Growth & Development
When developing a plan of care for a hospitalized child, nurse Mica knows that children in which age group is most likely to view illness as a punishment for misdeeds?
A. Infancy
B. Preschool age
C. School-age
D. Adolescence
B. Preschool age
Preschool-age children are most likely to view illness as a punishment for misdeeds.
The nurse is giving instructions to a mother with a child receiving a liquid oral iron supplement. The nurse tells the mother to:
A. Take it with meals.
B. Mix it with food.
C. Mix it with milk.
D. Administer it using a straw.
What is D? Administer it using a straw.
A child with known hemophilia A was brought to the emergency room with complaints of nose bleeding and some bruises in the joints. Which of the following should the nurse anticipate to be given to the child?
A. Oral iron supplement.
B. Cyclosporine.
C. Factor X.
D. Factor VIII.
What is D? Factor VIII.
Hemophilia A, also called factor VIII (FVIII) deficiency or classic hemophilia, is a genetic disorder caused by missing or defective factor VIII, a clotting protein. The initial treatment is the administration of factor VIII to replace the missing factor and decrease the bleeding episode.
A child is diagnosed with Wilms’ tumor. During assessment, the nurse in charge expects to detect:
A. Gross hematuria
B. Dysuria
C. Nausea and vomiting
D. An abdominal mass
What is D? An abdominal mass
The most common sign of Wilms’ tumor is a painless, palpable abdominal mass, sometimes accompanied by an increase in abdominal girth.
Mrs. Byers tells the nurse that she is very worried because her 2-year old child does not finish his meals. What should the nurse advise the mother?
A. Make the child seat with the family in the dining room until he finishes his meal
B. Provide a quiet environment for the child before meals
C. Do not give snacks to the child before meals
D. Put the child on a chair and feed him
What is C? do not give snacks to the child before meals.
If the child is hungry he/she more likely would finish his meals. Therefore, the mother should be advised not to give snacks to the child. The child is a “busy toddler.” He/she will not be able to keep still for a long time.
Hannah, age 12, is 7 months pregnant. When teaching parenting skills to an adolescent, the nurse knows that which teaching strategy is least effective?
A. Providing a one-on-one demonstration and requesting a return demonstration, using a live infant model.
B. Initiating a teenage parent support group with first and second-time mothers.
C. Using audiovisual aids that show discussions of feelings and skills.
D. Providing age-appropriate reading materials.
What is D? Providing age-appropriate reading materials.
Because adolescents absorb less information through reading, providing age-appropriate reading materials is the least effective way to teach parenting skills to an adolescent.
An infant with a patent ductus arteriosus is admitted to the pediatric unit ward. The nurse anticipates which of the following medications will be given to the infant?
A. Prednisone.
B. Ibuprofen.
C. Penicillin.
D. Albuterol.
What is B? Ibuprofen.
When surgical ligation is not indicated, prostaglandin inhibitors (e.g., nonsteroidal anti-inflammatory drugs [NSAIDs]) are used to close the ductus arteriosus.
Which of the following instructions should Nurse Cheryl include in her teaching plan for the parents of Reggie with otitis media?
A. Placing the child in the supine position to bottle-feed
B. Giving prescribed amoxicillin (Amoxil) on an empty stomach
C. Cleaning the inside of the ear canals with cotton swabs
D. Avoiding contact with people who have upper respiratory tract infections
What is D?
Avoiding contact with people who have upper respiratory tract infections.
Otitis media is commonly precipitated by an upper respiratory tract infection. Therefore, children prone to otitis should avoid people known to have an upper respiratory tract infection.
When a child injures the epiphyseal plate from a fracture, the damage may result in which of the following?
A. Rheumatoid arthritis
B. Permanent nerve damage
C. Osteomyelitis
D. Bone growth disruption
What is D? Bone growth disruption
The epiphyseal plate is a significant region of bone growth. Hence, any disruption may result in limb shortening.
Which of the following tests is most effective in diagnosing hemophilia?
A. Bleeding time
B. Complete blood count (CBC)
C. Partial thromboplastin time (PTT)
D. Platelet count
What is C? Partial thromboplastin time (PTT)
PTT is abnormal in hemophilia. Therefore, this test will be the most helpful in diagnosing the disorder.
A female child, age 6, is brought to the health clinic for a routine checkup. To assess the child’s vision, the nurse should ask?
A. “Do you have any problems seeing different colors?”
B. “Do you have trouble seeing at night?”
C. “Do you have problems with glare?”
D. “How are you doing in school?”
What is D?
“How are you doing in school?”
A child’s poor progress in school may indicate a visual disturbance.
Betty is a 9-year-old girl diagnosed with cystic fibrosis. Which of the following must Nurse Archie keep in mind when developing a care plan for the child?
A. Pulmonary secretions are abnormally thick.
B. Elevated levels of potassium are found in sweat.
C. CF is an autosomal dominant hereditary disorder.
D. Obstruction of the endocrine glands occurs.
What is A?
Pulmonary secretions are abnormally thick.
CF is identified by abnormally thick pulmonary secretions.
Nurse Katriz is planning a client education program for sickle cell disease (SCD); what topics should be included in the plan of care?
A. Aerobic exercise to improve oxygenation
B. Fluid restraint to 1 qt (1 L)/day
C. A high-iron, high-protein diet
D. Proper hand washing and infection avoidance
What is D? Proper handwashing and infection avoidance.
Prevention of infection is vital in the prevention of sickle cell crisis.
The nurse is evaluating a female child with acute post streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement?
A. Increased urine output
B. Increased appetite
C. Increased energy level
D. Decreased diarrhea
What is A? Increased urine output
Increased urine output, a sign of improving kidney function, typically is the first sign that a child with acute post-streptococcal glomerulonephritis (APSGN) is improving.
During a well-baby visit, Liza asks the nurse when she should start giving her infant solid foods. The nurse should instruct her to introduce which solid food first?
A. Applesauce
B. Egg whites
C. Rice cereal
D. Yogurt
What is C? Rice cereal
Rice cereal is the first solid food an infant should receive because it is easy to digest and is associated with few allergies. Next, the infant can receive pureed fruits, such as bananas, applesauce, and pears, followed by pureed vegetables, egg yolks, cheese, yogurt, and finally, meat.
When assessing a child’s cultural background, the nurse in charge should keep in mind that?
A. Heritage dictates a group’s shared values
B. Physical characteristics mark the child as part of a particular culture
C. Cultural background usually has little bearing on a family’s health practices
D. Behavioral patterns are passed from one generation to the next
What is D?
Behavioral patterns are passed from one generation to the next.
A family’s behavioral patterns and values are passed from one generation to the next.
A nurse provides medication instructions to a first-time mother. Which statement made by the mother indicates a need for further instructions?
A. "I should mix the medication in the baby food and give it when I feed the child".
B. "I should administer the oral medication sitting in an upright position and with the head elevated".
C. "I will give my child a toy after giving the medication".
D. "I will offer my child a juice drink after swallowing the medication".
What is A?
“I should mix the medication in the baby food and give it when I feed the child”.
The nurse would teach the mother to avoid putting medications in foods because it may cause an unpleasant taste to the food, and the child may refuse to accept the same food in the future. Additionally, the child may not consume the entire serving and would not require medication dosage.
Nurse Nancy is assessing a child with pyloric stenosis; she is likely to note which of the following?
A. "Currant jelly" stools
B. Regurgitation
C. Steatorrhea
D. Projectile vomiting
What is D? Projectile vomiting
Appropriate intervention is vital for many children with heart disease in order to go on to live active, full lives. Which of the following outlines an effective nursing intervention to decrease cardiac demands and minimize cardiac workload?
A. Feeding the infant over long periods
B. Allowing the infant to have her way to avoid conflict
C. Scheduling care to provide for uninterrupted rest periods
D. Developing and implementing a consistent care plan
What is C? Scheduling care to provide for uninterrupted rest periods.
Organizing nursing care to provide for uninterrupted periods of sleep reduces cardiac demand.
Mrs. Baker was instructed by the nurse on foods to encourage her child’s diet concerning the latter’s iron deficiency anemia; which of the following if stated by the mother would indicate the need for further instruction?
A. Fish
B. Lean meats
C. Whole-grain breads
D. Yellow vegetables
What is D? Yellow vegetables
If a parent states that she should stress the intake of yellow vegetables, she needs additional teaching because yellow vegetables are not a good source of iron.
Nurse Lorna is assessing infantile reflexes in a 9-month-old baby; which of the following would she identify as normal?
A. Persistent rooting
B. Bilateral parachute
C. Absent moro reflex
D. Unilateral grasp
What is B?
Bilateral parachute
The parachute reflex appears to about 9 months of age is normal.
Bryce is a child diagnosed with coarctation of aorta. While assessing him, Nurse Zach would expect to find which of the following?
A. Squatting posture
B. Absent or diminished femoral pulses
C. Severe cyanosis at birth
D. Cyanotic ("tet") episodes
What is B. Absent or diminished femoral pulses
Absent or diminished femoral pulse is a classic characteristic of coarctation of the aorta.
While examining a 2-year-old child, Nurse Galina sees that the anterior fontanel is open. She should:
A. Notify the doctor
B. Look for other signs of abuse
C. Recognize this as a normal finding
D. Ask about a family history of Tay-Sachs disease
What is A? Notify the doctor
Option A: Because the anterior fontanel normally closes between ages 12 and 18 months, the nurse should notify the doctor promptly of this finding.
Parents bring their infant to the clinic, seeking treatment for vomiting and diarrhea that has lasted for 2 days. On assessment, the nurse in charge detects dry mucous membranes and lethargy. What other findings suggest a fluid volume deficit?
A. A sunken fontanel
B. Decreased pulse rate
C. Increased blood pressure
D. Low urine specific gravity
Correct Answer: A. A sunken fontanel
Nurse Walter should expect a 3-year-old child to be able to perform which action?
A. Ride a tricycle
B. Tie the shoelaces
C. Roller-skates
D. Jump rope
What is A? Ride a tricycle
At age 3, gross motor development and refinement in eye-hand coordination enable a child to ride a tricycle.