Test Bank Wongs Essentials Pediatric Nursing 9th Edition, Marilyn
Chapter 01: Perspectives of Pediatric Nursing
1. A nurse is planning a teaching session for parents of preschool children. Which statement explains why the nurse should include information about morbidity and mortality?
a. Life-span statistics are included in the data.
b. It explains effectiveness of treatment.
c. Cost-effective treatment is detailed for the general population.
d. High-risk age groups for certain disorders or hazards are identified.
2. A clinic nurse is planning a teaching session about childhood obesity prevention for parents of school-age children. The nurse should include which associated risk of obesity in the teaching plan?
a. Type I diabetes
b. Respiratory disease
c. Celiac disease
d. Type II diabetes
3. Which is the leading cause of death in infants younger than 1 year?
a. Congenital anomalies
b. Sudden infant death syndrome
c. Respiratory distress syndrome
d. Bacterial sepsis of the newborn
4. Which leading cause of death topic should the nurse emphasize to a group of African-American boys ranging in ages 15 to 19 years?
c. Firearm homicide
d. Occupational injuries
5. Which is the major cause of death for children older than 1 year?
b. Heart disease
c. Unintentional injuries
d. Congenital anomalies
6. Which is the leading cause of death from unintentional injuries for females ranging in age from 1 to 14?
a. Mechanical suffocation
c. Motor–vehicle-related fatalities
d. Fire- and burn-related fatalities
7. Which factor most impacts the type of injury a child is susceptible to, according to the child’s age?
a. Physical health of the child
b. Developmental level of the child
c. Educational level of the child
d. Number of responsible adults in the home
8. Which is now referred to as the “new morbidity”?
a. Limitations in the major activities of daily living
b. Unintentional injuries that cause chronic health problems
c. Discoveries of new therapies to treat health problems
d. Behavioral, social, and educational problems that alter health
9. A nurse on a pediatric unit is practicing family-centered care. Which is most descriptive of the care the nurse is delivering?
a. Taking over total care of the child to reduce stress on the family
b. Encouraging family dependence on health care systems
c. Recognizing that the family is the constant in a child’s life
d. Excluding families from the decision-making process
10. The nurse is preparing an in-service education to staff about atraumatic care for pediatric patients. Which intervention should the nurse include?
a. Prepare the child for separation from parents during hospitalization by reviewing a video.
b. Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal.
c. Help the child accept the loss of control associated with hospitalization.
d. Help the child accept pain that is connected with a treatment or procedure.
Chapter 02: Community-Based Nursing Care of the Child and Family
1. Which term best describes the identification of the distribution and causes of disease, injury, or illness?
a. Nursing process
b. Epidemiologic process
c. Community-based statistics
d. Mortality and morbidity statistics
2. A community nurse at the health department is trying to identify how many new cases of acquired immunodeficiency syndrome (AIDS) disease have occurred in the city this past year. Which statistic should the nurse examine?
3. A nurse is collecting subjective and objective information about target populations to diagnose problems based on community needs. This describes which step in the community nursing process?
d. Establishing objectives
4. A nurse is establishing several health programs, such as bicycle safety, to improve the health status of a target population. This describes which step in the community nursing process?
5. A school nurse is conducting vision and hearing testing on fifth-grade children. Which level of prevention is the nurse demonstrating?
d. Health promotion
6. A community health nurse is collecting assessment data by interviewing community leaders. What type of assessment is this community nurse conducting?
b. Windshield survey
Chapter 03: Family Influences on Child Health Promotion
1. A nurse is selecting a family theory to assess a patient’s family dynamics. Which family theory best describes a series of tasks for the family throughout its life span?
a. Interactional theory
b. Developmental systems theory
c. Structural-functional theory
d. Duvall’s developmental theory
2. Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events?
a. Interactional theory
b. Developmental systems theory
c. Family stress theory
d. Duvall’s developmental theory
3. Which is the term for a family in which the paternal grandmother, the parents, and two minor children live together?
4. A nurse is assessing a family’s structure. Which describes a family in which a mother, her children, and a stepfather live together?
5. Which is considered characteristic of children who are the youngest in their family?
a. More dependent than firstborn children
b. More outgoing than firstborn children
c. Identify more with parents than with peers
d. Are subject to greater parental expectations
6. Parents of a firstborn child are asking whether it is normal for their child to be extremely competitive. The nurse should respond to the parents that studies about the ordinal position of children suggest that firstborn children tend to:
a. be praised less often.
b. be more achievement oriented.
c. be more popular with the peer group.
d. identify with peer group more than parents.
7. A 35-year-old client is currently on fertility treatments. When responding to a question from the client about multiple births, which statement by the nurse is accurate?
a. Use of fertility treatments has been associated with an increase in multiple births.
b. Your chance of having multiple births is at the same rate as all women of childbearing age.
c. There is not enough evidence about the use of fertility treatments increasing the rate of multiple births.
d. Because of your age and the fertility treatments, you have almost a 100% chance of a multiple birth.
8. Nicole and Kelly, age 5 years, are identical twins. Their parents tell the nurse that the girls always want to be together. The nurse’s suggestions should be based on which statement?
a. Some twins thrive best when they are constantly together.
b. Individuation cannot occur if twins are together too much.
c. Separating twins at an early age helps them develop mentally.
d. When twins are constantly together, pathologic bonding occurs.
9. The nurse is teaching a group of new parents about the experience of role transition. Which statement by a parent would indicate a correct understanding of the teaching?
a. “My marital relationship can have a positive or negative effect on the role transition.”
b. “If an infant has special care needs, the parents’ sense of confidence in their new role is strengthened.”
c. “Young parents can adjust to the new role easier than older parents.”
d. “A parent’s previous experience with children makes the role transition more difficult.”
10. When assessing a family, the nurse determines that the parents exert little or no control over their children. This style of parenting is called:
Chapter 04: Social, Cultural, and Religious Influences on Child Health Promotion
1. Which term best describes a group of people who share a set of values, beliefs, practices, social relationships, law, politics, economics, and norms of behavior?
d. Social group
2. Which term best describes the emotional attitude that one’s own ethnic group is superior to others?
3. Currently, the fastest-growing segment of the homeless population in the United States consists of:
b. “runaway” adolescents.
c. migrant farm workers.
d. individuals with mental disorders.
4. Maria, a Spanish-speaking 5-year-old girl, has started kindergarten in an English-speaking school. Crying most of the time, she appears helpless and unable to function in this new situation. Which description best explains Maria’s behavior?
a. Lacks adequate culture for attending school
b. Lacks the maturity needed in school
c. Is experiencing culture shock
d. Is experiencing minority group discrimination
5. When minority groups immigrate to another country, a certain degree of cultural or ethnic blending occurs through the involuntary process of:
c. culture shock.
d. cultural sensitivity.
6. Which is a frequent health problem of migrant children and adolescents in the United States?
d. Cardiovascular disease
7. The nurse observes that the families who do not show up for scheduled clinic appointments are usually from minority cultural groups. The best explanation for this is that these families often differ from the dominant culture because they:
a. lack education.
b. avoid health care.
c. are more forgetful.
d. view time differently.
8. The Vietnamese mother of a child being seen in the clinic avoids eye contact with the nurse. The best explanation for this, considering cultural differences, is that the parent:
a. feels responsible for her child’s illness.
b. feels inferior to the nurse.
c. is embarrassed to seek health care.
d. is showing respect for the nurse.
9. The belief that health is “a state of harmony with nature and the universe” is common in which culture?
c. Native American
10. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicle, and juices are left. Which statement would best explain this?
a. Parent is trying to feed child only what child likes most.
b. Parent is trying to restore normal balance through appropriate “hot” remedies.
c. Hispanics believe the “evil eye” enters when a person gets cold.
d. Hispanics believe an innate energy, called chi, is strengthened by eating soup.
Chapter 05: Developmental and Genetic Influences on Child Health Promotion
1. An infant gains head control before sitting unassisted. The nurse recognizes that this is which type of development?
c. Mass to specific
2. Which refers to those times in an individual’s life when he or she is more susceptible to positive or negative influences?
a. Sensitive period
b. Sequential period
c. Terminal points
d. Differentiation points
3. An infant who weighs 7 pounds at birth would be expected to weigh how many pounds at age 1 year?
4. By what age does birth length usually double?
a. 1 year
b. 2 years
c. 4 years
d. 6 years
5. Parents of an 8-year-old child ask the nurse how many inches their child should grow each year. The nurse bases the answer on the knowledge that after age 7 years, school-age children usually grow what number of inches per year?
6. Parents express concern that their pubertal daughter is taller than the boys in her class. The nurse should respond with which statement regarding how the onset of pubertal growth spurt compares in girls and boys?
a. It occurs earlier in boys.
b. It occurs earlier in girls.
c. It is about the same in both boys and girls.
d. In both boys and girls, the pubertal growth spurt depends on growth in infancy.
7. A 13-year-old girl asks the nurse how much taller she will get. She has been growing about 2 inches per year but grew 4 inches this past year. Menarche recently occurred. The nurse should base her response on which statement?
a. Growth cannot be predicted.
b. Pubertal growth spurt lasts about 1 year.
c. Mature height is achieved when menarche occurs.
d. Approximately 95% of mature height is achieved when menarche occurs.
8. A child’s skeletal age is best determined by:
a. assessment of dentition.
b. assessment of height over time.
c. facial bone development.
d. radiographs of the hand and wrist.
9. Trauma to which site can result in a growth problem for children’s long bones?
b. Connective tissue
c. Calcified cartilage
d. Epiphyseal cartilage plate
10. A nurse has completed a teaching session for adolescents regarding lymphoid tissue growth. Which statement, by the adolescents, indicates understanding of the teaching?
a. The tissue reaches adult size by age 1 year.
b. The tissue quits growing by 6 years of age.
c. The tissue is poorly developed at birth.
d. The tissue is twice the adult size by ages 10 to 12 years.
Chapter 06: Communication and Physical Assessment of the Child
1. The nurse is seeing an adolescent boy and his parents in the clinic for the first time. What should the nurse do first?
a. Introduce self.
b. Make family comfortable.
c. Explain purpose of interview.
d. Give assurance of privacy.
2. Which is most likely to encourage parents to talk about their feelings related to their child’s illness?
a. Be sympathetic.
b. Use direct questions.
c. Use open-ended questions.
d. Avoid periods of silence.
3. Which communication technique should the nurse avoid when interviewing children and their families?
a. Using silence
b. Using clichés
c. Directing the focus
d. Defining the problem
4. What is the single most important factor to consider when communicating with children?
a. The child’s physical condition
b. Presence or absence of the child’s parent
c. The child’s developmental level
d. The child’s nonverbal behaviors
5. Which approach would be best to use to ensure a positive response from a toddler?
a. Assume an eye-level position and talk quietly.
b. Call the toddler’s name while picking him or her up.
c. Call the toddler’s name and say, “I’m your nurse.”
d. Stand by the toddler, addressing him or her by name.
6. What is an important consideration for the nurse who is communicating with a very young child?
a. Speak loudly, clearly, and directly.
b. Use transition objects, such as a doll.
c. Disguise own feelings, attitudes, and anxiety.
d. Initiate contact with child when parent is not present.
7. A nurse is preparing to assess a 3-year-old child. What communication technique should the nurse use for this child?
a. Focus communication on child.
b. Explain experiences of others to child.
c. Use easy analogies when possible.
d. Assure child that communication is private.
8. The nurse’s approach when introducing hospital equipment to a preschooler should be based on which principle?
a. The child may think the equipment is alive.
b. The child is too young to understand what the equipment does.
c. Explaining the equipment will only increase the child’s fear.
d. One brief explanation will be enough to reduce the child’s fear.
9. A nurse is assigned to four children of different ages. In which age group should the nurse understand that body integrity is a concern?
c. School-age child
10. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is to:
a. ask her why she wants to know.
b. determine why she is so anxious.
c. explain in simple terms how it works.
d. tell her she will see how it works as it is used.
Chapter 07: Pain Assessment and Management in Children
1. A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain?
a. FACES pain rating tool
b. Numeric scale
c. Oucher scale
d. FLACC tool
2. The nurse is caring for a 6-year-old girl who had surgery 12 hours ago. The child tells the nurse that she does not have pain, but a few minutes later she tells her parents that she does. Which should the nurse consider when interpreting this?
a. Truthful reporting of pain should occur by this age.
b. Inconsistency in pain reporting suggests that pain is not present.
c. Children use pain experiences to manipulate their parents.
d. Children may be experiencing pain even though they deny it to the nurse.
3. A nurse is gathering a history on a school-age child admitted for a migraine headache. The child states, “I have been getting a migraine every 2 or 3 months for the last year.” The nurse documents this as which type of pain?
4. Physiologic measurements in children’s pain assessment are:
a. the best indicator of pain in children of all ages.
b. essential to determine whether a child is telling the truth about pain.
c. of most value when children also report having pain.
d. of limited value as sole indicator of pain.
5. Nonpharmacologic strategies for pain management:
a. may reduce pain perception.
b. make pharmacologic strategies unnecessary.
c. usually take too long to implement.
d. trick children into believing they do not have pain.
6. Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?
7. A lumbar puncture is needed on a school-age child. The most appropriate action to provide analgesia during this procedure is to apply _____ before the procedure.
a. TAC (tetracaine-adrenaline-cocaine) 15 minutes
b. transdermal fentanyl (Duragesic) patch immediately
c. EMLA (eutectic mixture of local anesthetics) 1 hour
d. EMLA (eutectic mixture of local anesthetics) 30 minutes
8. The nurse is caring for a child receiving intravenous (IV) morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to:
a. administer naloxone (Narcan).
b. discontinue IV infusion.
c. discontinue morphine until child is fully awake.
d. stimulate child by calling name, shaking gently, and asking to breathe deeply.
9. The nurse is completing a pain assessment on a 4-year-old child. Which of the depicted pain scale tools should the nurse use with a child this age?
Chapter 08: Health Promotion of the Newborn and Family
1. Which is the most critical physiologic change required of the newborn?
a. Closure of fetal shunts in the heart
b. Stabilization of fluid and electrolytes
c. Body-temperature maintenance
d. Onset of breathing
2. Which is a function of brown adipose tissue (BAT) in the newborn?
a. Provides ready source of calories in the newborn period
b. Insulates the body against lowered environmental temperature
c. Protects the newborn from injury during the birth process
d. Generates heat for distribution to other parts of body
3. Which characteristic is representative of the newborn’s gastrointestinal tract?
a. Stomach capacity is approximately 90 ml.
b. Peristaltic waves are relatively slow.
c. Overproduction of pancreatic amylase occurs.
d. Intestines are shorter in relation to body size.
4. The nurse notes the first stool of a newborn is black and tarry. Which term is used to describe this type of stool?
d. Milk stool
5. A nurse notes that a 12-hour-old newborn has not had the first meconium stool. The nurse documents this finding and continues to monitor the newborn because, in term newborns, the first meconium stool occurs within how many hours of birth?
a. 6 to 8
b. 8 to 12
c. 12 to 24
d. 24 to 48
6. A nurse is doing an assessment on a newborn. Which is characteristic of a newborn’s vision at birth and an expected finding during the assessment?
a. Ciliary muscles are mature.
b. Blink reflex is absent.
c. Tear glands function.
d. Pupils react to light.
7. The Apgar score of a newborn 5 minutes after birth is 8. Which is the nurse’s best interpretation of this?
a. Resuscitation is likely to be needed.
b. Adjustment to extrauterine life is adequate.
c. Additional scoring in 5 more minutes is needed.
d. Maternal sedation or analgesia contributed to the low score.
8. The nurse is presenting an in-service session on assessing gestational age in newborns. Which information should be included?
a. The newborn’s length and weight are the most accurate indicators of gestational age.
b. The newborn’s Apgar score and the mother’s estimated date of confinement (EDC) are combined to determine gestational age.
c. The newborn’s posture at rest and arm recoil are two physical signs used to determine gestational age.
d. The newborn’s chest circumference compared to the head circumference is the determinant for gestational age.
9. The nurse is assessing a 3-day-old, breast-fed newborn who weighed 7 pounds, 8 ounces at birth. The newborn’s mother is now concerned that the newborn weighs 6 pounds, 15 ounces. Which is the most appropriate nursing intervention?
a. Recommend supplemental feedings of formula.
b. Explain that this weight loss is within normal limits.
c. Assess child further to determine cause of excessive weight loss.
d. Encourage mother to express breast milk for bottle feeding the newborn.
10. Why are rectal temperatures not recommended in the newborn?
a. They are inaccurate.
b. They do not reflect core body temperature.
c. They can cause perforation of rectal mucosa.
d. They take too long to obtain an accurate reading.
Chapter 09: Health Problems of Newborns
1. Which is defined as a vaguely outlined area of edematous tissue situated over the portion of the scalp that presents in a vertex delivery?
a. Caput succedaneum
d. Subdural hematoma
2. Which finding on a newborn assessment should the nurse recognize as suggestive of a clavicle fracture?
a. Negative scarf sign
b. Asymmetric Moro reflex
c. Swelling of fingers on affected side
d. Paralysis of affected extremity and muscles
3. The parents of a newborn ask the nurse what caused the baby’s facial nerve paralysis. The nurse’s response is based on knowledge that this is caused by a(n):
a. genetic defect.
b. birth injury.
c. spinal cord injury.
d. inborn error of metabolism.
4. A mother is upset because her newborn has erythema toxicum neonatorum. The nurse should reassure her that this is:
a. easily treated.
b. benign and transient.
c. usually not contagious.
d. usually not disfiguring.
5. What is oral candidiasis (thrush) in the newborn?
a. Bacterial infection that is life threatening in the neonatal period
b. Bacterial infection of mucous membranes that responds readily to treatment
c. Yeastlike fungal infection of mucous membranes that is relatively common
d. Benign disorder that is transmitted from mother to newborn during the birth process only
6. Nursing care of the newborn with oral candidiasis (thrush) includes:
a. avoiding use of pacifier.
b. removing characteristic white patches with a soft cloth.
c. continuing medication for a prescribed number of days.
d. applying medication to oral mucosa, being careful that none is ingested.
7. Which is a bright red, rubbery nodule with a rough surface and a well-defined margin that may be present at birth?
a. Port-wine stain
b. Juvenile melanoma
c. Cavernous hemangioma
d. Strawberry hemangioma
8. The parents of a newborn with a strawberry hemangioma ask the nurse what the treatment will be. The nurse’s response should be based on knowledge that:
a. excision of the lesion will be necessary.
b. injections of prednisone into the lesion will reduce it.
c. no treatment is usually necessary because of the high rate of spontaneous involution.
d. pulsed dye laser treatments will be necessary immediately to prevent permanent disability.
9. Which term refers to a newborn born before completion of week 37 of gestation, regardless of birth weight?
c. Low birth weight
d. Small for gestational age
10. Which refers to a newborn whose rate of intrauterine growth was slowed and whose birth weight falls below the 10th percentile on intrauterine growth charts?
c. Low birth weight
d. Small for gestational age
Chapter 10: Health Promotion of the Infant and Family
1. A nurse is assessing a 12-month-old infant. Which statement best describes the infant’s physical development a nurse should expect to find?
a. Anterior fontanel closes by age 6 to 10 months.
b. Binocularity is well established by age 8 months.
c. Birth weight doubles by age 5 months and triples by age 1 year.
d. Maternal iron stores persist during the first 12 months of life.
2. The nurse is assessing a 6-month-old healthy infant who weighed 7 pounds at birth. The nurse should expect the infant to now weigh approximately how many pounds?
3. The nurse is doing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. The nurse should interpret this as a(n):
a. normal finding.
b. finding requiring a referral.
c. abnormal finding.
d. normal finding, but requires rechecking in 1 month.
4. A nurse is assessing a 6-month-old infant. The nurse recognizes the posterior fontanel usually closes at which age?
a. 6 to 8 weeks
b. 10 to 12 weeks
c. 4 to 6 months
d. 8 to 10 months
5. The parents of a 9-month-old infant tell the nurse that they have noticed foods such as peas and corn are not completely digested and can be seen in their infant’s stools. The nurse’s explanation of this is based on which statement?
a. Child should not be given fibrous foods until digestive tract matures at age 4 years.
b. Child should not be given any solid foods until this digestive problem is resolved.
c. This is abnormal and requires further investigation.
d. This is normal because of the immaturity of digestive processes at this age.
6. A 3-month-old infant, born at 38 weeks of gestation, will hold a rattle if it is put in her hands, but she will not voluntarily grasp it. The nurse should interpret this as:
a. normal development.
b. significant developmental lag.
c. slightly delayed development due to prematurity.
d. suggestive of a neurologic disorder such as cerebral palsy.
7. In terms of fine motor development, what should the infant of 7 months be able to do?
a. Transfer objects from one hand to the other and bang cubes on a table.
b. Use thumb and index finger in crude pincer grasp and release an object at will.
c. Hold a crayon between the fingers and make a mark on paper.
d. Release cubes into a cup and build a tower of two blocks.
8. At what age can most infants sit steadily unsupported?
a. 4 months
b. 6 months
c. 8 months
d. 10 months
9. The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. The nurse’s response should be based on knowledge that this is:
a. unacceptable because of the risk of sudden infant death syndrome (SIDS).
b. unacceptable because it does not encourage achievement of developmental milestones.
c. acceptable to encourage fine motor development.
d. acceptable to encourage head control and turning over.
10. By which age should the nurse expect an infant to be able to pull to a standing position?
a. 6 months
b. 8 months
c. 11 to 12 months
d. 14 to 15 months
Chapter 11: Health Problems of Infants
1. Recent studies indicate that a deficiency of which vitamin correlates with increased morbidity and mortality in children with measles?
d. Folic acid
2. Which vitamin is recommended for all women of childbearing age to reduce the risk of neural tube defects such as spina bifida?
d. Folic acid
3. A nurse is assessing a child with kwashiorkor disease. Which assessment findings should the nurse expect?
a. Thin wasted extremities with a prominent abdomen
c. Elevated hemoglobin
d. High levels of protein
4. A nurse is preparing to accompany a medical mission’s team to a third world country. Marasmus is seen frequently in children 6 months to 2 years in this country. Which symptoms should the nurse expect for this condition?
a. Loose, wrinkled skin
b. Edematous skin
c. Depigmentation of the skin
5. Rickets is caused by a deficiency in:
a. vitamin A.
b. vitamin C.
c. vitamin D and calcium.
d. folic acid and iron.
6. A nurse is preparing to administer an oral iron supplement to a hospitalized infant. Which should not be given simultaneously with the iron supplement?
c. Fruit juice
d. Meat, fish, poultry
7. Parents report that they have been giving a multivitamin to their 1-year-old infant. The nurse counsels the parents that which vitamin can cause a toxic reaction at a low dose?
8. The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their child. Which is most likely lacking in their particular diet?
c. Vitamins C and A
d. Complete protein
9. Which describes marasmus?
a. Deficiency of protein with an adequate supply of calories
b. Not confined to geographic areas where food supplies are inadequate
c. Syndrome that results solely from vitamin deficiencies
d. Characterized by thin, wasted extremities and a prominent abdomen resulting from edema (ascites)
10. Although infants may be allergic to a variety of foods, the most common allergens are:
a. fruit and eggs.
b. fruit, vegetables, and wheat.
c. cow’s milk and green vegetables.
d. eggs, cow’s milk, and wheat.
Chapter 12: Health Promotion of the Toddler and Family
1. Which factor is most important in predisposing toddlers to frequent infections?
a. Respirations are abdominal.
b. Pulse and respiratory rates are slower than those in infancy.
c. Defense mechanisms are less efficient than those during infancy.
d. Toddlers have a short, straight internal ear canal and large lymph tissue.
2. The psychosocial developmental tasks of toddlerhood include which characteristic?
a. Development of a conscience
b. Recognition of sex differences
c. Ability to get along with age-mates
d. Ability to delay gratification
3. The child of 15 to 30 months is likely to be struggling with which developmental task?
4. A parent of an 18-month-old boy tells the nurse that he says “no” to everything and has rapid mood swings. If he is scolded, he shows anger and then immediately wants to be held. The nurse’s best interpretation of this behavior is included in which statement?
a. This is normal behavior for his age.
b. This is unusual behavior for his age.
c. He is not effectively coping with stress.
d. He is showing he needs more attention.
5. A nurse is planning care for a 17-month-old child. According to Piaget, which stage should the nurse expect the child to be in cognitively?
c. Secondary circular reaction
d. Tertiary circular reaction
6. Which is descriptive of a toddler’s cognitive development at age 20 months?
a. Searches for an object only if he or she sees it being hidden
b. Realizes that “out of sight” is not out of reach
c. Puts objects into a container but cannot take them out
d. Understands the passage of time, such as “just a minute” and “in an hour”
7. Although a 14-month-old girl received a shock from an electric outlet recently, her parent finds her about to place a paper clip in another outlet. Which is the best interpretation of this behavior?
a. Her cognitive development is delayed.
b. This is typical behavior because toddlers are not very developed.
c. This is typical behavior because of the inability to transfer knowledge to new situations.
d. This is not typical behavior because toddlers should know better than to repeat an act that caused pain.
8. Two toddlers are playing in a sandbox when one child suddenly grabs a toy from the other child. Which is the best interpretation of this behavior?
a. This is typical behavior because toddlers are aggressive.
b. This is typical behavior because toddlers are egocentric.
c. Toddlers should know that sharing toys is expected of them.
d. Toddlers should have the cognitive ability to know right from wrong.
9. Steven, 16 months old, falls down a few stairs. He gets up and “scolds” the stairs as if they caused him to fall. This is an example of which of the following?
d. Delayed cognitive development
10. Which should the nurse expect for a toddler’s language development at age 18 months?
a. Vocabulary of 25 words
b. Increasing level of comprehension
c. Use of holophrases
d. Approximately one third of speech understandable
Chapter 13: Health Promotion of the Preschooler and Family
1. Which should the nurse expect of a healthy 3-year-old child?
a. Jump rope.
b. Ride a two-wheel bicycle.
c. Skip on alternate feet.
d. Balance on one foot for a few seconds.
2. In terms of fine motor development, which should the 3-year-old child be expected to do?
a. Lace shoes and tie shoelaces with a bow.
b. Use scissors to cut pictures, and print a few numbers.
c. Draw a person with seven parts and correctly identify the parts.
d. Draw a circle and name what has been drawn.
3. A nurse is assessing a preschool-age child and notes the child exhibits magical thinking. According to Piaget, which describes magical thinking?
a. Events have cause and effect.
b. God is like an imaginary friend.
c. Thoughts are all-powerful.
d. If the skin is broken, the child’s insides will come out.
4. A nurse, instructing parents of a hospitalized preschool child, explains that which is descriptive of the preschooler’s understanding of time?
a. Has no understanding of time
b. Associates time with events
c. Can tell time on a clock
d. Uses terms like “yesterday” appropriately
5. The nurse is caring for a hospitalized 4-year-old boy. His parents tell the nurse that they will be back to visit at 6 PM. When the child asks the nurse when his parents are coming, the nurse’s best response is
a. “They will be here soon.”
b. “They will come after dinner.”
c. “Let me show you on the clock when 6 PM is.”
d. “I will tell you every time I see you how much longer it will be.”
6. A 4-year-old child is hospitalized with a serious bacterial infection. The child tells the nurse that he is sick because he was “bad.” Which is the nurse’s best interpretation of this comment?
a. Sign of stress
b. Common at this age
c. Suggestive of maladaptation
d. Suggestive of excessive discipline at home
7. A 4-year-old child tells the nurse that she does not want another blood sample drawn because “I need all my insides, and I don’t want anyone taking them out.” Which is the nurse’s best interpretation of this?
a. Child is being overly dramatic.
b. Child has a disturbed body image.
c. Preschoolers have poorly defined body boundaries.
d. Preschoolers normally have a good understanding of their bodies.
8. Which play is most typical of the preschool period?
9. Imaginary playmates are beneficial to the preschool child because they:
a. take the place of social interactions.
b. take the place of pets and other toys.
c. become friends in times of loneliness.
d. accomplish what the child has already successfully accomplished.
10. Which characteristic best describes the language of a 3-year-old child?
a. Asks meanings of words
b. Follows directional commands
c. Describes an object according to its composition
d. Talks incessantly regardless of whether anyone is listening
Chapter 14: Health Problems of Toddlers and Preschoolers
1. Which is described as the time interval between infection or exposure to disease and appearance of initial symptoms?
a. Incubation period
b. Prodromal period
c. Desquamation period
d. Period of communicability
2. Airborne isolation is required for a child who is hospitalized with:
c. exanthema subitum (roseola).
d. erythema infectiosum (fifth disease).
3. Acyclovir (Zovirax) is given to children with chickenpox to:
a. minimize scarring.
b. decrease the number of lesions.
c. prevent aplastic anemia.
d. prevent spread of the disease.
4. The single parent of a 3-year-old child who has just been diagnosed with chickenpox tells the nurse that she cannot afford to stay home with the child and miss work. The parent asks the nurse if some medication will shorten the course of the illness. Which is the most appropriate nursing intervention?
a. Reassure the parent that it is not necessary to stay home with the child.
b. Explain that no medication will shorten the course of the illness.
c. Explain the advantages of the medication acyclovir (Zovirax) to treat chickenpox.
d. Explain the advantages of the medication VCZ immune globulin (VariZIG) to treat chickenpox.
5. Which may be given to high-risk children after exposure to chickenpox to prevent varicella?
a. Acyclovir (Zovirax)
b. Varicella globulin
c. Diphenhydramine hydrochloride (Benadryl)
d. VCZ immune globulin (VariZIG)
6. Vitamin A supplementation may be recommended for the young child who has which disease?
c. Measles (rubeola)
d. Erythema infectiosum
7. A nurse is teaching parents about caring for their child with chickenpox. The nurse should let the parents know that the child is considered to be no longer contagious when which occurs?
a. When fever is absent
b. When lesions are crusted
c. 24 hours after lesions erupt
d. 8 days after onset of illness
8. A nurse is assessing a child and notes Koplik spots. In which of these communicable diseases are Koplik spots present?
b. Measles (rubeola)
c. Chickenpox (varicella)
d. Exanthema subitum (roseola)
9. Which is a common childhood communicable disease that may cause severe defects in the fetus when it occurs in its congenital form?
a. Erythema infectiosum
10. Which is the causative agent of scarlet fever?
b. Corynebacterium organisms
c. Scarlet fever virus
d. Group A β-hemolytic streptococci (GABHS)
Chapter 15: Health Promotion of the School-Age Child and Family
1. The nurse is teaching a group of 10- to 12-year-old children about physical development during the school-age years. Which statement made by a participant, indicates the correct understanding of the teaching?
a. “My body weight will be almost triple in the next few years.”
b. “I will grow an average of 2 inches per year from this point on.”
c. “There are not that many physical differences among school-age children.”
d. “I will have a gradual increase in fat, which may contribute to a heavier appearance.”
2. Generally, the earliest age at which puberty begins is _____ years in girls, _____ in boys.
a. 13; 13
b. 11; 11
c. 10; 12
d. 12; 10
3. Which describes the cognitive abilities of school-age children?
a. Have developed the ability to reason abstractly
b. Are capable of scientific reasoning and formal logic
c. Progress from making judgments based on what they reason to making judgments based on what they see
d. Are able to classify, to group and sort, and to hold a concept in their minds while making decisions based on that concept
4. Which describes moral development in younger school-age children?
a. The standards of behavior now come from within themselves.
b. They do not yet experience a sense of guilt when they misbehave.
c. They know the rules and behaviors expected of them but do not understand the reasons behind them.
d. They no longer interpret accidents and misfortunes as punishment for misdeeds.
5. Which statement characterizes moral development in the older school-age child?
a. They are able to judge an act by the intentions that prompted it rather than just by the consequences.
b. Rules and judgments become more absolute and authoritarian.
c. They view rule violations in an isolated context.
d. They know the rules but cannot understand the reasons behind them.
6. An 8-year-old girl tells the nurse that she has cancer because God is punishing her for “being bad.” She shares her concern that if she dies, she will go to hell. The nurse should interpret this as:
a. a belief common at this age.
b. a belief that forms the basis for most religions.
c. suggestive of excessive family pressure.
d. suggestive of a failure to develop a conscience.
7. Parents ask the nurse whether it is common for their school-age child to spend a lot of time with peers. The nurse should respond, explaining that the role of the peer group in the life of school-age children provides:
a. opportunity to become defiant.
b. time to remain dependent on their parents for a longer time.
c. time to establish a one-on-one relationship with the opposite sex.
d. security as they gain independence from their parents.
8. A group of boys ages 9 and 10 years have formed a “boys-only” club that is open to neighborhood and school friends who have skateboards. This should be interpreted as:
a. behavior that encourages bullying and sexism.
b. behavior that reinforces poor peer relationships.
c. characteristic of social development at this age.
d. characteristic of children who later are at risk for membership in gangs.
9. A school nurse observes school-age children playing at recess. Which is descriptive of the play the nurse expects to observe?
a. Individuality in play is better tolerated than at earlier ages.
b. Knowing the rules of a game gives an important sense of belonging.
c. They like to invent games, making up the rules as they go.
d. Team play helps children learn the universal importance of competition and winning.
10. Teasing can be common during the school-age years. The nurse should recognize that which applies to teasing?
a. Can have a lasting effect on children
b. Is not a significant threat to self-concept
c. Is rarely based on anything that is concrete
d. Is usually ignored by the child who is being teased
Chapter 16: Health Promotion of the Adolescent and Family
1. In girls, the initial indication of puberty is:
b. growth spurt.
c. growth of pubic hair.
d. breast development.
2. A school nurse is teaching a group of preadolescent girls about puberty. Which is the mean age of menarche for girls in the United States?
a. 11 1/2 years
b. 12 3/4 years
c. 13 1/2 years
d. 14 years
3. A school nurse is teaching a group of preadolescent boys about puberty. By which age should concerns about pubertal delay be considered?
a. 12 to 12 1/2 years
b. 12 1/2 to 13 years
c. 13 to 13 1/2 years
d. 13 1/2 to 14 years
4. A 14-year-old male mentions that he now has to use deodorant but never had to before. The nurse’s response should be based on knowledge that which occurs during puberty?
a. Eccrine sweat glands in the axillae become fully functional during puberty.
b. Sebaceous glands become extremely active during puberty.
c. New deposits of fatty tissue insulate the body and cause increased sweat production.
d. Apocrine sweat glands reach secretory capacity during puberty.
5. According to Erikson, the psychosocial task of adolescence is developing:
6. A nurse is planning a teaching session for a group of adolescents. The nurse understands that by adolescence the individual is in which stage of cognitive development?
a. Formal operations
b. Concrete operations
c. Conventional thought
d. Post-conventional thought
7. Which aspect of cognition develops during adolescence?
a. Capability to use a future time perspective
b. Ability to place things in a sensible and logical order
c. Ability to see things from the point of view of another
d. Progress from making judgments based on what they see to making judgments based on what they reason
8. Parents are concerned about the number of hours their teenage daughter spends with peers. The nurse explains that peer relationships are important during adolescence for which reason?
a. Adolescents dislike their parents.
b. Adolescents no longer need parental control.
c. They provide adolescents with a feeling of belonging.
d. They promote a sense of individuality in adolescents.
9. An adolescent boy tells the nurse that he has recently had homosexual feelings. The nurse’s response should be based on knowledge that:
a. this indicates the adolescent is homosexual.
b. this indicates the adolescent will become homosexual as an adult.
c. the adolescent should be referred for psychotherapy.
d. the adolescent should be encouraged to share his feelings and experiences.
10. The school nurse tells adolescents in the clinic that confidentiality and privacy will be maintained unless a life-threatening situation arises. This practice is:
a. not appropriate in a school setting.
b. never appropriate because adolescents are minors.
c. important in establishing trusting relationships.
d. suggestive that the nurse is meeting his or her own needs.
Chapter 17: Health Problems of School-Age Children and Adolescents
1. Which statement is true about smoking in adolescence?
a. Smoking is related to other high-risk behaviors.
b. Smoking will not continue unless peer pressure continues.
c. Smoking is less common when the adolescent’s parent(s) smokes.
d. Smoking among adolescents is becoming more prevalent.
2. Smokeless tobacco is:
a. not addicting.
b. proven to be carcinogenic.
c. easy to stop using.
d. a safe alternative to cigarette smoking.
3. A child has been diagnosed with enuresis. TCA imipramine (Tofranil) has been prescribed for the child. The nurse understands that this medication is in which category?
4. A 12-year-old male has short stature because of a constitutional growth delay. The nurse should be the most concerned about which of the following?
a. Proper administration of thyroid hormone
b. Proper administration of human growth hormones
c. Child’s self-esteem and sense of competence
d. Helping child understand that his height is most likely caused by chronic illness and is not his fault
5. Which syndrome involves a common sex chromosome defect?
6. Turner syndrome is suspected in an adolescent girl with short stature. This is caused by:
a. absence of one of the X chromosomes.
b. presence of an incomplete Y chromosome.
c. precocious puberty in an otherwise healthy child.
d. excess production of both androgens and estrogens.
7. An adolescent asks the nurse what causes primary dysmenorrhea. The nurse’s response should be based on which statement?
a. It is an inherited problem.
b. Excessive estrogen production causes uterine pain.
c. There is no physiologic cause; it is a psychological reaction.
d. There is a relation between prostaglandins and uterine contractility.
8. An adolescent girl asks the school nurse for advice because she has dysmenorrhea. She says that a friend recommended she try an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The nurse’s response should be based on which statement?
a. Aspirin is the drug of choice for the treatment of dysmenorrhea.
b. Over-the-counter NSAIDs are rarely strong enough to provide adequate pain relief.
c. NSAIDs are effective because of their analgesic effect.
d. NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.
9. The school nurse is discussing testicular self-examination with adolescent boys. Why is this important?
a. Epididymitis is common during adolescence.
b. Asymptomatic sexually transmitted diseases may be present.
c. Testicular tumors during adolescence are generally malignant.
d. Testicular tumors, although usually benign, are common during adolescence.
10. Which is the usual presenting symptom for testicular cancer?
a. Hard, painful mass
b. Hard, painless mass
c. Epididymis easily palpated
d. Scrotal swelling and pain
Chapter 18: Quality of Life for Children Living with Chronic or Complex Diseases
1. The nurse case manager is planning a care conference about a young child who has complex health care needs and will soon be discharged home. Who should the nurse invite to the conference?
a. Family and nursing staff
b. Social worker, nursing staff, and primary care physician
c. Family and key health professionals involved in child’s care
d. Primary care physician and key health professionals involved in the child’s care
2. Which represents a common best practice in the provision of services to children with special needs?
a. Care is now being focused on the child’s chronologic age.
b. Children with special needs are being integrated into regular classrooms.
c. Children with special needs no longer have to be cared for by their families.
d. Children with special needs are being separated into residential treatment facilities.
3. Lindsey, age 5 years, will be starting kindergarten next month. She has cerebral palsy, and it has been determined that she needs to be in a special education classroom. Her parents are tearful when telling the nurse about this and state that they did not realize her disability was so severe. The best interpretation of this situation is that:
a. this is a sign parents are in denial.
b. this is a normal anticipated time of parental stress.
c. the parents need to learn more about cerebral palsy.
d. the parents are used to having expectations that are too high.
4. Approach behaviors are those coping mechanisms that result in a family’s movement toward adjustment and resolution of the crisis of having a child with a chronic illness or disability. Which is considered an approach behavior?
a. Is unable to adjust to a progression of the disease or condition
b. Anticipates future problems and seeks guidance and answers
c. Looks for new cures without a perspective toward possible benefit
d. Fails to recognize seriousness of child’s condition despite physical evidence
5. Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability. After the shock phase, a period of adjustment usually follows. This is often characterized by which of the following responses?
b. Guilt and anger
c. Social reintegration
d. Acceptance of child’s limitations
6. Which nursing intervention is especially helpful in assessing parental guilt when a disability or chronic illness is diagnosed?
a. Ask the parents if they feel guilty.
b. Discuss guilt only after the parents mention it.
c. Discuss the meaning of the parents’ religious and cultural background.
d. Observe for signs of overprotectiveness.
7. The nurse observes that a seriously ill child passively accepts all painful procedures. The nurse should recognize that this is most likely an indication that the child is experiencing a:
a. sense of hopefulness.
b. sense of chronic sorrow.
c. belief that procedures are a deserved punishment.
d. belief that procedures are an important part of care.
8. The nurse comes into the room of a child who was just diagnosed with a chronic disability. The child’s parents begin to yell at the nurse about a variety of concerns. Which is the nurse’s best response?
a. “What is really wrong?”
b. “Being angry is only natural.”
c. “Yelling at me will not change things.”
d. “I will come back when you settle down.”
9. A common parental reaction to a child with special needs is parental overprotection. Parental behavior suggestive of this includes:
a. giving inconsistent discipline.
b. providing consistent, strict discipline.
c. forcing child to help self, even when not capable.
d. encouraging social and educational activities not appropriate to child’s level of capability.
10. Most parents of children with special needs tend to experience chronic sorrow. This is characterized by:
a. lack of acceptance of child’s limitation.
b. lack of available support to prevent sorrow.
c. periods of intensified sorrow when experiencing anger and guilt.
d. periods of intensified sorrow and loss that occur in waves over time.
Chapter 19: Impact of Cognitive or Sensory Impairment on the Child and Family
1. A young child has an intelligence quotient (IQ) of 45. The nurse should document this finding as:
a. within the lower limits of the range of normal intelligence.
b. mild cognitive impairment but educable.
c. moderate cognitive impairment but trainable.
d. severe cognitive impairment and completely dependent on others for care.
2. When a child with mild cognitive impairment reaches the end of adolescence, which characteristic should be expected?
a. Achieves a mental age of 5 to 6 years
b. Achieves a mental age of 8 to 12 years
c. Unable to progress in functional reading or arithmetic
d. Acquires practical skills and useful reading and arithmetic to an eighth-grade level
3. When should children with cognitive impairment be referred for stimulation and educational programs?
a. As young as possible
b. As soon as they have the ability to communicate in some way
c. At age 3 years, when schools are required to provide services
d. At age 5 or 6 years, when schools are required to provide services
4. Which should be the major consideration when selecting toys for a child who is cognitively impaired?
b. Age appropriateness
c. Ability to provide exercise
d. Ability to teach useful skills
5. Appropriate interventions to facilitate socialization of the cognitively impaired child include:
a. providing age-appropriate toys and play activities.
b. providing peer experiences, such as scouting, when older.
c. avoiding exposure to strangers who may not understand cognitive development.
d. emphasizing mastery of physical skills because they are delayed more often than verbal skills.
6. The nurse is discussing sexuality with the parents of an adolescent girl with moderate cognitive impairment. Which should the nurse consider when dealing with this issue?
a. Sterilization is recommended for any adolescent with cognitive impairment.
b. Sexual drive and interest are limited in individuals with cognitive impairment.
c. Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.
d. Sexual intercourse rarely occurs unless the individual with cognitive impairment is sexually abused.
7. When caring for a newborn with Down syndrome, the nurse should be aware that the most common congenital anomaly associated with Down syndrome is:
b. pyloric stenosis.
c. congenital heart disease.
d. congenital hip dysplasia.
8. Mark, a 9-year-old with Down syndrome, is mainstreamed into a regular third-grade class for part of the school day. His mother asks the school nurse about programs, such as Cub Scouts, that he might join. The nurse’s recommendation should be based on which statement?
a. Programs like Cub Scouts are inappropriate for children who are mentally retarded.
b. Children with Down syndrome have the same need for socialization as other children.
c. Children with Down syndrome socialize better with children who have similar disabilities.
d. Parents of children with Down syndrome encourage programs, such as scouting, because they deny that their children have disabilities.
9. What is one of the major physical characteristics of the child with Down syndrome?
a. Excessive height
b. Spots on the palms
c. Inflexibility of the joints
d. Hypotonic musculature
10. A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of:
b. Down syndrome.
c. cerebral palsy.
d. fragile X syndrome.
Chapter 20: Family-Centered Home Care
1. Home care is being considered for a young child who is ventilator-dependent. Which factor is most important in deciding whether home care is appropriate?
a. Level of parents’ education
b. Presence of two parents in the home
c. Preparation and training of family
d. Family’s ability to assume all health care costs
2. The home health nurse asks a child’s mother many questions as part of the assessment. The mother answers many questions, then stops and says, “I don’t know why you ask me all this. Who gets to know this information?” The nurse should take which action?
a. Determine why the mother is so suspicious.
b. Determine what the mother does not want to tell.
c. Explain who will have access to the information.
d. Explain that everything is confidential and that no one else will know what is said.
3. When communicating with other professionals, it is important for home care nurses to:
a. ask others what they want to know.
b. share everything known about the family.
c. restrict communication to clinically relevant information.
d. recognize that confidentiality is not possible.
4. The home health nurse is caring for a child who requires complex care. The family expresses frustration related to obtaining accurate information about their child’s illness and its management. Which is the best action for the nurse?
a. Determine why family is easily frustrated.
b. Refer family to child’s primary care practitioner.
c. Clarify family’s request, and provide information they want.
d. Answer only questions that family needs to know about.
5. A family wants to begin oral feeding of their 4-year-old son, who is ventilator-dependent and currently tube-fed. They ask the home health nurse to feed him the baby food orally. The nurse recognizes a high risk of aspiration and an already compromised respiratory status. The most appropriate nursing action is to:
a. refuse to feed him orally because the risk is too high.
b. explain the risks involved, and then let the family decide what should be done.
c. feed him orally because the family has the right to make this decision for their child.
d. acknowledge their request, explain the risks, and explore with the family the available options.
6. The home health nurse outlines short- and long-term goals for a 10-year-old child with many complex health problems. Who should agree on these goals?
a. Family and nurse
b. Child, family, and nurse
c. All professionals involved
d. Child, family, and all professionals involved
7. One of the supervisors for a home health agency asks the nurse to give the family a survey evaluating the nurses and other service providers. The nurse should recognize this as:
a. inappropriate, unless nurses are able to evaluate family.
b. appropriate to improve quality of care.
c. inappropriate, unless nurses and other providers agree to participate.
d. inappropriate, because family lacks knowledge necessary to evaluate professionals.
8. The home care nurse has been visiting an adolescent with recently acquired quadriplegia. The teen’s mother tells the nurse, “I’m sick of providing all the care while my husband does whatever he wants to, whenever he wants to do it.” Which should be the initial action of the nurse?
a. Refer mother for counseling.
b. Listen and reflect mother’s feelings.
c. Ask father, in private, why he does not help.
d. Suggest ways the mother can get her husband to help.
9. The home health nurse is planning care for a 3-year-old boy who has Down syndrome and is receiving continuous oxygen. He recently began walking around furniture. He is spoon-fed by his parents and eats some finger foods. Which is the most appropriate goal to promote normal development?
a. Encourage mobility.
b. Encourage assistance in self-care.
c. Promote oral-motor development.
d. Provide opportunities for socialization.
10. A mother of a 5-year-old child, with complex health care needs and cared for at home, expresses anxiety about attending a kindergarten graduation exercise of a neighbor’s child. The mother says, “I wish it could be my child graduating from kindergarten.” The nurse recognizes that the mother is experiencing:
a. abnormal anxiety.
b. ineffective coping.
c. chronic sorrow.
AND MUCH MORE