Test Bank Wongs Nursing Care Infants Children 10th Edition, Marilyn
Chapter 01: Perspectives of Pediatric Nursing
1. The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination?
a. The United States is ranked last among 27 countries.
b. The United States is ranked similar to 20 other developed countries.
c. The United States is ranked in the middle of 20 other developed countries.
d. The United States is ranked highest among 27 other industrialized countries.
2. Which is the leading cause of death in infants younger than 1 year in the United States?
a. Congenital anomalies
b. Sudden infant death syndrome
c. Disorders related to short gestation and low birth weight
d. Maternal complications specific to the perinatal period
3. What is the major cause of death for children older than 1 year in the United States?
a. Heart disease
b. Childhood cancer
c. Unintentional injuries
d. Congenital anomalies
4. In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years?
a. Suicide and cancer
b. Suicide and homicide
c. Drowning and cancer
d. Homicide and heart disease
5. The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should the nurse include in the session with regard to deaths caused by injuries?
a. More deaths occur in males.
b. More deaths occur in females.
c. The pattern of deaths does not vary according to age and sex.
d. The pattern of deaths does not vary widely among different ethnic groups.
6. What do mortality statistics describe?
a. Disease occurring regularly within a geographic location
b. The number of individuals who have died over a specific period
c. The prevalence of specific illness in the population at a particular time
d. Disease occurring in more than the number of expected cases in a community
7. The nurse should assess which age group for suicide ideation since suicide in which age group is the third leading cause of death?
b. Young school age
c. Middle school age
d. Late school age and adolescents
8. Parents of a hospitalized toddler ask the nurse, “What is meant by family-centered care?” The nurse should respond with which statement?
a. Family-centered care reduces the effect of cultural diversity on the family.
b. Family-centered care encourages family dependence on the health care system.
c. Family-centered care recognizes that the family is the constant in a child’s life.
d. Family-centered care avoids expecting families to be part of the decision-making process.
9. The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning?
a. Purposeful and goal directed
b. A simple developmental process
c. Based on deliberate and irrational thought
d. Assists individuals in guessing what is most appropriate
10. Evidence-based practice (EBP), a decision-making model, is best described as which?
a. Using information in textbooks to guide care
b. Combining knowledge with clinical experience and intuition
c. Using a professional code of ethics as a means for decision making
d. Gathering all evidence that applies to the child’s health and family situation
Chapter 02: Social, Cultural, Religious, and Family Influences on Child Health Promotion
1. Children are taught the values of their culture through observation and feedback relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may be culturally determined?
b. Racial variation
d. Geographic boundaries
2. The nurse is aware that if patients’ different cultures are implied to be inferior, the emotional attitude the nurse is displaying is what?
c. Cultural shock
d. Cultural sensitivity
3. Which term best describes the sharing of common characteristics that differentiates one group from other groups in a society?
4. After the family, which has the greatest influence on providing continuity between generations?
c. Social class
5. The nurse is planning care for a patient with a different ethnic background. Which should be an appropriate goal?
a. Adapt, as necessary, ethnic practices to health needs.
b. Attempt, in a nonjudgmental way, to change ethnic beliefs.
c. Encourage continuation of ethnic practices in the hospital setting.
d. Strive to keep ethnic background from influencing health needs.
6. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child’s mother says she has rubbed the edge of a coin on her child’s oiled skin. The nurse should recognize this as what?
a. Child abuse
b. Cultural practice to rid the body of disease
c. Cultural practice to treat enuresis or temper tantrums
d. Child discipline measure common in the Vietnamese culture
7. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which statement best explains this?
a. The parent is trying to feed the child only what the child likes most.
b. Hispanics believe the “evil eye” enters when a person gets cold.
c. The parent is trying to restore normal balance through appropriate “hot” remedies.
d. Hispanics believe an innate energy called chi is strengthened by eating soup.
8. How is family systems theory best described?
a. The family is viewed as the sum of individual members.
b. A change in one family member cannot create a change in other members.
c. Individual family members are readily identified as the source of a problem.
d. When the family system is disrupted, change can occur at any point in the system.
9. Which family theory is described as a series of tasks for the family throughout its life span?
a. Exchange theory
b. Developmental theory
c. Structural-functional theory
d. Symbolic interactional theory
10. Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events?
a. Interactional theory
b. Family stress theory
c. Erikson’s psychosocial theory
d. Developmental systems theory
Chapter 03: Hereditary Influences on Health Promotion of the Child and Family
1. Which genetic term refers to a person who possesses one copy of an affected gene and one copy of an unaffected gene and is clinically unaffected?
2. Which genetic term refers to the transfer of all or part of a chromosome to a different chromosome after chromosome breakage?
3. Which is a birth defect or disorder that occurs as a new case in a family and is not inherited?
4. The nurse is assessing a neonate who was born 1 hour ago to healthy white parents in their early forties. Which finding should be most suggestive of Down syndrome?
b. Low-set ears
d. Long, thin fingers and toes
5. Which abnormality is a common sex chromosome defect?
a. Down syndrome
b. Turner syndrome
c. Marfan syndrome
6. Turner syndrome is suspected in an adolescent girl with short stature. What causes this?
a. Absence of one of the X chromosomes
b. Presence of an incomplete Y chromosome
c. Precocious puberty in an otherwise healthy child
d. Excess production of both androgens and estrogens
7. Which is a sex chromosome abnormality that is caused by the presence of one or more additional X chromosomes in a male?
b. Triple X
d. Trisomy 13
8. Parents ask the nurse about the characteristics of autosomal dominant inheritance. Which statement is characteristic of autosomal dominant inheritance?
a. Females are affected with greater frequency than males.
b. Unaffected children of affected individuals will have affected children.
c. Each child of a heterozygous affected parent has a 50% chance of being affected.
d. Any child of two unaffected heterozygous parents has a 25% chance of being affected.
9. Parents ask the nurse about the characteristics of autosomal recessive inheritance. Which is characteristic of autosomal recessive inheritance?
a. Affected individuals have unaffected parents.
b. Affected individuals have one affected parent.
c. Affected parents have a 50% chance of having an affected child.
d. Affected parents will have unaffected children.
10. Which is characteristic of X-linked recessive inheritance?
a. There are no carriers.
b. Affected individuals are principally males.
c. Affected individuals are principally females.
d. Affected individuals will always have affected parents.
Chapter 04: Communication, Physical, and Developmental Assessment
1. The nurse is seeing an adolescent and the parents in the clinic for the first time. Which should the nurse do first?
a. Introduce him- or herself.
b. Make the family comfortable.
c. Give assurance of privacy.
d. Explain the purpose of the interview.
2. Which is considered a block to effective communication?
a. Using silence
b. Using clichés
c. Directing the focus
d. Defining the problem
3. Which is the single most important factor to consider when communicating with children?
a. Presence of the child’s parent
b. Child’s physical condition
c. Child’s developmental level
d. Child’s nonverbal behaviors
4. Because children younger than 5 years are egocentric, the nurse should do which when communicating with them?
a. Focus communication on the child.
b. Use easy analogies when possible.
c. Explain experiences of others to the child.
d. Assure the child that communication is private.
5. The nurse’s approach when introducing hospital equipment to a preschooler who seems afraid should be based on which principle?
a. The child may think the equipment is alive.
b. Explaining the equipment will only increase the child’s fear.
c. One brief explanation will be enough to reduce the child’s fear.
d. The child is too young to understand what the equipment does.
6. When the nurse interviews an adolescent, which is especially important?
a. Focus the discussion on the peer group.
b. Allow an opportunity to express feelings.
c. Use the same type of language as the adolescent.
d. Emphasize that confidentiality will always be maintained.
7. The nurse is preparing to assess a 10-month-old infant. He is sitting on his father’s lap and appears to be afraid of the nurse and of what might happen next. Which initial actions by the nurse should be most appropriate?
a. Initiate a game of peek-a-boo.
b. Ask the infant’s father to place the infant on the examination table.
c. Talk softly to the infant while taking him from his father.
d. Undress the infant while he is still sitting on his father’s lap.
8. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is which?
a. Ask her why she wants to know.
b. Determine why she is so anxious.
c. Explain in simple terms how it works.
d. Tell her she will see how it works as it is used.
9. The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful?
a. Recommend that the child keep a diary.
b. Provide supplies for the child to draw a picture.
c. Suggest that the parent read fairy tales to the child.
d. Ask the parent if the child is always uncommunicative.
10. Which data should be included in a health history?
a. Review of systems
b. Physical assessment
c. Growth measurements
d. Record of vital signs
Chapter 05: Pain Assessment and Management in Children
1. Which is the most consistent and commonly used data for assessment of pain in infants?
d. Parental report
2. Children as young as age 3 years can use facial scales for discrimination. What are some suggested anchor words for the preschool age group?
a. “No hurt.”
b. “Red pain.”
c. “Zero hurt.”
d. “Least pain.”
3. What is an important consideration when using the FACES pain rating scale with children?
a. Children color the face with the color they choose to best describe their pain.
b. The scale can be used with most children as young as 3 years.
c. The scale is not appropriate for use with adolescents.
d. The FACES scale is useful in pain assessment but is not as accurate as physiologic responses.
4. What describes nonpharmacologic techniques for pain management?
a. They may reduce pain perception.
b. They usually take too long to implement.
c. They make pharmacologic strategies unnecessary.
d. They trick children into believing they do not have pain.
5. Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain?
a. Tactile stimulation
b. Commercial warm packs
c. Doing procedure during infant sleep
d. Oral sucrose and nonnutritive sucking
6. A 6-year-old child has patient-controlled analgesia (PCA) for pain management after orthopedic surgery. The parents are worried that their child will be in pain. What should your explanation to the parents include?
a. The child will continue to sleep and be pain free.
b. Parents cannot administer additional medication with the button.
c. The pump can deliver baseline and bolus dosages.
d. There is a high risk of overdose, so monitoring is done every 15 minutes.
7. Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?
a. Codeine sulfate (Codeine)
b. Morphine (Roxanol)
c. Methadone (Dolophine)
d. Meperidine (Demerol)
8. A child is in the intensive care unit after a motor vehicle collision. The child has numerous fractures and is in pain that is rated 9 or 10 on a 10-point scale. In planning care, the nurse recognizes that the indicated action is which?
a. Give only an opioid analgesic at this time.
b. Increase dosage of analgesic until the child is adequately sedated.
c. Plan a preventive schedule of pain medication around the clock.
d. Give the child a clock and explain when she or he can have pain medications.
9. The parents of a preterm infant in a neonatal intensive care unit are concerned about their infant experiencing pain from so many procedures. The nurse’s response should be based on which characteristic about preterm infants’ pain?
a. They may react to painful stimuli but are unable to remember the pain experience.
b. They perceive and react to pain in much the same manner as children and adults.
c. They do not have the cortical and subcortical centers that are needed for pain perception.
d. They lack neurochemical systems associated with pain transmission and modulation.
10. A preterm infant has just been admitted to the neonatal intensive care unit. The infant’s parents ask the nurse about anesthesia and analgesia when painful procedures are necessary. What should the nurse’s explanation be?
a. Nerve pathways of neonates are not sufficiently myelinated to transmit painful stimuli.
b. The risks accompanying anesthesia and analgesia are too great to justify any possible benefit of pain relief.
c. Neonates do not possess sufficiently integrated cortical function to interpret or recall pain experiences.
d. Pain pathways and neurochemical systems associated with pain transmission are intact and functional in neonates.
Chapter 06: Childhood Communicable and Infectious Diseases
1. Pertussis vaccination should begin at which age?
b. 2 months
c. 6 months
d. 12 months
2. A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain?
a. This cannot be prevented.
b. Infants do not feel pain as adults do.
c. This is not a good reason for refusing immunizations.
d. A topical anesthetic can be applied before injections are given.
3. A 4-month-old infant comes to the clinic for a well-infant checkup. Immunizations she should receive are DTaP (diphtheria, tetanus, acellular pertussis) and IPV (inactivated poliovirus vaccine). She is recovering from a cold but is otherwise healthy and afebrile. Her older sister has cancer and is receiving chemotherapy. Nursing considerations should include which?
a. DTaP and IPV can be safely given.
b. DTaP and IPV are contraindicated because she has a cold.
c. IPV is contraindicated because her sister is immunocompromised.
d. DTaP and IPV are contraindicated because her sister is immunocompromised.
4. Which serious reaction should the nurse be alert for when administering vaccines?
b. Skin irritation
c. Allergic reaction
d. Pain at injection site
5. Which muscle is contraindicated for the administration of immunizations in infants and young children?
d. Anterolateral thigh
6. Which is described as an elevated, circumscribed skin lesion that is less than 1 cm in diameter and filled with serous fluid?
7. Which vitamin supplementation has been found to reduce both morbidity and mortality in measles?
8. What does impetigo ordinarily results in?
a. No scarring
b. Pigmented spots
c. Atrophic white scars
d. Slightly depressed scars
9. What often causes cellulitis?
a. Herpes zoster
b. Candida albicans
c. Human papillomavirus
d. Streptococci or staphylococci
10. Lymphangitis (streaking) is frequently seen in what?
c. Impetigo contagiosa
d. Staphylococcal scalded skin
Chapter 07: Health Promotion of the Newborn and Family
1. What is a function of brown adipose tissue (BAT) in newborns?
a. Generates heat for distribution to other parts of body
b. Provides ready source of calories in the newborn period
c. Protects newborns from injury during the birth process
d. Insulates the body against lowered environmental temperature
2. Which characteristic is representative of a full-term newborn’s gastrointestinal tract?
a. Transit time is diminished.
b. Peristaltic waves are relatively slow.
c. Pancreatic amylase is overproduced.
d. Stomach capacity is very limited.
3. Which term is used to describe a newborn’s first stool?
b. Milk stool
4. In term newborns, the first meconium stool should occur no later than within how many hours after birth?
5. Which is true regarding an infant’s kidney function?
a. Conservation of fluid and electrolytes occurs.
b. Urine has color and odor similar to the urine of adults.
c. The ability to concentrate urine is less than that of adults.
d. Normally, urination does not occur until 24 hours after delivery.
6. The Apgar score of an infant 5 minutes after birth is 8. Which is the nurse’s best interpretation of this?
a. Resuscitation is likely to be needed.
b. Adjustment to extrauterine life is adequate.
c. Additional scoring in 5 more minutes is needed.
d. Maternal sedation or analgesia contributed to the low score.
7. Which statement best represents the first stage or the first period of reactivity in the infant?
a. Begins when the newborn awakes from a deep sleep
b. Is an excellent time to acquaint the parents with the newborn
c. Ends when the amounts of respiratory mucus have decreased
d. Provides time for the mother to recover from the childbirth process
8. Which statement reflects accurate information about patterns of sleep and wakefulness in the newborn?
a. States of sleep are independent of environmental stimuli.
b. The quiet alert stage is the best stage for newborn stimulation.
c. Cycles of sleep states are uniform in newborns of the same age.
d. Muscle twitches and irregular breathing are common during deep sleep.
9. The nurse observes that a new mother avoids making eye contact with her infant. What should the nurse do?
a. Ask the mother why she won’t look at the infant.
b. Examine the infant’s eyes for the ability to focus.
c. Assess the mother for other attachment behaviors.
d. Recognize this as a common reaction in new mothers.
10. Which should the nurse use when assessing the physical maturity of a newborn?
b. Apgar score
c. Posture at rest
d. Chest circumference
Chapter 08: Health Problems of Newborns
1. Which term is defined as a vaguely outlined area of edematous tissue situated over the portion of the scalp that presents in a vertex delivery?
c. Caput succedaneum
d. Subdural hematoma
2. Which finding on a newborn assessment should the nurse recognize as suggestive of a clavicle fracture?
a. Positive scarf sign
b. Asymmetric Moro reflex
c. Swelling of fingers on affected side
d. Paralysis of affected extremity and muscles
3. The parents of a newborn ask the nurse what caused the baby’s facial nerve paralysis. The nurse’s response is based on remembering that this is caused by what?
a. Birth injury
b. Genetic defect
c. Spinal cord injury
d. Inborn error of metabolism
4. A mother is upset because her newborn has erythema toxicum neonatorum. The nurse should reassure her that this is what?
a. Easily treated
b. Benign and transient
c. Usually not contagious
d. Usually not disfiguring
5. What should nursing care of an infant with oral candidiasis (thrush) include?
a. Avoid use of a pacifier.
b. Continue medication for the prescribed number of days.
c. Remove the characteristic white patches with a soft cloth.
d. Apply medication to the oral mucosa, being careful that none is ingested.
6. A mother brings her 6-week-old infant in with complaints of poor feeding, lethargy, fever, irritability, and a vesicular rash. What does the nurse suspect?
c. Neonatal herpes
d. Congenital syphilis
7. Which is a bright red, rubbery nodule with a rough surface and a well-defined margin that may be present at birth?
a. Port-wine stain
b. Juvenile melanoma
c. Cavernous hemangioma
d. Strawberry hemangioma
8. What is an infant with severe jaundice at risk for developing?
b. Bullous impetigo
c. Respiratory distress
d. Blood incompatibility
9. When should the nurse expect breastfeeding-associated jaundice to first appear in a normal infant?
a. 2 to 12 hours
b. 12 to 24 hours
c. 2 to 4 days
d. After the fifth day
10. Which intervention may decrease the incidence of physiologic jaundice in a healthy full-term infant?
a. Institute early and frequent feedings.
b. Bathe newborn when the axillary temperature is 36.3° C (97.5° F).
c. Place the newborn’s crib near a window for exposure to sunlight.
d. Suggest that the mother initiate breastfeeding when the danger of jaundice has passed.
Chapter 09: The High-Risk Newborn and Family
1. Which refers to an infant whose rate of intrauterine growth has slowed and whose birth weight falls below the 10th percentile on intrauterine growth charts?
c. Low birth weight
d. Small for gestational age
2. A woman in premature labor delivers an extremely low–birth-weight (ELBW) infant. Transport to a neonatal intensive care unit is indicated. The nurse explains that which level of service is needed?
a. Level I
b. Level IA
c. Level II
d. Level IIIB
3. What is an essential component in caring for the very low– or extremely low–birth-weight infant?
a. Holding the infant to help develop trust
b. Using electronic monitoring devices exclusively
c. Coordinating care to reduce environmental stress
d. Incorporating infant stimulation elements during assessment
4. What explains why a neutral thermal environment is essential for a high-risk neonate?
a. The neonate produces heat by increasing activity and shivering.
b. Metabolism slows dramatically in the neonate experiencing cold stress.
c. It permits the neonate to maintain a normal core temperature with minimum oxygen consumption.
d. It permits the neonate to maintain a normal core temperature with increased caloric consumption.
5. When caring for a neonate in a radiant warmer, what should the nurse be alert to?
a. Exposure to prolonged cold stress
b. Need for Plexiglas shields to protect the infant
c. Transepidermal water loss leading to dehydration
d. Increased risk of infection from the open environment
6. The nurse is caring for a high-risk neonate who has an umbilical catheter and is in a radiant warmer. The nurse notes blanching of the feet. Which is the most appropriate nursing action?
a. Place socks on the infant’s feet.
b. Elevate the infant’s feet 15 degrees.
c. Wrap the infant’s feet loosely in a prewarmed blanket.
d. Report the findings immediately to the practitioner.
7. Which statement is true concerning the nutritional needs of preterm infants?
a. The secretion of lactase is low.
b. Carbohydrates and fats are better tolerated than protein.
c. The demand for nutrients is less than in full-term infants.
d. Breast milk lacks the proper concentration of nutrients.
8. While a mother is feeding her high-risk neonate, the nurse observes the neonate having occasional apnea, pallor, and bradycardia. What is the most appropriate nursing action?
a. Let the neonate rest before breastfeeding again.
b. Resume gavage feedings until the neonate is asymptomatic.
c. Recognize that this may indicate an underlying illness.
d. Use a high-flow, pliable nipple because it requires less energy to use.
9. A preterm infant who is being fed commercial formula by gavage has had an increase in gastric residuals, abdominal distention, and apneic episodes. Which is the most appropriate nursing action?
a. Notify the practitioner.
b. Reduce the amount fed by gavage.
c. Feed human milk by gavage.
d. Feed only a glucose solution until the infant stabilizes.
10. A mother planned to breastfeed her infant before giving birth at 33 weeks of gestation. The infant is stable and receiving oxygen. What is the most appropriate nursing action related to this?
a. Assist the mother in expressing breast milk.
b. Assess the infant’s readiness to breastfeed.
c. Explain to the mother that the infant is too small to receive breast milk.
d. Reassure the mother that infant formula is a good alternative to breastfeeding.
Chapter 10: Health Promotion of the Infant and Family
1. At which age does an infant start to recognize familiar faces and objects, such as his or her own hand?
a. 1 month
b. 2 months
c. 3 months
d. 4 months
2. During the 2-month well-child checkup, the nurse expects the infant to respond to sound in which manner?
a. Respond to name.
b. React to loud noise with Moro reflex.
c. Turn his or her head to side when sound is at ear level.
d. Locate sound by turning his or her head in a curving arc.
3. Which characteristic best describes the fine motor skills of an infant at age 5 months?
a. Neat pincer grasp
b. Strong grasp reflex
c. Builds a tower of two cubes
d. Able to grasp object voluntarily
4. The nurse is checking reflexes on a 7-month-old infant. When the infant is suspended in a horizontal prone position, the head is raised and the legs and spine are extended. Which reflex is this?
c. Body righting
d. Labyrinth righting
5. In terms of gross motor development, what should the nurse expect an infant age 5 months to do?
a. Sit erect without support.
b. Roll from the back to the abdomen.
c. Turn from the abdomen to the back.
d. Move from a prone to a sitting position.
6. At which age can most infants sit steadily unsupported?
a. 4 months
b. 6 months
c. 8 months
d. 12 months
7. By which age should the nurse expect that an infant will be able to pull to a standing position?
a. 5 to 6 months
b. 7 to 8 months
c. 11 to 12 months
d. 14 to 15 months
8. According to Piaget, a 6-month-old infant should be in which developmental stage?
a. Use of reflexes
b. Primary circular reactions
c. Secondary circular reactions
d. Coordination of secondary schemata
9. At which age do most infants begin to fear strangers?
a. 2 months
b. 4 months
c. 6 months
d. 12 months
10. At which age should the nurse expect most infants to begin to say “mama” and “dada” with meaning?
a. 4 months
b. 6 months
c. 10 months
d. 14 months
Chapter 11: Health Problems of the Infant
1. Rickets is caused by a deficiency in what?
a. Vitamin A
b. Vitamin C
c. Folic acid and iron
d. Vitamin D and calcium
2. Which factors will decrease iron absorption and should not be given at the same time as an iron supplement?
b. Fruit juice
d. Meat, fish, poultry
3. The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their children. Which is most likely lacking in their particular diet?
c. Vitamins C and A
d. Iron and calcium
4. A 1-year-old child is on a pure vegetarian (vegan) diet. This diet requires supplementation with what?
b. Folic acid
c. Vitamins D and B12
d. Vitamins C and E
5. What is marasmus?
a. Deficiency of protein with an adequate supply of calories
b. Syndrome that results solely from vitamin deficiencies
c. Not confined to geographic areas where food supplies are inadequate
d. Characterized by thin, wasted extremities and a prominent abdomen resulting from edema (ascites)
6. At a well-child check-up, the nurse notes that an infant with a previous diagnosis of failure to thrive (FTT) is now steadily gaining weight. The nurse should recommend that fruit juice intake be limited to no more than how much?
a. 4 oz/day
b. 6 oz/day
c. 8 oz/day
d. 12 oz/day
7. An infant has been diagnosed with an allergy to milk. In teaching the parent how to meet the infant’s nutritional needs, the nurse states that
a. Most children will grow out of the allergy.
b. All dairy products must be eliminated from the child’s diet.
c. It is important to have the entire family follow the special diet.
d. Antihistamines can be used so the child can have milk products.
8. Lactose intolerance is diagnosed in an 11-month-old infant. Which should the nurse recommend as a milk substitute?
b. Ice cream
c. Fortified cereal
d. Cow’s milk–based formula
9. Which term refers to the relative lactase deficiency observed in preterm infants of less than 34 weeks of gestation?
a. Congenital lactase deficiency
b. Primary lactase deficiency
c. Secondary lactase deficiency
d. Developmental lactase deficiency
10. Which statement best describes colic?
a. Periods of abdominal pain resulting in weight loss
b. Usually the result of poor or inadequate mothering
c. Periods of abdominal pain and crying occurring in infants older than age 6 months
d. A paroxysmal abdominal pain or cramping manifested by episodes of loud crying
Chapter 12: Health Promotion of the Toddler and Family
1. What factor is most important in predisposing toddlers to frequent infections?
a. Respirations are abdominal.
b. Pulse and respiratory rates in toddlers are slower than those in infants.
c. Defense mechanisms are less efficient than those during infancy.
d. Toddlers have short, straight internal ear canals and large lymph tissue.
2. What do the psychosocial developmental tasks of toddlerhood include?
a. Development of a conscience
b. Recognition of sex differences
c. Ability to get along with age mates
d. Ability to delay gratification
3. The developmental task with which the child of 15 to 30 months is likely to be struggling is a sense of which?
4. Parents of an 18-month-old boy tells the nurse that he says “no” to everything and has rapid mood swings. If he is scolded, he shows anger and then immediately wants to be held. What is the nurse’s best interpretation of this behavior?
a. This is normal behavior for his age.
b. This is unusual behavior for his age.
c. He is not effectively coping with stress.
d. He is showing he needs more attention.
5. A 17-month-old child should be expected to be in which stage, according to Piaget?
b. Concrete operations
c. Tertiary circular reactions
d. Secondary circular reactions
6. Although a 14-month-old girl received a shock from an electrical outlet recently, her parent finds her about to place a paper clip in another outlet. Which is the best interpretation of this behavior?
a. Her cognitive development is delayed.
b. This is typical behavior because toddlers are not very developed.
c. This is typical behavior because of toddlers’ inability to transfer remembering to new situations.
d. This is not typical behavior because toddlers should know better than to repeat an act that caused pain.
7. A toddler, age 16 months, falls down a few stairs. He gets up and “scolds” the stairs as if they caused him to fall. What is this an example of?
d. Delayed cognitive development
8. What is a characteristic of a toddler’s language development at age 18 months?
a. Vocabulary of 25 words
b. Use of holophrases
c. Increasing level of understanding
d. Approximately one third of speech understandable
9. Which characteristic best describes the gross motor skills of a 24-month-old child?
b. Broad jumps
c. Rides tricycle
d. Walks up and down stairs
10. What developmental characteristic does not occur until a child reaches age 2 1/2 years?
a. Birth weight has doubled.
b. Anterior fontanel is still open.
c. Primary dentition is complete.
d. Binocularity may be established.
Chapter 13: Health Promotion of the Preschooler and Family
1. In terms of fine motor development, what should the 3-year-old child be expected to do?
a. Tie shoelaces.
b. Copy (draw) a circle.
c. Use scissors or a pencil very well.
d. Draw a person with seven to nine parts.
2. According to Piaget, magical thinking is the belief of which?
a. Thoughts are all powerful.
b. God is an imaginary friend.
c. Events have cause and effect.
d. If the skin is broken, the insides will come out.
3. In terms of cognitive development, a 5-year-old child should be expected to do which?
a. Think abstractly.
b. Use magical thinking.
c. Understand conservation of matter.
d. Understand another person’s perspective.
4. The nurse is caring for a hospitalized 4-year-old boy. His parents tell the nurse they will be back to visit at 6 PM. When he asks the nurse when his parents are coming, what would the nurse’s best response be?
a. “They will be here soon.”
b. “They will come after dinner.”
c. “Let me show you on the clock when 6 PM is.”
d. “I will tell you every time I see you how much longer it will be.”
5. A 4-year-old boy is hospitalized with a serious bacterial infection. He tells the nurse that he is sick because he was “bad.” What is the nurse’s best interpretation of this comment?
a. Sign of stress
b. Common at this age
c. Suggestive of maladaptation
d. Suggestive of excessive discipline at home
6. A 4-year-old child tells the nurse that she doesn’t want another blood sample drawn because “I need all of my insides and I don’t want anyone taking them out.” What is the nurse’s best interpretation of this?
a. The child is being overly dramatic.
b. The child has a disturbed body image.
c. Preschoolers have poorly defined body boundaries.
d. Preschoolers normally have a good understanding of their bodies.
7. Which type of play is most typical of the preschool period?
8. What characteristic best describes the language skills of a 3-year-old child?
a. Asks meanings of words
b. Follows directional commands
c. Can describe an object according to its composition
d. Talks incessantly regardless of whether anyone is listening
9. During a well-child visit, the father of a 4-year-old boy tells the nurse that he is not sure if his son is ready for kindergarten. The boy’s birthday is close to the cut-off date, and he has not attended preschool. What is the nurse’s best recommendation?
a. Start kindergarten.
b. Talk to other parents about readiness.
c. Perform a developmental screening.
d. Postpone kindergarten and go to preschool.
10. Parents tell the nurse they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom. What is the most appropriate recommendation for the nurse to make?
a. Punish the children so this behavior stops.
b. Neither condone nor condemn the curiosity.
c. Get counseling for this unusual and dangerous behavior.
d. Allow the children unrestricted permission to satisfy this curiosity.
Chapter 14: Health Problems of Early Childhood
1. A father calls the clinic because he found his young daughter squirting Visine eyedrops into her mouth. What is the most appropriate nursing action?
a. Reassure the father that Visine is harmless.
b. Direct him to seek immediate medical treatment.
c. Recommend inducing vomiting with ipecac.
d. Advise him to dilute Visine by giving his daughter several glasses of water to drink.
2. The nurse suspects that a child has ingested some type of poison. What clinical manifestation would be most suggestive that the poison was a corrosive product?
c. Stupor, lethargy, and coma
d. Edema of the lips, tongue, and pharynx
3. A young boy is found squirting lighter fluid into his mouth. His father calls the emergency department. The nurse taking the call should know that the primary danger is what?
a. Hepatic dysfunction
b. Dehydration secondary to vomiting
c. Esophageal stricture and shock
d. Bronchitis and chemical pneumonia
4. What is a clinical manifestation of acetaminophen poisoning?
b. Hepatic involvement
c. Severe burning pain in stomach
d. Drooling and inability to clear secretions
5. An awake, alert 4-year-old child has just arrived at the emergency department after an ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in which manner?
a. Giving half of the solution and then repeating the other half in 1 hour
b. Mixing with a flavorful beverage in an opaque container with a straw
c. Serving it in a clear plastic cup so the child can see how much has been drunk
d. Administering it through a nasogastric tube because the child will not drink it because of the taste
6. What is a significant secondary prevention nursing activity for lead poisoning?
a. Chelation therapy
b. Screening children for blood lead levels
c. Removing lead-based paint from older homes
d. Questioning parents about ethnic remedies containing lead
7. What is an important nursing consideration when a child is hospitalized for chelation therapy to treat lead poisoning?
a. Maintain bed rest.
b. Maintain isolation precautions.
c. Keep an accurate record of intake and output.
d. Institute measures to prevent skeletal fracture.
8. What is the most common form of child maltreatment?
a. Sexual abuse
b. Child neglect
c. Physical abuse
d. Emotional abuse
9. A child is admitted with a suspected diagnosis of Munchausen syndrome by proxy (MSBP). What is an important consideration in the care of this child?
a. Monitoring the parents whenever they are with the child
b. Reassuring the parents that the cause of the disorder will be found
c. Teaching the parents how to obtain necessary specimens
d. Supporting the parents as they cope with diagnosis of a chronic illness
10. When only one child is abused in a family, the abuse is usually a result of what?
a. The child is the firstborn.
b. The child is the same gender as the abusing parent.
c. The parent abuses the child to avoid showing favoritism.
d. The parent is unable to deal with the child’s behavioral style.
Chapter 15: Health Promotion of the School-Age Child and Family
1. What statement accurately describes physical development during the school-age years?
a. The child’s weight almost triples.
b. Muscles become functionally mature.
c. Boys and girls double strength and physical capabilities.
d. Fat gradually increases, which contributes to children’s heavier appearance.
2. The parents of 9-year-old twin children tell the nurse, “They have filled up their bedroom with collections of rocks, shells, stamps, and bird nests.” The nurse should recognize that this is which?
a. Indicative of giftedness
b. Indicative of typical twin behavior
c. Characteristic of cognitive development at this age
d. Characteristic of psychosocial development at this age
3. What statement characterizes moral development in the older school-age child?
a. Rule violations are viewed in an isolated context.
b. Judgments and rules become more absolute and authoritarian.
c. The child remembers the rules but cannot understand the reasons behind them.
d. The child is able to judge an act by the intentions that prompted it rather than just by the consequences.
4. An 8-year-old girl tells the nurse that she has cancer because God is punishing her for “being bad.” What should the nurse interpret this as?
a. A common belief at this age
b. Indicative of excessive family pressure
c. Faith that forms the basis for most religions
d. Suggestive of a failure to develop a conscience
5. What is the role of the peer group in the life of school-age children?
a. Decreases their need to learn appropriate sex roles
b. Gives them an opportunity to learn dominance and hostility
c. Allows them to remain dependent on their parents for a longer time
d. Provides them with security as they gain independence from their parents
6. What is descriptive of the social development of school-age children?
a. Identification with peers is minimum.
b. Children frequently have “best friends.”
c. Boys and girls play equally with each other.
d. Peer approval is not yet an influence for the child to conform.
7. What statement best describes the relationship school-age children have with their families?
a. Ready to reject parental controls
b. Desire to spend equal time with family and peers
c. Need and want restrictions placed on their behavior by the family
d. Peer group replaces the family as the primary influence in setting standards of behavior and rules
8. A parent asks about whether a 7-year-old child is able to care for a dog. Based on the child’s age, what does the nurse suggest?
a. Caring for an animal requires more maturity than the average 7-year-old possesses.
b. This will help the parent identify the child’s weaknesses.
c. A dog can help the child develop confidence and emotional health.
d. Cats are better pets for school-age children.
9. The school nurse has been asked to begin teaching sex education in the fifth grade. What should the nurse recognize?
a. Questions need to be discouraged in this setting.
b. Most children in the fifth grade are too young for sex education.
c. Sexuality is presented as a normal part of growth and development.
d. Correct terminology should be reserved for children who are older.
10. What is descriptive of the play of school-age children?
a. They like to invent games, making up the rules as they go.
b. Individuality in play is better tolerated than at earlier ages.
c. Knowing the rules of a game gives an important sense of belonging.
d. Team play helps children learn the universal importance of competition and winning.
Chapter 16: Health Problems of the School-Age Child
1. Deficiency of which vitamin or mineral results in an inadequate inflammatory response?
2. An occlusive dressing is applied to a large abrasion. This is advantageous because the dressing will accomplish what?
a. Deliver vitamin C to the wound.
b. Provide an antiseptic for the wound.
c. Maintain a moist environment for healing.
d. Promote mechanical friction for healing.
3. A toddler has a deep laceration contaminated with dirt and sand. Before closing the wound, the nurse should irrigate with what solution?
b. Normal saline
d. Hydrogen peroxide
4. The nurse should know what about Lyme disease?
a. Very difficult to prevent
b. Easily treated with oral antibiotics in stages 1, 2, and 3
c. Caused by a spirochete that enters the skin through a tick bite
d. Common in geographic areas where the soil contains the mycotic spores that cause the disease
5. The school nurse is seeing a child who collected some poison ivy leaves during recess. He says only his hands touched it. What is the most appropriate nursing action?
a. Soak his hands in warm water.
b. Apply Burow’s solution compresses.
c. Rinse his hands in cold running water.
d. Scrub his hands thoroughly with antibacterial soap.
6. A 6-year-old boy with very fair skin will be joining his family during a beach vacation. What should the nurse recommend?
a. Keep him off the beach during the daytime hours.
b. Use sunscreen with an SPF of at least 15 and reapply it every 2 to 3 hours.
c. Apply a topical sunscreen product with an SPF of 30 in the morning.
d. Dress him in long pants and long-sleeved shirt and keep him under a beach umbrella.
7. The management of a child who has just been stung by a bee or wasp should include applying what?
a. Cool compresses
b. Antibiotic cream
c. Warm compresses
d. Corticosteroid cream
8. A parent calls the clinic nurse because his 7-year-old child was bitten by a black widow spider. What action should the nurse advise the parent to take?
a. Apply warm compresses.
b. Carefully scrape off the stinger.
c. Take the child to the emergency department.
d. Apply a thin layer of corticosteroid cream.
9. A school-age child has been bitten on the leg by a large snake that may be poisonous. During transport to an emergency facility, what should the care include?
a. Apply ice to the snakebite.
b. Immobilize the leg with a splint.
c. Place a loose tourniquet distal to the bite.
d. Apply warm compresses to the snakebite.
10. Parents phone the nurse and say that their child just knocked out a permanent tooth. What should the nurse’s instructions to the parents include?
a. Place the tooth in dry container for transport.
b. Hold the tooth by the crown and not by the root area.
c. Transport the child and tooth to a dentist within 18 hours.
d. Take the child to hospital emergency department if his or her mouth is bleeding.
Chapter 17: Health Promotion of the Adolescent and Family
1. How does the onset of the pubertal growth spurt compare in girls and boys?
a. In girls, it occurs about 1 year before it appears in boys.
b. In girls, it occurs about 3 years before it appears in boys.
c. In boys. it occurs about 1 year before it appears in girls.
d. It is about the same in both boys and girls.
2. In girls, what is the initial indication of puberty?
b. Growth spurt
c. Breast development
d. Growth of pubic hair
3. Girls experience an increase in weight and fat deposition during puberty. What do nursing considerations related to this include?
a. Give reassurance that these changes are normal.
b. Suggest dietary measures to control weight gain.
c. Encourage a low-fat diet to prevent fat deposition.
d. Recommend increased exercise to control weight gain.
4. In boys, what is the initial indication of puberty?
a. Voice changes
b. Growth of pubic hair
c. Testicular enlargement
d. Increased size of penis
5. According to Piaget, adolescents tend to be in what stage of cognitive development?
a. Concrete operations
b. Conventional thought
c. Postconventional thought
d. Formal operational thought
6. What aspects of cognition develop during adolescence?
a. Ability to see things from the point of view of another
b. Capability of using a future time perspective
c. Capability of placing things in a sensible and logical order
d. Progress from making judgments based on what they see to making judgments based on what they reason
7. Adolescents often do not use reasoned decision making when issues such as substance abuse and sexual behavior are involved. What is this because of?
a. They tend to be immature.
b. They do not need to use reasoned decision making.
c. They lack cognitive skills to use reasoned decision making.
d. They are dealing with issues that are stressful and emotionally laden.
8. What is most descriptive of the spiritual development of older adolescents?
a. Beliefs become more abstract.
b. Rituals and practices become increasingly important.
c. Strict observance of religious customs is common.
d. Emphasis is placed on external manifestations, such as whether a person goes to church.
9. According to Erikson, the psychosocial task of adolescence is developing what?
10. What is true concerning the development of autonomy during adolescence?
a. Development of autonomy typically involves rebellion.
b. Development of autonomy typically involves parent–child conflicts.
c. Parent and peer influences are opposing forces in the development of autonomy.
d. Conformity to both parents and peers gradually declines toward the end of adolescence.
Chapter 18: Health Problems of the Adolescent
1. Tretinoin (Retin-A) is a commonly used topical agent for the treatment of acne. What do nursing considerations with this drug include?
a. Sun exposure increases effectiveness.
b. Cosmetics with lanolin and petrolatum are preferred in acne.
c. Applying of the medication occurs at least 20 to 30 minutes after washing.
d. Erythema and peeling are indications of toxicity and need to be reported.
2. What is the usual presenting symptom for testicular cancer?
a. Solid, painful mass
b. Hard, painless mass
c. Scrotal swelling and pain
d. Epididymis easily palpated
3. A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He denies any trauma to the scrotum. What is the most appropriate nursing action?
a. Refer him for immediate medical evaluation.
b. Administer analgesics and recommend scrotal support.
c. Apply an ice bag and observe for increasing pain.
d. Reassure the adolescent that occasional pain is common with the changes of puberty.
4. A 14-year-old boy is of normal weight, and his parents are concerned about bilateral breast enlargement. The nurse’s discussion of this should be based on what?
a. The presence of too much body fat
b. Symptom that a hormonal imbalance is present
c. Most likely part of normal pubertal development
d. Indication that he is developing precocious puberty
5. A 15-year-old girl tells the school nurse that she has not started to menstruate yet. Onset of secondary sexual characteristics was about 2 1/2 years ago. The nurse should take which action?
a. Explain that this is not unusual.
b. Refer the adolescent for an evaluation.
c. Make an assumption that the adolescent is pregnant.
d. Suggest that the adolescent stop exercising until menarche occurs.
6. An adolescent girl asks the school nurse for advice because she has dysmenorrhea. She says that a friend recommended she try an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The nurse’s response should be based on what?
a. Hormone therapy is necessary for the treatment of dysmenorrhea.
b. Acetaminophen is the drug of choice for the treatment of dysmenorrhea.
c. Over-the-counter NSAIDs are rarely strong enough to provide adequate pain relief.
d. NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.
7. What is a major physical risk for young adolescents during pregnancy?
a. Osteoporosis frequently develops.
b. Fetopelvic disproportion is a common problem.
c. Delivery is usually precipitous in this age group.
d. Pregnancy will adversely affect the adolescent’s development.
8. The nurse’s role in facilitating successful childrearing in unmarried teenage mothers includes what?
a. Facilitating marriage between the mother and father of the baby
b. Teaching the adolescent the long-term needs of the growing child
c. Providing information and feedback about positive parenting skills
d. Encouraging the infant’s grandmother to take responsibility for care
9. What is a priority goal in the postpartum care of an adolescent mother?
a. Prevention of subsequent pregnancies
b. Ensuring that the father of the baby cares for the child
c. Returning the mother to a prepregnancy lifestyle
d. Facilitating formula feeding to minimize interruptions
10. A pregnant 15-year-old adolescent tells the nurse that she did not use any form of contraception because she was afraid her parents would find out. The nurse should recognize what?
a. This is a frequent reason given by adolescents.
b. This suggests a poor parent–child relationship.
c. This is not a good reason to not get contraception.
d. This indicates that the adolescent is unaware of her legal rights.
Chapter 19: Family-Centered Care of the Child with Chronic Illness or Disability
1. What is the major health concern of children in the United States?
a. Acute illness
b. Chronic illness
c. Congenital disabilities
d. Nervous system disorders
2. What is a major premise of family-centered care?
a. The child is the focus of all interventions.
b. Nurses are the authorities in the child’s care.
c. Parents are the experts in caring for their child.
d. Decisions are made for the family to reduce stress.
3. What should the nurse determine to be the priority intervention for a family with an infant who has a disability?
a. Focus on the child’s disabilities to understand care needs.
b. Institute age-appropriate discipline and limit setting.
c. Enforce visiting hours to allow parents to have respite care.
d. Foster feelings of competency by helping parents learn the special care needs of the infant.
4. The potential effects of chronic illness or disability on a child’s development vary at different ages. What developmental alteration is a threat to a toddler’s normal development?
a. Hindered mobility
b. Limited opportunities for socialization
c. Child’s sense of guilt that he or she caused the illness or disability
d. Limited opportunities for success in mastering toilet training
5. A feeling of guilt that the child “caused” the disability or illness is especially common in which age group?
c. School-age child
6. What intervention is most appropriate for fostering the development of a school-age child with disabilities associated with cerebral palsy?
a. Provide sensory experiences.
b. Help develop abstract thinking.
c. Encourage socialization with peers.
d. Give choices to allow for feeling of control.
7. A 16-year-old boy with a chronic illness has recently become rebellious and is taking risks such as missing doses of his medication. What should the nurse explain to his parents?
a. That he needs more discipline
b. That this is a normal part of adolescence
c. That he needs more socialization with peers
d. That this is how he is asking for more parental control
8. What nursing intervention is most appropriate in promoting normalization in a school-age child with a chronic illness?
a. Give the child as much control as possible.
b. Ask the child’s peer to make the child feel normal.
c. Convince the child that nothing is wrong with him or her.
d. Explain to parents that family rules for the child do not need to be the same as for healthy siblings.
9. The nurse observes that a seriously ill child passively accepts all painful procedures. The nurse should recognize that this is most likely an indication that the child is experiencing what emotional response?
b. Chronic sorrow
c. Belief that procedures are a deserved punishment
d. Understanding that procedures indicate impending death
10. The parents of a child born with disabilities ask the nurse for advice about discipline. The nurse’s response should be based on remembering that discipline is which?
a. Essential for the child
b. Not needed unless the child’s behavior becomes problematic
c. Best achieved with punishment for misbehavior
d. Too difficult to implement with a special needs child
Chapter 20: Family-Centered Palliative Care
1. What is a principle of palliative care that can be included in the care of children?
a. Maintenance of curative therapy
b. Child and family as the unit of care
c. Exclusive focus on the spiritual issues the family faces
d. Extensive use of opiates to ensure total pain control
2. What factor is most important for parents implementing do not resuscitate (DNR) orders?
a. Parents’ beliefs about euthanasia
b. Presence of other children in the home
c. Experiences of the health care team with other children in this situation
d. Acknowledgment by health care team that child has no realistic chance for cure
3. A school-age child is diagnosed with a life-threatening illness. The parents want to protect their child from knowing the seriousness of the illness. The nurse should provide which explanation?
a. This attitude is helpful to give parents time to cope.
b. This will help the child cope effectively by denial.
c. Terminally ill children know when they are seriously ill.
d. Terminally ill children usually choose not to discuss the seriousness of their illness.
4. A 12-year-old child has failed several courses of chemotherapy. An experimental drug is available that his parents want him to receive. He has told his parents and the oncologists that he is ready to die and does not want any more chemotherapy. The nurse recognizes what to be true?
a. Parents and child both need support in the decision making.
b. Twelve-year-olds are minors and cannot give consent or refuse treatments.
c. The oncologists needs to make the decision because the parents and child disagree.
d. The parents have the right and responsibility to make decisions for their children younger than age 18 years.
5. What explanation best describes how preschoolers react to the death of a loved one?
a. Grief is acute but does not last long at this age.
b. Children this age are too young to have a concept of death.
c. Preschoolers may feel guilty and responsible for the death.
d. They express grief in the same way that the adults in the preschoolers’ life are expressing grief.
6. A preschooler is found digging up a pet bird that was recently buried after it died. What is the best explanation for this behavior?
a. He has a morbid preoccupation with death.
b. He is looking to see if a ghost took it away.
c. He needs reassurance that the pet has not gone somewhere else.
d. The loss is not yet resolved, and professional counseling is needed.
7. At which age do most children have an adult concept of death as being inevitable, universal, and irreversible?
a. 4 to 5 years
b. 6 to 8 years
c. 9 to 11 years
d. 12 to 16 years
8. What statement is most descriptive of a school-age child’s reaction to death?
a. Very interested in funerals and burials
b. Little understanding of words such as “forever”
c. Imagine the deceased person to be still alive
d. Can explain death from a religious or spiritual point of view
9. At which developmental period do children have the most difficulty coping with death, particularly if it is their own?
c. School age
10. An 8-year-old girl has been uncooperative and angry since the diagnosis of cancer was made. Her parents tell the nurse that they do not know what to do “because she is always so mad at us.” What nursing action is most appropriate at this time?
a. Explain to child that anger is not helpful.
b. Help the parents deal with her anger constructively.
c. Ask the parents to find out what she is angry about.
d. Encourage the parents to ignore the anger at this time.
AND MUCH MORE