Question 1

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 2

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 3

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 4

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 5

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 6

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 7

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 8

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 9

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 10

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. This is because of the stress from weight bearing and continuous movement.

Question 11

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 12

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.

Question 13

What type of play is most appropriate for a 6 year old child:

Accepted Answer

Make believe is most appropriate because it enhances the imitative play and imagination of the preschooler. Peek-a-boo and building blocks are appropriate for infants, while hide and seek is applicable to school age children.

Question 14

Which of the following information would indicate that a pre-school has normal growth and development:

Accepted Answer

Because Erik Erickson defines the developmental task of a preschool as learning Initiative vs. Guilt. Children can initiate motor activities of various sorts on their own and no longer responds to or imitate the actions of other children or of their parents.

Question 15

Which of the following is true about Mongolian Spots?

Accepted Answer

Mongolian spots are stale grey or bluish patches of discoloration commonly seen across the sacrum or buttocks due to accumulation of melanocytes and they disappear in 1 year. They are not linked to steroid use and pathologic conditions.

Question 16

Signs of cold stress that the nurse must be alert when caring for a newborn is:

Accepted Answer

A newborn will increase their respiration rate because the newborn will need more oxygen because of too much activity. Hypothermia is inaccurate because normally, temperature of a newborn drop, also a child under cold stress will kick and cry to increase the metabolic rate thereby increasing heat so B isn't a good choice. A newborn doesn't have the ability to shiver.

Question 17

A mother brought her child to the clinic with a nose bleed. The nurse showed the mother the most appropriate position for the child which is:

Accepted Answer

This position will minimize the amount of blood pressure in nasal vessels and keep blood moving forward not back into the nasopharynx, which will have the choking sensation and increase risk of aspiration. Other options are inappropriate because they can cause blood to enter the nasopharynx.

Question 18

Which of the following statements would the nurse expect a 5-year old boy to say whose pet gerbil just died:

Accepted Answer

A 5 year old views death in "degrees", so the child most likely will say that "he is just a bit dead". Personification of death occurs in ages 7 to 9 as well as believing they can avoid death by being good. Denying death using jokes and attributing life qualities to death occurs during age 3-5.

Question 19

When assessing the fluid and electrolyte balance in an infant, which of the following would be important to remember:

Accepted Answer

Infants have greater body surface area than adult, increasing their risk to F&E imbalances. Also infants can't concentrate a urine at an adult level and their metabolic rate, also called water turnover, is 2 to 3 times higher than adult. Also, more fluids of the infants are at the ECF spaces not in the ICF spaces.

Question 20

A mother tells the nurse "the doctor said that my child has pulmonic stenosis. What does it mean?" The nurse's best response should be:

Accepted Answer

The nurse needs to know how much information the mother has before giving any information. We know that the disease is narrowing at the entrance to the pulmonary artery and may vary in severity and treatment. Calling the doctor at this point abdicates the role of the nurse.

Quiz 3: Pediatrics