Pediatrics Exam 1 practice

For an infant, what should the nurse report to the health care provider?

a. Respiratory rate of 70 breaths per min.

b. Temperature of 99.5 degrees Fahrenheit

c. Blood pressure reading of 75/55 mm Hg

d. Heart rate of 100 bpm.

Respiratory rate of 70 breaths per min

Which toy would the nurse determine is not age-appropriate for a 5-month old infant?

a. Rattles that can be held

b. Large snap beads

c. Brightly colored mobiles

d. Soft large blocks

Large snap beads

Which action would the nurse take when an infant begins to cough and gag after a nasogastric tube insertion?

a. Auscultating for breath sounds

b. Removing the tube, then reinserting it

C. observing the infant for circumoral cyanosis

d. Administering the tube feeding slowly

Removing the tube, then reinserting it

Which food would the nurse instruct the parent of a 7-month-old to wait until 1 year of age to introduce into the child’s diet? SATA

a. Cow’s milk

b. sweet potatoes

c. Shellfish

d. Honey

a and b

The nurse is observing a preschool classroom of children between the ages of 3 to 4 years of age. When planning actions to ensure that each child meets normal developmental goals, which child will require the most immediate intervention?

a. A 4-year-old girl who engages only in parallel play

b. A 3-year-old girl who has an imaginary friend

c. A 3-year-old who draws stick figures

d. A 4-year-old girl who engages only in parallel play.

D.

What should eb the expected weight of an infant of 6-months-of-age whose birth weight was 3,600 grams?

a. 7.2 kg

b. 5.5 kg

c. 11 kg

d. 5.6 kg

A. 7.2

In developing a plan of care for a hospitalized preschooler, a nurse recognizes that is most essential to consider which of the following?

a. the child may believe the hospitalization is a punishment

b. ways to provide visitation from peers

c. ways to promote privacy and independence

d. how to incorporate play activities with other children

A. The child may believe the hospitalization is a punishment

Which action by a nurse would be most helpful in preparing a 2-year-old child for immunization?

a. Give the child a choice of two injection sites.

b. offer to provide a toy afterward if the child does not cry

c. Have the parents discuss the procedure the night before.

d. Show a video of a child receiving an immunization.

A. Give the child a choice of two injection sites.

Which rationale would the nurse provide the parent of a toddler to encourage pretend play? SATA

A. To help develop fine muscle skills

B. To help the child learn to understand other points of view

C. To help the child become more creative

D. To help improve sleeping habits

A, B, C, D

Which behavior would the nurse determine is developmentally appropriate in a healthy 7-month-old infant? SATA

A. playing peek-a-boo

b. pulling up to a standing position

c. holding onto furniture when walking

d. sitting in a tripod position

e. turning completely over

A, d, e

At what month do infants turn from abdomen to back?

4 months

At what age do infants turn form back to abdomen?

6 months

Colic resolves by what age?

3 months

At what age should head lag be absent (disappear)?

3 months

At what age with the infant be able to sit with support?

6 months

At what age can the infant transfer an object from one hand to another?

8 months old

At what age, can the infant pulls to stand?

10 months old

A nurse is preparing to administer immunizations to a 2-month old infant. Which of the following immunizations should the nurse plan to administer? SATA.

a. Measles, mumps, and Rubella (MMR)

b. Varicella (VAR)

c. Influenza

d. Diptheria tetanus & acellular pertussis (DTap)

e. Hepatitis B (HepB)

f. Inactivated poliovirus (IPV)

D, e, f

The child weighs 40 lb. Calculate how many mL of IV fluids should be administered to the child in a 24 hour period.

1,400

A nurse is caring for a child who requires intravenous maintenance fluid. The child weighs 45 kg. Which is the child’s daily maintenance fluid and hourly requirement?

2,000 mL per day; 83 mL/hr

Which interpretation would the nurse make when a 6-month old infant is startled by a loud noise but does not turn in the direction of the sound?

As evidence of hearing loss

Which assessment would the nurse make when caring for a 4-year old child who stutters

Typical preschooler speech

In which direction would the nurse manipulate the earlobe when instilling ear drops into the left ear of a 2-year old child?

Down and back

Starting at what age, do you pull the ear up and back to intill ear drops?

3 years old

Which psychosocial change does a toddler exhibit?

Engages in temper tantrums

Which parental action would require the nurse to provide additional education related to the toddler-age client’s achievements of autonomy versus shame and doubt?

Yelling at the child for having a bathroom-related accident in the waiting room

The parent of a 4-year old child tells a nurse that the child believes there are monsters hiding in the closet at bedtime. Which one of the following statements should the nurse make?

“Keep a night light in your child’s room

A nurse is caring for an 8-year old infant who screams when the parent leaves the room. The parent begins to cry and says, “ I don’t understand why my child is so upset. I’ve never seen my child act this way around others before”. Which of the following statements should the nurse make?

“ This is normal, expected reaction for a child of this age”

A nurse is assessing a 15-month old toddler. Which of the following findings should the nurse report to the provider as a developmental delay?

The toddler cannot stand upright without support

Which strategy would be the most effective for the nurse to teach a preschooler about medical interventions?

By initiating therapeutic play

A nurse is speaking with the mother of a 6-year old child. Which of the following statements by the mother should concern the nurse?

“The teacher says my child has to squint to see the board”

Which child would the nurse plan to start initial tests for lead screening at a scheduled health maintenance visit?

12-month old toddler

Initial lead screening should occur between what ages?

1-2 years old

While playing outside, 2-year old child says “bad, bad tree” after falling from a tree. Which characteristic of preoperational thought would this behavior indicate?

Animism

Which behaviors are expected to be observed in the 18-month old child? SATA

A. stacks four cubes

B. Climbs stairs with assistance

C. Uses names of familiar objects

D. Copies circle

E. Pedals tricycle

A, B, C

Which data collected for a 24-month old client indicates the need for further evaluation for delayed language? SATA

A. The child does not point to named body parts

B. The child uses 2-word sentences

C. The child cries and points at an object he wants.

D. The child states “ Me do it” when asked to stack blocks.

A and C

Which safety education would the nurse provide to the parent of a 3-month infant?

Test the temperature of water before bathing

Which behavior of a 3-year old child indicates delayed development? SATA

A. The child is unable to climb the stairs

B. The child is unable to count when asked.

C. The child is unable to name the colors.

D. The child is unable to feed him or herself

E. The child is unable to tie his or her shoes.

F. The child is unable to copy a circle

A,D,F

Which parental statement would the nurse recognize as indicating a need for additional education related to expected gross motor development of a 4-year old?

“ I shouldn’t be concerned that my child is unable to ride a tricycle”

For which client would the nurse measure head circumference during the growth and development assessment? SATA

A. A 2-month old infant

B. A 4-year old preschooler

C. A 3-year old preschooler

D. An 18-month old toddler

A, C, D

When preparing an intramuscular injection for a 1-week old infant, which needle would the most appropriate for the nurse to select?

25 G, 5/8 inch

Which behavior would the nurse expect in an 11-year old girl who is experiencing normal growth and development? SATA

A. Refuses to attend school

B. Has sleepovers with friends

C. Refuses to play with others

D. Begins to have crushes on boys in class

E. Texts and talks to friends on the phone

B, D, E

Which questions would the nurse ask the parents of a child who is suspected of being bullied at school? SATA

A. “Has your child committed any criminal acts?”

B. “Has your child tried to harm him- or herself?”

C. “How is your child’s academic performance?”

D. “Does the child exhibit any anxiety?”

B,C,D

A nurse is caring for a 6-month infant. Which of the following findings should indicate to the nurse that the client is experiencing pain following a procedure?

Increased crying episodes

A nurse is caring for a 6-month old infant. Which of the following findings should indicate to the nurse that the client is experiencing pain following a procedure?

Increased crying episodes

A nurse is caring for a toddler. Which of the following statements should the nurse use when preparing to obtain the child’s vital signs?

“ I am going to listen to your heart”

A nurse is administering vaccines at a county health immunization clinic for an 11-year old child. The child is up-to-date with immunizations prior to this visit. Which of the following vaccines should the nurse plan to administer? SATA

A. diptheria, tetanus, & acellular pertussis (Dtap)

B. Tetanus, diphtheria & acellular pertussis (Tdap)

C. Inactivated polio (IPV)

D. Inactivated polio (IPV)

E. meningococcal conjugate (MCV4)

F. measles, mumps, and rubella (MMR)

B, D

A nurse is obtaining the length and weight of a 6-month old infant. Which of the following actions should the nurse take? SATA

A. Balance the scale to 0 prior to use.

B. Weigh the infant in measure the infant

C. Use a stadiometer to measure the infant.

D. Measure the infant from crown of the head to the heels of feet.

E. Place a disposable covering on the scale.

A, D, E

Which assessment findings would cause a nurse to withhold scheduled immunizations in a child? SATA

A. Family history of egg allergy

B. Cold symptoms with temperature of 99.5 degrees Fahrenheit

C. Currently taking corticosteroids

D. Blood transfusion received 2 weeks ago

C, D

The nurse is ready to examine a 9-month old infant. The infant’s mother is holding the infant on her lap. Which of the following actions should the nurse perform first?

Auscultate heart and lung sounds

A nurse performs a comprehensive assessment on a 12-month old infant at a scheduled wellness visit at the clinic.

nurse’s notes:

An adolescent mother of a 12-month-old male infant arrives for a scheduled wellness visit. The infant was born at 37 weeks gestation via vaginal birth without any complications. Weight at birth 3.6kg (8 lb.), which is 50th percentile ranking for weight. The infant was breastfed for the first 6 months, but then the parent had to return to work. The parent states “ it seems like my infant barely sleeps, my infant has been so fussy and irritable ever since I stopped breastfeeding”. I have had to add water to the formula to have enough to feed my infant”. The infant’s current weight is 11.13 kg (24.5 lb) placing the infant at 90the percentile for weight. Last recorded weight was at the 6-month visit, weight was 7.27kg (16 lb), which is the 25th percentile. The parent states “ my infant is able to sit on their own but has not crawled or tried to walk yet even when I hold their hands. My infant used to be so happy babbling/cooing until my partner left”. The infant responds to their name, is able to hold a block but unable to pass it to the other hand, sucks on the fingers frequently.

Which of the following assessment findings would be considered a concern? SATA

A. Unable to crawl at 12 months of age

B. Babbling at 6 months

C. Able to sit on their own at 6 months

D. weight doubled at 6 months

E. Unable to move objects form one had to the other at 12 months of age

F. Not tried to walk at 12 months of age.

A, E, F

If the school-age child is not given the opportunity to engage in tasks and activities that he can carry through to completion, he is likely to develop feelings of?

Inferiority

The nurse must restart a peripheral intravenous (IV) infusion on a child. Which would the nurse do to promote the child’s sense of security?

Take the child to the treatment room for the procedure

Which anticipatory guidance topic would the nurse include during a scheduled health maintenance visit of a 12-year old client?

Changes that occur with puberty

A school nurse is performing annual heigh and weight screening. The nurse notes that three females who are close friends each lost 15 pounds over the past year. What is the priority nursing action in this situation?

Obtain a nutritional history for each of these adolescents.

Which strategy needs to be employed while interviewing the adolescent as a part of the health screening?

Explain the limits of confidentiality

Parents of a 13-year old adolescent girl expressed concern because she spends “ quite a bit of time in her room alone in front of the mirror”. The girl’s heigh and weight are in the 50th percentile. In the exam room, the girl is quiet but does answer questions appropriately. What advice should the nurse provide to the parents?

“ This behavior is normal. Your daughter is adjusting to the physical changes she is experiencing”

Which thoughts in an adolescent correspond to a sense of “invulnerability”?

“Even if I drive my car at 120 miles per hour, nothing will happen to me”

Vaccines to be given at 2 months? List them.

Hep B, Dtap, Rotavirus, Hib, Inactivated poliovirus, Pneumococcal (B Dr. Hip)

When should lead poisoning be completed?

at 12 months and 24 months

What stage created by Freud mentions bowel/bladder control where toilet training is a central task?

Anal stage

Which of Erickson’s stages mentions this child gaining independence and self control, negativism, egocentrism, parallel play?

Autonomy vs. Shame & Doubt

Which of Piaget’s theory describes early symbolic thought, dramatic play, animism, and domestic mimicry (imitating chores)?

Preoperational Stage

At what age can a child say 4-6 words and follow one-step directions?

15 months

At what age can a child use 200-300 words and create 2-3 word phrases/sentences?

24 months

What type of screening are vision and hearing tests?

Sensory

Infants develop stranger anxiety and separation anxiety at what age?

8-9 months

Illness that is the most common cause of severe gastroenteritis in infants and young children?

Rotavirus

Children can feed themselves at what age?

18 months

When using an otoscope to visualize the tympanic membrane of a 2-year old, what is the correct direction to pull the pinna?

Down and back

It is normal for toddlers to have this kind of spinal curvature?

Lumbar lordosis

At this age, a child may have an imaginary friend?

3-4 years

A heart rate range of 80-130 is normal for this age group?

infant to 2 years

This is a common childhood defense mechanism?

Regression

The term used to predict upcoming developmental tasks or needs of a child?

Anticipatory guidance

In children over age 2, the presence of this reflex can indicate neurologic disease?

Babinski reflex

Infants turn towards sounds at this age?

4 months

At this age, infants can sit without support?

6 months

Newborns lose what percentage range over the first week of life?

5-10%

In infants, how many cm does the head increase form birth to 1 year?

10 cm

Babinski disappears when?

12 months

Asymmetric tonic neck disappears when?

4 months

The moro reflex disappears when?

4 months

First food to start with when introducing infants to solid foods?

iron-fortified cereal

At what age, can this child walk up stairs with alternating feet?

30-36 months

Posterior fontanel closes at what month?

2 months

Anterior fontanel closes at what month?

18 months

Check for autism by what months?

9 months

At 1 year old checkup, what labs are done?

lead screening, CBC

At what age, can this child walk independantly?

12 months

What age group will you see Erickson’s Trust vs. Mistrust?

Infant

Piaget’s Sensorimotor stage is what age range?

birth to 2 years old

Freud’s oral stage is what age range?

birth to 1 year

Object permanence begins to develop at 4-7 months and should be solidified by ____?

8 months

At what age can infants recognize themselves in the mirror?

12 months

At what age do infants know they are separate from the parent or caregiver?

12 months

Gross motor skills are develop in a cephalocaudal fashion which means?

Head to toe

What pain scale can be used for 3 year olds?

FACES scale

Infants smile at what age?

2 months