Question 1

Stuttering among pre-schoolers is:

Accepted Answer

Stuttering among pre-schoolers is a common characteristic. It is normal and common for preschoolers to stutter and it is not to be considered as a problem. This happens as the child's advancing mental ability and level of comprehension exceed the vocabulary acquisitions.

Question 2

A 5-week-old infant tightly grasps a little toy placed in his hands. The mother was impressed with this ability. The nurse on duty should explain that this is:

Accepted Answer

In a case when the infant tightly grasps a toy in his hands, the nurse should explain to the mother that this is an involuntary behavior termed as the palmar grasp reflex is at its peak at 4 weeks of age and normally disappears at 3-4 months of age. Pincer grasp is a fine motor behavior which begins at 8 month of age.

Question 3

A primary school age boy was diagnosed with Myelogenous Leukemia. He is about to begin Chemotherapy and tells the nurse "I'm already 12 years old and I think I have the right to refuse the treatment". The nurse's most therapeutic response is:

Accepted Answer

In a case, the nurse finds out the boy is disinterested, "You seem afraid. Let me talk to you about it" is the best response because it permits exploration of the child's feelings. If the child starts to discuss feelings, there may not be a need to inform him that he is too young to refuse the treatment.

Question 4

Jessica, a 29-year-old mother, tells the nurse that her youngest son who is just 7-months-old can already sit without any support. The nurse should tell the mother that this:

Accepted Answer

Sitting without support is an expected developmental milestone that is expected of a 7-month-old infant. It is done by extending the legs to the side and leaning forward on the hands. After a month, an infant is expected to sit steadily without the use of his hands or mother's support. Sitting alone cannot be a predictor of when the baby will start to walk.

Question 5

A nurse teaches a mother of a 2-month-old infant to be sure that the floor is free of small objects when her child is crawling. The reason for this is that:

Accepted Answer

A 2-month-old infant already has the ability to use its fingers and thumbs in opposition (known as pincer grasp); this therefore enables it to pick up small objects and put them into its mouth which could lead to aspiration.

Question 6

What is the most appropriate toy that a nurse should give to a 12-week-old infant?

Accepted Answer

Metallic mirror is the best among the choices because a 3-month-old infant is more interested in self-recognition and playing with the "baby" in the mirror. The infant is old enough for a rattle and still too young for stuffed toys and plastic balls.

Question 7

An infant who weighed 6 pounds at birth now weighs 12 pounds at 1 year. The nurse at the clinic recognizes that this infant:

Accepted Answer

The baby should have a weight of 18 pounds according to the weight charts of the national center for health statistics. The weight at birth is expected to be doubled at 6 months and be tripled at 1 year. We cannot say that the infant was neglected or offered inadequate nourishment because it is a judgmental conclusion.

Question 8

A 2 year old boy was scheduled for an emergency surgery. It as noted that the mother is 16 year old and the father is 17 year old. The child's father and paternal grandfather, who care for the baby, are at the bedside. Informed consent should be signed by:

Accepted Answer

The child's father should be the one to sign the consent regardless of his age. In this case, parenthood confers the rights of an adult to the teenager. Informed consent can also signed by the mother if she is present. Option D is valid only if there's no relative that is present or if there's not enough time to obtain consent considering the condition of the patient.

Question 9

A 2 year old was brought to the pediatric clinic for a routine check up. When assessing the child's relationship with other children, the nurse would expect to observe.

Accepted Answer

Parallel play is typical of the toddler age group. They have not yet learned to interact with other toddler in a social situation. Initiative play does not identify any age group; moreover, it is not a recognized term for social play.

Question 10

Which of the following is the correct way of instilling eardrops among children below 3 years old:

Accepted Answer

Canal should be straighten by pulling it down and back so that the eardrops will reach the eardrum. This approach is applicable to children below 3 years old because their ear canal curves upward.

Question 11

When is the best time to do a corrective surgery for an infant with hypospadias:

Accepted Answer

6-18 months is the preferred age to do a corrective surgery for an infant with hypospadias because fear of castration and body image is not yet developed. It can't be performed shortly after birth because the phallus is not developed enough. Fear of bodily mutilation is present during pre school age.

Question 12

A pre-schooler is being prepared for an ear surgery in an ambulatory care facility. When the child is called to go to the operating room, the nurse should:

Accepted Answer

Most health institutions allow the parents accompany the child until he is sedated and to stay with the child as long as possible. This minimizes the stress related to fearful events. Also, current theory is consistent that parents should remain during the induction of anesthesia due to parent's positive feedback.

Question 13

Measles vaccine should be given among infant between:

Accepted Answer

Measles vaccine should be given immediately after the first birthday between 12 and 15 months. Maternal antibodies to measles are no longer present to block the formation of the Child's own antibodies. Other options has questionable efficacy of the vaccine because maternal antibodies are still present at those times.

Question 14

A school age girl with rubella should be isolated from an unimmunized:

Accepted Answer

An unimmunized woman like 18 year old sister who has recently got married and is exposed to rubella virus is at a higher risk. If she contracts the disease it may be transmitted to her fetus once she got pregnant. Option b has a lesser effect as it would probably be mild and confer immunity.

Question 15

Which of the following would a nurse expect to observe in a pediatric client who has a tentative diagnosis of Acute lymphocytic Leukemia:

Accepted Answer

Anorexia and Petechiae are indicative of catabolism and Bone marrow depression which are expected in a child with ALL. Alopecia would occur only until Chemotherapy in instituted. It is also expected that a child will be lethargic and sleep excessively due to Bone marrow depression.

Question 16

A nurse is aware that the most common site for bleeding to develop in a child with hemophilia is:

Accepted Answer

The most common sites for bleeding to develop in a child with hemophilia are the joints. It is probably related to weight bearing and their continuous movement.

Question 17

One goal of therapy for sickle cell anemia is prevention of sickling phenomenon, which is responsible for the pathologic sequelae. Which of the following plan of care is directed toward the prevention of a crisis:

Accepted Answer

Because low oxygen tension precipitates sickling, therefore adequate oxygenation is desirable. Hemodilution prevents increased viscosity, which can cause sickling and thrombus formation. Bed rest is desirable during a pain episode, but not routinely employed in preventing crisis.

Question 18

A father of a 16 year old who has sickle cell anemia tells a nurse that his family is scheduled to go camping this summer. He asks what activity would be appropriate for his child. The nurse would suggest:

Accepted Answer

The activity doesn't require high amount of oxygen. The goal is to prevent sickling, therefore activities which may lead to increased cellular metabolism and increased tissue hypoxia should be avoided.

Question 19

A nurse is aware that a child with AIDS is more prone to infection than an adult with AIDS because:

Accepted Answer

Adults have higher levels of antibodies than children because over time they have been exposed to more pathogens. Other options are incorrect because in comparison, they do not differ.

Question 20

Victor, a 4 year old child, is at the clinic for a routine clinic visit. In assessing Victor's growth and development, the nurse is guided by principles of growth and development. Which is not included:

Accepted Answer

Growth and development occurs in cephalo-caudal meaning development occurs through out the body's axis. Ex: the child must be able to lift the head before he is able to lift his chest. Proximo-distal is development that progresses from center of the body to the extremities. Ex: a child first develops arm movement before fine-finger movement. Different parts of the body grows at different range because some body tissue mature faster than the other such as the neurologic tissues peaks its growth during the first years of life while the genital tissue doesn't till puberty. Also G&D is predictable in the sequence which a child normally precedes such as motor skills and behavior. G&D can never be modified.

Quiz 3: Pediatrics