Introduction to Maternity and Pediatric Nursing 7th Edition, Leifer Test Bank

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Test Bank For Introduction to Maternity and Pediatric Nursing 7th Edition, Leifer. Note: This is not a text book. Description: ISBN-13: 978-1455770151, ISBN-10: 1455770159.

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Test Bank Introduction Maternity Pediatric Nursing 7th Leifer

Chapter 01: The Past, Present, and Future
1. A patient chooses to have the certified nurse midwife (CNM) provide care during her pregnancy. What does the CNMs scope of practice include?
a. Practice independent from medical supervision
b. Comprehensive prenatal care
c. Attendance at all deliveries
d. Cesarean sections
2. Which medical pioneer discovered the relationship between the incidence of puerperal fever and unwashed hands?
a. Karl Cred
b. Ignaz Semmelweis
c. Louis Pasteur
d. Joseph Lister
3. A pregnant woman who has recently immigrated to the United States comments to the nurse, I am afraid of childbirth. It is so dangerous. I am afraid I will die. What is the best nursing response reflecting cultural sensitivity?
a. Maternal mortality in the United States is extremely low.
b. Anesthesia is available to relieve pain during labor and childbirth.
c. Tell me why you are afraid of childbirth.
d. Your condition will be monitored during labor and delivery.
4. An urban area has been reported to have a high perinatal mortality rate. What information does this provide?
a. Maternal and infant deaths per 100,000 live births per year
b. Deaths of fetuses weighing more than 500 g per 10,000 births per year
c. Deaths of infants up to 1 year of age per 1000 live births per year
d. Fetal and neonatal deaths per 1000 live births per year
5. What is the focus of current maternity practice?
a. Hospital births for the majority of women b. The traditional family unit
c. Separation of labor rooms from delivery rooms d. A quality family experience for each patient
6. Who advocated the establishment of the Childrens Bureau?
a. Lillian Wald
b. Florence Nightingale
c. Florence Kelly
d. Clara Barton
7. What was the result of research done in the 1930s by the Childrens Bureau?
a. Children with heart problems are now cared for by pediatric cardiologists.
b. The Child Abuse and Prevention Act was passed.
c. Hot lunch programs were established in many schools.
d. Childrens asylums were founded.
8. What government program was implemented to increase the educational exposure of preschool children?
a. WIC b. Title XIX of Medicaid c. The Childrens Charter d. Head Start
9. What guidelines define multidisciplinary patient care in terms of expected outcome and timeframe from different areas of care provision?
a. Clinical pathways
b. Nursing outcome criteria
c. Standards of care
d. Nursing care plan
10. A nursing student has reviewed a hospitalized pediatric patient chart, interviewed her mother, and collected admission data. What is the next step the student will take to develop a nursing care plan for this child?
a. Identify measurable outcomes with a timeline.
b. Choose specific nursing interventions for the child.
c. Determine appropriate nursing diagnoses.
d. State nursing actions related to the childs medical diagnosis.

Chapter 02: Human Reproductive Anatomy and Physiology
1. A 14­year­old boy is at the pediatric clinic for a checkup. What physical changes of puberty will the nurse indicate are related to the production of testosterone?
a. Stimulation of production of white cells and platelets
b. Promotion of growth of small bones
c. Increase in muscle mass and strength
d. Decrease in production of sebaceous gland secretions
2. The nurse is educating high school students about puberty. What will the nurse indicate regulates the production of sperm and secretion hormones?
a. Testes
b. Vas deferens
c. Ejaculatory ducts
d. Prostate gland
3. The nurse is speaking with a couple trying to conceive a child. What will the nurse remind the couple is a factor that can decrease sperm production?
a. Infrequent sexual intercourse
b. The man not being circumcised
c. The penis and testes being small
d. The testes being too warm
4. When describing the female reproductive tract to a pregnant woman, the nurse would explain that which uterine layer is involved in implantation?
a. Perimetrium b. Endometrium c. Myometrium d. Internal os
5. A group of nursing students plans to teach a class of sixth­grade girls about menstruation. What correct information will the nursing students teach to the class?
a. Menarche usually occurs around 12 years of age.
b. Ovulation occurs regularly from the very first cycle.
c. A regular cycle is established by the third period.
d. Typically, menstrual flow is heavy and lasts up to 10 days.
6. A 10­year­old girl asks the nurse, What is the first sign of puberty? What is the correct nursing response?
a. An increase in height b. Breast development
c. Appearance of axillary hair d. The first menstrual period
7. A 12­year­old female pediatric patient experienced menarche 3 months ago. Her mother voices concern to the pediatric office nurse regarding the irregularity of her daughters menstrual cycle. What is the nurses best response?
a. Worrying is not the answer.
b. I will talk to the pediatrician about a gynecological referral.
c. I can only discuss this with your daughter.
d. Early cycles are often irregular.
8. Which hormone initiates the maturation of the ovarian follicle?
a. Estrogen
b. Follicle­stimulating hormone
c. Progesterone
d. Luteinizing hormone
9. What statement indicates a woman has correct information about oogenesis?
a. Women make fewer ova as they age.
b. Women have all of their ova at the time they are born.
c. Ova production begins at birth and continues until puberty.
d. New ova are made every month from puberty to climacteric.
10. A pregnant woman asks the nurse, Will I be able to have a vaginal delivery? The nurse knows that which is the most favorable pelvic type for vaginal birth?
a. Gynecoid b. Android
c. Anthropoid d. Platypelloid

Chapter 03: Fetal Development
1. What is the total number of chromosomes contained in a mature sperm or ovum?
a. 22 b. 23 c. 44 d. 46
2. A pregnant woman states, My husband hopes I will give him a boy because we have three girls. What will the nurse explain to this woman?
a. The sex chromosome of the fertilized ovum determines the gender of the child.
b. When the sperm and ovum are united, there is a 75% chance the child will be a girl.
c. When the pH of the female reproductive tract is acidic, the child will be a girl.
d. If a sperm carrying a Y chromosome fertilizes an ovum, then a boy is produced.
3. What is the most common site for fertilization?
a. Lower segment of the uterus
b. Outer third of the fallopian tube near the ovary
c. Upper portion of the uterus
d. Area of the fallopian tube farthest from the ovary
4. The embryo is termed a fetus at which stage of prenatal development?
a. 2 weeks b. 4 weeks c. 9 weeks d. 16 weeks
5. The nurse is reviewing fetal circulation with a pregnant patient and explains that blood circulates through the placenta to the fetus. What vessel(s) carry blood to the fetus?
a. One umbilical vein
b. Two umbilical veins
c. One umbilical artery
d. Two umbilical arteries
6. Where is the usual location for implantation of the zygote?
a. Upper section of the posterior uterine wall
b. Lower portion of the uterus near the cervical os
c. Inner third of the fallopian tube near the uterus
d. Lateral aspect of the uterine wall
7. What is the embryonic membrane that contains fingerlike projections on its surface, which attach to the uterine wall?
a. Amnion b. Yolk sac c. Chorion d. Decidua basalis
8. Which hormone is responsible for converting the endometrium into decidual cells for implantation?
a. Estrogen
b. Human chorionic gonadotropin
c. Human placental lactogen
d. Progesterone
9. A patient asks the nurse when her infants heart will begin to pump blood. What will the nurse reply?
a. By the end of week 3 b. Beginning in week 8 c. At the end of week 16 d. Beginning in week 24
10. What organ does the ductus venosus shunt blood away from in fetal circulation?
a. Liver b. Heart c. Lungs d. Kidneys

Chapter 04: Prenatal Care and Adaptations to Pregnancy
1. A woman who is 7 weeks pregnant tells the nurse that this is not her first pregnancy. She has a 2­year­ old son and had one previous spontaneous abortion. How would the nurse document the patients obstetric history using the TPALM system?
a. Gravida 2, para 20120 b. Gravida 3, para 10011 c. Gravida 3, para 10110 d. Gravida 2, para 11110
2. A woman calls her health care provider to schedule prenatal visits in an uncomplicated pregnancy. How frequently will the nurse assist the patient to schedule these appointments?
a. Every 3 weeks until the 6th month, then every 2 weeks until delivery
b. Every 4 weeks until the 7th month, after which appointments will become more frequent
c. Monthly until the 8th month
d. Every 2 to 3 weeks for the entire pregnancy
3. During the physical examination for the first prenatal visit, it is noted that Chadwicks sign is present. What is Chadwicks sign?
a. Bluish or purplish discoloration of the vulva, vagina, and cervix
b. Presence of early fetal movements
c. Darkening of the areola and breast tenderness
d. Palpation of the fetal outline
4. After the examination is completed, the patient asks the nurse why Chadwicks sign occurs during pregnancy. What would the nurse explain as the cause of Chadwicks sign?
a. Enlargement of the uterus
b. Progesterone action on the breasts
c. Increasing activity of the fetus
d. Vascular congestion in the pelvic area
5. The nurse has explained physiological changes that occur during pregnancy. Which statement indicates that the woman understands the information?
a. Blood pressure goes up toward the end of pregnancy.
b. My breathing will get deeper and a little faster.
c. Ill notice a decreased pigmentation in my skin.
d. There will be a curvature in the upper spine area.
6. A woman reports that her last normal menstrual period began on August 5, 2013. What is this womans expected delivery date using Ngeles rule?
a. April 30, 2014 b. May 5, 2014
c. May 12, 2014 d. May 26, 2014
7. During the second prenatal visit, the nurse attempts to locate the fetal heartbeat with an electronic Doppler device. How early might fetal heart tones be detected with an electronic Doppler device?
a. 4 weeks b. 8 weeks c. 10 weeks d. 14 weeks
8. In a routine prenatal visit, the nurse examining a patient who is 37 weeks pregnant notices that the fetal heart rate (FHR) has dropped to 120 beats/min from a rate of 160 beats/min earlier in the pregnancy.
What is the nurses first action?
a. Ask if the patient has taken a sedative.
b. Notify the physician.
c. Turn the patient to her right side.
d. Record the rate as a normal finding.
9. A womans prepregnant weight is determined to be average for her height. What will the nurse advise the woman regarding recommended weight gain during pregnancy?
a. 10 to 20 pounds b. 15 to 25 pounds c. 25 to 35 pounds d. 28 to 40 pounds
10. When the nurse tells a pregnant woman that she needs 1200 mg of calcium daily during pregnancy, the woman responds, I dont like milk. What dietary adjustments could the nurse recommend?
a. Increase intake of organ meats.
b. Eat more green leafy vegetables.
c. Choose more fresh fruits, particularly citrus fruits.
d. Include molasses and whole­grain breads in the diet.

Chapter 05: Nursing Care of Women with Complications During Pregnancy
1. A pregnant patient tells the nurse that she has been nauseated and vomiting. How will the nurse explain that hyperemesis gravidarum is distinguished from morning sickness?
a. Hyperemesis gravidarum usually lasts for the duration of the pregnancy.
b. Hyperemesis gravidarum causes dehydration and electrolyte imbalances.
c. Sensitivity to smells is usually the cause of vomiting in hyperemesis gravidarum.
d. The woman with hyperemesis gravidarum will have persistent vomiting without weight loss.
2. A woman is 9 weeks pregnant and experiencing heavy bleeding and cramping. She reports passing some tissue. Cervical dilation is noted on examination. What is the most likely cause of these symptoms?
a. Inevitable abortion
b. Incomplete abortion
c. Complete abortion
d. Missed abortion
3. The nurse finds a woman crying after she has undergone a dilation and evacuation (D&E) for a missed abortion. What is the most appropriate statement by the nurse?
a. There is usually something wrong with the fetus when this happens early in pregnancy.
b. Now there. You can try to conceive on your next cycle.
c. Im here if you need to talk.
d. You are young and strong. I know you can have a healthy pregnancy.
4. A woman who is 8 weeks pregnant becomes concerned when she has light vaginal bleeding accompanied by abdominal pain. An ectopic pregnancy is confirmed by ultrasound. Which statement indicates that the woman understands the explanation of an ectopic pregnancy?
a. The chorionic villi develop vesicles within the uterus.
b. The placenta develops in the lower part of the uterus.
c. The fetus dies in the uterus during the first half of the pregnancy.
d. The embryo is implanted in the fallopian tube.
5. An ultrasound on a woman who is 32 weeks pregnant reveals the placenta implanted over the entire cervical os. What does the nurse understand best describes this condition?
a. Low­lying placenta
b. Marginal placenta previa
c. Partial placenta previa
d. Total placenta previa
6. What symptom presented by a pregnant women is indicative of abruptio placentae?
a. Painless vaginal bleeding
b. Uterine irritability with contractions
c. Vaginal bleeding and back pain
d. Premature rupture of membranes
7. What situation would concern the nurse about the presence of Rh incompatibility?
a. Rh­negative mother, Rh­positive fetus
b. Rh­positive mother, Rh­negative fetus
c. Rh­negative mother, Rh­negative fetus
d. Rh­positive mother, Rh­positive fetus
8. A primigravida in her first trimester is Rh negative. What will this woman receive to prevent anti­Rh antibodies from forming?
a. Rh immune globulin during labor
b. Intrauterine transfusions with O­negative blood
c. Rh immune globulin at 28 weeks and within 72 hours after the birth of an Rh­positive infant
d. Rh immune globulin now and again in the last trimester
9. A woman seeking prenatal care relates a history of macrosomic infants, two stillbirths, and polyhydramnios with each pregnancy. What does the nurse recognize these factors highly suggest?
a. Toxoplasmosis b. Abruptio placentae c. Hydatidiform mole d. Diabetes mellitus
10. A nurse is providing prenatal education. The nurse will explain that pregnancy affects glucose metabolism in what way?
a. Placental hormones increase the resistance of cells to insulin.
b. Insulin cells cannot meet the bodys demands as the womans weight increases.
c. There is a decreased production of insulin during pregnancy.
d. The speed of insulin breakdown is decreased during pregnancy.

Chapter 06: Nursing Care of Mother and Infant During Labor and Birth
1. What does the nurse note when measuring the frequency of a laboring womans contractions?
a. How long the patient states the contractions last
b. The time between the end of one contraction and the beginning of the next
c. The time between the beginning and the end of one contraction
d. The time between the beginning of one contraction and the beginning of the next
2. Why is the relaxation phase between contractions important?
a. The laboring woman needs to rest.
b. The uterine muscles fatigue without relaxation.
c. The contractions can interfere with fetal oxygenation.
d. The infant progresses toward delivery at these times.
3. What contraction duration and interval does the nurse recognize could result in fetal compromise?
a. Duration shorter than 30 seconds, interval longer than 75 seconds
b. Duration shorter than 90 seconds, interval longer than 120 seconds
c. Duration longer than 90 seconds, interval shorter than 60 seconds
d. Duration longer than 60 seconds, interval shorter than 90 seconds
4. Vaginal examination reveals the presenting part is the infants head, which is well flexed on the chest. What is this presentation?
a. Vertex b. Military c. Brow d. Face
5. What does meconium­stained amniotic fluid indicate when the infant is in a vertex presentation?
a. Fetal distress b. Fetal maturity
c. Intact gastrointestinal tract d. Dehydration in the mother
6. It is determined that the presenting part of the fetus is the buttocks. At delivery the fetuss hips are flexed and the knees are extended. How would the nurse record this presentation?
a. Complete breech b. Frank breech c. Double footling d. Buttocks presentation
7. At a prenatal visit, a primigravida asks the nurse how she will know her labor has started. The nurse knows that what indicates the beginning of true labor?
a. Contractions that are relieved by walking
b. Discomfort in the abdomen and groin
c. A decrease in vaginal discharge
d. Regular contractions becoming more frequent and intense
8. While discussing labor and delivery during a prenatal visit, a primigravida asks the nurse when she should go to the hospital. What is the nurses most informative response?
a. When you feel increased fetal movement
b. When contractions are 10 minutes apart
c. When membranes have ruptured
d. When abdominal or groin discomfort occurs
9. The nurse is caring for a woman in the first stage of labor. What will the nurse remind the patient about contractions during this stage of labor?
a. They get the infant positioned for delivery.
b. They push the infant into the vagina.
c. They dilate and efface the cervix.
d. They get the mother prepared for true labor.
10. A woman is 7 cm dilated, and her contractions are 3 minutes apart. When she begins cursing at her birthing coach and the nurse, what does the nurse assess as the most likely explanation for the womans change in behavior?
a. Labor has progressed to the transition phase.
b. She lacked adequate preparation for the labor experience.
c. The woman would benefit from a different form of analgesia.
d. The contractions have increased from mild to moderate intensity.

Chapter 07: Nursing Management of Pain During Labor and Birth
1. A nurse is teaching a childbirth preparation class. The group is discussing individual expression of labor pain. What statement is accurate about a patients expression of pain?
a. It reduces the patients perception of pain.
b. It is intensified by the vertex position of the fetus.
c. It is influenced by culture.
d. It can be completely controlled by nonpharmacological techniques.
2. What chemical substance(s) produced in the body acts as a natural pain reliever?
a. Endorphins b. Morphine
c. Codeine d. Atropine
3. A nurse instructs a womans labor coach to comfort her by firmly pressing on her lower back. What is this technique?
a. Sacral pressure b. Distraction c. Effleurage d. Conscious relaxation
4. A woman who is 6 cm dilated has the urge to push. What will the nurse instruct the woman to do during the contraction?
a. Use slow­paced breathing.
b. Hold her breath and push.
c. Blow in short breaths.
d. Use rapid­paced breathing
5. Several hours into labor, a woman complains of dizziness, numbness, and tingling of her hands and mouth. What does the nurse recognize these symptoms signify?
a. Hypertension b. Anxiety c. Anoxia d. Hyperventilation
6. What is the most appropriate nursing action to take when a laboring woman hyperventilates?
a. Help her breathe into her cupped hands. b. Place her flat on her back.
c. Initiate oxygen at 2 liters via mask. d. Notify the doctor.
7. A woman in the transition phase of labor requests a narcotic analgesic medication for pain relief. What should the nurse explain regarding giving a narcotic analgesic medication at this stage of labor?
a. It can cause medication given at later stages to be ineffective.
b. It will have no complications for the mother or infant.
c. It may result in respiratory depression to the newborn.
d. It will speed up labor and increase pain.
8. What would the nurse guide a labor coach to do to comfort a woman tensing her muscles with contractions?
a. Offer warm liquids to the patient.
b. Encourage the patient to pant.
c. Engage the patient in conversation.
d. Assist the patient to the knee­chest position
9. A woman in labor will receive general anesthesia prior to cesarean section. The nurse reminds the patient that food and fluids need to be restricted for several hours prior to delivery. What will this prevent?
a. Nausea and vomiting
b. Vomiting and aspiration
c. Abdominal cramping
d. Intestinal obstruction
10. What assessment should be taken immediately after the anesthesiologist administers an epidural block to a laboring woman?
a. Bladder for distention b. Blood pressure
c. Sensation in the lower extremities d. Intravenous fluid flow rate

Chapter 08: Nursing Care of Women with Complications During Labor and Birth

1. What nursing assessment should be reported immediately after an amniotomy?
a. Fetal heart rate is regular at 154 beats/min.
b. Amniotic fluid is clear with flecks of vernix.
c. Amniotic fluid is watery and pale green.
d. Maternal temperature is 37.8 C.
2. A woman 2 weeks past her expected delivery date is receiving an oxytocin infusion to induce labor and begins to have contractions every 90 seconds. What is the nurses initial action?
a. Stop the oxytocin infusion.
b. Continue the infusion and report the findings to the physician.
c. Turn her on her left side and reassess the contractions.
d. Administer oxygen by mask.
3. What nursing care should be provided to a woman with a third­degree laceration immediately after delivery?
a. Warm compresses to the perineum
b. Cold pack to the perineum
c. Warm sitz bath
d. Elevation of hips to prevent edema
4. After several hours of labor, a nursing assessment reveals that a womans cervix is 5 cm dilated but contractions are becoming shorter and less frequent. What is this labor pattern considered?
a. Normal b. Hypotonic c. Hypertonic d. False
5. A labor dysfunction due to decreased uterine muscle tone occurs in a patient who is dilated to 5 cm with membranes intact. What action by the physician will the nurse anticipate?
a. Perform an amniotomy. b. Initiate tocolytic drugs.
c. Order a sedative for the patient. d. Plan to do an emergency cesarean section.
6. An infant is delivered with the use of forceps. What should the nurse assess for in the newborn?
a. Loss of hair from contact with forceps
b. Sacral hematoma
c. Facial asymmetry
d. Shoulder dislocation
7. A new mother is distressed and tearful about the elevated dome over her infants posterior fontanelle. The nurse responds, This condition will resolve itself in a few days. What is the cause?
a. Prolonged pressure against the partially dilated cervix b. Small leak of fluid through the posterior fontanelle
c. Pressure of the forceps during delivery d. The effect of the vacuum extractor
8. A frustrated patient in labor has been affected by decreased uterine muscle tone and reports, My doctor wont induce my labor because of some silly score. He said I was a 4. What kind of magic number do I need? What is the lowest Bishop score the patient should have prior to induction?
a. 6 b. 8 c. 10 d. 12
9. A woman is having a difficult labor because the fetus is presenting in the right occipital position (ROP). What position will the nurse promote to encourage fetal rotation and pain relief?
a. Prone with legs supported and give her a back massage
b. Supine with legs bent at the knee
c. Standing with support
d. Sitting up and leaning forward on the over­bed table
10. The initial vaginal examination of a woman admitted to the labor unit reveals that the cervix is dilated 9 cm. The panicked woman begs the nurse, Please give me something. What is the most appropriate pain relief intervention for a woman in precipitate labor?
a. Get an order for an intravenous narcotic.
b. Notify the anesthesiologist for an epidural block.
c. Stay and breathe with her during contractions.
d. Tell her to bear with it because she is close to delivery.

Chapter 09: The Family After Birth
1. The nurse is assessing a newborn. What sign of hypoglycemia does the nurse record?
a. Increased nasal mucus b. Increased temperature
c. Active muscle movements d. High­pitched cry
2. What would the nurse expect to find when assessing the fundus of the uterus immediately after delivery?
a. Well­contracted with its upper border at or just below the umbilicus
b. Well­contracted with its upper border three or four fingerbreadths above the umbilicus
c. Relaxed with its upper border level with the umbilicus
d. Relaxed with its upper border two or three fingerbreadths below the umbilicus
3. What statement made by a new mother indicates she needs additional information about breastfeeding?
a. I let the baby nurse 10 to 15 minutes on the first breast and then switch to the other breast.
b. The baby needs to nurse at least 5 minutes on the breast to get the hindmilk.
c. The baby has been nursing every 2 to 3 hours.
d. If the baby gets fussy between feedings, I give her a bottle of water.
4. After delivery, the nurses assessment reveals a soft, boggy uterus located above the level of the umbilicus. What is the most appropriate nursing intervention?
a. Notify the physician. b. Massage the fundus.
c. Initiate measures that encourage voiding. d. Position the patient flat.
5. What type of lochia will the nurse assess initially after delivery?
a. Serosa b. Rubra c. Alba d. Vaginalis
6. A woman will be discharged 48 hours after a vaginal delivery. When planning discharge teaching, the nurse would include what information about lochia?
a. Lochia should disappear 2 to 4 weeks postpartum.
b. It is normal for the lochia to have a slightly foul odor.
c. A change in lochia from pink to bright red should be reported.
d. A decrease in flow will be noticed with ambulation and activity.
7. What instruction should the nurse teach the postpartum woman about perineal self­care?
a. Perform perineal self­care at least twice a day.
b. Cleanse with warm water in a squeeze bottle from front to back.
c. Remove perineal pads from the rectal area toward the vagina.
d. Use cool water to decrease edema of the perineum.
8. A postpartum woman is not immune to rubella. What will the nurse expect?
a. The rubella virus vaccine should be administered before discharge.
b. The woman should receive the rubella virus vaccine at her 6­week postpartum checkup.
c. The woman should be instructed not to get pregnant until she receives the rubella vaccine.
d. No intervention is indicated at this time because the woman is not at risk for rubella.
9. Which statement indicates the new mother is breastfeeding correctly?
a. I will alternate breasts when feeding the baby.
b. I keep the baby on a 4­hour feeding schedule.
c. I let the baby stay on the first breast only 5 minutes.
d. I put only the nipple in the babys mouth when I am breastfeeding.
10. The nurse is counseling a lactating mother about diet. What would the nurse include with this information?
a. Consume 500 more calories than her usual prepregnancy diet.
b. Eat less meat and more fruits and vegetables.
c. Drink 3 to 4 tall glasses of fluid daily.
d. Eat 1000 more calories than her usual prepregnancy diet.

Chapter 10: Nursing Care of Women with Complications After Birth
1. What is the first sign of hypovolemic shock from postpartum hemorrhage?
a. Cold, clammy skin
b. Tachycardia
c. Hypotension
d. Decreased urinary output
2. Although the nurse has massaged the uterus every 15 minutes, it remains flaccid, and the patient continues to pass large clots. What does the nurse recognize these signs indicate?
a. Uterine atony
b. Uterine dystocia
c. Uterine hypoplasia
d. Uterine dysfunction
3. What should the nurses first action be when postpartum hemorrhage from uterine atony is suspected?
a. Teach the patient how to massage the abdomen and then get help.
b. Start IV fluids to prevent hypovolemia and then notify the registered nurse.
c. Begin massaging the fundus while another person notifies the physician.
d. Ask the patient to void and reassess fundal tone and location.
4. The nurse assesses a boggy uterus with the fundus above the umbilicus and deviated to the side. What should the nurses next assessment be?
a. Fullness of the bladder
b. Amount of lochia
c. Blood pressure
d. Level of pain
5. Massage and putting the infant to the breast of a postpartum patient have been ineffective in controlling a boggy uterus. What will the nurse anticipate might be ordered by the physician?
a. Ritodrine
b. Magnesium sulfate
c. Oxytocin
d. Bromocriptine
6. A 4­week postpartum patient with mastitis asks the nurse if she can continue to breastfeed. What is the nurses most helpful response?
a. Stop breastfeeding until the infection clears.
b. Pump the breasts to continue milk production, but do not give breast milk to the infant.
c. Begin all feedings with the affected breast until the mastitis is resolved.
d. Breastfeeding can continue unless there is abscess formation.
7. A woman had a vaginal delivery two days ago and is preparing for discharge. What will the nurse plan to teach the woman to report to help prevent postpartum complications?
a. Fever
b. Change in lochia from red to white
c. Contractions
d. Fatigue and irritability
8. One day after discharge, the postpartum patient calls the clinic complaining of a reddened area on her lower leg, temperature elevation of 37 C (99.8 F), rust­colored lochia, and sore breasts. What does the nurse suspect from these symptoms?
a. Phlebitis
b. Puerperal infection
c. Late postpartum hemorrhage
d. Mastitis
9. Which statement indicates to the nurse on a postpartum home visit that the patient understands the signs of late postpartum hemorrhage?
a. My discharge would change to red after it has been pink or white.
b. If I have a postpartum hemorrhage, I will have severe abdominal pain.
c. I should be alert for an increase in bright red blood.
d. I would pass a large clot that was retained from the placenta.
10. During a postpartum assessment, a woman reports her right calf is painful. The nurse observes edema and redness along the saphenous vein in the right lower leg. Based on this finding, what does the nurse explain the probable treatment will involve?
a. Anticoagulants for 6 weeks
b. Application of ice to the affected leg
c. Gentle massage of the affected leg
d. Passive leg exercises twice a day

Chapter 11: The Nurses Role in Womens Health Care
1. The nurse is preparing a community education program on preventive health care for women. What common screening test will the nurse plan on explaining to the women attending the program?
a. Breast examination by a health professional
b. Breast self­examination
c. Breast biopsy
d. Mammography
2. The nurse reviews the procedure for breast self­examination (BSE) with a 25­year­old woman who has a family history of breast cancer. When reviewing the procedure, when will the nurse indicate as the best time for a woman to perform a breast self­examination?
a. A few days before her period
b. During her menstrual period
c. On the last day of menstrual flow
d. One week after the beginning of her period
3. A woman asks the nurse, How do oral contraceptives prevent pregnancy? What will the nurse explain about the combination of estrogen and progesterone in oral contraceptives?
a. Makes cervical mucus hostile to sperm
b. Prevents ovulation
c. Prohibits implantation of the egg
d. Acts as a barrier by destroying sperm
4. What should a woman expect after insertion of an intrauterine device (IUD)?
a. Menstrual flow will be lighter.
b. Menstrual cramps will be eliminated.
c. A string should be felt in the vagina.
d. The device should be changed every 2 years.
5. What information will the nurse provide when educating a woman about the correct use of a diaphragm?
a. Use of a spermicidal cream or jelly is not recommended.
b. Leave in place for at least 6 hours after intercourse.
c. Remove immediately after intercourse for douching.
d. It is effective for up to 48 hours if positioned properly.
6. The nurse is providing sexual education to a group of high school students. What will the nurse explain is the most effective choice of birth control for preventing pregnancy and sexually transmitted diseases?
a. Abstain from sex.
b. Use the male condom.
c. Use the female condom.
d. Use the barrier method.
7. On day 13 of a 28­day cycle, a womans basal body temperature is 36.5 C (97.7 F). What will her temperature measurement most likely be if ovulation takes place on day 14?
a. 35.9 C (96.7 F) b. 36.3 C (97.3 F) c. 36.7 C (98.1 F) d. 37.1 C (98.9 F)
8. The nurse tells a woman who is trying to conceive to check her cervical mucus for changes. What will she expect the characteristic of cervical mucus to be a few days before ovulation?
a. Cloudy and tacky
b. Scant and thick
c. Thin and white
d. Clear and slippery
9. The nurse is discussing cervical mucus changes with a woman who wishes to use natural family planning methods. What information about cervical mucus at ovulation will the woman indicate to the nurse, demonstrating that learning has taken place?
a. Cervical mucus enhances the motility of the sperm.
b. Cervical mucus indicates endometrial readiness for implantation.
c. Cervical mucus facilitates movement of the ovum through the fallopian tube.
d. Cervical mucus provides vaginal lubrication during intercourse.
10. In the week before her menstrual period, a woman experiences irritability, anxiety, and difficulty concentrating. What remedy might the nurse suggest to relieve these symptoms?
a. Drink tea or hot chocolate before going to bed.
b. Take a daily folic acid and vitamin C supplement.
c. Include complex carbohydrates and fiber in the diet.
d. Avoid exercise when symptoms occur.

Chapter 12: The Term Newborn
1. While inspecting a newborns head, the nurse identifies a swelling of the scalp that does not cross the suture line. How would the nurse refer to this finding when documenting?
a. Molding
b. Caput succedaneum
c. Cephalohematoma
d. Enlarged fontanelle
2. What is the nurses best response to a mother who is voicing concern about the molding of her 2­day­old infant?
a. Molding doesnt cause any problems. Dont worry about it.
b. Did you deliver vaginally or by cesarean section?
c. The babys head conformed to the shape of the birth canal. It will go away soon.
d. A traumatic delivery can cause molding.
3. What symptom assessed in the newborn shortly after delivery should be reported?
a. Cyanosis of the hands and feet b. Irregular heart rate
c. Mucus draining from the nose d. Sternal or chest retractions
4. When the newborns crib was moved suddenly, the nurse noticed that his legs flexed and arms fanned out, and then both came back toward the midline. How would the nurse interpret this behavior?
a. The Moro reflex b. The grasp reflex
c. An abnormality of the musculoskeletal system d. A neurological abnormality
5. A first­time mother reports that she is experiencing difficulty breastfeeding her newborn. Which neonatal reflex would the nurse teach the mother to elicit to facilitate breastfeeding?
a. Sucking b. Rooting c. Grasping d. Tonic neck
6. What will the nurse expect when assessing the anterior fontanelle of a healthy, full­term newborn?
a. Depressed and sunken b. Triangular shaped
c. Smaller than the posterior fontanelle d. Open and diamond shaped
7. What statement indicates the parent understands the guidelines for bathing a newborn?
a. Ill use a mild soap to clean all of the body parts.
b. I am going to add bath oil to the water to keep the babys skin soft.
c. I should shampoo the head after washing the rest of the body.
d. Ill wash from the feet upward and change the washcloth for the face.
8. The nurse is measuring the vital signs of a full­term newborn. Which finding is abnormal?
a. An axillary temperature of 36.6 C (98 F)
b. An apical pulse rate of 178 beats/min
c. Respirations of 35 breaths/min
d. Blood pressure of 80/50 mm Hg
9. The nurse is caring for a newborn who is being breastfed. What will the nurse expect the stool color to be 2 days after birth?
a. Yellow b. Brown
c. Greenish brown d. Black and tarry
10. The mother of a 2­week­old infant tells the nurse, I think the baby is constipated. Ive noticed she strains when she has a bowel movement. What is nurses most helpful response?
a. Give the baby one serving of fruit per day.
b. Increase the amount and frequency of her feedings.
c. It sounds like the baby is uncomfortable because she is constipated.
d. Newborns might strain with bowel movements because their muscles arent fully developed.

Chapter 13: Preterm and Postterm Newborns
1. The nurse is assessing a preterm infant. To what does the infants level of maturation refer?
a. Actual time the fetus remained in the uterus
b. Age on the Dubowitz scoring system
c. Infants weight as compared to the gestational age
d. Ability of the organs to function outside of the uterus
2. A preterm infant has a yellow skin color and a rising bilirubin level. The nurse knows that this infant is at risk for what?
a. Skin breakdown b. Renal failure
c. Brain damage d. Heart failure
3. Why does a 4­day­old infant born at 33 weeks of gestation possibly need to be fed by gavage during the first few days of life?
a. Weak or absent sucking or swallowing reflex
b. Inability to digest food properly
c. Refusal to take formula by mouth
d. Need for a larger quantity of formula at each feeding
4. What deficiency causes a preterm infant respiratory distress syndrome?
a. Protein
b. Estrogen
c. Hyaline
d. Surfactant
5. How will the nurse safely ensure tube placement when preparing to initiate a gavage feeding?
a. Check tube placement by injecting air into the stomach.
b. Weigh the infant before the feeding.
c. Aspirate stomach contents.
d. Check serum glucose level.
6. The nurse explains to a patient in preterm labor that what may be ordered by the physician to accelerate fetal lung maturity?
a. Prostaglandins b. Oxytocin
c. Magnesium sulfate d. Corticosteroids
7. The apnea monitor indicates that a preterm infant is having an apneic episode. What is the most appropriate nursing action in this situation?
a. Administer oxygen via a nasal cannula.
b. Gently rub the infants feet or back.
c. Ventilate with an Ambu bag.
d. Perform nasopharyngeal suctioning.
8. What would the nurse assess for in a preterm infant receiving an intravenous infusion containing calcium gluconate?
a. Seizures
b. Bradycardia
c. Dysrhythmias
d. Tetany
9. What is the rationale for placing a preterm infant born at 34 weeks of gestation in an incubator?
a. The infant has a small body surface­to­weight ratio.
b. Heat increases the flow of oxygen to the extremities.
c. The infants temperature control mechanism is immature.
d. Heat within the incubator facilitates drainage of mucus
10. What nursing action is appropriate to prevent possible retinopathy in a preterm infant requiring oxygen therapy?
a. Monitor arterial oxygen levels with a pulse oximeter.
b. Position the head slightly lower than the body.
c. Administer low concentrations of oxygen.
d. Keep the infants eyes covered at all times.

Chapter 14: The Newborn with a Perinatal Injury or Congenital Malformation
1. What occurrence results from obstruction within the ventricles of the brain or inadequate reabsorption of cerebrospinal fluid?
a. Meningitis
b. Meningocele
c. Spina bifida occulta
d. Hydrocephalus
2. The nurse is caring for an infant with hydrocephalus. What nursing action is most important for this nurse to implement?
a. Align the limbs.
b. Support the head.
c. Keep the head lower than the hip.
d. Check intake and output.
3. The nurse observes that the infants anterior fontanelle is bulging after placement of a ventriculoperitoneal shunt. How should the nurse position this infant?
a. Prone, with the head of the bed elevated b. Supine, with the head flat
c. Side­lying on the operative side d. In a semi­Fowlers position
4. What nursing action will the nurse implement after feeding an infant with hydrocephalus?
a. Position the infant sitting upright in an infant seat.
b. Place the infant over the shoulder to burp.
c. Leave the infant in a side­lying position.
d. Stimulate the infant by rubbing its feet.
5. A newborn was just admitted to the neonatal intensive care unit with a meningomyelocele. What is the priority preoperative nursing care of this newborn?
a. Keep the sac dry.
b. Diaper snugly.
c. Position prone in an incubator.
d. Move from side to side every hour.
6. The nurse is caring for a child who has had a ventriculoperitoneal shunt (VP) for hydrocephalus and observes an increasing abdominal girth. What is the most appropriate response?
a. Elevate the childs head.
b. Check bowel sounds.
c. Record retention of feeding.
d. Notify the charge nurse of possible malabsorption.
7. The nurse is providing education to parents of a child with cleft palate. What will the nurse instruct the parents to report immediately?
a. Facial paralysis
b. Ear infections
c. Increasing intracranial pressure (ICP)
d. Drooling
8. Postoperative nursing care of the infant following surgical repair of a cleft lip would include:
a. Feeding the infant with a spoon to avoid sucking
b. Positioning the infant on the abdomen to facilitate drainage
c. Applying elbow restraints to protect the surgical area
d. Providing minimal stimulation to prevent injury to the incision
9. Which statement indicates that parents understand how to feed their infant who had a surgical repair for a cleft lip?
a. We are feeding the baby with a dropper for 2 weeks.
b. We resumed bottle feeding after discharge.
c. We started the baby on solid food yesterday.
d. The baby is drinking well from a straw.
10. An 18­month­old child had a surgical repair of a cleft palate and is now allowed to eat a regular diet. What nursing action is the most appropriate?
a. Feed solid foods with the spoon at the side of the mouth.
b. Puree foods and offer them through a straw.
c. Place small bites of food in the mouth with a tongue blade.
d. Offer small, frequent meals of finger foods.

Chapter 15: An Overview of Growth, Development, and Nutrition
1. What type of development is the nurse assessing when an infant can lift his or her head before he or she can sit?
a. Specific to general
b. Proximodistal
c. Cephalocaudal
d. General to specific
2. What is a unique organization of characteristics that determines an individuals pattern of behavior?
a. Environment b. Heredity
c. Personality d. Experience
3. An infants birth weight is 7 pounds, 8 ounces. What can the nurse project the weight to be at 6 months?
a. 12 pounds b. 15 pounds c. 18 pounds d. 22 pounds
4. What would the nurse further investigate when assessing patterns of growth in a child?
a. Previous weight was in the 75th percentile, and present weight is in the 25th percentile.
b. Height is in the 90th percentile, and weight is in the 75th percentile.
c. Last weight was in the 5th percentile, and present weight is in the 10th percentile.
d. Weight is in the 50th percentile, and siblings weight at the same age was in the 75th percentile.
5. A mother reports that she and her husband have had one child together, but both have children from previous marriages living in their home. The nurse will base the care planning on what type of family?
a. Nuclear b. Blended c. Alternate d. Extended
6. The mother of a 7­month­old reports that the first lower central incisor has erupted. She asks the nurse, How many teeth will he have by his first birthday? The nurse explains that the infant will have how many teeth by 1 year of age?
a. 2 b. 4 c. 6 d. 8
7. At a well­baby visit, parents of a 6­month­old ask when to take the infant for the first dental visit. What is the nurses best response?
a. If the teeth are brushed regularly, the child should see a dentist by 3 years of age.
b. The first dental visit should be arranged after the first tooth erupts.
c. The child should have a dental examination when all deciduous teeth have erupted.
d. A dental visit by 1 year of age is recommended by the American Academy of Pediatric Dentistry.
8. The nurse is planning anticipatory guidance for a caregiver of a preschool­age child. The nurse will explain that permanent teeth begin erupting at what age?
a. 4 years old b. 6 years old c. 8 years old d. 10 years old
9. A mother asks the nurse how much food should be offered to her 2­year­old. What is a good rule of thumb for serving size (in tablespoons) per year of age?
a. 2 b. 3 c. 4 d. 5
10. An assessment of a childs nutritional status reveals the child is alert, with shiny hair, firm gums, firm mucous membranes, and regular elimination. How would this childs nutritional status be described?
a. Overnourished b. Undernourished c. Well nourished d. Borderline

Chapter 16: The Infant
1. A mother calls the pediatricians office because her infant is colicky. What is the most helpful measure the nurse can suggest to the mother?
a. Sing songs to the infant in a soft voice. b. Place the infant in a well­lit room.
c. Walk around and massage the infants back. d. Rock the fussy infant slowly and gently.
2. When does the posterior fontanelle close?
a. 2 to 3 months b. 3 to 6 months c. 6 to 9 months d. 9 to 12 months
3. At what age does an infants birth weight triple?
a. 9 months b. 1 year
c. 18 months d. 2 years
4. What is the earliest age at which an infant is able to sit steadily alone?
a. 4 months b. 5 months c. 8 months d. 15 months
5. What is the earliest age at which the infant should be able to walk independently?
a. 8 to 10 months b. 12 to 15 months c. 15 to 18 months d. 18 to 21 months
6. The parent of a 3­month­old infant asks the nurse, At what age do infants usually begin drinking from a cup? What is the nurses most accurate response?
a. 5 months b. 9 months c. 1 year d. 2 years
7. What would the nurse expect a 4­month­old to be able to accomplish?
a. Hold a cup.
b. Stand with assistance.
c. Lift head and shoulders.
d. Sit with back straight.
8. What is an abnormal finding in an evaluation of growth and development for a 6­month­old infant?
a. Weight gain of 4 to 7 ounces per week
b. Length increase of 1 inch in 2 months
c. Head lag present
d. Can sit alone for a few seconds
9. A parent brings a 6­month­old infant to the pediatric clinic for her well­baby examination. Her birth weight was 8 pounds, 2 ounces. What will the nurse weighing the infant today would expect her weight to be?
a. At least 12 pounds b. At least 16 pounds c. At least 20 pounds d. At least 24 pounds
10. What will the nurse advise a parent to do when introducing solid foods?
a. Begin with one tablespoon of food.
b. Mix foods together.
c. Eliminate a refused food from the diet.
d. Introduce each new food 4 to 7 days apart.

Chapter 17: The Toddler
1. Which behavior reported by a parent of an 18­month­old toddler would the nurse report to the pediatrician as a cause for concern?
a. Has temper tantrums b. Feeds self sloppily
c. Walks by holding onto furniture d. Speaks in short sentences
2. What would the nurse assessing growth and development of a 2­year­old child expect to find?
a. The child jumps with both feet.
b. Twenty deciduous teeth have erupted.
c. The child can hop on one foot.
d. The child has a vocabulary of 900 words.
3. A parent remarks, My 18­month­old daughter carries her blanket around everywhere. Is this normal? What is the best explanation a nurse who has an understanding of toddler development might give?
a. She carries her blanket because she is ritualistic.
b. Carrying her favorite blanket is self­consoling behavior.
c. This behavior can be discouraged by offering new toys to the child.
d. This could be indicative of emotional distress.
4. The nurse observed three toddlers playing side by side with dolls. Closer observation revealed that the children were not interacting with one another. What type of play is this?
a. Solitary b. Parallel c. Associative d. Cooperative
5. What instruction would the nurse include when planning anticipatory guidance for parents of a toddler?
a. Adhere to a rigid schedule because the toddler is ritualistic.
b. Limit­setting should include praise.
c. Shoes should fit snugly at the toe and arch.
d. Dress the toddler in pants with a zipper so that he or she can learn to zip and unzip clothes.
6. What is the best advice the nurse can offer a parent concerned because her 2­year­old is very active and does not eat much?
a. Insist that the child eat one food on the plate.
b. Help the child wind down with a quiet activity before mealtime.
c. Maintain a consistent eating schedule for the family.
d. Serve the meal with a variety of interesting plates, cups, and utensils.
7. How would the nurse advise a parent who states, I never know how much food to feed my child?
a. Serving sizes should not exceed 1 teaspoon of each type of food.
b. Food quantities must be carefully measured to avoid overfeeding.
c. Use 1 tablespoon of each food for each year of age as a guideline.
d. A toddler should eat three balanced meals. Snacks are not necessary.
8. The nurse is discussing toilet training with parents. What behavior by the child would identify toilet training readiness?
a. Willing to sit on the potty for 15 to 20 minutes
b. Dry in the daytime for 4­hour periods
c. Able to communicate that he or she is wet
d. Curious about bathroom activities
9. What is the most appropriate toy for the nurse to select for a normal 2­year­old child?
a. Bicycle with training wheels
b. Dump truck
c. Wind­up toy
d. Building block set
10. What could the nurse recommend to a childs mother to encourage a toddler to practice independence?
a. Offer a variety of items to choose from to stimulate his mind.
b. Allow the child to determine his own daily routine.
c. Offer him a choice between two items.
d. Set the routine herself, but discuss with her toddler how he or she would have done it differently.

Chapter 18: The Preschool Child
1. Which statement best describes the 3­year­old child?
a. Boisterous, tattles on others
b. Aggressive, shows off
c. Helpful, wants to assist with chores
d. Talkative, inquisitive about the environment
2. The parents of a 4­year­old boy are concerned because they have noticed him frequently touching his penis. What knowledge would act as the basis for the nurses response?
a. This behavior indicates a normal curiosity about sexuality.
b. Masturbation suggests the boy has an excessive fear of castration.
c. It is usually a result of discomfort from a penile rash or irritation.
d. The behavior is abnormal and the child should be referred for counseling.
3. A preschool­age child is asked, Why do trees have leaves? Which response would be an example of animism?
a. So I can have shade over my sandbox. b. Because God made them that way.
c. To hide behind when they are scared. d. For the squirrels to play in.
4. What tasks would be appropriate to expect of a 5­year­old?
a. Setting the table with paper plates b. Washing the dirty knives
c. Carrying glasses from the table to the sink
d. Scrubbing out the sink with cleanser
5. A 3­year­old child, while playing with his favorite toy in the playroom of the pediatric unit, is approached by another child who also wants to play with the same toy. What behavior will the nurse anticipate from this child?
a. Will play well with the other child
b. Will give the toy up and then not play anymore
c. Will become angry and a physical response might ensue
d. Will ignore the toy and go on to something else
6. A parent is concerned about her childrens reaction should their grandmother die. What understanding will guide the nurses response?
a. Children are unlikely to notice their grandmothers absence if no one reminds them.
b. Young children often understand that other people die, but do not equate it with themselves.
c. The childrens response will depend entirely on whether they have been acquainted with death before this.
d. Children can understand the concept of a higher being much like adults can.
7. What is the most appropriate intervention when dealing with occasional aggression in a 4­year­old child?
a. Have the child take a time­out in the corner for 4 minutes.
b. Spank the child at the time of the incident.
c. Take away television privileges for the day.
d. Send the child to his room for 30 minutes.
8. A father is concerned about how long his preschool­age child will continue sucking his thumb. What is the most helpful response from the nurse?
a. Most children will stop thumb­sucking naturally by school age.
b. Over­the­counter treatments that give a bad taste can be placed on the thumb to discourage the practice.
c. Consistently touching the childs fingers whenever he sucks his thumb is most effective.
d. Thumb­sucking is detrimental to the eruption of the childs teeth and must be stopped as soon as possible.
9. How does the nurse characterize the play of 5­year­old children?
a. Enjoying rough and tumble play
b. Playing well­organized games
c. Following rules
d. Preferring inside activities
10. The nurse is discussing preschoolers sexual curiosity with the parent. What statement by the mother leads the nurse to determine that the mother understands the information?
a. Make up funny words for body parts.
b. Distract the child with a toy if they ask about sex.
c. Answer their questions when they ask.
d. Tell them to ask you again when they are 6 year old.

Chapter 19: The School­Age Child
1. The nurse is assessing a school­age child. What will the nurse expect in regard to physical development of this child?
a. Growth of 3 to 6 inches per year
b. Gain of 5 to 7 pounds per year
c. Increase of head circumference by 1 inch per year
d. A visual acuity of 20/20 by 9 years of age
2. What should the nurse keep in mind when planning to teach a class on nutrition to fourth­grade students?
a. School­age children can concentrate on only one aspect of a situation.
b. School­age children can think abstractly.
c. School­age children are egocentric in their thinking.
d. School­age children think logically and concretely.
3. What type of relationships are the preferred social interactions for the school­age child?
a. Heterosexual interest groups
b. Association with one best friend
c. Rigidly organized groups with complex rules
d. Same­sex peer groups
4. The nurse is advising parents of a 10­year­old boy about the most developmentally supportive experiences for their son. What is the best experience for this child according to Eriksons theory? a. Constant variety of activities
b. Successful performance in Little League
c. Feeling healthy and strong
d. Having a girlfriend
5. The parents of an 8­year­old tell the nurse the child wakes the household crying out during his frequent nightmares. What is the nurses most helpful response to explain nightmares?
a. They are a normal extension of the childs fear of mutilation.
b. They are an abnormal response to repressed feelings.
c. They are a common result of latent sexuality.
d. They are a side effect of overactivity and stimulation.
6. What is the best suggestion by the nurse for an appropriate toy for a hospitalized 6­year­old boy?
a. Handheld video game b. MP3 player
c. Adventure book d. Jigsaw puzzle
7. The nurse discusses preparation for school with the parents of a 6­year­old girl who will soon be starting first grade. What statement by the girls father leads the nurse to determine that the parents understood the information?
a. We should put a stop to her thumb­sucking.
b. Well have a talk about what school is like.
c. We will let her walk to the bus stop by herself.
d. Well have her meet some children who will be in her class.
8. A 9­year­old boy is often cranky and irritable, and his school performance has declined. What is the most probable factor causing this behavior?
a. He sleeps only 6 to 7 hours a night.
b. He eats eggs every day.
c. He has a new dog.
d. He plays about 1 to 3 hours each evening.
9. A parent asked the nurse, At what age are children capable of assuming more responsibility for personal belongings? What is the nurses best response based on knowledge of growth and development?
a. 6 years b. 7 years c. 9 years d. 12 years
10. The school nurse is preserving a tooth that was knocked out on the school playground. What will the nurse be especially careful to do?
a. Wrap the tooth loosely in a clean cloth.
b. Rinse the tooth with alcohol.
c. Handle the tooth only by the crown.
d. Place the tooth in a warm environment.

Chapter 20: The Adolescent
1. The nurse is assessing a 13­year­old boy. With what do physical changes in the pubertal male begin?
a. Development of axillary and facial hair
b. Enlargement of penis
c. Enlargement of testicles
d. Pigmentation of the scrotum
2. A 13­year­old boy states, The girls in my class tower over me. What would be the nurses most informative response?
a. It may seem that way because girls have a growth spurt 2 years earlier than boys.
b. Perhaps your parents are not exceptionally tall.
c. Boys usually experience a growth spurt 1 year earlier than girls.
d. You may feel short, but you are actually average height for your age.
3. A parent comments that her adolescent daughter seems to be daydreaming a lot. What does the nurse understand this behavior to indicate regarding their daughter?
a. She is bored.
b. She is not getting enough rest.
c. She is trying to block out stress and anxiety.
d. She is mentally preparing for real situations.
4. The nurse is planning a safety program for high school students. To what will the nurse relay that most accidental deaths in adolescence are related?
a. Firearms
b. Automobiles
c. Drowning
d. Diving injuries
5. A 16­year­old excitedly tells his parents that he was offered a part­time job. Which response represents an effective problem­solving approach for his parents?
a. Your studies are too important for you to have a part­time job.
b. When we went to high school, academics were the adolescents priority.
c. We want you to put your earnings in a savings account.
d. How do you think you will manage your school work and a job?
6. The nurse is planning care of an adolescent. What psychosocial task does the nurse understand is important for the adolescent to develop?
a. A sense of initiative
b. A sense of industry
c. A sense of identity
d. A sense of involvement
7. A 13­year­old girl tells the school nurse that she is getting fat, especially in her hips and legs. What understanding by the nurse would best guide the response?
a. Many adolescents are unaware of proper nutrition.
b. Adolescents of this age become less active and should eat fewer calories.
c. Puberty is often preceded by fat deposits in these areas.
d. As soon as menarche occurs, she will lose this excess weight.
8. The school nurse is planning a program for girls about the physical changes of puberty. Toward what age girl should this program be directed?
a. 10 years b. 12 years c. 14 years d. 16 years
9. What statement made by a parent indicates an understanding about helping a 13­year­old manage his allowance?
a. I set amounts he can earn for particular chores.
b. I give him a certain amount of money for each day.
c. I put money into his bank account each month.
d. I told him to ask me when he needs money.
10. What can the nurse suggests as a good dietary source of zinc for an adolescent who is a vegetarian?
a. Green, leafy vegetables
b. Citrus fruits
c. Nuts
d. Enriched breads