Maternal Child Nursing Exam Test Bank

The nurse is providing atraumatic care to children in a hospital setting. Which of the following are principles of this philosophy of care? Select all answers that apply.

A) Avoid or reduce painful procedures

B) Avoid or reduce physical distress

C) Minimize parent-child interactions

D) Provide child-centered care

E) Minimize child control

F) Use core primary nursing

(chapter 30)

A, B, F

Avoid or reduce painful procedures, Avoid or reduce physical distress, Use core primary nursing

The nurse is consulting with a child life specialist (CLS) to help minimize the stress of hospitalization for a child. Which of the following services would the CLS provide? Select all answers that apply.

A) Medical preparation for tests, surgeries, and other medical procedures

B) Support before and after, but not during, medical procedures

C) Activities to support normal growth and development

D) Grief and bereavement support

E) Emergency room interventions for children and families

F) Only inpatient consultations with families

C, D, E

Activities to support normal growth and development., Grief and bereavement support, Emergency room interventions for children and families

The nurse is implementing interventions to prevent physical stressors for a 9-year-old child receiving chemotherapy in the hospital. Which of the following is an example of using atraumatic care for this child?

A) Use restraint or "holding down" of the child during the procedure to prevent injury.

B) Have the parent stand near and/or rub the child's feet during the procedure.

C) Insert a saline lock if the child will require multiple doses of parenteral medications.

D) Avoid using numbing techniques for multiple blood draws or IV insertion.

C) Insert a saline lock if the child will require multiple doses of parenteral medications.

The nurse contacts a child life specialist (CLS) to work with children on a pediatric ward. What is the primary goal of the CLS?

A) Decrease anxiety and fear during hospitalization and painful procedures

B) Keep children who are hospitalized distracted from pain

C) Perform medical procedures using atraumatic principles

D) Act as a liaison between the nurse and the child

A) Decrease anxiety and fear during hospitalization and painful procedures

The nurse is preparing a child and his family for a lumbar puncture. Which of the following would be a primary intervention instituted by the CLS to keep the child safe?

A) Distraction methods

B) Stimulation methods

C) Therapeutic hugging

D) Therapeutic touch

C) Therapeutic hugging

The child life specialist (CLS) is preparing a 6-year-old child for a magnetic resonance imaging (MRI) scan. Which of the following statements reflects the use of atraumatic principles when explaining the procedure?

A) "You will be taken to a magnetic resonance imaging machine for an x-ray of your

liver."

B) "You may hear some loud noises when you are lying in the machine, but they won't

hurt you."

C) "You have nothing to worry about; the MRI machine is safe and will not cause you

any pain."

D) "Let's just get you to the x-ray department for your test and you'll see how simple it

is."

B) "You may hear some loud noises when you are lying in the machine, but they won't

hurt you."

The nurse uses family-centered care to care for children in a pediatric office. Upon what concept is family-centered care based?

A) The family is the constant in the child's life and the primary source of strength.

B) The care provider is the constant in the child's life and the primary source of

strength.

C) The child must be prepared to be his or her own source of strength during times of

crisis.

D) The wishes of the family should direct the nursing care plan for the child.

A) The family is the constant in the child's life and the primary source of strength.

A nurse is promoting the use of family-centered care in a local community clinic. Which of the following are advantages or disadvantages of this type of care provision? Select all answers that apply.

A) Recovery times are longer.

B) Anxiety is decreased.

C) Communication is improved.

D) Health care costs are increased.

E) Pain management is enhanced.

F) More health care resources are utilized.

B, C, E

Anxiety is decreased., Communication is improved., Pain management is enhanced.

The nurse knows that effective communication with children and their parents is critical to providing atraumatic quality nursing care. Which of the following statements accurately describes the communication patterns of children?

A) Communication patterns are similar from one child to the next.

B) Children often use more words than adults to describe their fears.

C) Children rely more on nonverbal communication and silence.

D) Parents more often require affective communication rather than neutral

communication.

C) Children rely more on nonverbal communication and silence.

The nurse is using verbal skills to explain the nursing care plan to parents of a 10-year-old child with cancer. Which of the following describes a guideline the nurse should follow to provide appropriate verbal communication?

A) Use closed-ended questions that do not restrict the child's or parent's answers. B) Allow the focus to change without redirecting the conversation.

C) Restate the child's and parents comments in your own words.

D) Paraphrase the child's or parent's feelings to demonstrate empathy.

D) Paraphrase the child's or parent's feelings to demonstrate empathy.

The nurse is incorporating nonverbal communication with verbal communication when explaining the treatment plan for a child with juvenile diabetes. Which of the following should the nurse do to communicate effectively with this family?

A) Relax; maintain an open posture, with the arms crossed.

B) Sit opposite the family and lean forward slightly.

C) Use eye contact sparingly to avoid embarrassment.

D) Speak a verbal yes or no; do not use head nods.

B) Sit opposite the family and lean forward slightly.

The nurse is teaching the student nurse how to communicate effectively with children. Which one of the following methods would the nurse recommend?

A) Position self above the child's level to denote authority.

B) If possible, communicate with the child apart from the parent.

C) Direct questions and explanations to the child.

D) Use the medical terms for body parts and medical care.

C) Direct questions and explanations to the child.

The nurse is implementing care for a hospitalized toddler. What communication technique would the nurse use with the child to reflect the child's developmental level?

A) Allow the child extra time to complete thoughts.

B) Communicate solely through play.

C) Provide simple but honest and straightforward responses.

D) Remain nonjudgmental to avoid alienation.

A) Allow the child extra time to complete thoughts.

The nurse is caring for a 4-year-old boy with Ewing sarcoma who is scheduled for a computed axial tomography (CAT) scan tomorrow. Which of the following is the best example of therapeutic communication?

A) Telling him he will get a shot when he wakes up tomorrow morning

B) Telling him how cool he looks in his baseball cap and pajamas

C) Using family-familiar words and soft words when possible

D) Describing what it is like to get a CAT scan using words he understands

D) Describing what it is like to get a CAT scan using words he understands

The nurse is caring for a 14-year-old boy with an osteosarcoma. Which of the following communication techniques would be least effective for him?

A) Letting him choose juice or soda to take pills

B) Seeking the teenager's input on all decisions

C) Discussing the benefits of chemotherapy with him

D) Avoiding undue criticism of noncompliance

A) Letting him choose juice or soda to take pills

The nurse is educating a 16-year-old girl who has just been diagnosed with acute myelogenous leukemia. Which of the following statements best demonstrates therapeutic communication?

A) Discussing the treatment plan in detail for the next few weeks

B) Using medical terms when describing the disease

C) Assessing the adolescent's emotional status in private

D) Talking about clothing and the stores where she shops

C) Assessing the adolescent's emotional status in private

The nurse is explaining a discharge plan to the parents of an infant being discharged from the hospital. Which of the following characteristics regarding adult learning should the nurse incorporate into her plan?

A) Adults are dependent learners.

B) Adults are problem focused.

C) Adults are future focused.

D) Adults do not value past learning.

B) Adults are problem focused.

(Chapter 31)

The nurse is caring for children in a physician's office where health supervision is practiced. Which of the following is a key focus of health supervision? Select all answers that apply.

A) Making referrals for all health care needs

B) Monitoring disease incidence

C) Optimizing level of functioning

D) Monitoring quality of care provided

E) Teaching parents to prevent injury

F) Providing care developed from national guidelines

C) Optimizing level of functioning

E) Teaching parents to prevent injury

F) Providing care developed from national guidelines

The nurse is providing care for children in a pediatric medical home. Which of the following is a characteristic of care in these types of facilities?

A) All insurance except Medicaid is accepted.

B) Ambulatory care is not provided

C) A centralized database contains all child information.

D) Continuity of care is provided from infancy through adulthood.

C) A centralized database contains all child information.

The nurse is preparing a presentation to a local parent group about pediatric health supervision. Which of the following would the nurse emphasize as the focus?

A) Injury prevention

B) Wellness

C) Health maintenance

D) Developmental surveillance

B) Wellness

A large portion of the nurse's efforts is dedicated to health supervision for children who use the facility as their primary medical contact. At which of the following facilities does the nurse work?A) An urgent care center

B) A pediatric practice

C) A mobile outreach immunization program

D) A dermatology practice

B) A pediatric practice

The nurse strives to provide culturally competent care for children in a health clinic that follows the principles of health supervision. Which of the following nursing actions reflects this type of care?A) The nurse treats all children the same regardless of their culture.

B) The nurse negotiates a care plan with the child and family.

C) The nurse researches the child's culture and provides care based on the findings.

D) The nurse provides future-based care for culturally diverse children.

B) The nurse negotiates a care plan with the child and family.

The nurse is aware that the community affects the health of its members. Which of the following statements accurately reflect a community influence of health care? Select all answers that apply.

A) A community can be a contributor to a child's health or be the cause of his or her

illnesses.

B) The child's health should be separated from the health of the surrounding

community.

C) Community support and resources are necessary for children with significant

problems.

D) Poverty has not been linked to an increase in health problems in communities.

E) The breakdown of community and family support systems can lead to depression

and violence.

F) Ideally, the child's medical home is located outside the community

A) A community can be a contributor to a child's health or be the cause of his or her

illnesses.

C) Community support and resources are necessary for children with significant

problems.

E) The breakdown of community and family support systems can lead to depression

and violence.

The nurse is conducting a psychosocial assessment of a child with asthma brought to the physician's office for a check-up. Which of the following are psychosocial issues that might be assessed? Select all answers that apply.

A) Health insurance coverage

B) Transportation to health care facilities C) School's response to the chronic illness

D) Past medical history

E) Future treatment plans

F) Health maintenance needs

A) Health insurance coverage

B) Transportation to health care facilities

C) School's response to the chronic illness

The nurse is examining a 2-year-old child who was adopted from Guatemala. Which of the following would be a priority screening for this child?

A) Screening for congenital defects

B) Screening for abuse

C) Screening for childhood illnesses

D) Screening for infectious diseases

D) Screening for infectious diseases

The mother of a 5-year-old child with eczema is getting a check-up for her child before school starts. Which of the following will the nurse do during the visit?

A) Change the bandage on a cut on the child's hand

B) Assess the compliance with treatment regimens

C) Discuss systemic corticosteroid therapy

D) Assess the child's fluid volume

B) Assess the compliance with treatment regimens

During the health history, the mother of a 4-month-old child tells the nurse she is concerned that her baby is not doing what he should be at this age. What is the nurse's best response?

A) "I'll be able to tell you more after I do his physical."

B) "Fill out the questionnaire and then I can let you know."

C) "Tell me what concerns you."

D) "All mothers worry about their babies. I'm sure he's doing well."

C) "Tell me what concerns you."

A 3-year-old child is scheduled for a hearing screening. The nurse would prepare the child for screening by which method?

A) Auditory brain stem response

B) Evoked otoacoustic emissions

C) Visual reinforcement audiometry

D) Conditioned play audiometry

D) Conditioned play audiometry

A 2-week-old child responds to a bell during an initial health supervision examination. The child's records do not show that a newborn hearing screening was done. Which of the following is the best action for the nurse to take?

A) Do nothing because responding to the bell proves he does not have a hearing

deficit.

B) Immediately schedule the infant for a newborn hearing screening.

C) Ask the mother to observe for signs that the infant is not hearing well.

D) Screen again with the bell at the 2-month-old health supervision visit.

B) Immediately schedule the infant for a newborn hearing screening.

The nurse is performing developmental surveillance for children at a medical home. Which of the following infants are most at risk for developmental delays? Select all answers that apply.

A) A child whose birthweight was 1,600 g

B) A child whose parent has a mental illness

C) A child raised by a single parent

D) A child with a lead level above 10 mg/dL

E) A child with hypertonia or hypotonia

F) A child with gestational age more than 33 weeks

B) A child whose parent has a mental illness

C) A child raised by a single parent

E) A child with hypertonia or hypotonia

The nurse is examining a 15-month-old child who was able to walk at the last visit and now can no longer walk. What would be the nurse's best intervention in this case?

A) Schedule a full evaluation since this may indicate a neurologic disorder.

B) Note the regression in the child's chart and recheck in another month.

C) Document the findings as a developmental delay since this is a normal occurrence.

D) Ask the parents if they have changed the child's schedule to a less active one.

A) Schedule a full evaluation since this may indicate a neurologic disorder.

During a physical assessment of a 5-month-old child, the nurse observes the first tooth has just erupted and uses the opportunity to advise the mother to schedule a dental examination for her baby. Which of the following is the correct time for the dentist visit?

A) By the first birthday

B) By the second birthday

C) By entry into kindergarten

D) By entry into first grade

A) By the first birthday

A mother and her 4-week-old infant have arrived for a health maintenance visit. Which of the following activities will the nurse perform?

A) Assess the child for an upper respiratory infection

B) Take a health history for a minor injury

C) Administer a varicella injection

D) Plot the child's head circumference on a growth chart

D) Plot the child's head circumference on a growth chart

The nurse is screening a 6-year-old child for mental ability. Which of the following tests would the nurse use to assess intelligence?

A) Denver Articulation Screening

B) Denver PRQ

C) Goodenough-Harris Drawing Test

D) Parents' Evaluation of Developmental Status (PEDS.

C) Goodenough-Harris Drawing Test

When assessing the vision of a 2-month-old, the nurse would use which of the following?

A) Black-and-white checkerboard

B) Red and blue circles

C) Gray and blue animal drawings

D) Green and yellow letters

A) Black-and-white checkerboard

The nurse is performing a risk assessment of a 5-year-old and determines the child has a risk factor for cystic fibrosis. What type of screening would the nurse perform to confirm or rule out this disease?

A) Universal screening

B) Selective screening

C) Hyperlipidemia screening

D) Developmental screening

B) Selective screening

The nurse is caring for an infant who had hyperbilirubinemia requiring exchange transfusion. Based on this information, this infant is at risk for what type of disorder? A) Vision loss

B) Hearing loss

C) Hypertension

D) Hyperlipidemia

B) Hearing loss

The nurse is performing a vision screening for a 4-year-old child. Which of the following screening charts would be best for determining the child's visual acuity?

A) Snellen

B) Ishihara

C) Allen figures

D) Color Vision Testing Made Easy (CVTME)

C) Allen figures

The nurse is explaining the difference between active and passive immunity to the student nurse. Which of the following statements accurately describes a characteristic of the process of immunity?

A) Active immunity is produced when the immunoglobulins of one person are

transferred to another.

B) Passive immunity can be obtained by injection of exogenous immunoglobulins.

C) Active immunity can be transferred from mothers to infants via colostrum or the

placenta.

D) Passive immunity is acquired when a person's own immune system generates the

immune response.

B) Passive immunity can be obtained by injection of exogenous immunoglobulins.

The nurse is administering a hepatitis B vaccine to a child. What is the classification of this type of vaccine?

A) Killed vaccines

B) Toxoid vaccines

C) Conjugate vaccines

D) Recombinant vaccines

D) Recombinant vaccines

A 15-month-old girl is having her first health visit at a clinic. The mother has no immunization record but says the child was immunized 3 months ago at the local health department. Which of the following is the best action for the nurse to take?

A) Ask the mother to bring the records to the next health maintenance visit.

B) Start the catch-up schedule since there are no immunization records.

C) Keep the child at the facility while the mother returns home for the records.

D) Call the local health department and verify the child's immunization status.

D) Call the local health department and verify the child's immunization status.

The nurse is discussing vaccination for Haemophilus influenzae type B (Hib) with the mother of a 6-month-old child. Which of the following comments provides the most compelling reason to get the vaccination?

A) "These bacteria live in every human."

B) "Young children are especially susceptible to these bacteria."

C) "You have a choice of two excellent vaccines."

D) "Your child needs this final dose for protection."

B) "Young children are especially susceptible to these bacteria."

The mother of a 15-month-old child is questioning the nurse about the need for the hepatitis B vaccination. Which of the following comments provides the most compelling reason for the vaccine?

A) "The most common side effect is injection site soreness."

B) "This is a recombinant or genetically engineered vaccine."

C) "Immunizations are needed to protect the general population."

D) "This protects your child from infection that can cause liver disease."

D) "This protects your child from infection that can cause liver disease."

When preparing to administer the polio vaccine to an infant, the nurse would expect to administer the vaccine by which route?

A) Intramuscular

B) Subcutaneous

C) Oral

D) Intradermal

B) Subcutaneous

After teaching the mother about follow-up immunizations for her daughter, who received the varicella vaccine at age 14 months, the nurse determines that the teaching was successful when the mother states that a follow-up dose should be given at which time?

A) When the child is 20 to 36 months of age

B) When the child is 4 to 6 years of age

C) When the child is 11 to 12 years of age

D) When the child is 13 to 15 years of age

B) When the child is 4 to 6 years of age

The nurse working in a community clinic attempts to establish a free vaccination program to refer low-income families. What is the key strategy for success when implementing a health promotion activity?

A) Partnership development

B) Funding for projects

C) Finding an audience

D) Adequate staffing

A) Partnership development

The nurse is providing anticipatory guidance to an obese teenager. Which of the following interventions would be most likely to promote healthy weight in teenagers?

A) Make the focus of the program weight centered.

B) Begin directly advising children about their weight at age 6.

C) Focus physical activity on competitive sports and activities.

D) Obtain nutritional histories directly from the school-age child and adolescent.

D) Obtain nutritional histories directly from the school-age child and adolescent.

(chapter 32)

he nurse is conducting a health history for a 9-year-old child with stomach pains. Which of the following is a recommended guideline when approaching the child for information?

A) Wear a white examination coat when conducting the interview.

B) Allow the child to control the pace and order of the health history.

C) Use quick deliberate gestures to get your point across.

D) Do not make physical contact with the child during the interview.

B) Allow the child to control the pace and order of the health history.

For which of the following children would the nurse conduct an immediate comprehensive health history?

A) A child who is brought to the emergency room with lacerations

B) A child who is a new client in a pediatric office

C) A child who is a routine client and presents with signs of a sinus infection

D) A child whose condition is improving

B) A child who is a new client in a pediatric office

The nurse is performing a health history on a 6-year-old boy who is having trouble adjusting to school. Which of the following questions would be most likely to elicit valuable information?

A) "Do you like your new school?"

B) "Are you happy with your teacher?"

C) "Do you enjoy reading a book?"

D) "What are your new classmates like?"

D) "What are your new classmates like?"

The nurse performing a health history on a child asks the parents if their child has experienced increased appetite or thirst. What body system is the nurse assessing with this question?

A) Endocrine

B) Genitourinary

C) Hematologic

D) Neurologic

A) Endocrine

The nurse is questioning the parents of a 2-year-old child to obtain a functional history. Which of the following topics might the nurse include? Select all answers that apply.

A) The child's toileting habits

B) Use of car seats and other safety measures

C) Problems with growth and development

D) Prenatal and perinatal history

E) The child's race and ethnicity

F) Use of supplements and vitamins

A) The child's toileting habits

B) Use of car seats and other safety measures

F) Use of supplements and vitamins

The nurse is conducting a physical examination of a child following a comprehensive health history. What should be the focus of the physical examination?

A) The child

B) The parents

C) Chief complaint

D) Developmental age

C) Chief complaint

The nurse is teaching the student nurse how to perform a physical assessment based on the child's developmental stage. Which of the following statements accurately describes a recommended guideline for setting the tone of the examination for a school-age child?

A) Keep up a running dialogue with the caregiver, explaining each step as you do it.

B) Include the child in all parts of the examination; speak to the caregiver before and

after the examination.

C) Speak to the child using mature language and appeal to his or her desire for

self-care.

D) Address the child by name; speak to the caregiver and do the most invasive parts

last.

B) Include the child in all parts of the examination; speak to the caregiver before and

after the examination.

Which of the following would be least effective in gaining the cooperation of a toddler during a physical examination?

A) Tell the child that another child the same age wasn't afraid.

B) Allow the child to touch and hold the equipment when possible.

C) Permit the child to sit on the parent's lap during the examination.

D) Offer immediate praise for holding still or doing what was asked.

A) Tell the child that another child the same age wasn't afraid.

The nurse is performing a physical examination on a sleeping newborn. Which of the following body systems should the nurse examine last?

A) Heart

B) Abdomen

C) Lungs

D) Throat

D) Throat

The nurse is teaching the student nurse the sequence for performing the assessment techniques during a physical examination. What is the appropriate order?

A) Inspection, palpation, percussion, auscultation

B) Inspection, percussion, palpation, auscultation

C) Palpation, percussion, inspection, auscultation

D) Inspection, auscultation, palpation, percussion

A) Inspection, palpation, percussion, auscultation

The nurse is examining the posture of a male toddler and notes the condition "lordosis." What would be the appropriate reaction of the nurse to this finding?

A) Explain that the child will need a back brace.

B) Refer the toddler to a physical therapist.

C) Do nothing; this is a normal condition for toddlers.

D) Notify the primary care physician about the condition.

C) Do nothing; this is a normal condition for toddlers.

The nurse is assessing the temperature of a diaphoretic toddler who is crying and being uncooperative. What would be the best method to assess temperature in this child?

A) Oral thermometer

B) Axillary method

C) Temporal scanning

D) Rectal route

B) Axillary method

The nurse is preparing to take a tympanic temperature reading of a 4-year-old. In order to get an accurate reading, what does the nurse need to do?

A) Pull the earlobe back and down

B) Direct the infrared sensor at the tympanic membrane

C) Pull the earlobe down and forward

D) Remove any visible cerumen from inside the ear canal

B) Direct the infrared sensor at the tympanic membrane

A mother brings her 31/2-year-old daughter to the emergency department because the child has been vomiting and having diarrhea for the past 36 hours. When assessing this child's temperature, which method would be least appropriate?

A) Oral

B) Tympanic

C) Rectal

D) Axillary

C) Rectal

The nurse is assessing heart rate for children on the pediatric ward. Which of the following is a normal finding based on developmental age?

A) An infant's rate is 90 bpm.

B) A toddler's rate is 150 bpm.

C) A preschooler's rate is 130 bpm.

D) A school-age child's rate is 50 bpm.

A) An infant's rate is 90 bpm.

The nurse is assessing the heart rate of a healthy 13-month-old child. The nurse knows to auscultate which of the following sites to obtain an accurate assessment?

A) Radial pulse

B) Brachial pulse

C) Apical pulse at the third or fourth intercostal space

D) Apical pulse at the fourth or fifth intercostal space at the midclavicular line

C) Apical pulse at the third or fourth intercostal space

The nurse is assessing the heart rate of a healthy school-age child. The nurse expects that the child's heart rate will be in which of the following ranges?

A) 80 to 150 bpm

B) 70 to 120 bpm

C) 65 to 110 bpm

D) 60 to 100 bpm

D) 60 to 100 bpm

The nurse is preparing to assess the pulse of an 18-month-old child. Which pulse would be most difficult for the nurse to palpate?

A) Radial

B) Brachial

C) Pedal

D) Femoral

A) Radial

While auscultating the heart of a 5-year-old child, the nurse notes a murmur that is soft and quiet and heard each time the heart is auscultated. The nurse documents this finding as which of the following?

A) Grade 1

B) Grade 2

C) Grade 3

D) Grade 4

B) Grade 2

The parents of a 2-day-old girl are concerned because her feet and hands are slightly blue. How should the nurse respond?

A) "Your daughter has acrocyanosis; this is causing her blue hands and feet."

B) "Let's watch her carefully to make sure she does not have a circulatory problem." C) "This is normal; her circulatory system will take a few days to adjust."

D) "This is a vasomotor response caused by cooling or warming."

C) "This is normal; her circulatory system will take a few days to adjust."

A nurse is assessing the fontanels of a crying newborn and notes that the posterior fontanel pulsates and briefly bulges. What do these findings indicate?A) Increased intracranial pressure

B) Overhydration

C) Dehydration

D) These are normal findings.

D) These are normal findings.

The nurse is assessing the neck of an 8-year-old child with Down syndrome. Which of the following findings would the nurse expect during the examination?

A) Webbing

B) Excessive neck skin

C) Lax neck skin

D) Shortened neck

C) Lax neck skin

The nurse is conducting a routine health assessment of a 3-month-old boy and notices a flat occiput. The nurse provides teaching and emphasizes the importance of tummy time. Which of the following responses by the mother indicates a need for further teaching?

A) "He must be positioned on his tummy as much as possible."

B) "I need to watch him during his tummy time."

C) "I need to change his head position while he is in an upright chair."

D) "His head has flattened due to the pressure of his head position."

A) "He must be positioned on his tummy as much as possible."

The nurse is measuring the blood pressure of a 12-year-old boy with an oscillometric device. The boy's reading is greater than the 90th percentile for gender and height. What is the appropriate nursing action?

A) Repeat the reading with the oscillometric device.

B) Repeat the blood pressure reading using auscultation.

C) Measure the blood pressure in all four extremities.

D) Measure the blood pressure with a Doppler.

B) Repeat the blood pressure reading using auscultation.

The nurse is inspecting the fingernails of an 18-month-old girl. Which of the following findings indicates chronic hypoxemia?

A) Nails that curve inward

B) Clubbing of the nails

C) Nails that curve outward

D) Dry, brittle nails

B) Clubbing of the nails

The nurse is using pulse oximetry to measure oxygen saturation in a 3-year-old girl. The nurse understands that falsely high readings may be associated with which situation or condition?

A) A nonsecure connection

B) Cold extremities

C) Hypovolemia

D) Anemia

D) Anemia

Assessment reveals that a child weighs 73 lb and is 4 ft 1 in. tall. The nurse calculates this child's body mass index as:

A) 19.1

B) 20.7

C) 21.4

D) 24.5

C) 21.4

The nurse is teaching the student nurse about abnormal findings when assessing the breasts of children. Which of the following may be associated with renal disorders?

A) Swollen nipples upon inspection of a newborn's breasts

B) Tender nodule palpated under the nipple of a 10-year-old

C) Observation of enlarged breast tissue in a male adolescent

D) Observation of a supernumerary nipple along the mammary ridge

D) Observation of a supernumerary nipple along the mammary ridge

The nurse is inspecting the genitals of a prepubescent girl. Which of the following are normal signs of the onset of puberty?A) Appearance of pubic hair around 11 to 13 years old

B) Swelling or redness of the labia minora

C) Presence of a small amount of downy pubic hair

D) Lesions on the external genitalia

A) Appearance of pubic hair around 11 to 13 years old

(chapter 33)

The nurse working in the emergency room monitors the admission of children. Statistically, for which one of the following disorders would children younger than 5 years most commonly be admitted?

A) Mental health problems

B) Injuries

C) Respiratory disorders

D) Gastrointestinal disorders

C) Respiratory disorders

The nurse is caring for a 7-year-old girl hospitalized in isolation. The nurse notices that she has begun sucking her thumb and changing her speech patterns to those of a toddler. What condition is the girl manifesting?

A) Regression

B) Suppression

C) Repression

D) Denial

A) Regression

The nurse is caring for an 8-year-old boy hospitalized for a bone marrow transplant. His parents are in and out of his room throughout the day. Which of the following behaviors of the child would alert the nurse that he is in the second stage of separation anxiety?

A) He ignores his parents when they return to his room.

B) He cries uncontrollably whenever they leave.

C) He forms superficial relationships with his caregivers.

D) He sits quietly and is uninterested in playing and eating.

D) He sits quietly and is uninterested in playing and eating.

The nurse is caring for a 4-year-old girl who has been hospitalized for over a week with severe burns. Which of the following would be a priority intervention to help satisfy this preschool child's basic needs?

A) Encourage friends to visit as often as possible.

B) Suggest that a family member be present with her 24 hours a day.

C) Explain necessary procedures in simple language that she will understand.

D) Allow her to make choices about her meals and activities as much as permitted.

C) Explain necessary procedures in simple language that she will understand

The nurse is caring for a hospitalized 13-year-old girl, who is questioning everything the medical staff is doing and is resistant to treatment. How should the nurse respond?

A) "Let's work together to plan your day along with your treatments."

B) "The sooner you cooperate, the sooner you are going to leave."

C) "If you are more cooperative, perhaps we can arrange a visit from friends."

D) "Please don't make me call your parents about this."

A) "Let's work together to plan your day along with your treatments."

The nurse is caring for a 10-year-old boy who is in traction. The boy has a nursing diagnosis of deficient diversional activity related to confinement in bed that is evidenced by verbalization of boredom and lack of participation in play, reading, and schoolwork. Which of the following would be the best intervention?

A) Offer the child reading materials.

B) Enlist the aid of a child life specialist.

C) Encourage the child to complete his homework.

D) Ask for the parents' assistance.

B) Enlist the aid of a child life specialist.

The nurse is caring for a 13-year-old girl hospitalized for complications from type 1 diabetes. The girl has a nursing diagnosis of powerlessness related to lack of control of multiple demands associated with hospitalization, procedures, treatments, and changes in usual routine. How can the nurse help promote control?

A) Ask the child to identify her areas of concern.

B) Encourage participation of parents in care activities.

C) Offer the girl as many choices as possible.

D) Enlist the family's assistance in creating a time schedule

C) Offer the girl as many choices as possible.

The nurse is caring for an 8-year-old girl who requires numerous venipunctures and injections daily. The nurse understands that the child is exhibiting signs of sensory overload and enlists the assistance of the child life specialist. What should the therapeutic play involve to best deal with the child's stressors?

A) Puppets and dolls

B) Drawing paper and crayons

C) Wooden hammer and pegs

D) Sewing puppets with needles

D) Sewing puppets with needles

After teaching a group of students about therapeutic play, the instructor determines that additional teaching is needed when the students identify which of the following as a characteristic?

A) Focus on coping

B) Use of a highly structured format

C) Dramatization of emotions

D) Expression of feelings

B) Use of a highly structured format

The mother of a hospitalized child reports that her daughter, who is having some difficulty eating, just had a 4-ounce cup of ice chips. The nurse documents this on the child's intake flow sheet as which of the following?

A) 2 ounces

B) 4 ounces

C) 6 ounces

D) 8 ounces

A) 2 ounces

The nurse is preparing a nursing care plan for a child hospitalized for cardiac surgery. Which of the following are examples of interventions that nurses perform in the "building a trusting relationship" stage? Select all answers that apply.

A) Gathering information about the child using the child's own toys

B) Preparing the child for a procedure by playing games

C) Explaining in simple terms what will happen during surgery

D) Allowing the child to devise an exercise plan following surgery

E) Praising the child for how well he is doing following instructions

F) Giving the child a favorite toy to cuddle following a painful procedure

B) Preparing the child for a procedure by playing games

C) Explaining in simple terms what will happen during surgery

The nurse is preparing a hospitalized 7-year-old girl for a lumbar puncture. Which of the following actions would help reduce her stress related to the procedure? Select all answers that apply.

A) Pretend to perform the procedure on her doll.

B) Explain the procedure to her in medical terms.

C) Do not allow her to see or touch the equipment.

D) Teach her the steps of the procedure.

E) Tell her not to pay attention to any sounds she might hear.

F) Introduce her to the health care personnel.

A) Pretend to perform the procedure on her doll.

D) Teach her the steps of the procedure.

F) Introduce her to the health care personnel.

The nurse is performing an admission of a 10-year-old boy. Which of the following actions will help the nurse establish a trusting and caring relationship with the child and his family? Select all answers that apply.

A) The nurse should not minimize the child's fears by smiling.

B) The nurse should initiate introductions.

C) The nurse should not use formal titles at the introduction.

D) The nurse should maintain eye contact at the appropriate level.

E) The nurse should start communication with the child first and then move on to the

family.

F) The nurse should use age-appropriate communication with the child.

B) The nurse should initiate introductions.

D) The nurse should maintain eye contact at the appropriate level.

F) The nurse should use age-appropriate communication with the child.

The nurse is caring for an 11-year-old girl preparing to undergo a magnetic resonance imaging (MRI) scan. Which of the following statements would best help prepare the girl for the test and decrease anxiety?

A) "You won't hear a sound if you wear your headphones."

B) "The machine makes a very loud rattle; however, headphones will help."

C) "There are a variety of loud sounds you will hear."

D) "The MRI scanner sounds like a machine gun."

B) "The machine makes a very loud rattle; however, headphones will help."

The nurse is caring for a 10-year-old girl who is in an isolation room. Which of the following interventions would be a priority intervention for this child?

A) Reduce noise as much as possible.

B) Provide age-appropriate toys and games.

C) Discourage visits from family members. D) Put on mask prior to entering the room.

B) Provide age-appropriate toys and games.

An adolescent is scheduled for outpatient arthroscopic surgery on his knee next week. As part of preparing him for the procedure, which action would be most appropriate?

A) Discussing the events with the adolescent and his mother upon arrival the morning

of the procedure

B) Providing detailed explanations of the procedure at least a week in advance of the

procedure

C) Encouraging the parent to stay with the adolescent as much as possible before the

procedure

D) Answering the adolescent's questions with simple answers, encouraging him to ask

the surgeon

B) Providing detailed explanations of the procedure at least a week in advance of the

procedure

The nurse is providing developmentally appropriate care for a toddler hospitalized for observation following a fall down the steps. Which of the following measures might the nurse consider when caring for this child? Select all answers that apply.

A) Use the en face position when holding the toddler.

B) Use a bed for toddlers who have an adult present.

C) Avoid leaving small objects that can be swallowed in the bed.

D) Explain activities in concrete, simple terms.

E) Allow the child to select meals and activities.

F) Encourage parents to stay to prevent separation anxiety.

C) Avoid leaving small objects that can be swallowed in the bed.

F) Encourage parents to stay to prevent separation anxiety.

The nurse is ordered to apply restraints to a toddler who keeps pulling at the tubes in his arm. Which of the following criteria must occur to ensure proper use of these restraints? Select all answers that apply.

A) The nurse must check the restraints every 15 minutes while they are in place.

B) Secure the restraints with ties to the side rails, not the bed or crib frame.

C) Assess the temperature of the affected extremities, pulses, and capillary refill every

15 minutes after placement

.D) Use a clove-hitch type of knot to secure the restraints with ties.

E) Remove the restraint every 2 hours to allow for range of motion and repositioning.

F) Encourage parent participation, providing continuous explanations about the

reasons and time frame for restraints.

D, E, F

D) Use a clove-hitch type of knot to secure the restraints with ties.

E) Remove the restraint every 2 hours to allow for range of motion and repositioning.

F) Encourage parent participation, providing continuous explanations about the

reasons and time frame for restraints.

The nurse is enlisting the parents' assistance for therapeutic hugging prior to an otoscopic examination. What should the nurse emphasize to the parents?

A) "You will need to keep his hands down and his head still."

B) "If this does not work, we will have to apply restraints."

C) "If you are not capable of this, let me know so I can get some assistance."

D) "I may need you to leave the room if your son will not remain still."

A) "You will need to keep his hands down and his head still."

The nurse is caring for a 7-year-old boy who needs his left leg immobilized. What is the priority nursing intervention?

A) Enlist the assistance of a child life specialist.

B) Explain to the boy that he must keep his leg very still.

C) Apply a clove-hitch restraint to the boy's left leg.

D) Explain that a restraint will be applied if he cannot hold still.

B) Explain to the boy that he must keep his leg very still.

The nurse is transporting a 6-month-old with a suspected blood disorder to the nursery. What is the most appropriate method of transporting the child by the nurse?

A) A wagon with rails

B) Cradle hold

C) Football hold

D) Over the shoulder

D) Over the shoulder

The nurse is caring for an immunosuppressed 3-year-old girl and is providing teaching to the mother about proper oral hygiene. Which of the following responses from the mother indicates a need for further teaching?

A) "I really need to carefully check for skin breakdown."

B) "I must really scrub her teeth and gums well."

C) "I must use a soft toothbrush."

D) "I can use a soft gauze sponge to care for her gums."

B) "I must really scrub her teeth and gums well."

When preparing to apply a restraint to a child, which of the following would be most important for the nurse to do?

A) Expect to keep the restraint on for at least 8 hours.

B) Explain that safety, not punishment, is the reason for the restraint.

C) Plan to use a square knot to secure the restraint to the side rails.

D) Use a limb restraint rather than a jacket restraint for most issues.

B) Explain that safety, not punishment, is the reason for the restraint.

The nurse is providing discharge planning for a 12-year-old boy with multiple medical conditions. Which of the following would be the best teaching method for this child and his family?

A) Demonstrate the care and ask for a return demonstration.

B) Provide and review educational booklets and materials.

C) Provide a written schedule for the child's care.

D) Provide a trial period of home care.

D) Provide a trial period of home care.