Question 1

The nurse is caring for a family with four children whose third child has been diagnosed with attention-deficit/hyperactivity disorder (ADHD).After completing an assessment,which statement made by the mother leads the nurse to a diagnosis of compromised family coping?
A) "I don't know how to tell the rest of the family or how we will manage the other children."
B) "We need to alert the teachers at school so they will know how to give the medication."
C) "Will he have to be put in an institution?"
D) "I'm not sure if we should let my child act in the school play."

Accepted Answer

A) The mother does not have a positive outlook on this situation and appears indecisive and ashamed. This family will need assistance with coping with the child and continuing on with life. Alerting the teachers at school is a positive action and a way to protect the child. The school play will be a decision made with the teachers, but the mother's statement does not suggest poor coping. Asking if the child will need to be placed in an institution is reasonable at this time.
B) The mother does not have a positive outlook on this situation and appears indecisive and ashamed. This family will need assistance with coping with the child and continuing on with life. Alerting the teachers at school is a positive action and a way to protect the child. The school play will be a decision made with the teachers, but the mother's statement does not suggest poor coping. Asking if the child will need to be placed in an institution is reasonable at this time.
C) The mother does not have a positive outlook on this situation and appears indecisive and ashamed. This family will need assistance with coping with the child and continuing on with life. Alerting the teachers at school is a positive action and a way to protect the child. The school play will be a decision made with the teachers, but the mother's statement does not suggest poor coping. Asking if the child will need to be placed in an institution is reasonable at this time.
D) The mother does not have a positive outlook on this situation and appears indecisive and ashamed. This family will need assistance with coping with the child and continuing on with life. Alerting the teachers at school is a positive action and a way to protect the child. The school play will be a decision made with the teachers, but the mother's statement does not suggest poor coping. Asking if the child will need to be placed in an institution is reasonable at this time.

Question 2

The community nurse develops an educational program that focuses on the developmental tasks of adults ages 50 to 60.Which developmental task accomplishment within Gould's theory should the nurse highlight?
A) Self-reflection
B) Personalities are seen as set
C) Adjustment to decreasing physical capacities
D) Period of transformation

Accepted Answer

A) According to Gould, the seventh stage is experienced by those ages 50-60 and is a period of transformation. Gould's theory states that personalities are set at ages 43-50, in stage six. Adjusting to decreasing physical capacities is a part of Peck's theory, and self-reflection occurs in stage five of Gould's theory, during the ages of 35 to 43.
B) According to Gould, the seventh stage is experienced by those ages 50-60 and is a period of transformation. Gould's theory states that personalities are set at ages 43-50, in stage six. Adjusting to decreasing physical capacities is a part of Peck's theory, and self-reflection occurs in stage five of Gould's theory, during the ages of 35 to 43.
C) According to Gould, the seventh stage is experienced by those ages 50-60 and is a period of transformation. Gould's theory states that personalities are set at ages 43-50, in stage six. Adjusting to decreasing physical capacities is a part of Peck's theory, and self-reflection occurs in stage five of Gould's theory, during the ages of 35 to 43.
D) According to Gould, the seventh stage is experienced by those ages 50-60 and is a period of transformation. Gould's theory states that personalities are set at ages 43-50, in stage six. Adjusting to decreasing physical capacities is a part of Peck's theory, and self-reflection occurs in stage five of Gould's theory, during the ages of 35 to 43.

Question 3

A toddler cannot stand next to furniture and does not try to pull himself up from a sitting position.Based on this data,the nurse plans care for this client based on which deficiency?
A) Behavior
B) Height
C) Development
D) Growth

Accepted Answer

A) Development is an increase in the complexity of function and skill progression. It is the behavioral aspect of growth-the individual's ability to walk, talk, and run. Growth is the physical change and increase in size. Height is one of the indicators of growth. Behavior is a component of the developmental stage. Behavior can sometimes indicate that development has taken place, but its absence does not mean that development has not occurred. The fact that the child does not exhibit a behavior in one instance does not mean that development is lagging.
B) Development is an increase in the complexity of function and skill progression. It is the behavioral aspect of growth-the individual's ability to walk, talk, and run. Growth is the physical change and increase in size. Height is one of the indicators of growth. Behavior is a component of the developmental stage. Behavior can sometimes indicate that development has taken place, but its absence does not mean that development has not occurred. The fact that the child does not exhibit a behavior in one instance does not mean that development is lagging.
C) Development is an increase in the complexity of function and skill progression. It is the behavioral aspect of growth-the individual's ability to walk, talk, and run. Growth is the physical change and increase in size. Height is one of the indicators of growth. Behavior is a component of the developmental stage. Behavior can sometimes indicate that development has taken place, but its absence does not mean that development has not occurred. The fact that the child does not exhibit a behavior in one instance does not mean that development is lagging.
D) Development is an increase in the complexity of function and skill progression. It is the behavioral aspect of growth-the individual's ability to walk, talk, and run. Growth is the physical change and increase in size. Height is one of the indicators of growth. Behavior is a component of the developmental stage. Behavior can sometimes indicate that development has taken place, but its absence does not mean that development has not occurred. The fact that the child does not exhibit a behavior in one instance does not mean that development is lagging.

Question 4

The nurse is assessing a 6-month-old infant using the Denver Developmental Screening test.The test shows that the infant is delayed in gross motor development.What activities can the nurse implement to help the child attain appropriate developmental levels?
A) Pull the child to a sitting position and prop the child in a sitting position.
B) Encourage the child to hold a rattle or play patty-cake.
C) Talk to the child and play music.
D) Encourage the child to stand.

Accepted Answer

A) The infant at 6 months should have head control and is working on sitting without support. Pulling the child to a sitting position allows the neck muscles to support the head. Propping the child in a sitting position helps to develop self-righting behaviors. It is too early to worry about standing. Talking to the child promotes language development, not gross motor development. Handling a rattle is a fine motor behavior, a not gross motor behavior.
B) The infant at 6 months should have head control and is working on sitting without support. Pulling the child to a sitting position allows the neck muscles to support the head. Propping the child in a sitting position helps to develop self-righting behaviors. It is too early to worry about standing. Talking to the child promotes language development, not gross motor development. Handling a rattle is a fine motor behavior, not a gross motor behavior.
C) The infant at 6 months should have head control and is working on sitting without support. Pulling the child to a sitting position allows the neck muscles to support the head. Propping the child in a sitting position helps to develop self-righting behaviors. It is too early to worry about standing. Talking to the child promotes language development, not gross motor development. Handling a rattle is a fine motor behavior, not a gross motor behavior.
D) The infant at 6 months should have head control and is working on sitting without support. Pulling the child to a sitting position allows the neck muscles to support the head. Propping the child in a sitting position helps to develop self-righting behaviors. It is too early to worry about standing. Talking to the child promotes language development, not gross motor development. Handling a rattle is a fine motor behavior, not a gross motor behavior.

Question 5

The mother of a child starting school in a few weeks is concerned how her child will interact with other children.Which response by the nurse is best to address this mother's concern?
A) "The home environment is the major influence."
B) "The child's physical characteristics play a large role in interactions with others."
C) "The child's temperament will determine interaction ability."
D) "The culture in which the child was raised plays a role in interactions with others."

Accepted Answer

A) Temperament is the way individuals respond to their external and internal environment, and it sets the stage for the interactive dynamics of growth and development. Physical characteristics include eye color and potential height but do not affect how children interact, for the most part. Environmental factors include family, religion, climate, culture, school, community, and nutrition; they do not play as significant a role in how the child responds to peers as temperament does. Culture is one of the environmental factors.
B) Temperament is the way individuals respond to their external and internal environment, and it sets the stage for the interactive dynamics of growth and development. Physical characteristics include eye color and potential height but do not affect how children interact, for the most part. Environmental factors include family, religion, climate, culture, school, community, and nutrition; they do not play as significant a role in how the child responds to peers as temperament does. Culture is one of the environmental factors.
C) Temperament is the way individuals respond to their external and internal environment, and it sets the stage for the interactive dynamics of growth and development. Physical characteristics include eye color and potential height but do not affect how children interact, for the most part. Environmental factors include family, religion, climate, culture, school, community, and nutrition; they do not play as significant a role in how the child responds to peers as temperament does. Culture is one of the environmental factors.
D) Temperament is the way individuals respond to their external and internal environment, and it sets the stage for the interactive dynamics of growth and development. Physical characteristics include eye color and potential height but do not affect how children interact, for the most part. Environmental factors include family, religion, climate, culture, school, community, and nutrition; they do not play as significant a role in how the child responds to peers as temperament does. Culture is one of the environmental factors.

Question 6

The school nurse cares for students with physical challenges and suspects that the needs for physical safety are not being adequately met for several students in the home environment.Which assessment findings support the nurse's concern? Select all that apply.
A) Wearing the same clothes to school several days of the week
B) Limited arm range of motion
C) Scrapes on knees caused be falling from a bicycle
D) Hand burn from touching a hot stove
E) Lunch contains leftovers from previous evening dinner

Accepted Answer

A) Wearing the same clothes to school several days of the week and eating leftovers for lunch could be an indication of the family's financial status. Evidence that physical safety needs are not being adequately met would include the formation of contractures, which limits arm range of motion; scrapes on knees after falling from a bicycle, indicating the lack of safety or protective equipment for the head and extremities; and hand burns obtained from touching a hot stove, which could mean the child was not attended in the kitchen at home.
B) Wearing the same clothes to school several days of the week and eating leftovers for lunch could be an indication of the family's financial status. Evidence that physical safety needs are not being adequately met would include the formation of contractures, which limits arm range of motion; scrapes on knees after falling from a bicycle, indicating the lack of safety or protective equipment for the head and extremities; and hand burns obtained from touching a hot stove, which could mean the child was not attended in the kitchen at home.
C) Wearing the same clothes to school several days of the week and eating leftovers for lunch could be an indication of the family's financial status. Evidence that physical safety needs are not being adequately met would include the formation of contractures, which limits arm range of motion; scrapes on knees after falling from a bicycle, indicating the lack of safety or protective equipment for the head and extremities; and hand burns obtained from touching a hot stove, which could mean the child was not attended in the kitchen at home.
D) Wearing the same clothes to school several days of the week and eating leftovers for lunch could be an indication of the family's financial status. Evidence that physical safety needs are not being adequately met would include the formation of contractures, which limits arm range of motion; scrapes on knees after falling from a bicycle, indicating the lack of safety or protective equipment for the head and extremities; and hand burns obtained from touching a hot stove, which could mean the child was not attended in the kitchen at home.
E) Wearing the same clothes to school several days of the week and eating leftovers for lunch could be an indication of the family's financial status. Evidence that physical safety needs are not being adequately met would include the formation of contractures, which limits arm range of motion; scrapes on knees after falling from a bicycle, indicating the lack of safety or protective equipment for the head and extremities; and hand burns obtained from touching a hot stove, which could mean the child was not attended in the kitchen at home.

Question 7

The nurse is utilizing Kohlberg's theory to assess the moral development of several school-age children.According to this theorist,the nurse should recognize this age group is mainly concerned with which step in moral development?
A) A feeling of justice
B) Belief in due process
C) Fear of punishment
D) Wanting the approval of others

Accepted Answer

A) Kohlberg believes that school-age through adult moral development begins with wanting the approval of others in stage 1 of the conventional level. Fear of punishment is characteristic of the toddler through age 7. Feeling of justice and belief in due process are experienced in post-conventional development, at stage 5.
B) Kohlberg believes that school-age through adult moral development begins with wanting the approval of others in stage 1 of the conventional level. Fear of punishment is characteristic of the toddler through age 7. Feeling of justice and belief in due process are experienced in post-conventional development, at stage 5.
C) Kohlberg believes that school-age through adult moral development begins with wanting the approval of others in stage 1 of the conventional level. Fear of punishment is characteristic of the toddler through age 7. Feeling of justice and belief in due process are experienced in post-conventional development, at stage 5.
D) Kohlberg believes that school-age through adult moral development begins with wanting the approval of others in stage 1 of the conventional level. Fear of punishment is characteristic of the toddler through age 7. Feeling of justice and belief in due process are experienced in post-conventional development, at stage 5.

Question 8

The nurse is interviewing the mother of a child who is being evaluated for attention-deficit/hyperactivity disorder (ADHD).When assessing the child's health history,which would the nurse identify as a risk factor for ADHD?
A) The measles, mumps, and rubella (MMR) vaccine
B) The immune response of the child
C) Young parental age at conception
D) Smoking during pregnancy

Accepted Answer

A) Research shows that a mother's use of cigarettes during pregnancy can increase the risk for ADHD. Immune response can be associated with autism spectrum disorders but not ADHD. Young parental age has not been associated with ADHD. The measles, mumps, and rubella vaccine has been thought to be associated with autism spectrum disorder, although a relationship has never been established through research.
B) Research shows that a mother's use of cigarettes during pregnancy can increase the risk for ADHD. Immune response can be associated with autism spectrum disorders but not ADHD. Young parental age has not been associated with ADHD. The measles, mumps, and rubella vaccine has been thought to be associated with autism spectrum disorder, although a relationship has never been established through research.
C) Research shows that a mother's use of cigarettes during pregnancy can increase the risk for ADHD. Immune response can be associated with autism spectrum disorders but not ADHD. Young parental age has not been associated with ADHD. The measles, mumps, and rubella vaccine has been thought to be associated with autism spectrum disorder, although a relationship has never been established through research.
D) Research shows that a mother's use of cigarettes during pregnancy can increase the risk for ADHD. Immune response can be associated with autism spectrum disorders but not ADHD. Young parental age has not been associated with ADHD. The measles, mumps, and rubella vaccine has been thought to be associated with autism spectrum disorder, although a relationship has never been established through research.

Question 9

The school nurse is talking to a child with attention-deficit/hyperactivity disorder (ADHD)who wants to play soccer.Which action is the most appropriate for the school nurse to take?
A) Recommend that the child become active in an individual sport, rather than a team sport.
B) Encourage the child to play soccer.
C) Discourage the child from playing a team sport like soccer.
D) Ask the child's mother to get permission from the child's physician to play soccer.

Accepted Answer

A) The child should be encouraged to play soccer. Participation in a team sport will assist the child with ADHD to expend some energy while cooperating with others and following game rules. Participating in a team sport can help promote self-esteem in the child with ADHD and encourage connectedness with other children. There is no reason for a child with ADHD not to play sports. The mother would not need physician approval for her son to play soccer. Vigorous physical activity is encouraged for all children with ADHD. Some of the benefits of participating in a team sport would not be available with individual sports.
B) The child should be encouraged to play soccer. Participation in a team sport will assist the child with ADHD to expend some energy while cooperating with others and following game rules. Participating in a team sport can help promote self-esteem in the child with ADHD and encourage connectedness with other children. There is no reason for a child with ADHD not to play sports. The mother would not need physician approval for her son to play soccer. Vigorous physical activity is encouraged for all children with ADHD. Some of the benefits of participating in a team sport would not be available with individual sports.
C) The child should be encouraged to play soccer. Participation in a team sport will assist the child with ADHD to expend some energy while cooperating with others and following game rules. Participating in a team sport can help promote self-esteem in the child with ADHD and encourage connectedness with other children. There is no reason for a child with ADHD not to play sports. The mother would not need physician approval for her son to play soccer. Vigorous physical activity is encouraged for all children with ADHD. Some of the benefits of participating in a team sport would not be available with individual sports.
D) The child should be encouraged to play soccer. Participation in a team sport will assist the child with ADHD to expend some energy while cooperating with others and following game rules. Participating in a team sport can help promote self-esteem in the child with ADHD and encourage connectedness with other children. There is no reason for a child with ADHD not to play sports. The mother would not need physician approval for her son to play soccer. Vigorous physical activity is encouraged for all children with ADHD. Some of the benefits of participating in a team sport would not be available with individual sports.

Question 10

The community health nurse,working with a group of women from another country who smoke,encourages them to stop smoking before and during pregnancy.A participant asks the nurse,"why is it important to stop smoking before and during pregnancy?" Which health problem associated with smoking before and during pregnancy will the nurse include in the response?
A) Benzodiazepine withdrawal
B) Attention-deficit/hyperactivity disorder (ADHD)
C) Unhappy memories
D) A personality disorder

Accepted Answer

A) Recent studies suggest that nicotinic dysregulation may play a role in child and adolescent disorders. Maternal smoking during pregnancy increases the risk for ADHD in children. Smoking during pregnancy is not related to personality disorder, unhappy memories, or benzodiazepine withdrawal.
B) Recent studies suggest that nicotinic dysregulation may play a role in child and adolescent disorders. Maternal smoking during pregnancy increases the risk for ADHD in children. Smoking during pregnancy is not related to personality disorder, unhappy memories, or benzodiazepine withdrawal.
C) Recent studies suggest that nicotinic dysregulation may play a role in child and adolescent disorders. Maternal smoking during pregnancy increases the risk for ADHD in children. Smoking during pregnancy is not related to personality disorder, unhappy memories, or benzodiazepine withdrawal.
D) Recent studies suggest that nicotinic dysregulation may play a role in child and adolescent disorders. Maternal smoking during pregnancy increases the risk for ADHD in children. Smoking during pregnancy is not related to personality disorder, unhappy memories, or benzodiazepine withdrawal.

Question 11

The nurse is caring for a young school-age child recently diagnosed with attention-deficit/hyperactivity disorder (ADHD).Which statement by the child's mother indicates that teaching goals have not been achieved?
A) "I will let my child do homework while watching a favorite television show."
B) "I will give my child ADHD medication with meals."
C) "I will take my child to the doctor every 3 months for a weight and height check."
D) "I will stick to the same routine each day after school."

Accepted Answer

A) This child should do homework in a quiet environment, away from distractions. Giving ADHD medication with meals will help counteract the anorexia associated with this medication. Maintaining the same daily routine helps the child know expectations, and a nighttime routine helps counteract insomnia. Children with ADHD should be screened regularly for height and weight to monitor growth.
B) This child should do homework in a quiet environment, away from distractions. Giving ADHD medication with meals will help counteract the anorexia associated with this medication. Maintaining the same daily routine helps the child know expectations, and a nighttime routine helps counteract insomnia. Children with ADHD should be screened regularly for height and weight to monitor growth.
C) This child should do homework in a quiet environment, away from distractions. Giving ADHD medication with meals will help counteract the anorexia associated with this medication. Maintaining the same daily routine helps the child know expectations, and a nighttime routine helps counteract insomnia. Children with ADHD should be screened regularly for height and weight to monitor growth.
D) This child should do homework in a quiet environment, away from distractions. Giving ADHD medication with meals will help counteract the anorexia associated with this medication. Maintaining the same daily routine helps the child know expectations, and a nighttime routine helps counteract insomnia. Children with ADHD should be screened regularly for height and weight to monitor growth.

Question 12

A psychiatric nurse is actively involved in the planning of a new children's mental health clinic.The nurse understands the importance of including a play area at this site because of the population it will serve.Which is the reason for the use of play and toys to assess children with suspected mental health disorders?
A) Pediatric clients express themselves through play.
B) Only toys that are developmentally appropriate and specific to the child's biological age are used.
C) Pediatric clients do not usually relate to adults.
D) Play enables the nurse to assess the cognitive ability of the pediatric client.

Accepted Answer

A) A mental status exam on a child consists of both a semi-structured interview and an unstructured play session with the child. Observing a child at play can also provide invaluable information about motor behavior, thought content, affect, and impulse control. There is a general belief that toys with ambiguous meaning and diverse uses foster symbolic play more effectively because they allow the child to project his or her own identity and function onto the toys. The children may or may not relate to adults, but that is not the reason for including the play area. Cognitive ability is only one of the areas of assessment, and not the overall reason for including the play area. Toys may or may not be specific to the child's biological age.
B) A mental status exam on a child consists of both a semi-structured interview and an unstructured play session with the child. Observing a child at play can also provide invaluable information about motor behavior, thought content, affect, and impulse control. There is a general belief that toys with ambiguous meaning and diverse uses foster symbolic play more effectively because they allow the child to project his or her own identity and function onto the toys. The children may or may not relate to adults, but that is not the reason for including the play area. Cognitive ability is only one of the areas of assessment, and not the overall reason for including the play area. Toys may or may not be specific to the child's biological age.
C) A mental status exam on a child consists of both a semi-structured interview and an unstructured play session with the child. Observing a child at play can also provide invaluable information about motor behavior, thought content, affect, and impulse control. There is a general belief that toys with ambiguous meaning and diverse uses foster symbolic play more effectively because they allow the child to project his or her own identity and function onto the toys. The children may or may not relate to adults, but that is not the reason for including the play area. Cognitive ability is only one of the areas of assessment, and not the overall reason for including the play area. Toys may or may not be specific to the child's biological age.
D) A mental status exam on a child consists of both a semi-structured interview and an unstructured play session with the child. Observing a child at play can also provide invaluable information about motor behavior, thought content, affect, and impulse control. There is a general belief that toys with ambiguous meaning and diverse uses foster symbolic play more effectively because they allow the child to project his or her own identity and function onto the toys. The children may or may not relate to adults, but that is not the reason for including the play area. Cognitive ability is only one of the areas of assessment, and not the overall reason for including the play area. Toys may or may not be specific to the child's biological age.

Question 13

A parent of a toddler-age child is explaining to the nurse that the family wishes to raise the child to reflect their spiritual beliefs.According to Westerhoff's stages of faith,which should the nurse advise the parent to help the child grow in the family's faith?
A) Baptize the child in the parents' faith.
B) Read spiritually oriented books to the child.
C) Follow and live the faith of their choice.
D) Take the child to ceremonies of their faith.

Accepted Answer

A) According to Westerhoff, the child experiences faith through interaction with others who are living the particular faith. Reading books on faith to a child is not as powerful as setting the example. Baptizing a child does not guarantee the child will experience faith. Taking the child to ceremonies is worthwhile but not as powerful as associating with those who live the faith.
B) According to Westerhoff, the child experiences faith through interaction with others who are living the particular faith. Reading books on faith to a child is not as powerful as setting the example. Baptizing a child does not guarantee the child will experience faith. Taking the child to ceremonies is worthwhile but not as powerful as associating with those who live the faith.
C) According to Westerhoff, the child experiences faith through interaction with others who are living the particular faith. Reading books on faith to a child is not as powerful as setting the example. Baptizing a child does not guarantee the child will experience faith. Taking the child to ceremonies is worthwhile but not as powerful as associating with those who live the faith.
D) According to Westerhoff, the child experiences faith through interaction with others who are living the particular faith. Reading books on faith to a child is not as powerful as setting the example. Baptizing a child does not guarantee the child will experience faith. Taking the child to ceremonies is worthwhile but not as powerful as associating with those who live the faith.

Question 14

The nurse is caring for an adolescent with cystic fibrosis who suddenly becomes noncompliant with the medication regimen.Which intervention should the nurse choose to help improve medication compliance for this client?
A) Give the client a computer-animated game that presents information on the management of cystic fibrosis.
B) Recommend to the client's parents that certain privileges should be taken away, such as cell phone use and texting, if compliance fails to improve.
C) Arrange for the physician to discuss the risks related to noncompliance with medications to the client.
D) Set up a meeting with some older teens with cystic fibrosis who have been managing their disease effectively.

Accepted Answer

A) Providing the adolescent with positive role models from his or her peer group is the intervention most likely to improve compliance. Interest in games might begin to wane at this age. Adult opinions, even from a physician, could be viewed negatively and challenged. Threatening punishment could further incite rebellion.
B) Providing the adolescent with positive role models from his or her peer group is the intervention most likely to improve compliance. Interest in games might begin to wane at this age. Adult opinions, even from a physician, could be viewed negatively and challenged. Threatening punishment could further incite rebellion.
C) Providing the adolescent with positive role models from his or her peer group is the intervention most likely to improve compliance. Interest in games might begin to wane at this age. Adult opinions, even from a physician, could be viewed negatively and challenged. Threatening punishment could further incite rebellion.
D) Providing the adolescent with positive role models from his or her peer group is the intervention most likely to improve compliance. Interest in games might begin to wane at this age. Adult opinions, even from a physician, could be viewed negatively and challenged. Threatening punishment could further incite rebellion.

Question 15

A school nurse is working with a group of teachers to help them address the developmental needs of preschool students.The nurse tells the group that preschool-age children are experiencing the stage of initiative versus guilt described in Erikson's theory.Which activity should the nurse suggest to foster development at this stage?
A) Providing time for running and playing sports, such as basketball, to increase gross motor skills
B) Helping them develop skills needed in the adult world, such as allowance budgeting
C) Allowing "pretend" time during their classes, such as dress-up or role-playing activities
D) Presenting diversity in culture and practices as part of classroom study

Accepted Answer

A) Preschool-aged children should be given activities that focus on gross motor skills as well as make-believe and pretend opportunities. School-age children are motivated by activities that provide a sense of worth. They concentrate on mastering skills that will help them function in the adult world. Understanding diversity, role preference, and performance is the task of the adolescent.
B) Preschool-aged children should be given activities that focus on gross motor skills as well as make-believe and pretend opportunities. School-age children are motivated by activities that provide a sense of worth. They concentrate on mastering skills that will help them function in the adult world. Understanding diversity, role preference, and performance is the task of the adolescent.
C) Preschool-aged children should be given activities that focus on gross motor skills as well as make-believe and pretend opportunities. School-age children are motivated by activities that provide a sense of worth. They concentrate on mastering skills that will help them function in the adult world. Understanding diversity, role preference, and performance is the task of the adolescent.
D) Preschool-aged children should be given activities that focus on gross motor skills as well as make-believe and pretend opportunities. School-age children are motivated by activities that provide a sense of worth. They concentrate on mastering skills that will help them function in the adult world. Understanding diversity, role preference, and performance is the task of the adolescent.

Question 16

A nurse is caring for a school-age client who is scheduled to have a tonsillectomy the next day.The nurse has planned a preoperative teaching session for the child,who has a history of attention-deficit/hyperactivity disorder (ADHD).Which teaching technique is most appropriate for this client?
A) Play a television show in the background.
B) Ask other children who have had this procedure to talk to the child.
C) Allow the child to lead the session to gain a sense of control.
D) Give instructions verbally and use a picture pamphlet, repeating points more than once.

Accepted Answer

A) A teaching session for a child with ADHD should foster attention. Giving instructions verbally and in written form, repeating the main points, will improve learning for a child with ADHD. Talking to other children who have had this procedure may not foster understanding, because this child has ADHD. A child who has difficulty concentrating should not lead the session even though the child needs to feel in control. The environment should be quiet, with minimal distractions. Distractions such as noise from a television should be minimized.
B) A teaching session for a child with ADHD should foster attention. Giving instructions verbally and in written form, repeating the main points, will improve learning for a child with ADHD. Talking to other children who have had this procedure may not foster understanding, because this child has ADHD. A child who has difficulty concentrating should not lead the session even though the child needs to feel in control. The environment should be quiet, with minimal distractions. Distractions such as noise from a television should be minimized.
C) A teaching session for a child with ADHD should foster attention. Giving instructions verbally and in written form, repeating the main points, will improve learning for a child with ADHD. Talking to other children who have had this procedure may not foster understanding, because this child has ADHD. A child who has difficulty concentrating should not lead the session even though the child needs to feel in control. The environment should be quiet, with minimal distractions. Distractions such as noise from a television should be minimized.
D) A teaching session for a child with ADHD should foster attention. Giving instructions verbally and in written form, repeating the main points, will improve learning for a child with ADHD. Talking to other children who have had this procedure may not foster understanding, because this child has ADHD. A child who has difficulty concentrating should not lead the session even though the child needs to feel in control. The environment should be quiet, with minimal distractions. Distractions such as noise from a television should be minimized.

Question 17

The nurse determines that a toddler-age client is unable to respond to noises in the environment and has difficulty following the movement of toys.Which diagnostic tools does the nurse anticipate will be used to further assess this client? Select all that apply.
A) CT scan of the brain
B) Vision test
C) Abdominal x-rays
D) Nerve conduction studies
E) Audiology testing

Accepted Answer

A) The child is not responding to environmental noise and is having difficulty tracking the movement of toys. The two tests that should be considered for this child are vision and hearing testing. There is not enough evidence to support that the child would need a CT scan of the brain, abdominal x-rays, or nerve conduction studies.
B) The child is not responding to environmental noise and is having difficulty tracking the movement of toys. The two tests that should be considered for this child are vision and hearing testing. There is not enough evidence to support that the child would need a CT scan of the brain, abdominal x-rays, or nerve conduction studies.
C) The child is not responding to environmental noise and is having difficulty tracking the movement of toys. The two tests that should be considered for this child are vision and hearing testing. There is not enough evidence to support that the child would need a CT scan of the brain, abdominal x-rays, or nerve conduction studies.
D) The child is not responding to environmental noise and is having difficulty tracking the movement of toys. The two tests that should be considered for this child are vision and hearing testing. There is not enough evidence to support that the child would need a CT scan of the brain, abdominal x-rays, or nerve conduction studies.
E) The child is not responding to environmental noise and is having difficulty tracking the movement of toys. The two tests that should be considered for this child are vision and hearing testing. There is not enough evidence to support that the child would need a CT scan of the brain, abdominal x-rays, or nerve conduction studies.

Question 18

The nurse is teaching the family of a child who is prescribed amphetamine mixed salts (Adderall)for attention-deficit/hyperactivity disorder (ADHD).Which is the best time for the nurse to teach the family to administer the medication?
A) Before lunch
B) At bedtime
C) With the evening meal
D) Early in the morning

Accepted Answer

A) Administering the medication early in the day can help alleviate the effect of insomnia. Before lunch might be difficult and cause embarrassment to the child if the child is in school. Evening and bedtime are incorrect as this medicine can cause insomnia.
B) Administering the medication early in the day can help alleviate the effect of insomnia. Before lunch might be difficult and cause embarrassment to the child if the child is in school. Evening and bedtime are incorrect as this medicine can cause insomnia.
C) Administering the medication early in the day can help alleviate the effect of insomnia. Before lunch might be difficult and cause embarrassment to the child if the child is in school. Evening and bedtime are incorrect as this medicine can cause insomnia.
D) Administering the medication early in the day can help alleviate the effect of insomnia. Before lunch might be difficult and cause embarrassment to the child if the child is in school. Evening and bedtime are incorrect as this medicine can cause insomnia.

Question 19

The nurse instructs a school-age client how to use a peak flow meter to monitor asthma.The client was frustrated at first but now is able to state the reason for using the meter on a daily basis.Which response by the nurse is most appropriate when dealing with the growth and development characteristics of the preadolescent?
A) "It's too bad that you don't want to use the meter; it's just something you'll have to do."
B) "You should feel very proud of yourself for understanding and using your meter."
C) "Maybe you could make a game out of the daily use of your meter."
D) "Think of using the meter as one of your daily chores."

Accepted Answer

A) It is generally accepted that positive reinforcement changes behavior. Chores often have negative associations for children, so suggesting that the child compare using the meter to chores may not provide the expected outcome. Using the meter is not a game; it is serious. It is not appropriate to make a game out of something as serious as a meter. A negative comment will not affect behavior change.
B) It is generally accepted that positive reinforcement changes behavior. Chores often have negative associations for children, so suggesting that the child compare using the meter to chores may not provide the expected outcome. Using the meter is not a game; it is serious. It is not appropriate to make a game out of something as serious as a meter. A negative comment will not affect behavior change.
C) It is generally accepted that positive reinforcement changes behavior. Chores often have negative associations for children, so suggesting that the child compare using the meter to chores may not provide the expected outcome. Using the meter is not a game; it is serious. It is not appropriate to make a game out of something as serious as a meter. A negative comment will not affect behavior change.
D) It is generally accepted that positive reinforcement changes behavior. Chores often have negative associations for children, so suggesting that the child compare using the meter to chores may not provide the expected outcome. Using the meter is not a game; it is serious. It is not appropriate to make a game out of something as serious as a meter. A negative comment will not affect behavior change.

Question 20

The school nurse is administering methylphenidate (Ritalin)to an adolescent is diagnosed with attention-deficit/hyperactivity disorder (ADHD).The adolescent is noncompliant with coming to the nurse's office at noon for the medication.Which does the nurse suspect as the cause of the adolescent's noncompliance with the current medication regimen?
A) The adolescent may fear that this drug may be a "gateway drug" that may lead to abusing other substances.
B) An additional dose of medication is not needed while at school.
C) Alternative coping mechanisms to increase focus during classes have been developed.
D) The adolescent may be embarrassed about having to take medicine at school and fear a social stigma.

Accepted Answer

A) Some adolescent clients believe that having to take drugs in school will cause them to be viewed as weak, unhealthy, or dependent. Clients can also perceive this as a social stigma. Methylphenidate (Ritalin) is a short-acting drug and doses must be administered about 4 hours apart, so the client must receive a dose during school hours. ADHD is a brain-based disorder, and the primary treatment is medication; alternative coping mechanisms will not usually help to increase focus during classes. Appropriate treatment of ADHD will result in lessening the likelihood for addiction to mood-altering substances, not an increase in the likelihood.
B) Some adolescent clients believe that having to take drugs in school will cause them to be viewed as weak, unhealthy, or dependent. Clients can also perceive this as a social stigma. Methylphenidate (Ritalin) is a short-acting drug and doses must be administered about 4 hours apart, so the client must receive a dose during school hours. ADHD is a brain-based disorder, and the primary treatment is medication; alternative coping mechanisms will not usually help to increase focus during classes. Appropriate treatment of ADHD will result in lessening the likelihood for addiction to mood-altering substances, not an increase in the likelihood.
C) Some adolescent clients believe that having to take drugs in school will cause them to be viewed as weak, unhealthy, or dependent. Clients can also perceive this as a social stigma. Methylphenidate (Ritalin) is a short-acting drug and doses must be administered about 4 hours apart, so the client must receive a dose during school hours. ADHD is a brain-based disorder, and the primary treatment is medication; alternative coping mechanisms will not usually help to increase focus during classes. Appropriate treatment of ADHD will result in lessening the likelihood for addiction to mood-altering substances, not an increase in the likelihood.
D) Some adolescent clients believe that having to take drugs in school will cause them to be viewed as weak, unhealthy, or dependent. Clients can also perceive this as a social stigma. Methylphenidate (Ritalin) is a short-acting drug and doses must be administered about 4 hours apart, so the client must receive a dose during school hours. ADHD is a brain-based disorder, and the primary treatment is medication; alternative coping mechanisms will not usually help to increase focus during classes. Appropriate treatment of ADHD will result in lessening the likelihood for addiction to mood-altering substances, not an increase in the likelihood.

Quiz 25: Development

The nurse is caring for a family with four children whose third child has been diagnosed with attention-deficit/hyperactivity disorder (ADHD) .After completing an assessment,which statement made by the mother leads the nurse to a diagnosis of compromised family coping?

The community nurse develops an educational program that focuses on the developmental tasks of adults ages 50 to 60.Which developmental task accomplishment within Gould's theory should the nurse highlight?

A toddler cannot stand next to furniture and does not try to pull himself up from a sitting position.Based on this data,the nurse plans care for this client based on which deficiency?

The nurse is assessing a 6-month-old infant using the Denver Developmental Screening test.The test shows that the infant is delayed in gross motor development.What activities can the nurse implement to help the child attain appropriate developmental levels?

The mother of a child starting school in a few weeks is concerned how her child will interact with other children.Which response by the nurse is best to address this mother's concern?

The school nurse cares for students with physical challenges and suspects that the needs for physical safety are not being adequately met for several students in the home environment.Which assessment findings support the nurse's concern? Select all that apply.

The nurse is utilizing Kohlberg's theory to assess the moral development of several school-age children.According to this theorist,the nurse should recognize this age group is mainly concerned with which step in moral development?

The nurse is interviewing the mother of a child who is being evaluated for attention-deficit/hyperactivity disorder (ADHD) .When assessing the child's health history,which would the nurse identify as a risk factor for ADHD?

The school nurse is talking to a child with attention-deficit/hyperactivity disorder (ADHD) who wants to play soccer.Which action is the most appropriate for the school nurse to take?

The nurse is caring for a young school-age child recently diagnosed with attention-deficit/hyperactivity disorder (ADHD) .Which statement by the child's mother indicates that teaching goals have not been achieved?

A parent of a toddler-age child is explaining to the nurse that the family wishes to raise the child to reflect their spiritual beliefs.According to Westerhoff's stages of faith,which should the nurse advise the parent to help the child grow in the family's faith?

The nurse is caring for an adolescent with cystic fibrosis who suddenly becomes noncompliant with the medication regimen.Which intervention should the nurse choose to help improve medication compliance for this client?

A nurse is caring for a school-age client who is scheduled to have a tonsillectomy the next day.The nurse has planned a preoperative teaching session for the child,who has a history of attention-deficit/hyperactivity disorder (ADHD) .Which teaching technique is most appropriate for this client?

The nurse determines that a toddler-age client is unable to respond to noises in the environment and has difficulty following the movement of toys.Which diagnostic tools does the nurse anticipate will be used to further assess this client? Select all that apply.

The nurse is teaching the family of a child who is prescribed amphetamine mixed salts (Adderall) for attention-deficit/hyperactivity disorder (ADHD) .Which is the best time for the nurse to teach the family to administer the medication?