his confidence level.
C. Acknowledge that his reluctance is normal but that the utilization of silence may well eventually represent the ability of a confident interviewer in knowing that sometimes it is equally important to listen rather than to keep talking.
Which explains the importance of detecting strabismus in young children?
A. Color vision deficit may result.
B. Amblyopia, a type of blindness, may result.
C. Epicanthal folds may develop in the affected eye.
D. Ptosis may develop secondarily.
B. Amblyopia, a type of blindness, may result.
For which scenario would the expectation of confidentiality by the nurse not be withheld during an interview format? (Select all that apply.)
A. 15-year-old emancipated minor who wants to discuss birth control methods
B. 14-year-old patient who denies abuse but who presents with multiple bruises over arms and legs which appear to be “defensive type” in nature
C. 16-year-old patient who appears sad and voices despair over having broken up with his boyfriend states he has no options
D. 18-year-old patient who confides in the nurse that she wants to move out and get her own apartment
A. 15-year-old emancipated minor who wants to discuss birth control methods
A nurse is conducting a health history on an adolescent. Components of the health history include (Select all that apply.)
A. sexual history.
B. review of systems.
C. physical assessment.
D. growth measurements.
E. family medical history.
A. sexual history.
B. review of systems.
D. growth measurements.
E. family medical history.