Q&A Hero

Q: The nurse in the well-child clinic is concerned with injury prevention and includes topics appropriate to the age and behaviors of the child. Which injury prevention topics would be appropriate to prevent hearing loss? 1. The five-year-old child should wear ear plugs when swimming to prevent otitis media. 2. The 12-year-old child should restrict noise levels when listening to music through earphones. 3. The bike helmet for a seven-year-old should be carefully fitted to prevent damage to the ear canal. 4. The nine-year-old child should avoid sports activities that involve cheering crowds to prevent hearing loss.

Q: As children grow and develop, their interests and activities change. Place the following childhood activities in order from interests of a 5-year-old to interests of a 12-year-old. Standard Text: Click and drag the options below to move them up or down. Choice 1. Hass-defined hobbies such as model building, building with wood, needlepoint Choice 2. Colors in coloring book, mostly staying inside the lines Choice 3. Learns to ride a two-wheel bicycle without training wheels; reads first readers Choice 4. Belongs to the basketball team or cheerleading squad at school

Q: The mother of a toddler asks the nurse: "Now that my child has outgrown his infant car seat, what should I do when we are in the car?" Which is the best response by the nurse? 1. "Place him in a booster chair on the seat beside you so you can watch him." 2. "Be sure to select a car seat according to his weight and height, and make sure it contains shoulder harnesses." 3. "Your child should remain in the rear-facing car seat until he reaches 40 pounds." 4. "The child can now be buckled safely into the regular car seat belts."

Q: The mother of an 18"month-old expresses concern that her toddler is having temper tantrums when things don"t go her way. What advice should the nurse offer the mother? Standard Text: Select all that apply. 1. "This is common in the toddler and represents a loss of self-control." 2. "Remove the child from the area where the tantrum occurs." 3. "Provide a distraction for the child without giving in to the child's desire." 4. "Remain calm while handling the child and do not raise your voice to the child." 5. "If the tantrum continues for more than a few minutes, the mother should tap the child lightly on the behind to remind the child the consequences of misbehavior."

Q: During a well-child visit, the nurse questions the mother about a toddler's food habits. The mother expresses concern that her child, who used to be a good eater and would eat all types of vegetables, now refuses all but three types of vegetables. Which is the appropriate response for the nurse to make to the mother? 1. "This is a serious concern, and we need to address this with the physician." 2. "Toddlers often go on food jags. Just continue to offer all types of vegetables without making it an issue." 3. "Don"t make an issue over it. Just stop offering those favorite vegetables and the child will start eating other vegetables." 4. "Have you thought about adding a multivitamin to the child's daily routine?"

Q: The pediatric clinic is scheduled to be remodeled. The charge nurse has been asked to design the new well-child waiting area. In planning the area, the nurse will want to include: Standard Text: Select all that apply. 1. Subdued colors to help calm the children. 2. A separate area where parents can sit and not be disturbed by the children's noise. 3. Avoiding carpet and draperies which cannot be readily cleaned. 4. Coloring books, crayons, and story books that are stored on a low shelf for easy child access. 5. All wall decorations securely fastened to the walls.

Q: The home health nurse is observing the home environment for safety issues to discuss with the mother. Which observation creates a risk of injury for the toddler? 1. The mother fills the mop bucket and places it on the floor. She then leaves the room to obtain the mop. 2. When cooking, the mother only uses the back burners of the stove. 3. The mother straps her child into the high chair. 4. The mother has child-proof latches only on the cabinets containing household chemicals, medications, and poisons.

Q: The nurse is teaching a group of mothers of toddlers and preschoolers about oral care and the prevention of caries. Which statements should the nurse include in the presentation? Standard Text: Select all that apply. 1. "The tendency toward dental caries is inherited." 2. "Fruit juice is an excellent source of vitamin C, so allow your child to drink as much fruit juice a day as desired." 3. "If your child is under two, you should use toothpaste without fluoride." 4. "Three-year-old children are mature enough to be able to brush their teeth independently." 5. "The child should see a dentist by one year of age."

Q: At a routine health care visit, a nurse measures a toddler and plots the height and weight on the growth charts. The nurse documents that the toddler is above the 95th percentile for weight and is at the 5th percentile for height. How should the nurse interpret these data? 1. The toddler is proportionate for age. 2. The height and weight are disproportionate, and the toddler needs further evaluation. 3. The toddler needs to eat more at each feeding. 4. The family most likely is short.

Q: A parent questions how her toddler will interact with other toddlers. The nurse's best description of the differences in play between the toddler and the preschooler is: 1. Toddlers play "side by side," while preschoolers play cooperatively. 2. Toddlers play cooperatively, while preschoolers play interactive games. 3. Toddlers play house and imitate adult roles, while preschoolers become the "mom or dad" while playing house. 4. There are no differences between toddlers and preschoolers because both play cooperatively.

Q: Parents of a preschool-age child report that they find it necessary to spank the child at least once a day. Which response should the nurse make to the parents? 1. "Spanking is one form of discipline; however, you want to be certain that you do not leave any marks on the child." 2. "Let's talk about other forms of discipline that have a more positive effect on the child." 3. "I think you are not parenting your child properly, so let's talk about ways to improve your parenting skills." 4. "Can you try only spanking the child every other day for one week and see how that affects the child's behavior?"

Q: A 27-month-old toddler who is in the pediatric office for a well-child visit begins to cry the moment he is placed on the examination table. The parent attempts to comfort the toddler, but nothing is effective. Which would be the most appropriate action for the nurse to take? 1. Instruct the father to hold the toddler down tightly to complete the examination. 2. Allow the toddler to sit on the parent's lap and begin the assessment. 3. Ask another nurse in the office to hold the toddler, since the parent is not able to control the toddler's behavior. 4. Allow the toddler to stand on the floor until the crying stops.

Q: The nurse recommends to the mothers of toddlers and preschoolers that they limit television to two hours a day. The nurse also discusses promoting physical activities that are related to kinesthesia. Which activities would the nurse suggest? Standard Text: Select all that apply. 1. Walking on a balance beam 2. Reading 3. Playing a memory game 4. Skipping 5. Giving up a pacifier

Q: A nurse is preparing to perform a physical assessment on a toddler. Which of these actions should the nurse take? 1. Explain each part of the examination to the child before performing it. 2. Ask the mother to tell the child not to be afraid. 3. Perform the assessment from head to toe. 4. Leave intrusive procedures, such as ear and eye examinations, until the end.

Q: A nurse who is the manager of an ambulatory pediatric health care center is planning protocols for the routine health care visits of the children. Children within the catchment area of this care center have a high incidence of obesity. The most important assessment data in monitoring the two-year-old child with obesity is: 1. Weight alone. 2. The child's percentile score of height and weight and weight on the growth chart. 3. Changes in the child's percentile on the growth chart from birth to the present. 4. The child's body mass index.

Q: Which of these developmental milestones should the nurse expect to find in children who are between two and three years old? Standard Text: Select all that apply. 1. Always feeds self 2. Throws ball overhand 3. Kicks a ball 4. Goes up and down stairs 5. Scribbles and draws on paper

Q: The nurse is explaining the primary purpose of performing health maintenance activities at each pediatric visit. The best explanation touches on: 1. Planning appropriate disciplinary measures for control of behavior. 2. Reviewing developmental milestones with the parents. 3. Prevention of disease and injury. 4. Teaching growth and development to the parents.

Q: The nurse has been following the infant in the well-baby clinic and has checked the child's vision on every visit. At four months of age, the nurse will add the cover-uncover test to check the child for: 1. Conjunctivitis. 2. Strabismus. 3. Amblyopia. 4. Cataracts.

Q: The home health nurse is concerned that the teenage mother tends to watch television while feeding the baby rather than talking and playing with her baby. Which statement by the nurse will most likely encourage the mother to talk and play with the baby more? 1. "Babies who are talked to more have higher IQs later on." 2. "You should talk to your baby more." 3. "Watch how I talk to the baby and see if you can follow my lead." 4. "Have you noticed how your baby looks at you when you speak? You can see how he knows your voice."

Q: Which parental behavior presents a risk for the infant in the home? 1. The father admits smoking cigarettes in the home but says he never smokes around the baby. 2. The parents have parties once a month in the home and serve alcoholic beverages. 3. The parents allow their other children, ages six and 10, to supervise the infant while the parents are working in another room. 4. The mother is a diabetic and has insulin and syringes in the household.

Q: The home health nurse visits a home with an eight-month-old baby. Which observation is a safety issue that should be discussed with the mother? 1. The infant crib mattress has been lowered to its lowest level. 2. The mother cuts hot dogs into pieces for the baby to "gum." 3. The cords to the window blinds have been shortened and do not hang below the window. 4. The mother has placed infant barriers around the gas heat stove.

Q: The nurse is teaching a group of parents about car safety. Which statement by a parent requires additional teaching? 1. "The safest place in the car for the baby is the middle of the back seat." 2. "I will use a rear facing car seat for my baby." 3. "I will take the car seat to the local police station for them to check placement and safety." 4. "For the trip home from the birth hospital, I will bucket myself in the back seat and hold the baby carefully. I am borrowing a car seat and should have it by my next trip out."

Q: Nurses need to know normal development so they can recognize infants who fail to meet developmental milestones. Place the following developmental milestones in order from the earliest to appear to the latest to appear. Standard Text: Click and drag the options below to move them up or down. Choice 1. Responds to name Choice 2. Waves bye-bye when directed Choice 3. Lifts head when prone Choice 4. Rolls from front to back Choice 5. Makes cooing sounds

Q: The new mother tells the nurse that sometimes her infant seems to become frantic when crying and asks what she can do when this happens. Which actions would the nurse recommend? Standard Text: Select all that apply. 1. Offer breast or bottle if it has been two hours or longer since the last feeding. 2. If the infant is not hungry or wet, allow the infant to cry it out. 3. Swaddle the infant in a blanket and rock the infant. 4. Try patting the infant on the back to help the baby expel gas. 5. Take the infant to a different room or outside to distract the infant.

Q: A six-month-old infant has been hospitalized several times with diarrhea. The nurse evaluates home care to determine the cause of the repeated illnesses. Which is the most likely cause of the repeated gastroenteritis? 1. The infant is allowed to drink from her parents' drinks at meal time. 2. If the infant doesn"t finish her bottle, the mother returns it to the refrigerator to be used later in the day. 3. There are three school-age children in the family. 4. The infant often wears only a diaper around the house.

Q: The nurse has been discussing behaviors to promote infant sleep with the mother of a two-month-old. Which statement by the mother indicates the need for additional discussion? 1. "I will read to my baby every night when getting him ready for bed." 2. "I will not bring him into my bed when he is having trouble falling asleep." 3. "I will have active play at bedtime to tire him out so he will sleep better." 4. "It is okay for my baby to have a "blankie" as a security object when he is put in his bed."

Q: A foster mother is caring for an infant who experienced an intrauterine drug exposure to cocaine. The infant often is irritated and cries for several hours each day. Which of these interventions will assist the infant in developing self-regulatory behaviors? 1. Encouraging the infant to suck as a comfort measure by placing the infant's fingers in the mouth while crying 2. Placing the infant about 15 inches from the TV and turning on an infant show such as Sesame Street 3. Swaddling the infant 4. Allowing the infant to cry but observing the infant to prevent injury

Q: An infant is born at 24 weeks' gestational age. Which of these interventions should the nurse plan when the infant is discharged home? 1. Instructing the parents that infants need warmed milk and to heat the milk in a microwave for no more than 15 seconds 2. Giving the parents information on HIV screening that is necessary for infants born at this gestational age 3. Referring the infant for developmental screening 4. No particular instructions are necessary because discharge teaching is completed immediately after the birth of the infant.

Q: The nurse is working with first-time parents. Which of these activities will the nurse suggest to encourage the development of good muscle tone? 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

Q: The parents of an eight-month-old infant are very distressed that the infant cries for at least one hour when they go out on Friday nights. Which of these statements should the nurse make to the parents? 1. "Your infant is attached to you. This is an expected infant response." 2. "Your baby seems to be afraid of the sitter. Why don"t you try another sitter?" 3. "Your infant is too young to be experiencing stranger anxiety; however, you might need to stop going out on Friday nights for a while." 4. "Oh, don't worry. All infants and toddlers display these behaviors until at least 2 years old."

Q: A nurse asks the mother to undress her four-month-old infant. The nurse observes the mother taking off several layers of clothing, knowing that the outdoor temperature is 70F. Which of these statements should the nurse make to the mother? 1. "When you leave the office, only put one layer of clothing on your baby." 2. "My, you are dressing your infant warmly today." 3. "Did you think it was it cold when you left your home this morning?" 4. "I see that you have many layers of clothing on your baby. This could cause your baby's temperature to rise."

Q: The nurse working with a family has observed that the older children have a large number of dental caries, so the nurse plans to provide the mother with information to prevent the development of dental caries in her new infant. What instructions will the nurse include in the teaching provided to the mother? Standard Text: Select all that apply. 1. Wiping the infant's gums with soft, moist gauze once or twice daily 2. Giving foods high in sugar only at breakfast time 3. Not allowing the infant to sleep with a bottle in the bed 4. Reminding the mother that dental care is not needed until the permanent teeth erupt 5. Using a topical anesthetic daily, beginning as soon as the first tooth begins to erupt

Q: While breastfeeding is recommended by the American Academy of Pediatrics, there are maternal and infant conditions that should be evaluated as being possible contraindications to breastfeeding. Some of these contraindications include: Standard Text: Select all that apply. 1. The mother has heart disease. 2. The mother is infected with HIV. 3. The infant has been diagnosed with galactosemia. 4. The mother has small breasts. 5. The mother takes medications for a chronic health condition.

Q: A newborn is admitted to the nursery from the delivery room. All of the activities must be performed. Place the activities in order of performance from first to last. Standard Text: Click and drag the options below to move them up or down. Choice 1. Administer a vitamin K injection. Choice 2. Take vital signs. Choice 3. Place in an overbed warmer. Choice 4. Administer eye prophylaxis. Choice 5. Administer an admission bath.

Q: During a prenatal visit, the pregnant mother asks the nurse if she should have her baby's cord blood collected and stored. The best response by the nurse would be: 1. "If I were pregnant, I would certainly bank by baby's cord blood." 2. "You wonder if you should have your baby's cord blood banked?" 3. "Let's discuss the pros and cons of cord blood banking." 4. "What does the baby's father think about cord blood banking?"

Q: The nurse overhears the new parents discussing the care of the newborn. The father is heard to say, "We want to be careful not to spoil the baby by holding him too much." The nurse will want to provide anticipatory guidance and might respond by saying: 1. "You are so right. A spoiled baby is hard to manage. Only pick the baby up when he needs to be fed." 2. "It is important that the baby learns to soothe himself, so wait at least 15 minutes before you respond to his cries." 3. "When the baby cries, offer him the bottle. If that doesn"t work, put him in his bed to cry it out." 4. "Don"t worry about spoiling the baby by holding him. You will find both the baby and you will be better satisfied if you respond to the baby's cries quickly and soothe him with your presence, voice, and touch.

Q: Prior to discharge from the birth hospital, the new mother asks the nurse about the use of a mobile over the crib. The nurse would explain to the mother that the mobile should be placed about 10 inches above the level of the baby. The nurse would explain that this placement: 1. Is based on the fact that newborns can focus at a distance of 8 to 12 inches. 2. Will prevent the infant from being injured by the mobile. 3. Is most convenient for the parents. 4. Is for decoration only. The newborn does not have vision sufficient to see the mobile.

Q: A pregnant woman is planning to breastfeed. The nursing intervention that will promote breastfeeding in the new mother is: 1. Facilitating breastfeeding within the first 30 to 60 minutes of life. 2. Telling the mother that the physician strongly advises new mothers to breastfeed their newborns. 3. Encouraging the mother to attend breastfeeding classes before discharge from the hospital. 4. Giving the woman literature on breastfeeding as soon as she enters the labor room.

Q: A mother asks the nurse about feeding her infant. The nurse's best response that includes the recommendation made by the American Academy of Pediatrics (AAP) concerning feeding infants is: 1. Introduce solid foods beginning at four months of age. 2. Introduce table foods only after tooth eruption. 3. Breastfeed exclusively for the first year of life. 4. Following birth, begin exclusive breastfeeding with no water, juice, or other foods.

Q: The nurse is providing anticipatory guidance instructions to the parents of a newborn. Which of these instructions should the nurse give as disease/injury prevention strategies? Standard Text: Select all that apply. 1. SIDS risk reduction 2. Fall prevention 3. Formula safety 4. Immunization schedule 5. Risk of poisoning

Q: The recommendation for an infant's sleeping position is now "back to sleep." Which nursing intervention is needed to prevent flattening of the occipital bones? 1. Place an infant hat on the head of the infant during sleep for the first three months of life. 2. Allow the infant to sleep on his abdomen while an adult is present and observing the infant during sleep. 3. Alternate the head position from left to right during sleep. 4. Wrap the occipital portion of the infant's head with an ace bandage for 20 minutes each day.

Q: An infant is born at 28 weeks' gestational age. A nurse should inform the parents that the infant should be expected to reach developmental milestones about how many weeks later than would a full-term infant? 1. 8 2. 6 3. 12 4. 16

Q: A nurse observes an infant in a crib lying still, without facial movements except for occasional sucking movements. At this time, the nurse will avoid: 1. Assessing heart and respiratory rate. 2. Attempts to feed the infant. 3. Skin assessment. 4. Repositioning the head of the infant.

Q: An infant weighs 9 pounds, 3 ounces at birth. When the infant is seven days old, the mother calls the pediatrician's office worried about her child's weight loss. What is the lowest acceptable weight the infant should be at this age? 1. 9 pounds 2. 8 pounds, 12 ounces 3. 8 pounds, 2 ounces 4. 7 pounds, 12 ounces

Q: The nurse in the newborn nursery is admitting a neonate. In order to determine the health and development of the newborn, what will the nurse assess? Standard Text: Select all that apply. 1. Head and chest circumference 2. Weight and length 3. Body fat determination 4. Presence of newborn reflexes 5. Gestational age of the infant

Q: A mother who is bottle-feeding her newborn requests to be discharged 24 hours post-delivery, because the mother also has twin two-year-olds at home. The nurse should schedule the follow-up visit for the newborn on which of these days? 1. Within 48 hours of discharge 2. When the infant is one month old 3. Within two weeks of discharge 4. Within one week of discharge

Q: Which activities should the nurse in the newborn unit perform prior to discharge from the birth hospital? Standard Text: Select all that apply. 1. Perform a heel stick to obtain blood for the newborn screen. 2. Monitor the mother as she performs the first newborn bath to remove blood and amniotic fluids. 3. Administer a folic acid injection to the infant to prevent bleeding. 4. Perform a hearing screening. 5. Monitor feeding behaviors.

Q: During the visit to the pediatric office, a nurse observes the mother frequently looking at and massaging her infant. Based on these observations, the nurse's conclusion should be: 1. That the mother is displaying positive maternal-infant attachment. 2. That the mother is trying to show the nurse that she can be affectionate to the infant. 3. That there is insufficient data to assess the mother-infant relationship. 4. That the mother might be overwhelmed by the demands of infant care.

Q: A four"year-old child is seen in the pediatric clinic for a well-child visit. During this visit, the nurse recognizes that appropriate assessments that should be completed at this time include: Standard Text: Select all that apply. 1. Height and weight. 2. Head circumference. 3. Four-year-old required immunizations. 4. Developmental assessment. 5. Safety counseling.

Q: A new patient is admitted to the pediatric clinic. The nurse wants to partner with the parents in creating a health care home. The first step for the nurse in becoming an effective partner with the parents would be to: 1. Develop a relationship with the parents with open supportive communication and display an interest and a concern for the family's goals. 2. Determine the family's financial stability and identify community resources. 3. Provide the parents with the nurse's home phone number so the parents can call when they need information. 4. Remind the parents that it is necessary for the child to receive health supervision on a regular basis.

Q: The nurse is evaluating the developmental skills of an eight-month-old child recently adopted from a foreign country. The nurse attempts to get the child to wave "bye-bye" and to play "patty-cake." When the child is unable to perform either skill, the nurse should: 1. Document developmental delay on the child's record. 2. Refer the child for an electroencephalogram. 3. Encourage the parents to seek medical attention for the child's developmental delay. 4. Recognize that this child's language skills and previous experience may not allow for these activities at this time.

Q: The nurse wants to perform developmental screenings on a five-year-old child. Which screening tools would be appropriate for this purpose? Standard Text: Select all that apply. 1. Denver II 2. Bayley Infant Neurodevelopmental Screener 3. McCarthy Scales of Children's Abilities 4. Denver Articulation Screening Exam 5. Early Language Milestone Scale

Q: A nurse in the outpatient pediatric clinic is reviewing the records of a preschool-age child and notes that the parents have missed the last two health care visits. The nurse also notes that the child has not received the second measles, mumps, and rubella (MMR) vaccine. The nurse should: 1. Plan to discuss the principles of health supervision at the next scheduled visit. 2. Call the parents and encourage them to bring the child for recommended care. 3. Notify the physician that the child's immunizations are no longer up to date. 4. Speak firmly with the parents at the next health care visit about the importance of being compliant.

Q: During a well-child visit, the nurse asks the mother of a six-month-old infant, "Does your baby sit without assistance?" and "Is the baby crawling?" Which process is the nurse using in this interaction? 1. Disease surveillance 2. Health promotion 3. Health maintenance 4. Developmental surveillance

Q: The mother of a two-year-old child becomes very anxious when the child has a temper tantrum in the medical office. The appropriate nursing response to the mother would be to say: 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."

Q: A parent asks a nurse, "How do you know when my child needs these screening tests the doctor just mentioned?" How should the nurse respond to the parent? 1. "Screening tests are done at each office visit." 2. "Screening tests are done in the newborn nursery, and from these results, additional screening tests are ordered throughout the first two years of life." 3. "Screening tests are administered at the ages when a child is most likely to develop a condition." 4. "Screening tests are most often done when the doctor suspects something is wrong with the child."

Q: The nurse at an outpatient clinic is sitting with the parents while their adolescent goes for a test. The parents are complaining about their child's behavior. Which response by the nurse would promote family-centered communication? 1. "I agree with you; discipline is an important part of parenting." 2. "Tell me how you feel when your adolescent is aggressive with you." 3. "You are so right. Adolescents function in the me-first mode all the time." 4. "I know just how you feel. I had the same experience with my children."

Q: A pediatric nurse who is employed in a busy ambulatory clinic setting is informed by the nurse manager that average nursing time allocated for each child and family is being reduced to 10 minutes to manage the clinic more efficiently. The nursing activities must include a nursing assessment and discussion on anticipatory guidance. Which of these strategies should the nurse utilize in the plan of care delivery? 1. Ask each parent to complain to the nurse manager that there is not adequate time to talk with the nurse at each visit. 2. Perform a limited assessment based on reason for visit and provide pamphlets covering anticipatory guidance. 3. Focus anticipatory guidance strategies on topics in which the parent or child has expressed interest. 4. Plan to do the anticipatory guidance first, because either the nurse practitioner or the physician can perform an assessment of the child.

Q: Which nursing assessment activities should be included for the child and family at each health supervision visit? Standard Text: Select all that apply. 1. Performing an age-appropriate developmental assessment 2. Performing age-appropriate screening examinations 3. Monitoring parents' ability to pay for services 4. Assessing for genetic abnormalities 5. Obtaining an updated health history

Q: Which of these strategies would be most effective for a "teachable moment" for the parents of a four-year-old child during a routine office visit? 1. Discuss with the parents preparation for school because the child will start kindergarten next year 2. Review five-year-old anticipatory guidelines with the parents. 3. Select one topic that is a common problem or concern for parents of four-year-olds and present a brief amount of information on the topic. 4. Review all four-year-old anticipatory guidelines with the parents.

Q: A mother brings her two-year-old child to the pediatric office for a sick visit. The child is seen regularly at the office and was last seen at her well-child visit two months ago. Based on this information, which is the most appropriate action by the nurse? 1. Asking the mother to leave the room after obtaining the history 2. Obtaining a comprehensive history, including sociodemographic data 3. Focusing exclusively on the reported illness 4. Reviewing health promotion and maintenance activities

Q: A mother says to a nurse, "I am so concerned about my 14-year-old daughter because she has been caught stealing small articles of clothing and jewelry from stores on several occasions." The nurse begins a discussion on strategies for improving ethical behavior. This plan of care is part of: 1. Moral conditioning. 2. Health maintenance. 3. Behavioral discipline. 4. Health promotion.

Q: Student nurses are observing in the pediatric well-child clinic. The students observe that prior to administering an immunization to a child, a nurse explains the reason for the immunization series to the mother. While discussing the incident in post-conference, the students report that this activity was: 1. Health screening. 2. Health promotion. 3. Health maintenance. 4. Health assessment.

Q: The nurse working in the pediatric clinic performs many activities. Which of these nursing activities can be classified promoting health promotion and maintenance? Standard Text: Select all that apply. 1. Administering the flu vaccine to infants from 6 to 23 months of age 2. Administering an antibiotic to a child with a diagnosis of acute otitis media 3. Teaching parents how to perform pulmonary drainage and cupping on their child with a respiratory infection 4. Instructing adolescents how to use dental floss 5. Discussing of daily feeding schedules for infants

Q: The nurse is assessing a new admission to the newborn nursery. Which physical findings suggest the infant was preterm? Standard Text: Select all that apply. 1. The ear pinna quickly returns to original position after being bent manually. 2. The infant's resting position is tightly flexed. 3. Labia widely separated with clitoris prominent. 4. Breast area barely perceptible with flat areola, no bud. 5. Sole creases do not extend the length of the foot.

Q: The nurse is assessing a newborn while the new parents watch. The nurse uses an ophthalmoscope to examine the back of the eye (the retina) and notes a positive red reflex. The nurse would explain to the parents that the red reflex indicates: 1. The absence of congenital cataracts. 2. The presence of intraocular hemorrhage. 3. The optic nerve has been traumatized during delivery. 4. Presence of amblyopia.

Q: While assessing newborns, the nurse should differentiate normal findings from findings which require further evaluation and intervention. Which would be normal newborn findings? Standard Text: Select all that apply. 1. Swelling over the occiput that crosses suture lines 2. Tiny white papules located primarily on the nose and chin 3. Tiny red macules and pustules that come and go, primarily on the trunk and extremities 4. When the Moro reflex is elicited, the right arm extends and returns to the body. The left arm remains resting against the chest. 5. Greenish discoloration of skin over the entire body that is not removed by the initial bath

Q: While assessing the blood pressure of an eight-year-old child, the nurse notes the following: Systolic sound is heard at 98, but the sound continues until it reaches 0. There is a distinct sound softening at 48. How should the nurse record this finding? 1. 98/48 2. 98/48/0 3. 98/0 4. 48/0

Q: While assessing a seven-year-old girl, the nurse notices a regularirregular heartbeat. The nurse listens carefully and notes that the heart rate increases on inspiration and decreases on expiration. What is the most appropriate action for the nurse to take next? 1. Record the finding as normal. 2. Notify the physician. 3. Schedule an EKG. 4. Ask the mother if a murmur has been detected before.

Q: To accurately access blood pressure on a child, the nurse would select a cuff: 1. By the cuff labelinfant, child, adult. 2. That covers 2/3 of the upper arm with a bladder that wraps around at least 80% of the circumference of the arm. 3. Based on availability as the size of the cuff will not influence the blood pressure. 4. That extends up to 50 % of the upper arm and the bladder covers 1/4 of the circumference of the arm.

Q: The nurse wants to do a quick evaluation of a one-month-old infant's hearing. Which assessment will provide the best information? 1. Examining the ear canal with an otoscope 2. Using a vibrating tuning fork placed against the child's skull 3. Using tympanometry 4. Using a noisemaker in the infant's presence to evaluate the child's response

Q: The policy of the pediatric clinic is that head circumferences are performed at each visit, if appropriate. The nurse should plan to check head circumferences on which of the children being seen today? Standard Text: Select all that apply. 1. One-month-old child who is coming for his first well-child visit 2. Two-month-old child with failure to thrive 3. Nine-month-old child with otitis media 4. 18-month-old well-child visit for a child with Down's syndrome

Q: While evaluating development of children, the nurse notes that the development of secondary sexual characteristics follows a typical pattern. Place the appearance of secondary sexual characteristics in the female in order of appearance from earliest to latest. Standard Text: Click and drag the options below to move them up or down. Choice 1. Appearance of pubic hair Choice 2. Menarche Choice 3. Breast budding Choice 4. Breast Tanner stage 5, areola strongly pigmented

Q: While assessing a 10-month-old African American infant, the nurse notices that the sclerae have a yellowish tint. Which organ system would the nurse suspect as having an ongoing disease process? 1. Genitourinary 2. Cardiac 3. Gastrointestinal 4. Respiratory

Q: While inspecting a five-year-old child's ears with an otoscope, the nurse notes that the right membrane is red and there is an absence of light reflex. In view of these findings, which vital sign parameter would most concern the nurse? 1. Heart rate 2. Temperature 3. Blood pressure 4. Respirations

Q: A seven-year-old presents to the clinic with an exacerbation of asthma symptoms. On physical exam, the nurse would expect which of the following findings? Standard Text: Select all that apply. 1. Increased tactile fremitus 2. Decreased vocal resonance 3. Bronchophony 4. Decreased tactile fremitus 5. Wheezing

Q: The nurse is caring for an infant diagnosed with "failure to thrive." The nurse observes the physician taking blood pressures in all four extremities and recognizes that the physician suspects which congenital cardiac defect? 1. Tetralogy of Fallot 2. Ventricular septal defect 3. Pulmonary atresia 4. Coarctation of the aorta

Q: A nurse caring for a nine-year-old notices some swelling in the child's ankles. The nurse presses against the ankle bone for five seconds, then releases the pressure, noticing a markedly slow disappearance of the indentation. Based on these physical findings, the nurse would be most concerned with assessing: 1. Skin integrity, especially in the lower extremities. 2. Level of consciousness. 3. Urine output. 4. Range of motion and ankle mobility.

Q: A very concerned 14-year-old boy presents to the clinic because of an enlargement of his left breast. Except for the breast enlargement, the client's history and physical are normal. The most appropriate intervention for the nurse to implement next would be to inform the child that: 1. This is a normal finding in adolescent males and that the breast tissue generally regresses by the time of full sexual maturity. 2. His condition is related to a high-fat diet and that limiting fat intake usually will resolve the enlargement over a period of a couple of months. 3. A pediatric endocrine consult is being arranged. 4. The healthcare provider is arranging a surgical consult for him.

Q: Put the following nursing assessments of a toddler in the best order for the nurse to proceed (from first assessment to last assessment). Standard Text: Click and drag the options below to move them up or down. Choice 1. Auscultation of chest Choice 2. Examination of eyes, ears, and throat Choice 3. Palpation of abdomen Choice 4. General appearance