PEDS Exam 1 Practice Questions

The clinic administrator has asked each nurse to classify the nursing activities as a

beginning step of clinic reorganization. Which of these strategies can be classified as health

promotion and health maintenance? Select all that apply.

1. Instructing on how to use dental floss

2. Treating a child with a diagnosis of acute otitis media

3. Administering the flu vaccine to infants 6 to 23 months old

4. Working with new parents to create daily feeding schedules for infants

5. Conducting developmental screening examinations for toddlers

1, 3, 4, 5

The mother of a newborn asks the nurse what the purpose of the first scheduled health

maintenance visit will be. Which are appropriate responses by the nurse to this question?

Select all that apply.

1. "To determine if your baby is being abused."

2. "To determine compatibility between you and the provider."

3. "To discuss policies related to provision of care."

4. "To evaluate your understanding of the services offered."

5. "To determine your baby's risk for obesity."

2, 3, 4

During a health supervision visit, the nurse is attempting to develop a partnering

relationship with the child and family. Which is the initial action by the nurse?

1. Telling the family what the child should be doing physically for the age level

2. Telling the family that the healthcare provider will answer any questions they might

have related to their child's growth and development

3. Setting goals for the family related to the child's health

4. Discussing a plan with the family to address the child's health needs

4

During a scheduled health maintenance visit for a 6-month-old infant the nurse asks, "Does

the baby sit without assistance, and is the baby crawling?" Which process is the nurse using

in this interaction?

1. Health promotion

2. Developmental surveillance

3. Health maintenance

4. Disease surveillance

2

A parent says to a nurse, "How do you know when my baby needs these screening tests the

doctor just mentioned?" Which response by the nurse is most appropriate?

1. "Screening tests are done in the newborn nursery, and from these results, additional

screening tests are ordered throughout the first 2 years of life."

2. "Screening tests are done at each office visit."

3. "Screening tests are most often done when the doctor suspects something is wrong with

the child."

4. "Screening tests are administered at the ages when a child is most likely to develop a

condition."

4

The nurse is working with first-time parents. Which activity will the nurse suggest to

encourage the development of good muscle tone in their infant?

1. Placing the infant in an infant seat rather than lying down in a crib

2. Surrounding the infant with toys and other stimulating items to encourage motor

movement

3. Swaddling the infant

4. Putting the infant to bed each night at 8 p.m., even if the infant protests with crying

2

A mother who is bottlefeeding her newborn is discharged 48 hours postdelivery. When

should the nurse schedule the first office visit for the newborn with the pediatrician?

1. Within 5 days of discharge

2. Within 7 days of discharge

3. Within 2 weeks of discharge

4. Within 3 weeks of discharge

1

While interviewing the parents of a toddler-age client, the nurse notes that the mother is

pregnant. At the end of the visit, the nurse decides to give a new pamphlet to the parents

about car seat usage for newborns. Which is the purpose of this action by the nurse?

1. Secondary preventative health maintenance

2. Developmental health screening

3. Tertiary preventative health maintenance

4. Primary preventative health maintenance

4

A nurse assesses the height and weight measurements on an infant and documents these

measurements at the 75th percentile. The nurse notes that the measurements 2 months ago

were at the 25th percentile. Which interpretation of these data by the nurse is accurate?

1. The infant is not gaining enough weight.

2. The infant has gained a significant amount of weight.

3. These measurements most likely are inaccurate.

4. The previous measurements were most likely inaccurate.

2

The mother of a 2-year-old child becomes very anxious when the child has a temper

tantrum in the medical office. Which response by the nurse to the mother is appropriate?

1. "Let's ignore this behavior. It will stop sooner."

2. "What do you usually do or say during a temper tantrum?"

3. "This is definitely a temper tantrum. I know exactly what you are feeling right now."

4. "Pick up and cuddle your child now, please."

2

Parents are in the pediatric clinic with their infant for a 1-month checkup. Which

assessment question regarding immunizations should the nurse ask the infant's parents?

1. "Did your baby receive the influenza vaccine prior to hospital discharge?"

2."Did your baby receive the hepatitis B vaccine prior to hospital discharge?"

3. "Did your baby receive the rubella vaccine prior to hospital discharge?"

4. "Did your baby receive the rotavirus vaccine prior to hospital discharge?"

2

A nurse is assessing an 11-month-old infant, and notes that the infant's height and weight

are at the 5th percentile on the growth chart; the infant was previously plotted at the 25th

percentile. Psychosocial history reveals that the parents are separated and are planning to

divorce. Which is the priority when planning this infant's care?

1. Parental anxiety

2. Risk for failure to thrive

3. Excessive nutritional intake

4. Risk for injury

2

Which observation in a health supervision visit leads the nurse to have concerns about the

infant's mental health?

1. A 1-month-old is swaddled by the parent because of crying after an immunization.

2. A 7-month-old infant grabs her mother and cries when the nurse attempts touch.

3. A 9-month-old avoids eye contact with parents and the nurse.

4. A 10-month-old reportedly sleeps about 12 hours total per night.

3

The nurse is assessing a small-for-gestational-age newborn who had an older sibling who

died of sudden infant death syndrome (SIDS). Which should the nurse include in the

newborns plan of care based on these data?

1. Encourage the parents to sleep with the newborn for close observation.

2. Encourage the parents to place the newborn on the abdomen to sleep.

3. Encourage the parents to place the newborn in a crib with a tight-fitting, firm mattress.

4. Encourage the parents to place the newborn in a crib with a soft mattress with extra

blankets.

3

Which nursing actions are appropriate for the 2-month-old infant during a scheduled health

maintenance visit? Select all that apply.

1. Reviewing infant fluid needs with the parents

2. Reinforcing the importance of heating bottles with water versus the microwave

3. Demonstrating proper gum care to the parents

4. Educating the parents to begin introducing solid foods, such as rice cereal

5. Recommending that juice be introduced in a sippy cup

1, 2, 3

Which topics are appropriate for the nurse to include when teaching preventive disease

strategies during infancy? Select all that apply.

1. Metabolic screenings

2. Hearing screenings

3. Risks of environmental smoke exposure

4. Stranger danger strategies

5. Bike safety

1, 2, 3

Which actions are appropriate when the nurse is performing general observations during the

assessment process for an infant? Select all that apply.

1. Asking the family how they are adjusting to having the infant in the home

2. Monitoring the parents for clinical manifestations associated with fatigue

3. Assessing for behaviors that indicate appropriate bonding

4. Placing the infant on the scale for a weight and length assessment

5. Auscultating heart and lung sounds while the infant is asleep

1, 2, 3

What is the purpose of making general observations during the assessment process for an

infant during a scheduled health maintenance visit? Select all that apply.

1. To invite discussion with the parents

2. To validate positive parenting efforts

3. To promote a partnership between healthcare providers and parents

4. To decrease the risk of communicable diseases

5. To meet standards required for The Joint Commission accreditation

1, 2, 3

The nurse is preparing for a health maintenance visit for a 9-month-old infant. Which

teaching topics are appropriate for the nurse to include during the scheduled visit? Select all that

apply.

1. Using iron-fortified formula

2. Encouraging self-feeding of finger foods

3. Increasing the number of daily milk feedings

4. Encouraging cups for all feedings

5. Introducing burping techniques

1, 2

The nurse is educating the parents of a 2-month-old infant when to contact the healthcare

provider. Which statements by the parents indicate the need for further instruction? Select all that

apply.

1. "We will contact the doctor if our baby does not have a bowel movement each day."

2. "We will contact the doctor if our baby is vomiting."

3. "We will contact the doctor if our baby has a temperature greater than 99°F."

4. "We will contact the doctor if our baby does finish each bottle."

5. "We will contact the doctor if our baby develops a skin rash."

1, 3, 4

Which instruction from the nurse is appropriate when conducting teaching to new parents

regarding infant care and feeding?

1. Delay supplemental foods until the infant is 4 to 6 months old.

2. Begin diluted fruit juice at 2 months of age but wait 3 to 5 days before trying a new

food.

3. Add rice cereal to the nighttime feeding if the infant is having difficulty sleeping after 2

months of age.

4. Delay supplemental foods until the infant reaches 15 pounds or greater.

1

A nurse is teaching an African American mother of a 3-month-old infant, born in the late

fall, who is being exclusively breastfed. Which is the priority nutrient for the nurse to

include in the teaching session?

1. Iron

2. Vitamin D

3. Calcium

4. Fluoride

2

Which statement should the nurse include when teaching parents of an infant about normal

growth and development regarding weight gain?

1. "Your baby's weight should triple by 9 months of age."

2. "Your baby's weight should double by 5 months of age."

3. "Your baby's weight should triple by 6 months of age."

4. "Your baby's weight should double by 1 year of age."

2

The nurse is teaching the parents of a 4-month-old infant about good feeding habits. Which

is the rationale for not letting the baby go to sleep with the bottle?

1. To decrease the risk for aspiration

2. To decrease the risk for dental caries

3. To decrease the risk for malocclusion problems

4. To decrease the risk for sleeping disorders

2

A vegetarian adolescent is placed on iron supplementation secondary to a diagnosis of iron-

deficiency anemia. Which will the nurse encourage the adolescent to drink when taking the

daily iron supplement?

1. Orange juice

2. Black or green tea

3. Milk

4. Tomato juice

1

The nurse is presenting a program on healthy eating habits to the parents of children

attending the clinic. Which parental comment indicates the need for more information about

safe food preparation?

1. 2. "We always wash our hands well before any food preparation."

"We use separate utensils for preparing raw meat and for preparing fruits, vegetables,

and other foods."

3. "We take the meat out of the freezer and then allow it to thaw on the counter for 2 to 3

hours before cooking it thoroughly."

4. "If our baby doesn't drink all the formula in his bottle, we throw the rest out."

3

During a 4-month-old infant's well-child checkup, the nurse discusses introduction of solid

foods into the infant's diet. Although the nurse recommends delaying the introduction of

many foods into the diet, which food(s) will the nurse discuss delaying because they

increase the risk for food allergy?

1. Honey

2. Carrots, beets, and spinach

3. Pork

4. Cow's milk, eggs, and peanuts

4

The parents of a 2.5-year-old boy are concerned about their child's finicky eating habits.

While counseling the parents, which statements by the nurse would be accurate? Select all

that apply.

1. "Nutritious foods should be made available at all times of the day so that the child is

able to 'graze' whenever he is hungry."

2. "The child is experiencing physiologic anorexia, which is normal for this age group."

3. "A general guideline for food quantity at a meal is one quarter cup of each food per year

of age."

4. "It is more appropriate to assess a toddler's nutritional demands over a 1-week period

rather than a 24-hour one."

5. "The toddler should drink 16 to 24 ounces of milk daily."

2, 4, 5

The mother of a 6-week-old male infant tells the nurse that her baby has had colic for several

days, crying for up to 3 hours and drawing his legs up on his abdomen. The mother says she

is at "wits end" and wonders what she can do. The nurse learns that the infant is being

formula-fed and gaining weight satisfactorily. Which recommendations will the nurse make

based on the current data? Select all that apply.

1. Breastfeeding the infant

2. Switching to a bottle that has a collapsible bag inside

3. Putting the infant in a baby swing after feeding

4. Burping the baby more frequently

5. Giving the baby a suppository once each morning

2, 3, 4

An adolescent is admitted to the eating disorders unit with a 2-year history of anorexia

nervosa. Assessment data indicate that the adolescent has recently sustained additional

weight loss and electrolyte imbalances. Which is the priority when planning care for this

client?

1. Individual counseling

2. Family therapy

3. Regulation of antidepressant drugs

4. Nutritional support

4

A 2-month-old infant is admitted to the hospital with a diagnosis of "failure to thrive"

(FTT). Which possible causes for FTT will the nurse include in the infant's plan of care?

Select all that apply.

1. Overdilution of formula concentrate

2. Parental neglect

3. Rumination

4. Malabsorption syndromes

5. Pica

1, 2, 3, 4

A vegetarian adolescent is prescribed iron supplementation secondary to a diagnosis of iron-

deficiency anemia. Which food will the nurse encourage the adolescent to increase intake of

based on the current diagnosis?

1. Black tea

2. Eggs

3. Fresh fruit

4. Milk

2

The nurse is providing nutritional guidance to the parents of a school-age child. Which

comment by a parent would prompt the nurse to provide further education?

1. "We use separate utensils for food preparation and for eating."

2. "We allow our child to drink only pasteurized apple cider."

3. "We let our child sample cookie dough while making cookies."

4. "We always wash our hands well before any food preparation."

3

The nurse collects the weight and height measurements of a child, and calculates the child's

body mass index (BMI) to be in the 10th percentile. Previous assessments indicate that the

child's BMI was also in the 10th percentile. Which should the nurse include in the

discussion of this child's BMI with the parents?

1. Undernutrition

2. Inconsistent growth

3. Consistent growth

4. Overnutrition

3

Which concepts will the nurse use when conducting client teaching to a family regarding

Dietary Reference Intake (DRI) in the United States (U.S.)? Select all that apply.

1. Estimated Average Requirement (EAR)

2. Recommended Daily Allowance (RDA)

3. Adequate Intake (AI)

4. Upper Intake (UI)

5. Reference Nutrient Intake (RNI)

1, 2, 3, 4

The nurse is teaching the parents of a 6-month-old infant about the introduction of solid

foods. Which foods will the nurse include in the teaching session? Select all that apply.

1. Rice cereal

2. Fruits

3. Vegetables

4. Meats

5. Nut products

1, 2, 3

Which parental statements during the nutrition assessment for a toddler would cause the

nurse concern? Select all that apply.

1. "My child drinks 20 ounces of fat-free milk each day."

2. "My child drinks 6 ounces of 100% fruit juice each day."

3. "We eat at fast-food restaurants several times each week."

4. "We only give our child pasteurized fruit juices."

5. "My child likes to drink water with snacks."

1, 3

Which assessment findings would cause the nurse to believe that a school-age child is not

receiving enough vitamin C in the diet? Select all that apply.

1. Dermatitis

2. Bleeding gums

3. Scaling of the skin

4. Muscle weakness

5. Headaches

1, 2

The nurse is providing care to a toddler-age client who is diagnosed with celiac disease.

Which interventions will the nurse include in the toddler's plan of care? Select all that apply.

1. Temporary removal of wheat products from the diet

2. Permanent removal of oat products from the diet

3. Fat-soluble vitamin supplements

4. Avoidance of processed foods

5. Obtaining a dietary prescription

3, 4, 5

The nurse is providing care for an infant who is diagnosed with colic. Which interventions

will the nurse include in the infant's plan of care? Select all that apply.

1. Using a front-carrying sling

2. Recommending swaddling

3. Suggesting frequent burping

4. Recording all feedings in an intake journal

5. Removing gluten from the diet

1, 2, 3

Which adolescent behavior, reported by a parent, would cause the nurse to suspect possible

substance abuse?

1. Becoming very involved with friends and in activities related to basketball

2. Becoming moody, crying, and weeping one minute and then cheerful and excited the next

3. Receiving numerous detentions for sleeping in class

4. Wearing baggy, oversized clothing and dyeing hair black

3

During a well-child examination, the parents of a 4-year-old client inform the nurse that

they are thinking of buying a television for their child's bedroom and ask for advice as to

whether this is appropriate. Which response by the nurse is most appropriate?

1. "It is okay for children to have a television in their room as long as you limit the amount

of time they watch it to less than 2 hours per day."

2. "Research has shown that watching educational television shows improves a child's

performance in school."

3. "Don't buy a television for your child's room; he is much too young for that."

4. "Research has shown that children with a television in their bedroom spend significantly

less time playing outside than other children."

4

A mother of two children, an 8-year-old and a 10-year-old, tells you that her husband has

recently been deployed to the Middle East. The mother is concerned about the children's

constant interest in watching TV news coverage of activities in the Middle East. Which

suggestion by the nurse to the mother is most appropriate?

1. "Spend time with your children, and take cues from them about how much they want to

discuss."

2. "Allow the children to watch as much television as they want. This is how they are

coping with their father's absence."

3. "The less that you discuss this, the quicker the children will adjust to their father's

absence. Try to keep them busy and use distractions to keep their mind off of it."

4. "It will just take some time to adjust to their father's absence and then everything will

return to normal."

1

A 7-year-old child is seen in the pediatric clinic 3 times in the last 2 months for complaints

of abdominal pain. On each occasion, the physical examination and all ordered laboratory

work have been normal. Which is the priority nursing assessment at this time?

1. The child's normal eating habits

2. Recent viral illnesses or other infectious symptoms

3. Review of the child's immunization history

4. Changes in school or home life

4

The nurse is providing care to homeless adolescents at an outreach clinic. Which concept is

important for the nurse to consider when providing care to this population?

1. Teens who are homeless will get a job and somewhere to live.

2. Teens who are homeless will seek help when needed.

3. Teens who are homeless will not be fearful of authority figures.

4. Teens who are homeless are most likely to have unprotected sex.

4

A parent is concerned about her 8-year-old child's recent behavior and calls the nurse for

advice. According to the parent, her child is constantly crying, is not sleeping well, has

withdrawn from activities, and does not want to attend school. Which should the nurse

explore in more detail with the parent?

1. Bullying

2. Sexual abuse

3. Lead poisoning

4. Drug abuse

1

A high school student calls to ask the nurse for advice on how to care for a new navel

piercing. Which response by the nurse is appropriate?

1. "Avoid contact with another person's bodily fluids until the area is well healed."

2. "Do not move or turn the jewelry for the first 3 days."

3. "Apply lotion to the area, rubbing gently, to prevent skin from becoming dry and

irritated."

4. "Apply warm soaks to the area for the first 2 days to minimize swelling."

1

The school nurse is planning a smoking prevention program for middle school students.

Which is most likely to be effective in preventing this population from smoking?

1. A demonstration of the pathophysiology of the effects of smoking tobacco on the body

given by the school's biology teacher

2. A talk on the importance of not smoking given by a local high school basketball star

3. Colorful posters with catchy slogans displayed throughout the school

4. A pledge campaign during which students sign contracts saying that they will not use

tobacco products

2

Which is the priority nursing action when working with a parent who is suspected of

Munchausen syndrome by proxy?

1. Try to keep the parent separated from the child as much as possible.

2. Explain to the child that the parent is causing the illness and that the healthcare team

will prevent the child from being harmed.

3. Carefully document parent-child interactions.

4. Confront the parent with concerns of possible abuse.

3

An infant presents to the emergency department (ED) with physical injuries. The nurse is

taking the child's history. Which parental statement would cause the nurse to be suspicious of

abuse?

1. "I was walking up the steps and slipped on the ice and fell while carrying my baby."

2. "The baby's 18-month-old brother was trying to pull the baby out of the crib and

dropped the baby on the floor."

3. "I placed the baby in the infant swing. His 6-year-old brother was running through the

house and tripped over the swing, causing it to fall."

4. "I did not realize that my baby was able to roll over yet, and I was just gone a minute to

check on dinner when the baby rolled off of the couch and onto our tile floor."

2

While taking the history of a 10-year-old child, the parents admit to owning firearms.

Which should the nurse suggest to enhance the child's safety based on this information?

1. Keeping all the guns put away and out of the child's reach

2. Taking the child to a shooting range for lessons on how to use a gun properly

3. Storing the guns and ammunition in the same place

4. Using a gun lock on all firearms in the house

4

The nurse is providing care to a 3-year-old client whose mother states, "I am not sure that I

have enough money to buy both food for the rest of the month and the antibiotic for my

child's ear infection." Which nursing intervention would be beneficial for the child and this

family?

1. Talking with the mother about keeping the child's ear clean by using a Q-tip

2. Putting the mother in contact with a local agency that provides food on a regular basis to

needy families and helps them access other resources in the community

3. Providing the mother with samples of food and food stamps for the child

4. Giving the mother free samples of an antibiotic

2

The mother of an infant tells the nurse that her maternity leave is almost over and she will

be returning to work soon. The mother states that she will need to place her infant in a day

care facility, and she asks the nurse how to know which day care facility is best. Which

topics will the nurse include in the response to the mother? Select all that apply.

1. A day care facility that is close to her work in the event of an emergency

2. A day care facility that requires all staff have criminal background checks

3. A day care facility that is attractive in appearance, with bright colors and interesting

visual stimulation

4. A day care facility that provides regular training of the staff and administration

5. A day care facility that has policies regarding child health and emergencies, such as

immunization requirements and emergency medical forms

2, 4, 5

The pediatric public health nurse visits a facility for the homeless. Which types of medical

issues will the nurse assess these children for based on the current data? Select all that

apply.

1. Dental caries

2. Infections secondary to tattoos

3. Lack of immunizations

4. Nutritional deficits

5. Munchausen syndrome by proxy

1, 3, 4

A child is brought to the emergency department in a coma. The mother thinks the child may

have ingested a poison. Which will the nurse assess based on this information? Select all

that apply.

1. For oral burns

2. The child's breath

3. The child's vomitus

4. Hair samples

5. Blood and urine toxicology screens

1, 2, 3, 5

A child is admitted to the hospital with a diagnosis of lead poisoning. Which should be

included in the home assessment to determine the probable source of the lead poisoning?

1. The home's foundation for a possible radon leak

2. The home's water pipes

3. The dirt surrounding the house

4. The presence of imported toys or antique baby furniture

5. Gas stored in cans in the garage.

2, 3, 4

A child is admitted to the hospital unit for physical injuries. The mother's boyfriend is

suspected of child abuse. Which is the primary role of the nurse in addition to reporting the

information to the proper authorities?

1. Gathering information about how the injuries occurred.

2. Collecting evidence against the suspected abuser.

3. Encouraging the child to talk about his experience.

4. Protecting the child from further injury.

4

The school nurse recognizes that many adolescents who are currently pregnant are hiding

their pregnancies from adults, both at school and at home. Which should the nurse educate

the adolescents about based on the current data?

1. Safe haven laws

2. Birth control available to all teenagers

3. Domestic abuse protection

4. The father's financial responsibility for the infant

1

A child is admitted to the emergency department (ED) for scald burns to the buttocks and thighs. According to the mother, she was preparing the child's bath and before she could

test the water, the child fell in and was scalded. Which would cause the nurse to suspect

abuse?

1. The burns are uneven, with some burns deeper than others.

2. The child's hands and feet are free of burns.

3. In addition to the main burn site, there are splash burns surrounding the area.

4. The mother was home alone with the child.

2

Which characteristics of abusers should the nurse include in the teaching session for

elementary school teachers regarding child abuse? Select all that apply.

1. Physical illness

2. Alcoholism

3. Many friends and families nearby

4. Unrealistic expectations for their child

5. The abuser has no relationship to the child.

2, 4

A recently divorced mother who must return to work is concerned about the effects of

placing her child in day care full-time. In counseling the mother, the nurse knows that

which factor is most influential in determining whether day care has a positive or negative

effect on the child?

1. The amount of time that the children spend playing outside

2. The closeness of the parent-child relationship

3. The ratio of day care workers to children

4. The cleanliness of the day care facility

2

Which clinical manifestations should the nurse anticipate when providing care to a pediatric

client who huffing glue? Select all that apply.

1. Impaired coordination

2. Elevated liver enzymes

3. Delirium

4. Dementia

5. Giddiness

1, 2, 3

Which nursing interventions should the nurse implement for a school-age child who is the

victim of physical abuse by a parent? Select all that apply.

1. Referring members of the family for appropriate counseling

2. Protecting the child from further injury

3. Allowing the child to wear clothing during the examination process

4. Discouraging parental participation in the plan of care

5. Documenting the child's response to parental interaction

1, 2, 3, 5

The nurse is providing care to a child who is admitted to the hospital due to environmental

exposure to a toxic agent. Which questions should the nurse ask the child and the parent during

the assessment process?

1. "Do you work around harmful substances that could have been brought to the home

environment?"

2. "What year was your home built?"

3. "Does your child have a hobby that includes working with glue?"

4. "Does your home have a smoke detector?"

5. "Does your home have a carbon monoxide detector?"

1, 2, 3, 5

The nurse is providing care to a pediatric client who is homeless. Which nursing actions will

decrease the risk for the child developing an infectious disease? Select all that apply.

1. Teaching hygienic methods

2. Arranging for medications, as needed

3. Evaluating the family for food security

4. Performing a nutritional assessment

5. Teaching oral hygiene

1, 2

The nurse is assessing a child and suspects the child's mother is abusing an opiate. Which

clinical manifestations exhibited by the child's mother lead the nurse to this conclusion?

1. Constricted pupils

2. Mood swings

3. Impaired memory

4. Tremors

5. Psychosis

1, 2, 3

The nurse develops and implements a health promotion plan for an adolescent client. What

should the nurse include in the evaluation of the plan?

1. Methods to expand and sustain successful approaches

2. Instruction to the client on what is considered healthy behavior

3. Advice for promoting health behaviors that will maintain a healthy lifestyle

4. Information on the client's attitude toward health

1

The nurse is assessing an adolescent client to determine relationships with others. Which

nursing action is appropriate?

1. Telling the parents that information from the assessment will be shared with them after

the examination

2. Providing separate time to communicate with both the adolescent and the parents

3. Avoiding asking the parents their opinions of the adolescent's friends

4. Telling the parents they are not allowed to come into the examination room

2

Which should the nurse keep in mind when providing care to an adolescent client during the

initial visit?

1. The importance of explaining procedures and introducing personnel to adolescents.

2. Adolescents usually are quiet and will offer no opinions.

3. The importance of attending to and discharging the adolescent quickly.

4. Adolescents are comfortable with their surroundings.

1

Which nursing action is appropriate when providing care to an adolescent client who is

accompanied to an appointment by a parent?

1. Instructing the parent to stay in the waiting room with the explanation that the

adolescent will provide a report after the examination

2. Telling the parent it is against policy for a parent to accompany the adolescent to the

examination room

3. Reassuring the parent that the nurse will discuss any parental concerns or questions after

the examination

4. Allowing the parent to come into the examination room with the adolescent

3

A school nurse is performing annual height and weight screening. The nurse notes that three

adolescent girls who are close friends each lost 15 pounds over the past year. Which is the

priority nursing action?

1. Obtaining a nutritional history for each of these adolescents

2. Referring these adolescents to the school psychologist

3. Calling the respective parents to discuss the eating patterns of each adolescent

4. Speaking with the adolescents in a group to discuss the problems associated with

anorexia nervosa

1

The following information is collected during the nursing assessment: the adolescent's

menses began when she was 12 years old; a current body mass index (BMI) of 27.5;

inconsistent school performance over the last several years. Which is the priority area of

teaching for this adolescent?

1. Menstrual cycle

2. Nutritional intake

3. School performance

4. Mental health status

2

The nurse is assessing an adolescent patient during a scheduled health maintenance visit.

The adolescent's mother is currently in the examination room with the patient. Which topic

should the nurse avoid until the mother has left the examination room?

1. School performance

2. Cigarette smoking

3. School friends

4. Seat belt use

2

The nurse is assessing an adolescent client during a scheduled health maintenance

appointment. Which issues should the nurse address when the parents are not present?

1. The adolescent's role in the family

2. Teen job responsibilities

3. Possible domestic violence

4. Activities done as a family

3

An obese adolescent who adamantly denies sexual activity has a positive pregnancy test.

Which response by the nurse is most appropriate?

1. "When was your last menstrual period (LMP)?"

2. "Tell me how you feel about your body image."

3. "Let's discuss some activities that you have done within the past few months that could

possibly lead to pregnancy."

4. "Why are you denying sexual intercourse?"

3

A mother reports that her adolescent daughter is always late. The mother states, "She was

born late and has been late every day of her life." Which response by the nurse is

appropriate?

1. "Setting specific alarms and then reinforce the value of being 'on-time' may be helpful

strategies to assist her to be more of an 'on-time' individual."

2. "Just let it go for now. Teachers and, in the future, employers will be the best people to

help her be 'on-time.

'"

3. "You need to establish specific time frames for your adolescent and be certain she

adheres to them."

4. "You have a major problem. There must be a lot of screaming in your home."

1

Which screening is appropriate for the school nurse to perform on all adolescent students?

1. Respiratory rate

2. Hepatitis B profile

3. Chest x-ray

4. Scoliosis

4

During a health maintenance visit an adolescent states, "I have no friends in my new school,

and I no longer want to go to college. I know I will be lonely there, too." Which is the

priority nursing action?

1. Stressing the importance of remaining in a close parent-child relationship during these

stressful times

2. Promoting healthy mental health outcomes

3. Acknowledging the fact that it takes several months to make new friends at a new

school due to adolescent exclusion behaviors

4. Helping the adolescent realize the value of postsecondary education

2

The nurse is planning to teach a group of adolescents about what can happen when having

unprotected sex. Which nursing action will allow effective communication with the group?

1. Offering personal opinions on the topic

2. Allowing for discussion among the participants

3. Lecturing on the topic for the allotted time without any discussion

4. Discussing sex education related to religious belief

2

Which nursing action is best when teaching adolescent health promotion and health

maintenance topics?

1. Contacting the parents and asking what issues they have with their adolescents

2. Having the adolescents identify a personal health goal

3. Asking the advice of the counselors at school

4. Telling the adolescents information that will be included in the lecture

2

Which screenings are appropriate for an adolescent client who admits to being sexually

active during a scheduled health maintenance visit? Select all that apply.

1. Herpes simplex virus

2. Gonorrhea

3. Chlamydia

4. Impetigo

5. Mononucleosis

1, 2, 3

Which nursing action maintains confidentiality when performing height and weight

measurements during a co-ed physical education class?

1. Having a student worker record the screening findings on the appropriate adolescent's

record

2. Having a volunteer weigh and measure the adolescents and verbally give the findings to

the nurse to calculate the body mass index and record

3. Providing a privacy screen and have the health aid record the findings directly on the

record. The nurse will then calculate body mass index

4. Using a buddy system with the students, having the students measure each other and

record the findings.

3

The nurse is planning care for an overweight adolescent. Which topic may also be

appropriate for the nurse to include in the adolescent's plan of care?

1. Substance abuse

2. School phobia

3. Spiritual distress

4. Negative self-esteem

4

The school nurse is assessing an adolescent who reports getting less than 6 hours of sleep at

night. Which consequences of inadequate sleep will the nurse include when responding to

the adolescent? Select all that apply.

1. Hyperactivity

2. Increased nocturnal emissions

3. Increased risk of automobile accidents when driving

4. Moodiness

5. An inability to perform well at school

3, 4, 5

Which teaching topics are appropriate for the nurse to include for an adolescent who admits

to the use of chewing tobacco? Select all that apply.

1. Lung cancer

2. Nicotine addiction

3. Mouth cancers

4. Emphysema

5. Mouth ulcers

2, 3, 5

Which question is appropriate for the nurse to include in the assessment for an adolescent

client related to developmental tasks?

1. "How are you adapting to the high school setting?"

2. "What type of relationship do you have with your friends?

3. "Have you thought about your future career goals?"

4. "Do you play any team sports?"

2

The nurse notes dental issues during the assessment of an adolescent client. Which topics

will the nurse explore further to determine the cause of the issues? Select all that apply.

1. Use of fluoridated water

2. Use of a mouth guard when playing physical sports

3. Anorexia nervosa

4. Bulimia nervosa

5. Use of daily vitamins

2, 3, 4, 5

The nurse is planning care for an adolescent whose parents have both recently been laid off

from their jobs. Which is the priority diagnosis for the adolescent and family?

1. Disturbed Sleep Pattern

2. Imbalanced Nutrition: Less Than Body Requirements

3. Knowledge Deficit

4. Risk for Injury

2

Which is the most appropriate assessment question for the nurse to ask when collecting

nutritional data from an adolescent client?

1. "How do you feel about your weight and the way you look?"

2. "What did you have to eat so far today?"

3. "What is your favorite grocery store?"

4. "Do you eat school lunches or pack a lunch from home each day?"

1

A nurse obtains a nutritional health history from a 10-year-old child. Which food increases

the risk for dental caries necessitating education regarding oral hygiene?

1. Sorbet and yogurt

2. Fluoridated water

3. Gummy bears and licorice

4. Peanuts and crackers

3

The mother of a 12-year-old child informs the nurse that the child's father died from sudden

cardiac death at 44 years old. Which laboratory tests does the nurse anticipate will be

prescribed by the healthcare provider?

1. Chest x-ray

2. Complete blood count (CBC) with differential

3. Electroencephalogram (EEG)

4. Lipid profile

4

Which will the nurse include in the assessment process for a school-age child who is

exhibiting poor school performance? Select all that apply.

1. Hearing screen

2. Muscle tone

3. Dental inspection

4. Vision screen

5. Throat culture

1, 2, 4

The school nurse is planning an education program for fourth-grade children regarding

prepubescent changes. What nursing action will make the educational program successful?

1. Discussing program content with the parents

2. Talking to all of the classes at one time

3. Planning the program for after school

4. Having the parents present during the program

1

During the psychosocial portion of the nursing assessment a school-age child states, "I

know I am not as good as them, so I just play by myself at recess every day." Which

conclusion by the nurse is accurate?

1. The child has a good sense of self-worth.

2. The child has a poor body image.

3. The child has decreased self-esteem.

4. The child has a self-determined concept.

3

An overweight school-age girl states, "I would like to be more active but my parents won't

let me try out for the soccer team." Which is an appropriate nursing action based on this

statement?

1. Referring the child to the school psychologist to discuss the weight issue

2. Telling the child to talk to the school nurse each day about the foods eaten

3. Encouraging the parents to investigate the option of ride sharing with a classmate's

family

4. Suggesting that the family plan an activity night and play board games together

3

Which is the priority nursing action when performing a physical assessment on a toddler?

1. Leaving intrusive procedures such as eye and ear examinations until the end

2. Explaining each part of the examination to the child before performing it

3. Performing the assessment from head to toe

4. Asking the mother to tell the child not to be afraid

1

`At which age will the nurse begin to calculate body mass index (BMI) as a part of the

nursing assessment process?

1. 12 months

2. 18 months

3. 2 years

4. 4 years

3

During a well-child visit with a 4-year-old girl the nurse notes that the parents speaks

harshly to the child and used negative remarks when speaking with the nurse. Which

statement by the nurse would be beneficial in this situation?

1. "Perhaps you should leave the room so that I can speak with your child privately."

2. "I am going to refer you for counseling since your interactions with your child seem so

negative."

3. Addressing the child, the nurse says, "Are you unhappy when mommy talks to you like

this?"

4. "Let's talk privately. We should discuss the way you speak with your child and possible

ways to be more positive."

4

Which action by the nurse is appropriate when teaching the parents of a 2-year-old child

during a scheduled health maintenance visit?

1. Encouraging the parents to allow the child to pour liquids using a pitcher

2. Being sure that all major foods group have been introduced to the child

3. Teaching the parents that it is appropriate to switch from whole to 2% milk

4. Educating the child about food groups

3

The visiting nurse is evaluating the home environments of several preschool-age children as they relate to child safety. The nurse visits the home of each child and gathers the following

data. Which activity noted during the visit places a child at the greatest risk for bodily

harm?

1. The parents are in a methadone program.

2. The parents consume alcohol on a daily basis.

3. The child watches television for 2 hours each day.

4. The child is permitted to swim in the family pool unsupervised.

4