Deck 2: Child Health

Question 1

An 8-month-old infant is scheduled for a femorally inserted balloon angioplasty of a congenital pulmonic stenosis in the cardiac catheterization laboratory.  Which finding should the nurse report to the health care provider that could possibly delay the procedure?

A)Auscultation of a loud heart murmur
B)Infant has been NPO for 4 hours
C)Infant has severe diaper rash
D)Slight cyanosis of the nail beds

Answer 1

Infant has severe diaper rash

Question 2

The nurse is planning care for a child being admitted with Kawasaki disease and should give priority to which nursing intervention?

A)Apply cool compresses to the skin of the hands and feet
B)Monitor for a gallop heart rhythm and decreased urine output
C)Prepare a quiet, non-stimulating, and restful environment
D)Provide soft foods and liberal amounts of clear liquids

Answer 2

Monitor for a gallop heart rhythm and decreased urine output

Question 3

The school nurse evaluates a 9-year-old who is sweating, trembling, and pale.  The client has type 1 diabetes managed with insulin glargine and NPH.  What is the most appropriate action by the nurse?

A)Administer scheduled dose of NPH insulin
B)Give emergency glucagon IM injection
C)Give peanut butter and crackers
D)Provide 4 oz (120 mL) of a regular soft drink

Answer 3

Provide 4 oz (120 mL) of a regular soft drink

Question 4

The home health nurse is visiting an infant who recently had surgery to repair tetralogy of Fallot.  Which of the following signs of heart failure should the nurse teach the parents to report to the health care provider?  Select all that apply.

A)Cool extremities
B)Increase in appetite
C)Puffiness around the eyes
D)Reduction in number of wet diapers
E)Weight gain

Question 5

A nurse is assisting a new mother as she is breastfeeding her infant.  The infant has been diagnosed with tetralogy of Fallot.  During feeding, the infant becomes cyanotic and is having difficulty breathing.  What should be the nurse's first action?

A)Administer morphine to the infant
B)Administer oxygen via mask
C)Assess infant's vital signs and pulse oximetry
D)Place the infant in the knee-chest position

Question 6

The nurse is planning a client care conference with the parents of a 3-year-old with newly diagnosed type 1 diabetes mellitus.  What is the priority outcome for the caregivers?

A)Demonstrating adequate coping skills
B)Knowing how to keep blood sugars stable
C)Understanding how to perform meal planning
D)Understanding the need for periodic follow-up visits

Question 7

The nurse has been providing care for the past month to a 7-year-old client recently diagnosed with type 1 diabetes mellitus.  Initially, the family seemed devastated about the diagnosis and the client's parent stated, "Our lives will never be the same."  Which statement made by the parent indicates that nursing interventions and education have been effective?

A)"Our child will not be able to participate in any sporting events."
B)"Our whole family will have to make sacrifices to deal with this disease."
C)"We are working to manage this disease so that it cannot control our child's life."
D)"We have set aside a place in the pantry for our child's special foods."

Question 8

A 3-month-old who weighs 8.8 lb (4 kg) has just returned to the intensive care unit after surgical repair of a congenital heart defect.  Which finding by the nurse should be reported immediately to the health care provider?

A)Chest tube output of 50 mL in the past hour
B)Heart rate of 150/min
C)Temperature of 97.5 F (36.4 C)
D)Urine output of 8 mL in the past hour

Question 9

Which of the following statements made by the mother of a child recently diagnosed with celiac disease indicates a need for further teaching?

A)"I will need to read the labels of all processed foods."
B)"It is okay if my child eats rice, corn, and potatoes."
C)"My child can have small amounts of foods containing wheat as long as she remains symptom free."
D)"My child will need to be on a gluten-free diet for the rest of her life."

Question 10

When monitoring an infant with a left-to-right-sided heart shunt, which findings would the nurse expect during the physical assessment?  Select all that apply.

A)Clubbing of fingertips
B)Cyanosis when crying
C)Diaphoresis during feedings
D)Heart murmur
E)Poor weight gain

Question 11

The nurse is providing discharge instructions to the parent of a child with Kawasaki disease.  The nurse informs the parent that the presence of which symptom should be immediately reported to the health care provider?

A)Fever
B)Irritability
C)Knee pain
D)Skin peeling

Question 12

The nurse is reinforcing education to the caregivers of a 9-year-old client diagnosed with scarlet fever.  The client has a history of type 1 diabetes mellitus.  Which statement by the caregivers indicates that further teaching is needed?

A)"We will encourage extra fluid intake while our child is sick."
B)"We will increase the frequency of blood glucose checks."
C)"We will monitor our child's urine for ketones with each void."
D)"We will not administer insulin if our child is unable to eat."

Question 13

A nurse is assessing a 1-month-old infant with an atrial septal defect (ASD).  Which assessment finding does the nurse expect?

A)Muffled heart tones
B)Murmur
C)Cyanosis
D)Weak femoral pulses

Question 14

A nurse is teaching the parents of an infant with tetralogy of Fallot.  Which of the following actions should the nurse include to reduce the incidence of hypercyanotic spells?  Select all that apply.

A)Encourage smaller, frequent feedings
B)Offer a pacifier when the infant begins to cry
C)Promote a quiet period upon waking in the morning
D)Swaddle the infant during procedures
E)Turn the infant frequently during sleep

Question 15

A nurse is caring for a 1-month-old client who is being evaluated for congenital hypothyroidism.  The nurse should recognize which of the following as clinical manifestations of hypothyroidism in infants?  Select all that apply.

A)Difficult to awaken
B)Dry skin
C)Frequent, loose stools
D)Hoarse cry
E)Tachycardia

Question 16

The nurse is assisting with an education conference for graduate nurses about infant CPR.  Which of the following statements are appropriate to include in the teaching?  Select all that apply.

A)"A single rescuer responding to an unwitnessed infant arrest should perform 2 minutes of CPR before retrieving a defibrillator."
B)"Depth of chest compressions for infants should be half the depth of the anterior-posterior chest diameter."
C)"Rescuers should place the heel of one hand on the lower sternum when delivering chest compressions to infants."
D)"The ratio of chest compressions to breaths during CPR by a single rescuer is 15:2 for infants."
E)"You should assess the infant's brachial pulse for no longer than 10 seconds."

Question 17

The nurse is caring for a newborn with patent ductus arteriosus.  Which assessment finding should the nurse expect?

A)Harsh systolic murmur
B)Loud machine-like murmur
C)Soft diastolic murmur
D)Systolic ejection murmur

Question 18

A 6-year-old client was diagnosed with type 1 diabetes mellitus 2 years ago.  The nurse would like to encourage the client to participate in disease management.  Which of the following diabetes care tasks are appropriate for the child to perform?  Select all that apply.

A)Choose insulin injection site with parental oversight of rotation schedule
B)Push plunger of insulin syringe after a parent inserts and stabilizes the needle
C)Select and clean the site for finger-stick blood glucose testing
D)Use a chart to determine insulin dose based on glucometer reading
E)Verbalize two or three signs and symptoms of hypoglycemia

Question 19

The nurse has received report on 4 pediatric clients on a telemetry unit.  Which client should the nurse assess first?

A)Adolescent client with coarctation of the aorta and diminished femoral pulses
B)Infant client with ventricular septal defect with reported grunting during feeding
C)Newborn client with patent ductus arteriosus and a loud machinery-like systolic murmur
D)Preschool client with tetralogy of Fallot who has finger clubbing and irritability

Question 20

The school nurse is caring for 4 clients with type 1 diabetes mellitus.  Which of these clients should the nurse assess first?

A)5-year-old whose capillary blood glucose is 71 mg/dL (3.9 mmol/L)
B)7-year-old who is busy drawing pictures and refusing to eat lunch
C)9-year-old who is sweating after recess and irritably states, "I'm so hungry!"
D)11-year-old whose prescribed dose of insulin glargine is 30 minutes overdue

Question 21

The nurse is caring for a 2-year-old who is receiving a saline enema for treatment of intussusception.  Reporting which client finding to the health care provider (HCP) is most important?

A)Passed a normal brown stool
B)Passed a stool mixed with blood
C)Stopped crying
D)Vomited a third time

Question 22

The nurse is reviewing anticipatory guidance with the parents of a 6-month-old infant with phenylketonuria.  Which statements by the nurse are appropriate?  Select all that apply.

A)"A low-phenylalanine diet is required."
B)"Meat and dairy products should not be introduced into the diet."
C)"Phenylketonuria is self-limiting and usually resolves by adulthood."
D)"Special infant formula is required."
E)"Tyrosine should be removed from the diet."

Question 23

A newborn had a bowel resection with temporary colostomy for Hirschsprung's disease.  The nurse should alert the health care provider (HCP) for which assessment finding postoperatively?

A)Moderate amount of blood-tinged mucus from the stoma on postoperative day 2
B)Small amount of non-formed stool in the colostomy bag on postoperative day 6
C)Stoma bleeds a small amount during colostomy bag change on postoperative day 3
D)Stoma is gray-tinged at the edges but pink at the center on postoperative day 5

Question 24

The nurse is educating the parents of a 6-month-old about introducing solid foods into the infant's diet.  Which parental statement indicates a need for further teaching?

A)"I can introduce soft finger foods before my child has teeth."
B)"I can offer a variety of foods within the first week of introducing solids."
C)"I can prepare rice cereal with formula, breast milk, or water."
D)"I can save money by preparing baby food at home instead of buying it."

Question 25

The nurse is discussing feeding and eating practices with the mother of a 1-year-old.  Which statement made by the mother indicates a need for further instruction?

A)"I give my child chopped fruit rather than juice."
B)"I make sure my child drinks plenty of water between meals."
C)"My child is fussy at bedtime so I put him to sleep with a bottle of milk."
D)"When I give my child a new food, I wait a week before trying a second new food."

Question 26

A 2-year-old in the emergency department is suspected of having intussusception.  Which assessment finding should the nurse expect?

A)Black, sticky stools
B)Greasy, foul-smelling stools
C)Stools mixed with blood and mucus
D)Thin, "ribbon-like" stools

Question 27

The school nurse is teaching a class of 10-year-old children about prevention of dental caries.  Which recommendations would be part of the nurse's teaching plan?  Select all that apply.

A)Chew sugar-free gum
B)Drink fruit drinks/juices instead of sugary, carbonated beverages
C)Include milk, yogurt, and cheese in dietary intake
D)Minimize consumption of sweet, sticky foods
E)Rinse mouth with water after meals when brushing is not possible

Question 28

The parent of a 21-day-old male infant reports that the infant is "throwing up a lot."  Which assessments should the nurse make to help determine if pyloric stenosis is an issue?  Select all that apply.

A)Assess the parent's feeding technique
B)Check for family history of gluten enteropathy
C)Check for history of physiological hyperbilirubinemia
D)Check if the vomiting is projectile
E)Compare current weight to birth weight

Question 29

A newborn is being evaluated for possible esophageal atresia with tracheoesophageal fistula.  Which finding is the nurse most likely to observe?

A)Choking and cyanosis during feeding
B)Concave (scaphoid) abdomen
C)Diminished lung sounds
D)Projectile vomiting after feeding

Question 30

During a routine assessment of a developmentally normal 18-month-old, the parent expresses concern about the small amount of food the child consumes.  What is the nurse's priority intervention?

A)Check the child for parasitic infections
B)Consult a pediatric nutritionist for suspected eating disorder
C)Educate the parent about physiologic anorexia
D)Notify the primary health care provider

Question 31

A nurse in the neonatal intensive care unit discovers a cyanotic newborn with excessive frothy mucus in the mouth.  What should be the nurse's first action?

A)Administer 100% oxygen
B)Auscultate the lungs
C)Place infant in knee-chest position
D)Suction the infant's mouth

Question 32

The clinic nurse is caring for several clients during well-child visits.  The nurse should recognize which client as being the most at risk for anemia?

A)1-month-old infant born at term gestation who exclusively breastfeeds
B)2-month-old infant born at preterm gestation who exclusively receives iron-fortified formula
C)3-month-old infant born at preterm gestation who is exclusively bottle-fed with breastmilk
D)6-month-old infant born at term gestation who breastfeeds and eats iron-fortified infant cereal

Question 33

An overweight toddler is diagnosed with iron deficiency anemia.  Which is the most likely explanation for the anemia?

A)Excessive intake of meat products
B)Excessive intake of milk
C)Gastrointestinal blood loss
D)Impaired iron transfer from the mother

Question 34

A parent brings a 6-month-old child to the primary health care provider after the child abruptly started crying and grabbing intermittently at the abdomen.  The client's stool has a red, currant jelly appearance.  What intervention does the nurse anticipate?

A)Administer epoetin alfa (erythropoietin)
B)Give air (pneumatic) enema
C)Have the parent give 2 ounces of extra juice a day for constipation
D)Perform hemoccult test on stool

Question 35

The nurse is teaching a class on nutrition and feeding practices for young children.  What should the nurse recommend as the best snack for a toddler?

A)½ cup orange juice
B)Dry, sweetened cereal
C)Raw carrot sticks
D)Slices of cheese

Question 36

The nurse is assessing an infant with intussusception.  Which of the following clinical findings should the nurse expect?  Select all that apply.

A)Palpable olive-shaped mass in epigastrium
B)Palpable sausage-shaped abdominal mass
C)Projectile vomiting without visualized blood
D)Screaming and drawing of the knees up to the chest
E)Stool mixed with blood and mucus

Question 37

The mother of a 6-year-old child with cystic fibrosis (CF) has received instruction on the use of pancreatic enzymes.  Which statement made by the mother indicates a need for further teaching?

A)"I need to monitor the total amount of this medication that I give to my child every day."
B)"I should give this medication with or just before my child has a meal or snack."
C)"It is okay for my child to chew this medication."
D)"It is okay to open the capsule and sprinkle the medicine on a tablespoon of applesauce."

Question 38

A nurse is evaluating a client's understanding about infant formula preparation.  Which of the following client statements indicate proper understanding?  Select all that apply.

A)"I can add extra water to powdered formula if it seems that my baby wants to feed longer."
B)"I can heat formula in the microwave for less than 1 minute."
C)"I must wash the top of concentrated formula cans before opening."
D)"Leftover milk in the bottle may be refrigerated and used at a later feeding."
E)"Unused, prepared formula should be kept in the refrigerator and discarded after 48 hours."

Question 39

The nurse is performing a physical examination on a 10-year-old client with abdominal discomfort.  Which actions would be appropriate during the examination?  Select all that apply.

A)Ask the accompanying parent to rate and describe the client's pain
B)Ask the client to describe the chief symptom
C)Conduct a head-to-toe assessment in the same manner as an adult assessment
D)Explain the outcome of the examination to the parent without the child present
E)Honor the client's request to be examined without a parent present

Question 40

The parent of a 7-month-old reports that the child has been crying and vomiting with a distended belly for the past 4 hours.  The infant is now lying quietly in the parent's arms with a pulse of 200/min and respirations of 60/min.  Which of the following components of SBAR (situation, background, assessment, recommendation/read-back) communication is most important for the nurse to report to the health care provider?

A)Client has been ill for approximately 4 hours
B)Client has improved from apparent earlier distress
C)Client is now lethargic with abnormal vital signs
D)Does the health care provider want to order a laxative?

Question 41

The school nurse creates a cafeteria menu for a newly enrolled child with celiac disease.  Which lunches would be appropriate for this child?  Select all that apply.

A)Beef barley soup with mixed vegetables and French bread
B)Grilled chicken, baked potato, and strawberry yogurt
C)Mexican corn tacos with ground beef and cheese
D)Peanut butter and jelly on rice cakes with an oatmeal cookie
E)Rice noodles with chicken and broccoli

Question 42

A 3-month-old infant has irritability, facial edema, a 1-day history of diarrhea with adequate oral intake, and seizure activity.  During assessment, the parents state that they have recently been diluting formula to save money.  Which is the most likely cause for the infant's symptoms?

A)Hypernatremia due to diarrhea
B)Hypoglycemia due to dilute formula intake
C)Hypokalemia due to excess gastrointestinal output
D)Hyponatremia due to water intoxication

Question 43

The clinic nurse supervises a graduate nurse who is teaching the parents of a 2-year-old with acute diarrhea about home management.  The nurse would need to intervene when the graduate nurse provides which instruction?

A)"Do not administer antidiarrheal medications to your child."
B)"Follow the bananas, rice, applesauce, and toast diet for the next few days."
C)"Record the number of wet diapers and return to the clinic if you notice a decrease."
D)"Use a skin barrier cream such as zinc oxide in the diaper area until diarrhea subsides."

Question 44

A nurse is performing an assessment of a 12-month-old child.  Which of the following findings would the nurse expect?  Select all that apply.

A)Approaches strangers with ease
B)Birth weight is tripled
C)Can skip and hop on one foot
D)Fully developed pincer grasp
E)Sits from a standing position

Question 45

The registered nurse is teaching the parent of a 6-year-old about behavioral strategies for treating fecal incontinence due to functional constipation.  Which statement by the parent indicates a need for further teaching?

A)"I will give my child a picture book to look at during toilet time."
B)"I will give my child a reward for each bowel movement while sitting on the toilet."
C)"I will keep a log of my child's bowel movements, laxative use, and episodes of soiling."
D)"I will schedule regular toilet sitting time for my child."

Question 46

A nurse is planning to complete a physical examination of a toddler.  Which approach is an appropriate intervention by the nurse?

A)Encourage the parent to be involved with the child
B)Engage in physical contact by removing the toddler's outer clothing first
C)Have medical equipment lying on a counter within view
D)Perform an examination in a head-to-toe order

Question 47

The nurse is caring for an infant diagnosed with Hirschsprung disease who is awaiting surgery.  Which assessment finding requires the nurse's immediate action?

A)Abdominal distension with no change in girth for 8 hours
B)Did not pass meconium or stool within 48 hours after birth
C)Episode of foul-smelling diarrhea and fever
D)Excessive crying and greenish vomiting

Question 48

The nurse teaching the parents of a child diagnosed with cystic fibrosis will advise the parents to choose foods that satisfy which recommended diet?

A)Gluten-free with added protein
B)High calorie, high protein, high fat
C)High protein, low fat, low phosphate
D)High protein, low fat, low sodium

Question 49

The nurse is reinforcing discharge teaching for the parents of a 1-year-old with a newly diagnosed cow's milk allergy.  Which nutrients normally provided by milk should be obtained from other sources?  Select all that apply.

A)Calcium
B)Fiber
C)Iron
D)Vitamin D
E)Vitamin K

Question 50

The nurse is teaching a group of new parents about oral hygiene for their children.  One of the parents asks, "When should I take my child to the dentist?"  What would be the best response from the nurse?

A)"It is recommended that your child's first dental visit be after age 1."
B)"The first visit should be when all of your child's baby teeth have come in."
C)"The initial dentist visit should be soon after the child's first tooth appears."
D)"Your child will need to be taken to the dentist before starting preschool."

Question 51

A nurse in a pediatric clinic is performing a physical examination of a 30-month-old child.  Which finding requires further evaluation?

A)Bladder and bowel control achieved
B)Chest circumference is greater than abdominal circumference
C)Current weight is 6 times greater than birth weight
D)Head circumference increased by 1 in (2.5 cm) in the past year

Question 52

The nurse is performing a well-child assessment on a sleeping 2-month-old client.  Organize the assessment in the correct order based on the developmental age of the client.  All options must be used.

A)Assess pupillary response
B)Auscultate heart and lungs
C)Elicit Moro reflex
D)Observe skin color and respiratory pattern
E)Palpate fontanelles and abdomen

Question 53

A 12-month-old client has a high blood lead level of 18 mcg/dL (0.87 µmol/L).  The nurse educates the parents about lead poisoning.  Which statements made by the parent indicate that teaching is successful?  Select all that apply.

A)"I should get our home inspected for the source of the lead."
B)"I will vacuum our hard-surface floors daily."
C)"I will wash my child's hands often, especially before eating."
D)"We should use hot tap water for cooking."
E)"We will have to return for a follow-up lead level."

Question 54

A nurse is discussing the fine motor abilities of a 10-month-old infant with the infant's parent.  Which are developmentally appropriate skills for an infant of this age?  Select all that apply.

A)Grasps a small doll by the arm
B)Stacks 3 wooden blocks
C)Transfers small objects from hand to hand
D)Turns single pages in a book
E)Uses a basic pincer grasp

Question 55

The nurse plans care for a pediatric client who has just undergone a cleft palate repair.  Which of the following interventions should the nurse include in the plan of care?  Select all that apply.

A)Assist and encourage caregivers to hold and comfort the child
B)Offer a pacifier in between feedings to promote the child's comfort
C)Position the child supine with an elevated head of bed after feedings
D)Remove elbow restraints per policy for skin and circulatory assessment
E)Use tongue blade and penlight to assess surgical site every 4 hours

Question 56

The nurse is gathering data on a 5-week-old admitted with a suspected diagnosis of pyloric stenosis.  The nurse should expect to find which laboratory value?

A)Blood pH of 7.1
B)Hematocrit of 57% (0.57)
C)Potassium of 5.2 mEq/L (5.2 mmol/L)
D)White blood cells of 28,500/mm³ (28.5 x 10⁹/L)

Question 57

The nurse is reinforcing education with the parents of a 2-year-old child about diet choices to promote growth.  The family observes a strict vegan diet.  Which of the following statements by the nurse are appropriate?  Select all that apply.

A)"Diets consisting of legumes as the only protein source are sufficient for growth."
B)"It is important to feed your child fortified breads and cereals to help with iron intake."
C)"Preparing meals with vegetables and fruits will ensure sufficient vitamin B₁₂ intake."
D)"Try to pair foods high in iron with foods high in vitamin C to aid iron absorption."
E)"Your child may require calcium and vitamin D supplementation due to lack of dairy intake."

Question 58

The nurse in a clinic is obtaining a developmental history of an 18-month-old during a well-child visit.  Which activities should the child be able to perform?  Select all that apply.

A)Calls self by name
B)Goes up stairs while holding a hand
C)Stacks 6 blocks in a tower
D)Turns 2 pages in a book at a time
E)Twists doorknob to open doors

Question 59

The nurse assesses a child with intussusception.  Which assessment findings require priority intervention?

A)Abdominal rigidity with guarding
B)Absence of tears in crying child with IV start
C)Blood-streaked mucous stool in diaper
D)Sausage-shaped right-sided mass on palpation

Question 60

The clinic nurse is interviewing the parents of a 6-month-old client about the infant's diet.  Which statement by the parents is most concerning?

A)"Because apples are healthy, we make apple pie and feed small, soft bites to our baby."
B)"If our baby refuses to finish foods, we continue to offer small bites, so food isn't wasted."
C)"Infant oatmeal sweetened with fresh honey is our baby's favorite breakfast."
D)"We found that the food in TV dinners can be easily pureed and is convenient."

Question 61

The nurse on a pediatric unit is caring for a preschooler who exhibits separation anxiety when the parents go to work.  Which interventions should the nurse implement?  Select all that apply.

A)Encourage the parents to leave the child's favorite stuffed animal
B)Establish a daily schedule similar to the child's home routine
C)Give the child time to calm down alone when visibly upset
D)Provide frequent opportunities for play and activity
E)Remove visual reminders of the parents from the room

Question 62

A nurse is discussing parallel play with the parent of a 2-year-old.  Which statement by the parent indicates understanding of the discussion?

A)"I encourage working in a group to build towers with large blocks."
B)"I have a chalk board available to teach the alphabet and numbers."
C)"I set out a basket of various balls in the backyard when other children come to play."
D)"I try to organize games that involve a team approach."

Question 63

A nurse in a clinic is talking with a parent about the onset of puberty in boys.  What is the first sign of pubertal change that occurs?

A)Appearance of upper lip hair
B)Increase in height
C)Presence of axillary hair
D)Testicular enlargement

Question 64

A nurse on a pediatric unit is reviewing interventions for a toddler with a practical nurse who will be caring for this child.  Which of the following are appropriate activities to minimize the effect of hospitalization on a toddler?  Select all that apply.

A)Integrate preferred snack foods in the day's routine
B)Plan quiet play prior to usual nap time
C)Point out body changes that may occur
D)Post a daily schedule by the child's bed
E)Provide 1 or 2 options when choosing toys

Question 65

The nurse assists with a staff education conference about appropriate nonpharmacological pain-management interventions for newborns and infants.  Which of the following strategies should be included in the presentation?  Select all that apply.

A)Administer an oral sucrose solution to a newborn during a circumcision procedure
B)Apply a cold pack to a newborn's heel 30 minutes before performing a heel stick
C)Assist the parent to hold a newborn skin-to-skin during an immunization injection
D)Offer a pacifier to an infant while performing venipuncture
E)Swaddle an infant while leaving one arm unwrapped during an IV dressing change

Question 66

A nurse is discussing the concept of parallel play with parents of toddlers.  Which statement should the nurse include to describe this type of play?

A)"Children play near other children but without significant interaction."
B)"Children playing together are strongly influenced by each other's choice of toy."
C)"The child primarily plays alone or with familiar people, such as parents."
D)"When playing in a group, one child will take on a follower role."

Question 67

A 2-month-old infant has been admitted to the hospital with suspected shaken baby syndrome (abusive head trauma).  In reviewing the infant's chart, the nurse expects to encounter which of these clinical findings?

A)A reported history of recent trauma
B)Abdominal bruising
C)External signs of trauma
D)Irritability and vomiting

Question 68

A nurse is talking with the parent of a 6-year-old regarding sleep and rest.  Which information should be included?

A)Active play before bedtime promotes restful sleep
B)Bedtime hours should be established
C)Rest needs are related to the high rate of growth in this age group
D)Seven to 8 hours of sleep are required

Question 69

The nurse is conducting a psychosocial developmental checkup on a 2-year-old child.  What is the priority assessment finding that should be reported to the primary health care provider?

A)Does not talk or respond to being talked to or read to
B)Likes to imitate others by playing house and talking on the telephone
C)Rides a Big Wheel and plays with a softball and bat
D)Says "no" to everything and throws temper tantrums

Question 70

A distraught parent informs the nurse of bleeding in a 1-day-old girl.  What is an appropriate response by the nurse after assessing a small amount of bloody mucus in the newborn's diaper?

A)"Laboratory work will need to be completed to determine your newborn's hormone levels."
B)"The health care provider will prescribe a dose of medication to stop the bleeding."
C)"We will continue to monitor the amount, color, and consistency of the drainage."
D)"What visitors have been present since the baby was born?"

Question 71

The nurse is providing health promotion education to the parent of a toddler.  Which statement by the parent requires the nurse to clarify teaching?

A)"I will offer my child options rather than asking yes or no questions."
B)"I will wait at least 15 minutes after a play period to offer a meal to my child."
C)"If my child is having a tantrum, I will have them sit in a quiet area for a short time-out."
D)"If my child refuses a meal, I will have them stay at the table until they eat half the food."

Question 72

What communication strategies would the nurse have in place when establishing rapport with the caregiver and an 8-year-old during a health history interview?  Select all that apply.

A)Ask only closed-ended questions to obtain information
B)Allow the child to describe their current issue
C)Isolate the child from the parents and interview them separately
D)Maintain an eye level position when speaking with the child
E)Use language that both the child and caregiver can understand

Question 73

What socioeconomic indicators would the nurse identify as risk factors for a 2-month-old infant to develop failure to thrive (FTT)?  Select all that apply.

A)Both caregivers work outside the home
B)Infant lives only with mother, who is currently unemployed
C)Infant's primary caregiver has cognitive disabilities
D)Parents are socially and emotionally isolated
E)Parents live together but are not married

Question 74

The nurse is assessing an 8-month-old client during a well-child visit.  Which assessment finding should the nurse report to the health care provider?

A)Infant responds to their name when called but has not spoken any words
B)Infant was gaining 5 oz (140 g) per week at age 6 months and is now gaining 3 oz (84 g) per week
C)Infant's head stays behind the shoulders when raised from a supine to a sitting position
D)Infant's posterior fontanel is not palpable when performing assessment of the head

Question 75

The public health nurse has received a referral to make a follow-up home visit to a 1-year-old recently diagnosed with failure to thrive (FTT).  Which intervention is the priority nursing action for this child?

A)Assess overall parenting skills
B)Complete a 24-hour dietary intake
C)Measure the child's height, weight, and head circumference
D)Observe the child feeding

Question 76

The registered nurse has completed a well-baby assessment of an 18-month-old.  Which assessment findings prompted the nurse to make a referral for a formal developmental screening test?

A)Cannot climb steps by self, pulls a toy, turns the pages of a book
B)Is bottle fed, can hold a spoon, creeps down stairs
C)Throws a ball, is able to point to 2 or 3 body parts, cannot draw a picture
D)Uses 2 words, cannot hold a cup, can seat self in a small chair

Question 77

The nurse is reviewing the medical record of a 4-year-old client with failure to thrive.  Which of the following risk factors likely contribute to the client's condition?  Select all that apply.

A)Child is the youngest of four children in the home
B)One parent is incarcerated for spousal abuse
C)One parent was diagnosed with anorexia nervosa prior to having children
D)One parent works a full-time job outside the home
E)Parents are concerned about not having enough money to buy food

Question 78

The parent of an 8-year-old client asks the nurse for guidance on how to help the client cope with the recent death of the other parent.  When developing a response to the parent, the nurse considers that a school-aged child is most likely to do what?

A)React anxiously to altered daily routines
B)Realize that death eventually affects everyone
C)Think about the religious or spiritual aspects of death
D)Understand that death is permanent but be curious about it

Question 79

A 9-year-old has terminal cancer, but the parents do not want the child to know the prognosis.  The child has been asking questions such as what dying is like and whether the child will die.  Which action by the nurse is most appropriate?

A)Encourage the child to ask the parents these questions
B)Notify the health care provider (HCP) about the child's questions
C)Reassure the child that everyone is trying to help the child get better
D)Tell the parents about the child's questions

Question 80

A 15-year-old parent brings a 4-month-old infant for a well-baby checkup.  The parent tells the nurse that the baby cries all the time; the parent has tried everything to keep the infant quiet but nothing works.  What is the priority nursing action?

A)Advise the parent to give a pacifier whenever the infant cries
B)Ask the parent to describe what is done to "keep the baby quiet"
C)Assess the infant's pattern and frequency of crying
D)Explore the parent's support system