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1.
Which nursing role is not directly involved when pro- 4. Researcher
viding family-centered approach to the pediatric population?
1. Advocacy
2. Case management
3. Patient education
4. Researcher
2.
A nurse is working with pediatric clients in a research 2. The 7-year-old
facility. The nurse recognizes that federal guidelines leukemia client electing to
are in place that delineate which pediatrics clients
receive a newly developed
must give assent for participation in research trials. medication, now being reBased upon the clients age, the nurse would seek
searched.
assent from which children? Select all that apply.
3. The 10-year-old starting
1. The precocious 4-year-old starting as a cystic fibro- in an investigative study
sis research-study participant.
for clients with precocious
2. The 7-year-old leukemia client electing to receive a puberty.
newly developed medication, now being researched. 4. The 13-year-old client
3. The 10-year-old starting in an investigative study for beginning participation in
clients with precocious puberty.
a research program for
4. The 13-year-old client beginning participation in a ADHD treatments.
research program for ADHD treatments.
3.
The nurse in a pediatric acute-care unit is assigned the 1. Diagnose an 8-year-old
following tasks. Which task is not appropriate for the with acute otitis media
registered to nurse complete?
and prescribe an antibiot1. Diagnose an 8-year-old with acute otitis media and ic.
prescribe an antibiotic.
2. Listen to the concerns of an adolescent about being
out of school for a lengthy surgical recovery.
3. Provide information to a mother of a newly diagnosed 4-year-old diabetic about local support-group
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options.
4. Diagnose a 6-year-old with Diversional Activity
Deficit related to placement in isolation.
4.
A 7-year-old child is admitted for acute appendicitis. 2. Clinical pathways
The parents are questioning the nurse about expectations during the childs recovery. Which information
tool would be most useful in answering a parents
questions about the timing of key events?
1. Healthy People 2020
2. Clinical pathways
3. Child mortality statistics
4. National clinical practice guidelines
5.
The nurse recognizes that the pediatric client is from a 2. Facilitate the family's
cultural background different from that of the hospital ability to comply with the
staff. Which goal is most appropriate for this client
care needed.
when planning nursing care?
1. Overlook or minimize the differences that exist.
2. Facilitate the family's ability to comply with the care
needed.
3. Avoid inadvertently offending the family by imposing the nurses perspective.
4. Encourage complementary beneficial cultural practices as primary therapies.
6.
The telephone triage nurse at a pediatric clinic knows 1. A 3-week-old infant
each call is important. Which call would require extra born at 35 weeks gestaattentiveness from the registered nurse because of an tion with gastroenteritis
increased risk of mortality?
1. A 3-week-old infant born at 35 weeks gestation with
gastroenteritis
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2. A term 2-week-old infant of American Indian descent with an upper respiratory infection
3. A post term 4-week-old infant non-Hispanic black
descent with moderate emesis after feeding
4. A 1-week-old infant born at 40 weeks gestation with
symptoms of colic
7.
Despite the availability of Childrens Health Insur3. To advocate for the child
ance Programs (CHIP), many eligible children are not by encouraging the family
enrolled. Which nursing intervention would be the
to investigate its CHIP elimost appropriate to help children become enrolled in gibility
CHIP?
1. Assessment of the details of the familys income and
expenditures
2. Case management to limit costly, unnecessary duplication of services
3. To advocate for the child by encouraging the family
to investigate its CHIP eligibility
4. To educate the family about the need for keeping
regular well-childvisit appointments
8.
A supervisor is reviewing the documentation of the 1. 2/2/05 1630 Catheternurses in the unit. Which client documentation is the ized using an 8 French
most accurate and contains all the required part for a catheter, 45 mL clear yelnarrative entry?
low urine obtained, speci1. 2/2/05 1630 Catheterized using an 8 French
men sent to lab, squirmed
catheter, 45 mL clear yellow urine obtained, specimen and cried softly during insent to lab, squirmed and cried softly during insertion sertion of catheter. Quiet
of catheter. Quiet in mothers arms following catheter in mothers arms following
removal. M. May RN
catheter removal. M. May
2. 1/9/05 2 pm NG tube placement confirmed and
RN
irrigated with 30 ml sterile water. Suction set at low,
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intermittent. Oxygen via nasal canal at 2 L/min. Nares
patent, pink, and nonirritated. K. Earnst RN
3. 4:00 Trach dressing removed with dime-size stain of
dry serous exudate. Site cleansed with normal saline.
Dried with sterile gauze. New sterile trach sponge
and trach ties applied. Respirations regular and even
throughout the procedure. F. Luck RN
4. Feb. 05 Port-A-Cath assessed with Huber needle.
Blood return present. Flushed with NaCl sol., IV gamma globins hung and infusing at 30cc/hr. Child smiling
and playful throughout the procedure. P. Potter, RN
9.
A 12-year-old pediatric client is in need of surgery.
2. Physician
Which member of the health care team is legally responsible for obtaining informed consent for an invasive procedure?
1. Nurse
2. Physician
3. Unit secretary
4. Social worker
10.
A child is being prepared for an invasive procedure. 4. A babysitter with written
The mother of the child has legal custody but is not proxy consent
present. After details of the procedure are explained,
who can provide legal consent on behalf of a minor
child for treatment?
1. The divorced parent without custody
2. A cohabitating unmarried boyfriend of the childs
mother
3. A grandparent who lives in the home with the child
4. A babysitter with written proxy consent
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11.
A 12-year-old child is admitted to the unit for a surgical 3. That of assent.
procedure. The child is accompanied by two parents
and a younger sibling. What is the level of involvement
in treatment decision making for this child?
1. That of an emancipated minor.
2. That of a mature minor.
3. That of assent.
4. None.
12.
Which nursing intervention is most appropriate when 3. Working toward the
providing education to the pediatric client and fami- goal of informed choices
ly?
with the family
1. Giving primary care for high-risk children who are
in hospital settings
2. Giving primary care for healthy children
3. Working toward the goal of informed choices with
the family
4. Obtaining a physician consultation for any technical
procedures at delivery
13.
What is the pediatric nurses best defense against an 2. Meeting the scope and
accusation of malpractice or negligence?
standards of practice for
1. Following the physicians written orders
pediatric nursing
2. Meeting the scope and standards of practice for
pediatric nursing
3. Being a nurse practitioner or clinical nurse specialist
4. Acting on the advice of the nurse manager
14.
Which legal or ethical offense would be committed
if a nurse tells family members the condition of a
newborn baby without first consulting the parents?
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1. A breach of privacy
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1. A breach of privacy
2. Negligence
3. Malpractice
4. A breach of ethics
15.
Pediatric nurses have foundational knowledge ob2. Anatomical and develtained in nursing school and add specific competen- opmental differences
cies related to the pediatric client. Which would be
considered an additional specific expected competency of the pediatric nurse?
1. Physical assessment
2. Anatomical and developmental differences
3. Nursing process
4. Management of healthcare conditions
16.
The nurse is planning care for an adolescent client
2. Asking the adolescent
who will be hospitalized for several weeks following what foods to include dura traumatic brain injury. Which interventions will en- ing meal time
hance family-centered care for this client and family? 3. Allowing the family time
Select all that apply.
to pray each day with the
1. Making all ADL decisions for the adolescent and
adolescent
family
4. Encouraging the ado2. Asking the adolescent what foods to include during lescents friends to visit
meal time
during visiting hours
3. Allowing the family time to pray each day with the
adolescent
4. Encouraging the adolescents friends to visit during
visiting hours
5. Leaving all questions for the healthcare provider
17.
A new pediatric hospital will open soon. While plan- 4. Conferring with the
ning nursing care, the hospital administration is con- family in deciding which
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sidering two models of providing health care: fami- healthcare option will be
ly-focused care and family-centered care. Which ac- chosen
tion best implements family-centered care?
1. Telling the family what must be done for the familys
health
2. Assuming the role of an expert professional to direct the health care
3. Intervening for the child and family as a unit
4. Conferring with the family in deciding which healthcare option will be chosen
18.
A school-age client tells you that Grandpa, Mommy, 2. Extended family
Daddy, and my brother live at my house. Which type
of family will the nurse identify in the medical record
based on this description?
1. Binuclear family
2. Extended family
3. Gay or lesbian family
4. Traditional nuclear family
19.
The nurse is performing an assessment of a childs bio- 4. Cohabitating informal
logic family history. Which situation would necessitate stepfamily
the nurses asking the mother for information should
use the term childs father instead of your husband?
1. Traditional nuclear family
2. Traditional extended family
3. Two-income nuclear family
4. Cohabitating informal stepfamily
20.
Several children arrived at the emergency depart1. The divorced one from
ment accompanied only by their fathers. Which father the binuclear family
may legally sign emergency medical consent for treat7 / 53
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ment?
1. The divorced one from the binuclear family
2. The stepfather from the blended or reconstituted
family
3. The divorced one when the single-parent mother
has custody
4. The nonbiologic one from the heterosexual cohabitating family
21.
The community-health nurse is assessing several fam- 3. The single-parent family
ilies for various strengths and needs in regard to
after-school and backup child-care arrangements.
Which family type will benefit the most from this assessment and subsequent interventions?
1. The binuclear family
2. The extended family
3. The single-parent family
4. The traditional nuclear family
22.
The nurse is working on parenting skills with a group 2. Authoritative one
of mothers. Which mother would need the fewest discipline-related suggestions?
1. Authoritarian one
2. Authoritative one
3. Indifferent one
4. Permissive one
23.
The nurse in the pediatric clinic observes a parental 3. Indifferent
lack of warmth and interest toward the child. Which
family style will the nurse most likely document in this
situation?
1. Authoritarian
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2. Authoritative
3. Indifferent
4. Permissive
24.
The nurse is working on parenting skills with a mother 3. Behavior modification
of three children. The nurse demonstrates a strategy that uses reward to increase positive behavior.
Which strategy will the nurse document in the medical
record based on this description?
1. Time out
2. Reasoning
3. Behavior modification
4. Experiencing consequences of misbehavior
25.
The nurse is assessing a family's effective coping
1. Family-stress theory
strategies and ineffective defensive strategies. Which
family-social-system theory is the nurse using in this
assessment of the family?
1. Family-stress theory
2. Family-development theory
3. Family-systems theory
4. Family life-cycle theory
26.
The nurse is assigned to a child in a spica cast for a 1. Compromised Family
fractured femur suffered in an automobile accident. Coping Related to the EfThe childs teenage brother was driving the car, which fects of Multiple Simultawas totaled. The nurse learns that the father lost his neous Stressors
job three weeks ago and the mother has just accepted
a temporary waitress job. Which nursing diagnosis will
the nurse use when planning care for this child and
family?
1. Compromised Family Coping Related to the Effects
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of Multiple Simultaneous Stressors
2. Impaired Social Interaction (Parent and Child) Related to the Lack of Family or Respite Support
3. Interrupted Family Processes Related to Child with
Significant Disability Requiring Alteration in Family
Functioning
4. Risk for Caregiver Role Strain Related to Child with a
Newly Acquired Disability and the Associated Financial
Burden
27.
A nurse is working with the family of a pediatric client. 1. Establish a trusting reWhen planning to obtain an accurate family assess- lationship with the family.
ment, which initial step is the most appropriate?
1. Establish a trusting relationship with the family.
2. Select the most relevant family-assessment tool.
3. Focus primarily upon the mother, while learning her
greatest concern.
4. Observe the family in the home setting, since this
step always proves indispensable.
28.
The camp nurse is assessing a group of children attending summer camp. The nurse will expect which
children to most likely have problems perceiving a
sense of belonging?
1. Children whose parents divorced recently
2. Children who gained a stepparent recently
3. Children recently placed into foster care
4. Children adopted as infants
29.
There are several tools that help with obtaining a cul- 2. Model for cultural comtural assessment of a client and his family. Which tool petence
would be appropriate to gather 12 major concepts of
10 / 53
3. Children recently placed
into foster care
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cultural assessment?
1. Sunrise enabler
2. Model for cultural competence
3. Transcultural assessment model
4. Health traditions model
30.
Cultures have many different childrearing practices. 3. Chinese
Which culture is known to value the male child more
than the female child, and often teaches children to
avoid displaying emotion?
1. Mexican
2. Amish
3. Chinese
4. Navajo
31.
The nurse is planning care for a school-age client and 2. Encouraging the parfamily who have expressed wanting to use comple- ents to share which
mentary and alternative modalities (CAM) in the treat- modalities they would like
ment plan. Which interventions can the nurse safely to implement
implement into the plan of care? Select all that apply. 3. Educating on the ben1. Substituting an herbal remedy for a prescribed
efits and risks for each
medication
modality
2. Encouraging the parents to share which modalities 4. Using essential oils to
they would like to implement
decrease nausea
3. Educating on the benefits and risks for each modality
4. Using essential oils to decrease nausea
5. Discouraging the use of faith-based therapies
32.
While in the pediatricians office for their childs
1. Soft toys that can be
12-month well-child exam, the parents ask the nurse manipulated
for advice on age-appropriate toys for their child.
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Based on the child's developmental level, which types 3. Jack-in-the-box toys
of toys would the nurse suggest? Select all that apply. 5. Push-and-pull toys
1. Soft toys that can be manipulated
2. Small toys that can pop apart and go back together
3. Jack-in-the-box toys
4. Toys with black and white patterns
5. Push-and-pull toys
33.
A mother of a school-age client who recently had
3. Regression
surgery for the removal of tonsils and adenoids complains that the child has begun sucking his thumb
again. Which coping mechanisms is the child using to
cope with the surgery and hospitalization?
1. Repression
2. Rationalization
3. Regression
4. Fantasy
34.
While being comforted in the emergency department, 4. Reassuring the child
a young school-age sibling of a pediatric trauma vic- that it is normal to get
tim blurts out to the nurse, Its all my fault! When
angry and say things that
we were fighting yesterday, I told him I wished he
we do not mean but that
was dead! Which response is most appropriate by the we have no control over
nurse?
whether or not an acci1. Asking the child if she would like to sit down and dent happens
drink some water
2. Sitting the child down in an empty room with markers and paper so that she can draw a picture
3. Calmly discussing the catheters, tubes, and equipment that the patient requires and explaining to the
sibling why the patient needs them
4. Reassuring the child that it is normal to get angry
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and say things that we do not mean but that we have
no control over whether or not an accident happens
35.
While assessing the development of a 9-month-old 1. Object permanence
infant, the nurse asks the mother if the child actively
looks for toys when they are placed out of sight. Which
developmental task is the nurse assessing this infant
for?
1. Object permanence
2. Centration
3. Transductive reasoning
4. Conservation
36.
The nurse is counseling the parents of a
1. Soft, fluid-filled ring that
6-1/2-month-old infant. Which age-appropriate toy is can be chilled in the remost appropriate for the nurse to suggest to these frigerator
parents?
1. Soft, fluid-filled ring that can be chilled in the refrigerator
2. Colorful rattle
3. Jack-in-the-box toy
4. Push-and-pull toy
37.
A nurse is assessing language development in all the 3. 9 and 12 months
infants presenting at the doctors office for well-child
visits. At which age range would the nurse expect a
child to verbalize the words dada and mama?
1. 3 and 5 months
2. 6 and 8 months
3. 9 and 12 months
4. 13 and 18 months
38.
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The parents of an 8-year-old state that their son seems 3. Industry versus inferiorvery interested in trying new activities. When the par- ity
ents ask for suggested activities for this age child,
the nurse recommends scouts as an activity that will
foster growth and development. In which stage of
Eriksons psychosocial stages of development is this
child?
1. Trust versus mistrust
2. Initiative versus guilt
3. Industry versus inferiority
4. Identity versus role confusion
39.
Two 3-year-olds are playing in a hospital playroom
3. Parallel play
together. One is working on a puzzle while the other is
stacking blocks. Which type of play are these children
exhibiting?
1. Cooperative play
2. Associative play
3. Parallel play
4. Solitary play
40.
The nurse, talking with the parents of a toddler who 2. Autonomy versus
is struggling with toilet training, reassures them that shame and doubt
their child is demonstrating a typical developmental stage. According to Erikson, which developmental
stage will the nurse document in the medical record
for this toddler?
1. Trust versus mistrust
2. Autonomy versus shame and doubt
3. Initiative versus guilt
4. Industry versus inferiority
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41.
A new parent group inquires about the stages through Choice 1. Sensorimotor
which their children will progress as they grow older. Choice 3. Preoperational
The nurse is discussing Piagets developmental stages. Choice 4. Concrete operaIn what order would the nurse expect the child to
tional
progress through Piagets stages of development? List Choice 2. Formal operathem in order.
tional
Choice 1. Sensorimotor
Choice 2. Formal operational
Choice 3. Preoperational
Choice 4. Concrete operational
42.
While trying to inform a young school-age client about 4. You must be so excitwhat will occur during an upcoming CT scan, the nurse ed to have a new pupnotices that the child is engaged in a collective mono- py! They are so much fun.
logue, talking about a new puppy. Which response by Now, let me tell you again
the nurse is the most appropriate in this situation?
about going downstairs in
1. Please stop talking about your puppy. I need to tell a wheelchair to a special
you about your CT scan.
room.
2. Ignore the child's responses and continue discussing the procedure.
3. I'll come back when you are ready to talk with me
more about your CT scan.
4. You must be so excited to have a new puppy! They
are so much fun. Now, let me tell you again about
going downstairs in a wheelchair to a special room.
43.
An adolescent client with cystic fibrosis suddenly be- 3. Set up a meeting with
comes non-compliant with the medication regime.
some older teens with cysWhich intervention by the nurse will most likely im- tic fibrosis who have been
prove compliance for this client?
managing their disease ef1. Give the child a computer-animated game that pre- fectively.
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sis.
2. Arrange for the physician to sit down and talk to the
child about the risks related to non-compliance with
medications.
3. Set up a meeting with some older teens with cystic
fibrosis who have been managing their disease effectively.
4. Discuss with the child's parents the privileges that
can be taken away, such as cell phone, if compliance
fails to improve.
44.
A neonatal nurse who encourages parents to hold
1. Attachment
their baby and provides opportunities for Kangaroo
Care most likely is demonstrating concern for which
aspect of the infants psychosocial development?
1. Attachment
2. Assimilation
3. Centration
4. Resilience
45.
Which statement by the nurse is most appropri3. It is all right to cry, I
ate prior to giving an intramuscular injection to a
know that this hurts. After
2-1/2-year-old child?
we are done you can go to
1. We will give you your shot when your mommy
the box and pick out your
comes back.
favorite sticker.
2. This is medicine that will make you better. First we
will hold your leg, then I will wipe it off with this magic
cloth that kills the germs on your leg right here, then
I will hold the needle like this and say one, two, three
. . . go and give you your shot. Are you ready?
3. It is all right to cry, I know that this hurts. After
we are done you can go to the box and pick out your
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favorite sticker.
4. This is a magic sword that will give you your medicine and make you all better.
46.
The parents of a 1-year-old infant are concerned that 2. Your infant displays
this baby seems more shy and scared of new situa- a predominantly negative
tions than their other child and ask the nurse if this is mood.
normal. The nurse knows that the infant is exhibiting
a characteristic of the slow-to-warm-up. Which statement to the parents is most appropriate by the nurse?
1. Your infant is showing a regularity in patterns of
eating.
2. Your infant displays a predominantly negative
mood.
3. Your infant initially reacts to new situations by withdrawing.
4. Your infant has intense reactions to the environment.
47.
The nurse educator is presenting a lecture about risks 3. Recent loss of employto developmental progression. Which items will the ment
educator include in the lecture? Select all that apply. 4. Terminal illness of a
1. Family support
family member
2. Access to the Internet
5. Hazards within the
3. Recent loss of employment
home environment
4. Terminal illness of a family member
5. Hazards within the home environment
48.
The nurse is performing an assessment of the ecolog- 1. Parental involvement in
ical systems of childhood. What will the nurse include school
when assessing mesosystems? Select all that apply. 4. Influences of the reli1. Parental involvement in school
gious community
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2. Local political influences
3. Libraries in the community
4. Influences of the religious community
5. Age of each family member
49.
The nurse is taking a health history from a family of a 3. Tell me about the con3-year-old child. Which statement by the nurse would cerns that brought you to
most likely establish rapport and elicit an accurate
the clinic today.
response from the family?
1. Does any member of your family have a history of
asthma, heart disease, or diabetes?
2. Hello, I would like to talk with you and get some
information on you and your child.
3. Tell me about the concerns that brought you to the
clinic today.
4. You will need to fill out these forms; make sure that
the information is as complete as possible.
50.
When assessing the cognitive development, which
2. Ask the child to repeat
technique would be appropriate to test the remote his address.
memory of a 5-year-old?
1. Say the name of an object and after 5 minutes ask
the child to tell you what you said the object was.
2. Ask the child to repeat his address.
3. Ask the child to say a poem and listen to the child's
speech articulation.
4. Have the child point to various parts of the body as
you name them.
51.
Place the nursing assessments of a toddler in the best Choice 4. Developmental
order.
assessment
Choice 1. Examination of eyes, ears, and throat
Choice 2. Auscultation of
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Choice 2. Auscultation of chest
Choice 3. Palpation of abdomen
Choice 4. Developmental assessment
chest
Choice 3. Palpation of abdomen
Choice 1. Examination of
eyes, ears, and throat
52.
While assessing a 10-month-old African American in- 3. Gastrointestinal
fant, the nurse notices that the sclerae have a yellowish tint. Which organ system should the nurse further
evaluate to determine an ongoing disease process?
1. Cardiac
2. Respiratory
3. Gastrointestinal
4. Genitourinary
53.
A nurse caring for a school-age client notices some 2. Urine output
swelling in the childs ankles. The nurse presses
against the ankle bone for five seconds, then releases the pressure and notices a markedly slow disappearance of the indentation. Which priority nursing
assessment is appropriate?
1. Skin integrity, especially in the lower extremities
2. Urine output
3. Level of consciousness
4. Range of motion and ankle mobility
54.
A new mother is worried about a soft spot on the
3. 12 to 18 months of age
top of her newborn infants head. The nurse informs
her that this is a normal physical finding called the
anterior fontanel. At what age will the nurse educate
the mother that the soft spot will close?
1. 2 to 3 months of age
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2. 6 to 9 months of age
3. 12 to 18 months of age
4. Approximately 2 years of age
55.
While inspecting a 5-year-old childs ears, the nurse 1. Temperature
notes that the right pinna protrudes outward and that
there is a mass behind the right ear. In light of these
findings, which vital-sign parameter would the nurse
assess on priority?
1. Temperature
2. Heart rate
3. Respirations
4. Blood pressure
56.
A 7-year-old child presents to the clinic with an exacerbation of asthma symptoms. On physical examination, the nurse would expect which assessment
findings? Select all that apply.
1. Wheezing
2. Increased tactile fremitus
3. Decreased vocal resonance
4. Decreased tactile fremitus
5. Bronchophony
57.
The nurse is caring for a newly-admitted infant diag- 3. Coarctation of the aorta
nosed with failure to thrive. The nurse begins to implement the healthcare provider prescribed orders by
taking blood pressures in all four extremities. Which
congenital cardiac defect does the nurse anticipate
based on the prescribed order?
1. Tetralogy of Fallot
2. Pulmonary atresia
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1. Wheezing
3. Decreased vocal resonance
4. Decreased tactile fremitus
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3. Coarctation of the aorta
4. Ventricular septal defect
58.
During an examination, a nurse asks a 5-year-old child 3. Remote memory
to repeat his address. What is the nurse evaluating
with this action?
1. Recent memory
2. Language development
3. Remote memory
4. Social-skill development
59.
During the newborn examination, the nurse assesses 4. asymmetric thigh and
the infant for signs of developmental dysplasia of the gluteal folds.
hip. A finding that would strongly indicate this disorder would be:
1. soles are flat with prominent fat pads.
2. positive Babinski reflex.
3. metatarsus varus.
4. asymmetric thigh and gluteal folds.
60.
The nurse must assess each of the 2-year-olds listed 2. A child who has stridor
below. Which one should be evaluated first?
1. A child with a temperature of 101 degrees F
2. A child who has stridor
3. A child who has absent Babinski sign
4. A child who has a pot belly appearance
61.
The nurse notes a history of a grade III heart murmur 2. hear a moderately loud
in a small infant. When assessing the heart, the nurse murmur without a palpawould expect to:
ble thrill.
1. hear a quiet but easily heard murmur.
2. hear a moderately loud murmur without a palpable
thrill.
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3. hear a very loud murmur with easily palpable thrill.
4. listen without a stethoscope and hear a murmur at
chest wall.
62.
The nurse is measuring an abdominal girth on a child 1. Just above the umbiliwith abdominal distension. Identify the area on the cus, around the largest
child's abdomen where the tape measure should be circumference of the abplaced for an accurate abdominal girth.
domen
1. Just above the umbilicus, around the largest circumference of the abdomen
2. Below the umbilicus
3. Just below the sternum
4. Just above the pubic bone
63.
The nurse is preparing to assessment a toddler client. 2. Allowing the client to sit
Which activities would gain cooperation from the tod- in the parents lap
dler? Select all that apply.
4. Handing the client a
1. Asking the parents to wait outside
stethoscope while taking
2. Allowing the client to sit in the parents lap
the health history
3. Administering vaccinations prior to the assessment
4. Handing the client a stethoscope while taking the
health history
5. Making a game out of the assessment process
64.
The nurse is assessing an infant client during a health 1. Sucking pads in the
supervision visit. Which assessment findings are con- mouth
sidered normal variations for this client? Select all that 2. A rounded chest
apply.
3. Hearing breath sounds
1. Sucking pads in the mouth
over the entire chest
2. A rounded chest
3. Hearing breath sounds over the entire chest
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4. Pubertal development
5. Knock-knees
65.
The nurse is conducting a health surveillance visit with 1. Weigh the infant twice
a 6-month-old infant. Which methods are appropriate and average together
to monitor the infants growth pattern since birth?
3. Measure the infant's
Select all that apply.
head circumference
1. Weigh the infant twice and average together
5. Plot the infants growth
2. Measure the infants height
on appropriate chart
3. Measure the infant's head circumference
4. Determine the infant's body mass index
5. Plot the infants growth on appropriate chart
66.
A nursery nurse is planning care for the newborns cur- 1. Monitor feeding behavrently in the newborn nursery. Which activities does iors.
the nurse plan for the first 48 hours of life? Select all 2. Perform a hearing
that apply.
screening.
1. Monitor feeding behaviors.
3. Perform a heel stick to
2. Perform a hearing screening.
obtain blood for the new3. Perform a heel stick to obtain blood for the newborn born screen.
screen.
4. Monitor the mother as she performs the first newborn bath to remove blood and amniotic fluids.
5. Administer folic-acid injection to the infant to prevent bleeding.
67.
The nurse is planning care for clients seen in a new- 2. Assessing the newborn clinic. Which is the priority for a newborn client born-and-family interacduring the first clinic visit?
tions
1. Providing pamphlets to reinforce information provided at the visit
2. Assessing the newborn-and-family interactions
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3. Modeling infant-nurturing behaviors
4. Informing the parents of the infants gains in height
and weight
68.
The nurse in the newborn nursery is admitting a
neonate. To determine the health and development
of the newborn, what will the nurse include in the
assessment? Select all that apply.
1. Head circumference
2. Body length
3. Weight
4. Length of pregnancy
5. Hearing screens
69.
An infant weighs 9 pounds, 3 ounces at birth. The
2. 8 pounds, 2 ounces
nurse plans to make a home visit to the mother and
infant when the infant is 7 days old. What is the lowest
acceptable weight the infant should be at this age?
1. 7 pounds, 12 ounces
2. 8 pounds, 2 ounces
3. 8 pounds, 12 ounces
4. 9 pounds
70.
The nurse is teaching a new mother developmental 1. Bring hands to eyes and
expectations. Which activity should the nurse expect mouth.
a newborn to do within the first month of life?
1. Bring hands to eyes and mouth.
2. Push up with hands, moving chest up.
3. Keep hands in a relaxed position.
4. Roll over from back to abdomen.
71.
The nurse is providing anticipatory guidance instruc- 4. SIDS risk-reduction
tions to the parents of a newborn. Which instruction measures
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1. Head circumference
2. Body length
3. Weight
4. Length of pregnancy
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should the nurse give as a strategy for illness/disease
prevention?
1. Don't allow visitors for the first month.
2. Smoke outside only.
3. Take the newborn to weekly child-stimulation classes.
4. SIDS risk-reduction measures
72.
A nurse assesses the height and weight measure2. The infant has gained
ments on an infant and documents these measure- a significant amount of
ments at the 75th percentile. The nurse notes that the weight.
previous measurements two months ago were at the
25th percentile. Which interpretation by the nurse is
the most accurate?
1. The infant is not gaining enough weight.
2. The infant has gained a significant amount of
weight.
3. The previous measurements were most likely inaccurate.
4. These measurements are most likely inaccurate.
73.
A nurse asks the mother of a 4-month-old infant to 3. I see that you have
undress the infant. The nurse observes the mother many layers of clothing on
taking off several layers of clothing and knows that your baby. This may cause
the outdoor temperature is 70 degrees Fahrenheit. your baby's temperature
Which statement by the nurse is most appropriate in to rise.
this situation?
1. My, you are dressing your infant warmly today.
2. Did you think it was cold when you left your home
this morning?
3. I see that you have many layers of clothing on your
baby. This may cause your baby's temperature to rise.
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4. When you leave the office, only put one layer of
clothing on your baby.
74.
The nurse working with a family has observed that the 1. Avoiding nursing or givolder children have a large number of dental caries ing the infant a bottle at
and plans to provide the mother with information to bedtime
prevent the development of dental caries in her new 3. Using a soft moist gauze
infant. Which interventions will prevent the develop- for cleaning
ment of dental caries in the infant? Select all that
apply.
1. Avoiding nursing or giving the infant a bottle at
bedtime
2. Giving foods high in sugar only at breakfast time
3. Using a soft moist gauze for cleaning
4. Using a topical anesthetic daily beginning as soon
as the first tooth begins to erupt
75.
A nurse is assessing an 11-month-old infant and notes 1. Alteration in Growth
that the infants height and weight are at the 5th per- Pattern Related to Parental
centile on the growth chart. Family history reveals
Anxiety
that the infants two siblings are at the 50th percentile
for height and at the 75th percentile for weight. Psychosocial history reveals that the parents are separated and are planning to divorce. Which of these nursing
diagnoses takes priority?
1. Alteration in Growth Pattern Related to Parental
Anxiety
2. Alteration in Growth Pattern Secondary to Familial
Short Stature
3. Nutritional Intake: Excessive Secondary to Maternal
Feeding Patterns
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4. At Risk for Constitutional Growth Delay Related to
Decreased Appetite
76.
While teaching parents of a newborn about normal
growth and development, which statement is most
appropriate for the nurse to include in the session?
1. Weight should triple by 6 months of age.
2. Weight should double by 1 year of age.
3. Weight should double by 4 months of age.
4. Weight should triple by 1 year of age.
77.
A mother who is bottle feeding her newborn asks
1. Within 48 hours of disto be discharged 24 hours post delivery, because
charge
she also has twin 2-year-old children at home. When
should the nurse schedule the first office visit for this
newborn?
1. Within 48 hours of discharge
2. Within one week of discharge
3. Within two weeks of discharge
4. When the infant is 1 month old
78.
A follow-up visit for a newborn client is scheduled with 1. Feeding pattern
the pediatric nurse practitioner 3 days after discharge. 2. Jaundice
What will the nurse include in the assessment during 5. Sleep pattern
the scheduled visit for this newborn? Select all that
apply.
1. Feeding pattern
2. Jaundice
3. Length
4. Vision screen
5. Sleep pattern
79.
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4. Weight should triple by
1 year of age.
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A mother asks which developmental milestones she 3. Transfers objects from
can expect when her baby is 6 months old. Which
one hand to the other
response by the nurse is the most appropriate?
1. Lifts head momentarily when prone
2. Has well-developed pincer grasp
3. Transfers objects from one hand to the other
4. Rolls from front to back
80.
Injury prevention is an important aspect of parent
3. Position the infant on
teaching. Which injury prevention strategy would re- her back to sleep.
duce the risk of suffocation?
1. Measure crib slat spacing at 2-3/8 inches or less.
2. Never leave an infant alone in a bath.
3. Position the infant on her back to sleep.
4. Use only approved restraint systems.
81.
The nurse is assessing an infant client and parents
3. Temperament during
during a routine health supervision visit at 2 months the visit
of age. Which items will the nurse assess to deter4. Feeding schedule
mine if the infants mental health needs are being
5. Sleep-wake patterns
addressed?
Standard Text: Select all that apply.
1. Immunization record
2. Newborn screen results
3. Temperament during the visit
4. Feeding schedule
5. Sleep-wake patterns
82.
Which of these aspects of developmental health su- 1. Assessment
pervision should be included in each healthcare visit 3. Education
of young children? Select all that apply.
4. Intervention
1. Assessment
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2. Discipline
3. Education
4. Intervention
5. Toilet training
83.
A 27-month-old toddler who is in the pediatric office 2. Allow the toddler to sit
for a well-child visit begins to cry the moment he is on the parents lap and beplaced on the examination table. The parent attempts gin the assessment.
to comfort the toddler; however, nothing is effective.
Which of these actions by the nurse takes priority?
1. Instruct the father to hold the toddler down tightly
to complete the examination.
2. Allow the toddler to sit on the parents lap and begin
the assessment.
3. Allow the toddler to stand on the floor until he stops
crying.
4. Ask another nurse in the office to hold the toddler,
since the parent is not able to control the toddlers
behavior.
84.
At a routine healthcare visit, a nurse measures a tod- 3. The height and weight
dler and plots the height and weight on the growth are disproportionate, and
charts. The nurse documents that the toddler is above the toddler needs further
the 95th percentile for weight and is at the 5th per- evaluation.
centile for height. How should the nurse interpret
these data?
1. The toddler is proportionate for the age.
2. The toddler needs to eat more at each feeding.
3. The height and weight are disproportionate, and
the toddler needs further evaluation.
4. The family is most likely short.
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85.
A nurse is preparing to perform a physical assessment 2. Leave intrusive proceon a toddler. Which action is most appropriate for the dures such as ear and
nurse to take?
eye examinations until the
1. Perform the assessment from head to toe.
end.
2. Leave intrusive procedures such as ear and eye
examinations until the end.
3. Explain each part of the examination to the child
before performing it.
4. Ask the mother to tell the child not to be afraid.
86.
Which of these developmental milestones should the 2. Scribbles and draws on
nurse expect to find in children who are between 2 paper
and 3 years old? Select all that apply.
3. Kicks a ball
1. Always feeds self
5. Goes up and down
2. Scribbles and draws on paper
stairs
3. Kicks a ball
4. Throws ball overhand
5. Goes up and down stairs
87.
A nurse observes the parent/child interaction during 3. Let's talk privately. Let's
the 4-year-old well-child checkup and notes that the discuss the way you speak
parent speaks harshly to the child and uses negative with your child and possiremarks when speaking with the nurse. Which state- ble ways to be more posiment by the nurse would be most beneficial?
tive.
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. Let's talk privately. Let's discuss the way you speak
with your child and possible ways to be more positive.
4. Addressing the child, the nurse says, Are you unhappy when Mommy talks to you like this?
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88.
A nurse who is the manager of an ambulatory pedi- 2. 24 months
atric healthcare center is planning protocols for the
routine healthcare visits of the children. Children at
this care center have a high incidence of obesity. At
which age should the nurses at this clinic calculate the
body mass index (BMI) for all pediatric clients?
1. 12 months
2. 24 months
3. 36 months
4. 4 years
89.
Which of these measures used by a nurse will help re- 1. Discussing the growth
lieve parental anxiety related to the changing appetite of the toddler as comin the toddler who is gaining weight along the 50th pared to the growth chart
percentile?
1. Discussing the growth of the toddler as compared
to the growth chart
2. Suggesting ways to have the toddler eat higher
calorie foods
3. Instructing the mother to feed the toddler alone
without any distractions such as TV or music
4. Teaching the mother to avoid disciplining the toddler within one-half hour of eating
90.
Parents of a preschool child report that they find it
2. Lets talk about othnecessary to spank the child at least once a day. Which er forms of discipline that
response should the nurse make to the parents?
have a more positive effect
1. Spanking is one form of discipline; however, you
on the child.
want to be certain that you do not leave any marks on
the child.
2. Lets talk about other forms of discipline that have a
more positive effect on the child.
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3. Can you try only spanking the child every other
day for one week and see how that affects the child's
behavior?
4. I think you are not parenting your child properly, so
let's talk about ways to improve your parenting skills.
91.
A parent questions how her toddler plays with other 1. Toddlers play side by
toddlers. Which response by the nurse displays the side, while preschoolers
best description of the differences in play between the play cooperatively.
toddler and the preschooler?
1. Toddlers play side by side, while preschoolers play
cooperatively.
2. Toddlers play house and imitate adult roles, while
preschoolers become the Mom or Dad while playing
house.
3. Toddlers play cooperatively, while preschoolers play
interactive games.
4. There are no differences between toddlers and
preschoolers since both groups play cooperatively.
92.
A mother of an 18-month old asks the nurse whether 2. 24 months
she can begin to introduce low-fat milk like the rest
of the family drinks. The nurse answers the mother
based on the knowledge that low-fat milk can safely
be introduced at what age?
1. 18 months
2. 24 months
3. 3 years
4. 4 years
93.
The nurse is evaluating the car seat of a 3-year-old
who weighs 42 pounds. Which recommendation
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should the nurse make about the car seat to the par- 3. A car seat with a harents?
ness approved for higher
1. Convertible, rear-facing seat
weights and heights
2. Belt-positioning booster seat
3. A car seat with a harness approved for higher
weights and heights
4. A regular seat with lap and shoulder strap
94.
During a clinic visit, the parents of a 15-month-old ask 2. Teaching simple handwhat disease and injury prevention topics would be washing is a good topic at
appropriate to discuss at this age. Which response by this age.
the nurse is the most appropriate?
1. It's never too early to teach a child to wear a helmet
when riding a bicycle.
2. Teaching simple handwashing is a good topic at this
age.
3. Tell the child over and over to stay away from water
unless you are with him.
4. Tell him firmly no when he tries to cross the street.
95.
Which assessment question would get the most ac- 4. Do you keep books for
curate response when a nurse is assessing learnyour child readily availing/reading skills in the early childhood years?
able?
1. What rewards do you use when your child does
something good?
2. What is your childs language like now?
3. Does your child get along well with others?
4. Do you keep books for your child readily available?
96.
The nurse is asked to teach injury prevention measures to a classroom of 4-year-old preschoolers.
Which teaching points are most appropriate at this
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1. Stop, drop and roll if
clothes catch fire
2. Never go into the road
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age? Select all that apply.
alone.
1. Stop, drop and roll if clothes catch fire
4. Safe meeting place out2. Never go into the road alone.
side the house in case of
3. Acceptable places for climbing
fire
4. Safe meeting place outside the house in case of fire 5. Car seat safety
5. Car seat safety
97.
The nurse is performing a well-child exam on a child 2. Throw a ball
who turned 4 years old 3 months ago. What can the
nurse ask the child to do to assess appropriate milestones for this age?
1. Jump up and down
2. Throw a ball
3. Stack three or more blocks
4. Draw lines on paper
98.
Which health promotion activities can the nurse rec- 1. Encourage a play date
ommend to the parents of a preschool-age child in
with a school-age child.
order to enhance the childs self-concept? Select all
2. Praise the child for staythat apply.
ing dry at night.
1. Encourage a play date with a school-age child.
4. Set aside time for the
2. Praise the child for staying dry at night.
child each day.
3. Tell the child there will be a punishment for bathroom accidents.
4. Set aside time for the child each day.
5. Discuss appropriate activities to engage in with the
daycare provider.
99.
The nurse is planning care for a preschool-age child 1. Discuss of the child's
and family. In order to assess the family, what should developmental status
the nurse plan to do during each health supervision 2. Observe interactions
visit? Select all that apply.
among the family mem34 / 53
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1. Discuss of the child's developmental status
2. Observe interactions among the family members
3. Discuss concerns with the parents
4. Administer age appropriate vaccinations
5. Record height and weight
bers
3. Discuss concerns with
the parents
100. An adolescent female presents at a nurse practition- 3. A health-supervision
ers office and requests a signature for working paopportunity
pers. The nurse reviews her chart and notes that the
last physical examination was two years ago. In addition to providing the signature for the working papers,
what else should the nurse use this visit?
1. An opportunity to discuss birth-control measures
2. A time to discuss exercise and sports participation
3. A health-supervision opportunity
4. A chance to discuss the importance of pursuing post
secondary education
101. An adolescent is accompanied by the mother for an 1. Sexual activity
annual physical examination. The nurse is aware of 2. Cigarette smoking
privacy issues related to the adolescent. While the
4. Use of alcohol
mother is in the room, the nurse should avoid which
questions? Select all that apply.
1. Sexual activity
2. Cigarette smoking
3. School performance
4. Use of alcohol
5. Car seatbelt use
102. The school nurse performs screenings on all students 1. Hearing
in the middle school. In addition, the nurse will per- 2. Height and weight
form selected screenings on individual school-age
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children. When planning the screenings for the
year, which screenings will the nurse include for all
school-age children? Select all that apply.
1. Hearing
2. Height and weight
3. Blood-pressure measurement
4. Hepatitis B profile serology
5. Chest x-ray
3. Blood-pressure measurement
103. A school nurse is performing annual height and
4. Obtain a nutritional hisweight screening. The nurse notes that three females tory for each of these adowho are close friends each lost 15 pounds over the lescents.
past year. What is the priority nursing action in this
situation?
1. Call the respective parents to discuss the eating
patterns of each adolescent.
2. Speak with the girls in a group to discuss the problems associated with anorexia nervosa.
3. Refer these adolescents to the school psychologist.
4. Obtain a nutritional history for each of these adolescents.
104. An school-age client who recently moved to a new
2. Promoting healthy
school in a different town presents to an ambulatory mental-health outcomes
care center and describes the following: I have no
friends in my new school, and I no longer want to
go to play soccer. I know I will be lonely there, too.
Which of these takes priority when speaking with the
school-age client?
1. Helping the school-age client realize the value of
soccer
2. Promoting healthy mental-health outcomes
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3. Acknowledging the fact that it takes several months
to make new friends at a new school
4. Stressing the importance of remaining in a close
parent-child relationship during these stressful times
105. An adolescent reports participating in an exercise
2. The adolescent is not
program at school each Wednesday throughout the meeting the recommenschool year. Further history reveals that the adoles- dations of the Healthy
cent does not participate in any other physical acPeople 2020 initiative.
tivities. Which outcome is most appropriate for this
adolescent?
1. The adolescent is reporting information consistent
with what 60 percent of adolescents report as participation in physical activities.
2. The adolescent is not meeting the recommendations of the Healthy People 2020 initiative.
3. The adolescent should be encouraged to continue
this program of exercise, since something is better
than nothing.
4. The adolescent should be encouraged to vigorously
exercise for at least five minutes each day.
106. An adolescent reports the following: I get up at 6
1. How many hours of
am, I attend early-morning band classes three times sleep do you get each
each week, I play sports for two hours each day after night?
school, and homework takes me three hours each
night. I always feel tired. Which question by the nurse
is most appropriate based on this information?
1. How many hours of sleep do you get each night?
2. Do you consume foods high in iron?
3. Do you think you are doing too much?
4. Have you considered talking with your teachers
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about decreasing your homework, since you have so
many extracurricular activities?
107. The nurse working in the clinic includes an adolescent 1. Possible domestic viohistory in every client intake interview. Which issue lence
should the nurse address when the parents are not
present?
1. Possible domestic violence
2. Teen job responsibilities
3. Activities that are done as a family
4. The adolescents role in the family
108. The nurse is reviewing the immunization record of an 4. Plans to get a tattoo
adolescent who will be seen later in the day. Which
item in the client's history makes hepatitis B status a
priority?
1. Chronic acne
2. Overuse injuries from playing varsity sports
3. Chronic asthma
4. Plans to get a tattoo
109. An obese adolescent who adamantly denies sexual 3. Let's discuss some
activity has a positive pregnancy test, which was per- activities that you have
formed in the adolescent clinic. Which statement by done within the past few
the nurse is the most appropriate in this situation?
months that could possi1. Tell me how you feel about your body image.
bly lead to pregnancy.
2. When was your last menstrual period (LMP)?
3. Let's discuss some activities that you have done
within the past few months that could possibly lead
to pregnancy.
110. A mother reports that her adolescent is always late.
The mother states, She was born late and has been
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2. You should not expect
your adolescent to be an
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late every day of her life. Which response should the on-time individual unless
nurse make to this mother?
you set specific alarms
1. You need to establish specific time frames for your and then reinforce the valadolescent and be certain she adheres to them.
ue of being on-time.
2. You should not expect your adolescent to be an
on-time individual unless you set specific alarms and
then reinforce the value of being on-time.
3. You should not expect your adolescent to be on
time. Teenagers are always late.
4. You have a major problem. There must be a lot of
screaming in your home.
111. When examining a 7-year-old, which action by the
1. Allow the child to particnurse would be most appropriate?
ipate in the exam.
1. Allow the child to participate in the exam.
2. Ask the parent what kind of food the child likes to
eat.
3. Ask the child whether he plays outside for at least
30 minutes a day.
4. Allow the child to decide whether he is ready for his
next immunization.
112. The school health nurse recognizes that children who 1. Decreased ability to
display certain characteristics are at risk for poor
perform visual tracking.
school performance. The nurse will, therefore, ob2. Decreased auditory
serve each school-age child for which characteristics? stimulation.
Select all that apply.
3. Decreased muscle tone.
1. Decreased ability to perform visual tracking.
2. Decreased auditory stimulation.
3. Decreased muscle tone.
4. Multiple dental caries.
5. Chronic tonsillitis.
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113. A nurse obtains a nutritional health history from a
3. Gummy bears and
10-year-old child. Which of these food selections, if licorice
consumed on a regular basis, should lead the nurse
to become concerned about the need for improving
oral hygiene?
1. Peanuts and crackers
2. Sorbet and yogurt
3. Gummy bears and licorice
4. Fluoridated water
114. The school health nurse is evaluating the home envi- 3. The child is permitted to
ronment of several children as it relates to child safety. target practice with a reThe nurse visits the home of each child and gathers volver, unsupervised.
the following data. Which activity places a child at
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 is permitted to target practice with a revolver, unsupervised.
4. The child is a latchkey child.
115. The school nurse is teaching a class about safety. The 1. Skateboarding
nurse will teach the children that they should wear
2. Playing football
protective athletic gear when participating in selected 4. Playing lacrosse
activities. Which of these activities require protective
athletic gear? Select all that apply.
1. Skateboarding
2. Playing football
3. Swimming
4. Playing lacrosse
5. Performing acrobatic tricks
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116. A 9-year-old child who has been followed in the same 2. The child is obese and
pediatric home since birth is at the healthcare center needs dietary counseling.
for a well-child visit. A nurse who measures the height
and weight of the child documents 35th percentile for
height and 90th percentile for weight. How should the
nurse interpret these data?
1. The child is beginning a growth spurt.
2. The child is obese and needs dietary counseling.
3. The parents are most likely below the 50th percentile for height and weight.
4. As soon as the child begins the adolescent growth
spurt, the height and weight measurements will normalize.
117. The nurse is preparing to complete a health surveil- 1. Client who does not
lance appointment with a school-age client and par- make eye contact
ents. Which observations would necessitate the need 2. Client with visible bruisfor further assessment by the nurse? Select all that es in various stages of
apply.
healing
1. Client who does not make eye contact
5. Client who appears red
2. Client with visible bruises in various stages of heal- in the face while walking
ing
to exam room
3. Client holding a video game talking with parent
4. Client playing a card game with sibling
5. Client who appears red in the face while walking to
exam room
118. The parents of a critically injured child wish to stay in 2. Allow the parents to stay
the room while the child is receiving emergency care. with the child.
Which action by the nurse is the most appropriate?
1. Escort the parents to the waiting room and assure
them that they can see their child soon.
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2. Allow the parents to stay with the child.
3. Ask the physician if the parents can stay with the
child.
4. Tell the parents that they do not need to stay with
the child.
119. The charge nurse on a hospital unit is developing
2. 18-month-old
plans of care related to separation anxiety. The charge
nurse recognizes that which hospitalized child at highest risk to experience separation anxiety when parents cannot stay?
1. 6-month-old
2. 18-month-old
3. 3-year-old
4. 4-year-old
120. A group of children on one hospital unit are all suffer- 4. Lies quietly in bed
ing separation anxiety. Which child is experiencing the
despair stage of separation anxiety?
1. Does not cry if parents return and leave again
2. Screams and cries when parents leave
3. Appears to be happy and content with staff
4. Lies quietly in bed
121. A preschool-age client is seen in the clinic for a sore
throat. In this child's mind, what is the most likely
causative agent for the sore throat?
1. Was exposed to someone else with a sore throat.
2. Did not eat the right foods.
3. Yelled at his brother.
4. Did not take his vitamins.
122.
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3. Yelled at his brother.
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The charge nurse is concerned with reducing the
4. Encourage a parent to
stressors of hospitalization. Which nursing interven- stay with the child.
tion is most helpful in decreasing the stressors for the
toddler-age client?
1. Assign the same nurse to the toddler as much as
possible.
2. Let the child listen to an audiotape of the mother's
voice.
3. Place a picture of the family at the bedside.
4. Encourage a parent to stay with the child.
123. The nurse is caring for a client in the pediatric in3. Acknowledge the partensive-care unit (PICU). The parents have expressed ents concerns and collabanger over the nursing care their child is receiving. orate with them regarding
Which nursing intervention is most appropriate based the care of their child.
on the situation?
1. Ask the physician to talk with the family.
2. Explain to the parents that their anger is affecting
their child so they will not be allowed to visit the child
until they calm down.
3. Acknowledge the parents concerns and collaborate
with them regarding the care of their child.
4. Call the chaplain to sit with the family.
124. A toddler recently diagnosed with a seizure disorder 3. Drawing up the medwill be discharged home on an anticonvulsant. Which ication correctly in an oral
action by the mother best demonstrates understand- syringe and administering
ing of how to give the medication?
it to the child
1. Verbalizing how to give the medication
2. Acknowledging understanding of written instructions
3. Drawing up the medication correctly in an oral sy43 / 53
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ringe and administering it to the child
4. Observing the nurse draw up the medication and
administering it to the child.
125. The nurse must perform a procedure on a toddler.
4. Allow the child to cry or
Which technique is the most appropriate when per- scream.
forming the procedure?
1. Ask the mother to restrain the child during the
procedure.
2. Ask the child if it is okay to start the procedure.
3. Perform the procedure in the child's hospital bed.
4. Allow the child to cry or scream.
126. A young school-age client is in the playroom when the 4. Assist the child back to
respiratory therapist arrives on the pediatric unit to his room for the treatment
give the child a scheduled breathing treatment. Which but reassure the child that
action by the nurse is the most appropriate?
he may return when the
1. Reschedule the treatment for a later time.
procedure is completed.
2. Show the respiratory therapist to the playroom so
the treatment may be performed.
3. Escort the child to his room and ask the child-life
specialist to bring toys to the bedside.
4. Assist the child back to his room for the treatment
but reassure the child that he may return when the
procedure is completed.
127. The nurse is working with a hospitalized
1. Provide the child with
preschool-age child. The nurse is planning activities to a doll and safe medical
reduce anxiety in this child. Which action by the nurse equipment.
is the most appropriate?
1. Provide the child with a doll and safe medical equipment.
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2. Read a story to the child.
3. Use an anatomically correct doll to teach the child
about the illness.
4. Talk to the child about the hospitalization.
128. The nurse needs to administer a medication to a
3. Crush the tablet and mix
preschool-age child. The medication is only available it in a teaspoon of applein tablet form. Which action by the nurse is the most sauce.
appropriate?
1. Place the tablet on the child's tongue and give the
child a drink of water.
2. Break the tablet in small pieces and ask the child to
swallow the pieces one by one.
3. Crush the tablet and mix it in a teaspoon of applesauce.
4. Crush the table and mix it in a cup of juice.
129. A child is being discharged from the hospital after a 3. Parental Anxiety Relat3-week stay following a motor vehicle accident. The ed to Care of the Child at
mother expresses concern about caring for the child's Home
wounds at home. She has demonstrated appropriate
technique with medication administration and wound
care. Which nursing diagnosis is the priority in this
situation?
1. Knowledge Deficit of Home Care
2. Altered Family Processes Related to Hospitalization
3. Parental Anxiety Related to Care of the Child at
Home
4. Risk for Infection Related to Presence of Healing
Wounds
130.
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An infant has been NPO for surgery for 4 hours and 4. Call the physician to see
does not have an intravenous line. The nurse receives if the infant needs to have
a call from the operating room with the information an intravenous line startthat the surgery has been postponed due to an emer- ed.
gency. Which action by the nurse is the most appropriate?
1. Feed the infant 4 ounces of formula.
2. Reassure the parents that it will not be much longer
before surgery.
3. Allow the parents to feed the infant an ounce of oral
rehydration solution.
4. Call the physician to see if the infant needs to have
an intravenous line started.
131. The nurse is working with an adolescent client who 1. Have teens who have
will be admitted to the hospital in two days. Which
had similar experiences
nursing approach is most appropriate to prepare this talk to the adolescent
client for hospitalization?
about hospitalization.
1. Have teens who have had similar experiences talk
to the adolescent about hospitalization.
2. Provide an opportunity for the child to talk with an
adult who has had a similar experience.
3. Teach parents what to expect so the information
can be shared with the adolescent.
4. Provide an opportunity for the teen to try on surgical attire.
132. The nurse is providing care to a school-age client who 3. An orientation to the
is admitted to the hospital after a motor vehicle acci- unit
dent. Which interventions are appropriate to prepare 4. An age-appropriate exthis client and family for their hospital stay? Select all planation of procedures
that apply.
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1. A hospital tour
2. A health fair brochure
3. An orientation to the unit
4. An age-appropriate explanation of procedures
5. A child life program consultation
5. A child life program
consultation
133. The nurse is providing care to a preschool-age client 1. Discussing rooming in
who was admitted to the medicalsurgical unit after with the parents of the
an acute asthma attack. Which interventions foster client
a family-centered focus to client care? Select all that 3. Providing comfort items
apply.
from home, such as a
1. Discussing rooming in with the parents of the client blanket
2. Allowing the client to cry it out after the parents
5. Discussing what to exleave for the evening
pect during the hospital
3. Providing comfort items from home, such as a blan- stay
ket
4. Maintaining strict visitation for the family
5. Discussing what to expect during the hospital stay
134. The nurse is admitting a school-age Vietnamese client 1. Use the FLACC scale to
who hit a parked car while riding a bike. The child has determine the child's pain
a fracture of the left radius and femur in addition to level.
a fractured orbit. The child is stoic and denies pain. 3. Administer pain medWhich nursing actions are most appropriate in this ication now and continue
situation?
on a regular basis.
Standard Text: Select all that apply.
4. Ask the child's parents
1. Use the FLACC scale to determine the child's pain to notify the nurse if the
level.
child complains of pain.
2. Tell the child to ring the call bell if the leg starts
hurting.
3. Administer pain medication now and continue on a
regular basis.
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4. Ask the child's parents to notify the nurse if the child
complains of pain.
5. Use the NIPS scale to determine the child's pain
level.
135. During the nurses initial assessment of a school-age 1. Administer prescribed
child, the child reports a pain level of 6 out of 10. The analgesic.
child is lying quietly in bed watching television. Which
action by the nurse is most appropriate?
1. Administer prescribed analgesic.
2. Ask the child's parents if they think the child is
hurting.
3. Reassess the child in 15 minutes to see if the pain
rating has changed.
4. Do nothing, since the child appears to be resting.
136. A school-age client has been receiving morphine
4. Call the healthevery two hours for postoperative pain as ordered. care provider to see if
The medication relieves the pain for approximately 90 the child's orders for
minutes, and then the pain returns. Which action by pain medication can be
the nurse is the most appropriate?
changed.
1. Tell the child that pain medication cannot be administered more frequently than every two hours.
2. Reposition the child and quietly leave the room.
3. Inform the parents that the child is dependent on
the medication.
4. Call the healthcare provider to see if the child's
orders for pain medication can be changed.
137. The nurse is working in a pediatric surgical unit. In
4. 12-year-old, postoperdiscussing patient-controlled analgesia (PCA) in a pre- ative spinal fusion for scooperative parental meeting, which client would be a liosis
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candidate for PCA?
1. Developmentally delayed 16-year-old, postoperative bone surgery
2. 5-year-old, postoperative tonsillectomy
3. 10-year-old who has a fractured femur and concussion from a bike accident
4. 12-year-old, postoperative spinal fusion for scoliosis
138. A toddler is hospitalized with a fractured femur. In
addition to pain medication, which will best provide
pain relief for this child?
1. Parents presence at the bedside
2. Age-appropriate toys
3. Deep-breathing exercises
4. Videos for the child to watch
1. Parents presence at the
bedside
139. The nurse is caring for a toddler client in the post1. FLACC Behavioral Pain
operative period. Which pain assessment tool is most Assessment Scale
appropriate for this client?
1. FLACC Behavioral Pain Assessment Scale
2. FACES pain scale
3. Oucher scale
4. Poker-chip tool
140. A hospitalized toddler-age client needs to have an IV 2. Anxiety Related to Anticrestarted. The child begins to cry when carried into ipated Painful Procedure
the treatment room by the mother. Which nursing
diagnosis is most appropriate?
1. Ineffective Individual Coping Related to an Invasive
Procedure
2. Anxiety Related to Anticipated Painful Procedure
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3. Fear Related to the Unfamiliar Environment
4. Knowledge Deficit of the Procedure
141. A parent asks the nurse if there is anything that can 2. EMLA cream (lidocaine
be done to reduce the pain that his 3-year-old experi- 2.5% and prilocaine 2.5%)
ences each morning when blood is drawn for lab stud- applied to skin at least one
ies. Which intervention would the nurse implement hour prior to the procebased on the parents concern?
dure
1. Intravenous sedation 15 minutes prior to the procedure
2. EMLA cream (lidocaine 2.5% and prilocaine 2.5%)
applied to skin at least one hour prior to the procedure
3. Use of guided imagery during the procedure
4. Use of muscle-relaxation techniques
142. As an advocate for the child undergoing bone-mar- 2. Conscious sedation
row aspiration, which intervention would the nurse
suggest to decrease the pain experienced due to the
procedure?
1. General anesthesia
2. Conscious sedation
3. Intravenous narcotics ten minutes before the procedure
4. Oral pain medication for discomfort after the procedure
143. A school-age client is being discharged from the out- 3. Since my child just had
patient surgical center. Which statement by the parent surgery today, I can expect
would indicate the need for further teaching?
the pain level to be higher
1. I can expect my child to have some pain for the next tomorrow.
few days.
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2. I will plan to give my child pain medicine around the
clock for the next day or so.
3. Since my child just had surgery today, I can expect
the pain level to be higher tomorrow.
4. I will call the office tomorrow if the pain medicine is
not relieving the pain.
144. The nurse is caring for a child who has been sedated 3. Assess the child's respifor a painful procedure. Which nursing activity is the ratory effort.
priority for this child?
1. Allow parents to stay with the child.
2. Monitor pulse oximetry.
3. Assess the child's respiratory effort.
4. Place the child on a cardiac monitor.
145. A young school-age client is hospitalized with a frac- 1. FACES pain scale
tured femur. Which assessment tools are appropriate 2. Oucher scale
for this client? Select all that apply.
5. Poker-chip tool
1. FACES pain scale
2. Oucher scale
3. Visual Analog Scale
4. CRIES Scale
5. Poker-chip tool
146. The nurse is caring for a child who has a long leg cast. 4. Check to see if the cast
The child complains of increasing pain in the toes of is too tight.
the casted foot. Which initial action by the nurse is the
most appropriate?
1. Call the healthcare provider to report increasing
pain.
2. Administer pain medication.
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3. Reposition the child in bed.
4. Check to see if the cast is too tight.
147. The nurse is preparing to perform a heel stick on a
2. Sucrose pacifier
neonate. Which complementary therapy is appropriate for the nurse to use decrease pain during this
quick but painful procedure?
1. Swaddling
2. Sucrose pacifier
3. Massage
4. Holding the infant
148. A preschool-age client is hospitalized following
3. The client is experiencsurgery for a ruptured appendix. During assessment ing respiratory depression
of the child, the nurse notes that the child is sleeping. secondary to opioid adVital signs are as follows: temperature 97.8 degrees F ministration for postoperaxillary, pulse 90, respirations 12, and blood pressure ative pain.
100/60. Which conclusion by the nurse is appropriate
based on the assessment findings?
1. The client is comfortable and the pain is controlled.
2. The client is in shock secondary to blood loss during
surgery.
3. The client is experiencing respiratory depression
secondary to opioid administration for postoperative
pain.
4. The client is sleeping to avoid pain associated with
surgery.
149. The nurse is working with a preschool-age client in 1. It provides continuity
Bryant traction for a fractured femur. Why is the Ouch- and consistency in assesser Scale useful to the nurse caring for this child?
ing and monitoring the
1. It provides continuity and consistency in assessing child's pain.
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and monitoring the child's pain.
2. It decreases anxiety in the child.
3. It increases the child's comfort level.
4. It reduces the child's fear of painful procedures.
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