A child with cancer is receiving chemotherapy, and his mother is concerned that the nausea and vomiting associated with chemotherapy are reducing is ability to eat and gain weight appropriately. What is the most appropriate nursing action?

A child with cancer is receiving chemotherapy, and his mother is concerned that the nausea and vomiting associated with chemotherapy are reducing is ability to eat and gain weight appropriately. What is the most appropriate nursing action?

1. administer an antiemetic at the first hint of nausea
2. offer the child's favorite foods to encourage him to eat
3. start antiemetic drugs prior to the chemotherapy infusion
4. maintain IV fluid infusion to avoid dehydration


Answer: start antiemetic drugs prior to the chemotherapy infusion

A child with leukemia received chemotherapy about 10 days ago. She presents today with a temperature of 100.4F, an absolute neutrophil count of 500, and mild bleeding of the gums. What is the priority nursing intervention?

A child with leukemia received chemotherapy about 10 days ago. She presents today with a temperature of 100.4F, an absolute neutrophil count of 500, and mild bleeding of the gums. What is the priority nursing intervention?

1. administer IV antibiotics as ordered
2. provide vigorous oral care freuently with a firm toothbrush
3. monitor pulse and blood pressure changes
4. administer packed red blood cell transfusion


Answer: administer IV antibiotics as ordered

A child with leukemia has the following AM lab results: hgb 8.0, Hct 24.2, WBC 8,000, patelets 150,000. What is the priority nursing assessment?

A child with leukemia has the following AM lab results: hgb 8.0, Hct 24.2, WBC 8,000, patelets 150,000. What is the priority nursing assessment?

1. monitor for fever
2. assess for bruising or bleeding
3. determine intake and output
4. assess for pallor, fatigue, and tachycardia


Answer: assess for pallor, fatigue, and tachycardia

A 5 y/o has been diagnosed with Wilms tumor. What is the priority nursing intervention for this child?

A 5 y/o has been diagnosed with Wilms tumor. What is the priority nursing intervention for this child?

1. educate the parents about dialysis, as the kidney will be removed
2. measure abdominal girth every shift
3. avoid palpating the child's abdomen
4. monitor BUN and creatinine every 4h


Answer: avoid palpating the child's abdomen

A mother has received instructions about avoiding wheat and soy allergens. Which response by the mother would indicate that further education is needed?

A mother has received instructions about avoiding wheat and soy allergens. Which response by the mother would indicate that further education is needed?

1. "I will not feed my child any breads made with wheat flour."
2. "I will allow my child to eat semolina pasta, the kind that he loves."
3. "I will not feed my child shakes made with soy protein"
4. "I will read labels to be sure I am avoiding wheat and soy."


Answer: "I will allow my child to eat semolina pasta, the kind that he loves."

A 4 month old infant born to an HIV-infected mother is going into foster care because the mother is too ill to care for the child. The foster mother wants to know if the infant is also infected. What is the best response by the nurse?

A 4 month old infant born to an HIV-infected mother is going into foster care because the mother is too ill to care for the child. The foster mother wants to know if the infant is also infected. What is the best response by the nurse?

1. "It's too early to know; we have to wait until the infant has symptoms."
2. "Since the mother is so ill, it's likely the child is also infected with HIV."
3. "The ELISA test is positive, so the child is definitely infected."
4. "The PCR test is positive; this indicates HIV infecion, which may or may not progress to AIDS."


Answer: "The PCR test is positive; this indicates HIV infecion, which may or may not progress to AIDS."

The mother of a child with hypogammaglobulinemia reports that her child had a fever and slight chills with an IV gammaglobulin infusion last month. She wants to know what other course of treatment might be available. What is the best response by the nurse?

The mother of a child with hypogammaglobulinemia reports that her child had a fever and slight chills with an IV gammaglobulin infusion last month. She wants to know what other course of treatment might be available. What is the best response by the nurse?

1. Administration of acetaminophen or diphenhydramine prior to the next infusion may decrease the incidence of fever or chills
2. Giving the gammaglobulin IM is recommended to prevent a reaction
3. Talk to her physician or NP about alternative medications that may b e used to boost the gammaglobulin level in the blood.
4. If the child is no longer experiencing frequent infections, then the IV infusions may not be necessary


Answer: Administration of acetaminophen or diphenhydramine prior to the next infusion may decrease the incidence of fever or chills

A 14 y/o with systemic lupus erythematosus wants to know how to care for her skin. What should the nurse teach this adolescent?

A 14 y/o with systemic lupus erythematosus wants to know how to care for her skin. What should the nurse teach this adolescent?

1. Careful sun tanning will give her skin an attractive color
2. No special skin care is needed
3. Use sunscreen daily to avoid rashes
4. Use makeup to camouflage the butterfly rash on her face


Answer: Use sunscreen daily to avoid rashes

The nurse is caring for a 6 y/o with juvenile idiopathic arthritis. The mother states that she has trouble getting her daughter out of bed in the morning and believes the girl's behavior is d/t a desire to avoid going to school. What is the best advice by the nurse?

The nurse is caring for a 6 y/o with juvenile idiopathic arthritis. The mother states that she has trouble getting her daughter out of bed in the morning and believes the girl's behavior is d/t a desire to avoid going to school. What is the best advice by the nurse?

1. Refere the girl to a psychologist for evaluation of school phobia related to chronic illness
2. Administer a warm bath every morning before school
3. Give the child her prescribed NSAIDs 30 mins before getting out of bed
4. Allow her to stay in bed some mornings if she wants


Answer: Administer a warm bath every morning before school.

When administering ear drops to a 2-year-old, which action would be most appropriate?

When administering ear drops to a 2-year-old, which action would be most appropriate?

1. Tell the child that the drops are to treat his infection.
2. Pull the pinna of the child's ear down and back.
3. Have the child turn his head to the opposite side after giving the drops.
4. Massage the child's forehead to facilitate absorption of the medication.


Answer: Pull the pinna of the child's ear down and back.

The nurse is caring for an infant who weighs 8.2 kg and is NPO and receiving IV fluid therapy. What rate does the nurse calculate as meeting the child's daily fluid requirements?

The nurse is caring for an infant who weighs 8.2 kg and is NPO and receiving IV fluid therapy. What rate does the nurse calculate as meeting the child's daily fluid requirements?

1. 82 mL per hour
2. 41 mL per hour
3. 34 mL per hour
4. 22 mL per hour


Answer: 34 mL per hour

A 3-year-old child is to receive a medication that is supplied as an enteric-coated tablet. What is the best nursing action?

A 3-year-old child is to receive a medication that is supplied as an enteric-coated tablet. What is the best nursing action?

1. Crush the tablet and mix it with applesauce.
2. Dissolve the medication in the child's milk.
3. Place a pill in the posterior part of the pharynx and tell the child to swallow.
4. Check with the prescriber to see if an alternative form can be used.


Answer: Check with the prescriber to see if an alternative form can be used.

A nurse is preparing to administer an intramuscular injection to an infant. What is the most appropriate site for this injection?

A nurse is preparing to administer an intramuscular injection to an infant. What is the most appropriate site for this injection?

1. Deltoid muscle
2. Vastus lateralis
3. Dorsogluteal
4. Rectus femoris


Answer: Vastus lateralis

The nurse is caring for a child with a fractured left femur who has been in skeletal traction for several days. Upon assessment, she notes that the left foot is pale, with a nonpalpable pedal pulse. What is the priority nursing intervention?

The nurse is caring for a child with a fractured left femur who has been in skeletal traction for several days. Upon assessment, she notes that the left foot is pale, with a nonpalpable pedal pulse. What is the priority nursing intervention?

1. Release the traction, as there may be too much weight on it
2. Nothing; alterations in circulation are expected with skeletal traction
3. Immediately notify the physician or NP of this abnormal finding
4. Massage the foot immediately to increase circulation


Answer: Immediately notify the physician or NP of this abnormal finding

The nurse is caring for orthopedic children who are in the postoperative period following spinal fusion. What is the most appropriate activity to delegate to a unlicensed assistive personnel (UAP)?

The nurse is caring for orthopedic children who are in the postoperative period following spinal fusion. What is the most appropriate activity to delegate to a unlicensed assistive personnel (UAP)?

1. ambulate the children twice daily to promote mobility
2. encourage commode use to promote bowel function
3. provide diversionary activities, as the children must stay flat on their backs
4. assist with log-rolling the children every 2 hours


Answer: assist with log-rolling the children every 2 hours

The nurse is providing education related to use of a brae that the orthopedic surgeon has ordered as treatment for idiopathic scoliosis in an adolecent girl. Which statement by the teen best indicates an understanding of appropriate use of the brace?

The nurse is providing education related to use of a brae that the orthopedic surgeon has ordered as treatment for idiopathic scoliosis in an adolecent girl. Which statement by the teen best indicates an understanding of appropriate use of the brace?

1. "I can take my brace off only for special occasions."
2. "I will take my brace off for only 1 hour per day for showering."
3. "I do not need to wear my brace at night while I am sleeping."
4. "It is most important for me to wear my brace during the day, while I am upright."


Answer: "I will take my brace off for only 1 hour per day for showering."

The nurse is evaluating a parent's understanding of treatment for torticollis. Which response best indicates that the parent understands the appropriate treatment?

The nurse is evaluating a parent's understanding of treatment for torticollis. Which response best indicates that the parent understands the appropriate treatment?

1. Encourage the infant to turn the head to the unaffected side
2. States that prone positioning for sleep will be needed
3. Places the infant on the affected side
4. Stretches the infant's neck to the opposite side and holds it for 5 seconds


Answer: Encourage the infant to turn the head to the unaffected side

The public health nurse has been asked to provide information to local child care centers on controlling the spread of infectious diseases. What is the best information the nurse can provide?

The public health nurse has been asked to provide information to local child care centers on controlling the spread of infectious diseases. What is the best information the nurse can provide?

1. The etiology of common infectious diseases
2. Proper hand washing techniques
3. The physiology of the immune system
4. Why children are at a higher risk of infection than adults


Answer: Proper hand washing techniques

A neonate should be evaluated by a physician if which signs and symptoms are present?

A neonate should be evaluated by a physician if which signs and symptoms are present?

1. Acting fussier than normal
2. Refusing the pacifier
3. Rectal temperature above 38°C
4. Mottling that is present during bathing


Answer: Rectal temperature above 38°C

A mother calls the clinic because her 2-year-old daughter has a rectal temperature of 37.8°C (100°F). She wonders how high a fever should be before she should give medications to reduce it. What is the best response by the nurse?

A mother calls the clinic because her 2-year-old daughter has a rectal temperature of 37.8°C (100°F). She wonders how high a fever should be before she should give medications to reduce it. What is the best response by the nurse?

1. "All fevers should be treated to prevent seizures."
2. "Antipyretics should be used with any rise in temperature. They can help change the course of the infection."
3. "Give your child aspirin when her fever is above 38°C (100.4°F)."
4. "In a normal healthy child, if your child is not uncomfortable, fevers less than 39°C (102.2°F) do not require medication."


Answer: "In a normal healthy child, if your child is not uncomfortable, fevers less than 39°C (102.2°F) do not require medication."

Compared with adults, why are infants and children at an increased risk for infection and communicable diseases?

Compared with adults, why are infants and children at an increased risk for infection and communicable diseases?

1. The infant has had limited exposure to disease and is losing the passive immunity acquired from maternal antibodies.
2. The infant demonstrates an increased inflammatory response.
3. Cellular immunity is not functional at birth.
4. Infants have an increased risk for infection until they receive their first set of immunizations.


Answer: The infant has had limited exposure to disease and is losing the passive immunity acquired from maternal antibodies.

A mother is discussing with the nurse a recent story in the local news about a child being abducted. She is concerned about the safety of her preschool child and wonders what she should tell her child to keep her safe but without frightening her. Which of the following would be the best recommendation for the nurse to give the mother in this case?

A mother is discussing with the nurse a recent story in the local news about a child being abducted. She is concerned about the safety of her preschool child and wonders what she should tell her child to keep her safe but without frightening her. Which of the following would be the best recommendation for the nurse to give the mother in this case?

a) Explain in a calm and everyday manner how the child should stay away from strangers in cars
b) Don't worry about it; the odds of your child being abducted are very low
c) It is your responsibility to keep your child safe, not your child's; keep her in your sight at all times
d) Wait until the child is school-aged before telling her what to do, so she will be better able to handle it


Answer: Explain in a calm and everyday manner how the child should stay away from strangers in cars

A 3½-year-old shouts, "Look out for Boo-ga-loo!" as the nurse enters the exam room. The father explains Boo-ga-loo is his daughter's imaginary friend. How should the nurse respond?

A 3½-year-old shouts, "Look out for Boo-ga-loo!" as the nurse enters the exam room. The father explains Boo-ga-loo is his daughter's imaginary friend. How should the nurse respond?

a) "Are you kidding me?"
b) "Tell me about Boo-ga-loo."
c) "I don't see anyone."
d) "Where did you get that funny name?"


Answer: "Tell me about Boo-ga-loo."

A nurse is providing a routine wellness examination for a 5-year-old boy. Which response by the parents indicates a need for an additional referral or follow-up?

A nurse is providing a routine wellness examination for a 5-year-old boy. Which response by the parents indicates a need for an additional referral or follow-up?

a) "We often have to translate his speech to others."
b) "He can count to 30 but gets confused after that."
c) "He knows his name and address."
d) "He is always talking and telling detailed stories."


Answer: "We often have to translate his speech to others."

The caregiver of a 6-year-old tells the clinic nurse that he is concerned that his 5-year-old child cannot yet print his first and last name, and the caregiver is wondering if this is normal. Which response by the nurse would be most appropriate?

The caregiver of a 6-year-old tells the clinic nurse that he is concerned that his 5-year-old child cannot yet print his first and last name, and the caregiver is wondering if this is normal. Which response by the nurse would be most appropriate?

a) "By the age of 6 most children can print some letters and maybe their first name."
b) "Some children this age cannot hold a pencil or crayon well enough to write legibly."
c) "Usually by the age of 6, most children can write numbers up to nine, but no letters."
d) "It is not unusual for children of this age to be writing their first name in cursive."


Answer: "By the age of 6 most children can print some letters and maybe their first name."

Parents tell the nurse their 3½-year-old refuses to eat meat but are pleased she drinks "lots of milk." What risk does the nurse identify?

Parents tell the nurse their 3½-year-old refuses to eat meat but are pleased she drinks "lots of milk." What risk does the nurse identify?

a) Dental caries
b) Obesity
c) Iron deficiency
d) Interference with growth


Answer: Iron deficiency

A nurse is observing a 3-year-old preschooler engaged in play. What behavior would the nurse most likely expect to observe?

A nurse is observing a 3-year-old preschooler engaged in play. What behavior would the nurse most likely expect to observe? 

a) Group play
b) Solitary play
c) Parallel play
d) Imitative play

Answer: Imitative play

The nurse is providing teaching about preventing poisoning. Which statement by the mother would warrant further discussion?

The nurse is providing teaching about preventing poisoning. Which statement by the mother would warrant further discussion?

a) "I never transfer cleaning products out of their original containers."
b) "We keep our lawn and garden products on a high shelf in the garage."
c) "We have the poison control number located near our phone."
d) "All medicine in our bathroom is in childproof containers."


Answer: "All medicine in our bathroom is in childproof containers."

The nurse is providing teaching about proper dental care for the parents of a 5-year-old girl. Which response indicates a need for further teaching?

The nurse is providing teaching about proper dental care for the parents of a 5-year-old girl. Which response indicates a need for further teaching?

a) "We should use only a pea-sized amount of toothpaste."
b) "She should see a dentist every 6 months."
c) "Too much fluoride can contribute to fluorosis."
d) "She needs to floss her teeth before brushing."


Answer: "She needs to floss her teeth before brushing."

In counseling a group of parents regarding the development of school readiness in preschoolers, the nurse emphasizes:

In counseling a group of parents regarding the development of school readiness in preschoolers, the nurse emphasizes:

a) library visits and story hour.
b) visiting the kindergarten.
c) the home environment.
d) enrollment in a preschool.


Answer: the home environment.

In assessing the bilingual 4-year-old's speech and language development, the nurse should find that the child will:

In assessing the bilingual 4-year-old's speech and language development, the nurse should find that the child will:

a) be able to use each language as a separate system.
b) be prone to stuttering.
c) mix the two languages in the same sentence.
d) avoid asking questions.


Answer: be able to use each language as a separate system.

The best activity that a preschooler's parents could use to help her achieve the developmental task of the preschool period is to:

The best activity that a preschooler's parents could use to help her achieve the developmental task of the preschool period is to:

a) provide her with clothes that snap rather than button.
b) allow her to experiment with Play-Doh.
c) teach her street-crossing safety.
d) help her learn how to follow rules.


Answer: allow her to experiment with Play-Doh.

A mother confides in a nurse that her preschool daughter only wants to play with her father as soon as he comes home from work in the evenings and doesn't seem to have any interest in spending time with the mother. This phenomenon is an example of which of the following?

A mother confides in a nurse that her preschool daughter only wants to play with her father as soon as he comes home from work in the evenings and doesn't seem to have any interest in spending time with the mother. This phenomenon is an example of which of the following?

a) Genu valgus
b) Centering
c) Electra complex
d) Oedipus complex



Answer: Electra complex

A 5-year-old boy's father was recently injured in a motorcycle accident, but has fully recovered. The father confides to the school nurse that he is concerned about the child not acting the way he did before the accident. The boy is not testing boundaries as he was before the accident. Which situation best describes the reason for the behavior Jack's father is seeing?

A 5-year-old boy's father was recently injured in a motorcycle accident, but has fully recovered. The father confides to the school nurse that he is concerned about the child not acting the way he did before the accident. The boy is not testing boundaries as he was before the accident. Which situation best describes the reason for the behavior Jack's father is seeing?

a) The boy wanted to go with his father on the motorcycle ride. When he was told he couldn't go he told his father he hoped he would crash, so he believes he caused the accident.
b) The thought of losing his father was scary, and the child is trying to show his father how much he loves him.
c) The child is afraid of being hurt himself and thinks being especially good will protect him from accidents.
d) Everyone in the family is being nicer to each other and the boy is imitating the adults' behavior.


Answer: The boy wanted to go with his father on the motorcycle ride. When he was told he couldn't go he told his father he hoped he would crash, so he believes he caused the accident.

A 3-year-old wants to do everything independently, including putting on shoes. Every day, no matter how hard he tries, he puts the shoes on the wrong feet until finally he is successful. According to Erikson, what developmental task is this child trying to master?

A 3-year-old wants to do everything independently, including putting on shoes. Every day, no matter how hard he tries, he puts the shoes on the wrong feet until finally he is successful. According to Erikson, what developmental task is this child trying to master?

a) Initiative vs. guilt
b) Trust vs. mistrust
c) Industry vs. inferiority
d) Autonomy vs. shame


Answer: Initiative vs. guilt

Broken fluency is a serious condition, and children who exhibit it should be referred to a speech pathologist for treatment.

Broken fluency is a serious condition, and children who exhibit it should be referred to a speech pathologist for treatment.

a) False
b) True


Answer: False

The nurse is providing teaching about child safety to the parents of a 4-year-old girl. Which statement by the parents indicates a need for further teaching?

The nurse is providing teaching about child safety to the parents of a 4-year-old girl. Which statement by the parents indicates a need for further teaching?

a) "We need to know the basics of CPR and first aid."
b) "We need to continually remind her about safety rules."
c) "She still needs a booster seat in the car."
d) "We need to tell her that her vitamins are candy."


Answer: "We need to tell her that her vitamins are candy."

Language development is rapid in the preschool years. At the age of 2 most children use about 50 to 100 words. By the time the child is 5 years of age how many additional words do most children use?

Language development is rapid in the preschool years. At the age of 2 most children use about 50 to 100 words. By the time the child is 5 years of age how many additional words do most children use?

a) 3,000 words
b) 2,000 words
c) 1,500 words
d) 1,000 words


Answer: 2,000 words

The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching?

The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching?

a) "I usually have him in time-out for about 10 minutes."
b) "He is allowed out of time-out when he is calm."
c) "The time-out doesn't just have to be in his room."
d) "I put him in time-out when the problem occurs."


Answer: "I usually have him in time-out for about 10 minutes."

The nurse is doing a well-child exam of a 5½-year-old girl. Which statement by the mother would alert the nurse that further teaching is needed about healthy eating habits?

The nurse is doing a well-child exam of a 5½-year-old girl. Which statement by the mother would alert the nurse that further teaching is needed about healthy eating habits?

a) "We eat fast food less than once a month."
b) "Our family rule is that all children clean up their plates at each meal, and we feed them a lot."
c) "I try to set a good example and eat a variety of fruits and vegetables."
d) "She enjoys planning meals and helping me in the kitchen."
e) "Her serving sizes are about half the size of ours."


Answer: "Our family rule is that all children clean up their plates at each meal, and we feed them a lot."

The mother of a 4-year-old boy reports her son has voiced curiosity about her breasts. She asks the nurse what she should do. Which information is best for the nurse to give the parent?

The mother of a 4-year-old boy reports her son has voiced curiosity about her breasts. She asks the nurse what she should do. Which information is best for the nurse to give the parent?

a) Encourage the parent to determine what the child's specific questions are and answer them briefly.
b) Encourage the parent to provide a detailed discussion about human sexuality with the child.
c) Advise the parent that sexual curiosity is unusual at this age.
d) Advise the parent to explain to the child that he is too young to discuss such things.


Answer: Encourage the parent to determine what the child's specific questions are and answer them briefly.

The nurse is discussing nutritional issues and concerns with the caregivers of preschoolers. Which of the following statements made by the caregivers best indicates a common aspect of the diet and nutrition of the preschool child?

The nurse is discussing nutritional issues and concerns with the caregivers of preschoolers. Which of the following statements made by the caregivers best indicates a common aspect of the diet and nutrition of the preschool child?

a) "My 4-year-old eats as much as my adolescent does every day."
b) "My husband is insistent that our 5-year-old not eat any snacks so he will eat he all of his meals at mealtime."
c) "My child is so picky and eats the same thing every day for days on end!"
d) "Our child gets into food jags where she will only eat one food all day long."


Answer: "My child is so picky and eats the same thing every day for days on end!"

Broken fluency is a serious condition, and children who exhibit it should be referred to a speech pathologist for treatment.

Broken fluency is a serious condition, and children who exhibit it should be referred to a speech pathologist for treatment.

a) False
b) True


Answer: False

A mother brings her 4-year-old son in for a check-up. Which of the following findings should the nurse be concerned about?

A mother brings her 4-year-old son in for a check-up. Which of the following findings should the nurse be concerned about?

a) No increase in appetite compared with that in toddler years
b) Weight gain of 5 lb in the past year
c) Ectomorphic body type
d) Resting pulse rate of 120


Answer: Resting pulse rate of 120

Johnny exhibits the following growth pattern. How should the nurse interpret or manage this data? Select all that apply.

Johnny exhibits the following growth pattern. How should the nurse interpret or manage this data? Select all that apply.

3 yrs: Ht. 37 inches Wt. 32 pounds
4 yrs: Ht. 39 inches Wt. 39 pounds
5 yrs: Ht. 40 inches Wt. 46 pounds

a) Johnny may be at risk for overweight or obesity.
b) Johnny is following a normal pattern of growth for the preschool years.
c) Johnny is growing slowly in height but rapidly in weight.
d) Johnny's height and weight should be plotted on a growth chart.


Answer:


• Johnny is growing slowly in height but rapidly in weight.
• Johnny may be at risk for overweight or obesity.
• Johnny's height and weight should be plotted on a growth chart.

The mother of a preschool-age child is discussing normal development of this age child with the pediatric nurse. The nurse explains the developmental milestone of initiative. The mother makes the following statements about her son. Which statement is an example of what might be this developmental milestone?

The mother of a preschool-age child is discussing normal development of this age child with the pediatric nurse. The nurse explains the developmental milestone of initiative. The mother makes the following statements about her son. Which statement is an example of what might be this developmental milestone?

a) "He broke my favorite plate but blamed it on some friend he called Paul, but we don't know anyone named Paul."
b) "He tries to sweep up cereal his brother spilled but cries when he can't do it well."
c) "He refuses to hold my hand while we are crossing the street."
d) "When I leave him with a babysitter he gets upset, but she says he still does what she asks him to do."


Answer: "He tries to sweep up cereal his brother spilled but cries when he can't do it well."

A 5-year-old girl is pretending to be a crocodile during a physical examination. Her mother just smiles and rolls her eyes at the nurse. Which of the following would be the best response for the nurse to give the child?

A 5-year-old girl is pretending to be a crocodile during a physical examination. Her mother just smiles and rolls her eyes at the nurse. Which of the following would be the best response for the nurse to give the child?

a) "What happened to my patient? Did you eat her?"
b) "Oh no! I have a crocodile in my room. Please don't bite me!"
c) "My dear, you are a girl, not a crocodile. Now sit still so that I can examine you."
d) "What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile."


Answer: "What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile."

A father and his 4-year-old son are waiting in an exam room when the nurse enters and greets them. Which of the following activities that the nurse observes the boy doing would best demonstrate the primary developmental task of the preschool-age child, according to Erikson?

A father and his 4-year-old son are waiting in an exam room when the nurse enters and greets them. Which of the following activities that the nurse observes the boy doing would best demonstrate the primary developmental task of the preschool-age child, according to Erikson?

a) Rough-housing with his father
b) Opening drawers in the room, pulling out supplies, and examining them
c) Reading a book
d) Singing a song he learned at preschool


Answer: Opening drawers in the room, pulling out supplies, and examining them

A type of play seen in the preschool child encourages children to act out troubling situations such as occur in the hospitalized child who must undergo an upsetting procedure. This type of play is referred to as which of the following?

A type of play seen in the preschool child encourages children to act out troubling situations such as occur in the hospitalized child who must undergo an upsetting procedure. This type of play is referred to as which of the following?

a) Solitary independent play
b) Parallel play
c) Independent play
d) Dramatic play


Answer: Dramatic play

Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of these actions? Select all that apply.

Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of these actions? Select all that apply.

a) A time-out of about 8 minutes would be appropriate for intentional misbehavior.
b) Books and stories can help preschoolers master proper behavior.
c) When discussing improper behavior, call the behavior "bad" or "naughty," not the child.
d) Spank with an open hand only and never with an object.
e) Anticipate situations likely to cause misbehavior and redirect the child to another activity.


Answer:
• Books and stories can help preschoolers master proper behavior.
• When discussing improper behavior, call the behavior "bad" or "naughty," not the child.
• Anticipate situations likely to cause misbehavior and redirect the child to another activity.

A nursing instructor is teaching students about changes during the preschool years. One predominant change that the teacher would emphasize is which of the following?

A nursing instructor is teaching students about changes during the preschool years. One predominant change that the teacher would emphasize is which of the following?

a) Physical growth accelerates.
b) Personality growth slows.
c) Cognitive growth slows.
d) Physical growth slows.


Answer: Physical growth slows

Which of the following would be most effective in helping promote initiative and nutritional health for a preschooler?

Which of the following would be most effective in helping promote initiative and nutritional health for a preschooler?

a) Praising the child for cleaning his large plate of food
b) Encouraging the child to cut up small pieces of apple for a snack
c) Allowing the child to spread soft cheese on crackers
d) Giving the child a high carbohydrate snack after preschool


Answer: Allowing the child to spread soft cheese on crackers

The major developmental task according to Erikson is for the preschool child to develop which of the following?

The major developmental task according to Erikson is for the preschool child to develop which of the following?

a) Autonomy
b) Industry
c) Trust
d) Initiative


Answer: Initiative

A mother reports to the nurse that her 4 year old does everything that she does. She says she is becoming somewhat frustrated with these actions. What would be the best response by the nurse to this mother?

A mother reports to the nurse that her 4 year old does everything that she does. She says she is becoming somewhat frustrated with these actions. What would be the best response by the nurse to this mother?

a) "I am sure there are ways to get your daughter to stop imitating you."
b) "I can imagine that it would be very irritating."
c) "Preschoolers imitate as a healthy behavior--it is part of their imagination and normal growth and development."
d) "This is not normal behavior. I am going to get the doctor's advice."


Answer: "Preschoolers imitate as a healthy behavior--it is part of their imagination and normal growth and development."

Question: Place the steps for using time-out as a disciplinary measure for a 4-year-old in proper order.

Question: Place the steps for using time-out as a disciplinary measure for a 4-year-old in proper order.

1 If the child gets up, replace the child and restart the time.
2 Parent knows the misbehavior was intentional.
3 Remove the preschooler to a boring spot.
4 Set a timer for no more than 4 minutes.
5 Warn the child there will be a time-out if the behavior does not stop.


Answer:


Parent knows the misbehavior was intentional.
Warn the child there will be a time-out if the behavior does not stop.
Remove the preschooler to a boring spot.
Set a timer for no more than 4 minutes.
If the child gets up, replace the child and restart the time.

In working with the preschool-age child, the nurse recognizes which of the following as a characteristic of the preschooler?

In working with the preschool-age child, the nurse recognizes which of the following as a characteristic of the preschooler?

a) The child takes in new information at a rapid rate and asks "why" and "how."
b) The child grows and develops skills more rapidly than at any other time in their life.
c) The child insists they can "do it," and the next moment they revert to being dependent.
d) The child has an increased attention span and can be interested in an activity for a long length of time.


Answer: The child takes in new information at a rapid rate and asks "why" and "how."

Which project or game would you anticipate that a preschooler would most enjoy while hospitalized?

Which project or game would you anticipate that a preschooler would most enjoy while hospitalized?

a) Playing an electronic, hand-held game
b) Planting flower bulbs that she can watch grow next spring
c) Turning out the lights to play hide and seek
d) Dressing in her mother's coat to play house


Answer: Dressing in her mother's coat to play house

The father of a 4-year-old confides in the school nurse that he is concerned about his child not telling the truth. The father states, "I found a broken tool in my garage and when I asked my son about it, he said that his friend Andrew broke it, but we don't know anyone named Andrew." The best response by the nurse would be

The father of a 4-year-old confides in the school nurse that he is concerned about his child not telling the truth. The father states, "I found a broken tool in my garage and when I asked my son about it, he said that his friend Andrew broke it, but we don't know anyone named Andrew." The best response by the nurse would be

a) "Your son may have a friend named Andrew, but it could be an imaginary friend."
b) "You should watch this type of behavior closely since most children this age tell the truth."
c) "You need to show your child the broken tool since at this age they must see something in order to understand."
d) "You should punish your son because no child should be telling lies at this age."


Answer: "Your son may have a friend named Andrew, but it could be an imaginary friend."

The nurse is discussing the topic of nutrition with a group of caregivers of preschoolers. Which of the following statements made by the caregivers is most accurate regarding nutrition in the preschooler?

The nurse is discussing the topic of nutrition with a group of caregivers of preschoolers. Which of the following statements made by the caregivers is most accurate regarding nutrition in the preschooler?

a) "If I give snacks throughout the day, my child can meet her nutritional requirements."
b) "It is important for me to give my child calcium so his muscles will grow."
c) "It is hard for me to get my child to drink the 4 cups of milk he needs each day."
d) "My child is growing so rapidly, she needs to eat three big meals a day."



Answer: "If I give snacks throughout the day, my child can meet her nutritional requirements."

The nurse is discussing development of fine motor skills in the preschool-age group with a group of nursing students. Which of the following statements is most accurate regarding the fine motor skills of a 3-year-old?

The nurse is discussing development of fine motor skills in the preschool-age group with a group of nursing students. Which of the following statements is most accurate regarding the fine motor skills of a 3-year-old?

a) The child can button their clothes.
b) The child can use scissors.
c) The child can tie their shoelaces.
d) The child can print a few letters.


Answer: The child can button their clothes

In teaching caregivers of preschool children, the nurse would reinforce that which of the following would be most important for this age group?

In teaching caregivers of preschool children, the nurse would reinforce that which of the following would be most important for this age group?

a) The preschool child should cover mouth when coughing or sneezing.
b) The preschool child should wear a seat belt when riding in a vehicle.
c) The preschool child should be screened for amblyopia.
d) The preschool child should brush and floss teeth after snacks and meals.


Answer: The preschool child should wear a seat belt when riding in a vehicle.

The nurse is caring for a 4-year-old child who is hospitalized and in traction. The child talks about an invisible friend to the nurse. Which action by the nurse is indicated?

The nurse is caring for a 4-year-old child who is hospitalized and in traction. The child talks about an invisible friend to the nurse. Which action by the nurse is indicated?

a) The nurse should explain to the child that there are no friends present.
b) The nurse should recognize this behavior as normal for the child's developmental age and do nothing.
c) The nurse should document the reports of hallucinations by the child.
d) The nurse should discourage the child from talking about the imaginary friend.


Answer: The nurse should recognize this behavior as normal for the child's developmental age and do nothing.

A nurse is caring for a 4-year-old girl. The parents indicate that their daughter often reports that objects in the house are her friends. They are concerned because the girl says that the grandfather clock in the hallway smiles and sings to her. Which response by the nurse is best?

A nurse is caring for a 4-year-old girl. The parents indicate that their daughter often reports that objects in the house are her friends. They are concerned because the girl says that the grandfather clock in the hallway smiles and sings to her. Which response by the nurse is best?

a) "Do you think your daughter is hallucinating?
b) "Is there a family history of mental illness?"
c) "Attributing life-like qualities to inanimate objects is quite normal at this age."
d) "Your daughter is demonstrating animism which is common."


Answer: "Attributing life-like qualities to inanimate objects is quite normal at this age."

Fear of mutilation is significant during the preschool age.

Fear of mutilation is significant during the preschool age.

a) False
b) True


Answer: True

If the child is gaining weight at an expected rate, a child who weighs 36 lbs. at 3 years of age would weigh which of the following at age 5?

If the child is gaining weight at an expected rate, a child who weighs 36 lbs. at 3 years of age would weigh which of the following at age 5?

a) 58 lbs.
b) 38 lbs.
c) 50 lbs.
d) 44 lbs.


Answer: 44 lb

The developmental task of preschoolers is to achieve a sense of

The developmental task of preschoolers is to achieve a sense of

a) initiative versus guilt.
b) accomplishment versus inefficiency.
c) autonomy versus shame and doubt.
d) cognition versus attitude.


Answer: initiative versus guilt.

The nurse is doing teaching with a group of caregivers of preschool children on various topics. The topic of sexual development is discussed. Which of the following statements made by the caregivers indicates an understanding of the sexual development of the preschool age child?

The nurse is doing teaching with a group of caregivers of preschool children on various topics. The topic of sexual development is discussed. Which of the following statements made by the caregivers indicates an understanding of the sexual development of the preschool age child?

a) "I feel better knowing that what she is doing is normal."
b) "When I find my son masturbating, I will tell him that is unacceptable."
c) "I will tell my daughter that she will have time to explore her body as she gets older."
d) "I will encourage my son to ask his father any questions that are sexual in nature."


Answer: "I feel better knowing that what she is doing is normal."

A 4-year-old girl has begun stuttering. Which practice by the parents will the nurse discourage?

A 4-year-old girl has begun stuttering. Which practice by the parents will the nurse discourage?

a) Enunciating clearly and slowing down parental speech
b) Giving the child opportunity to speak and finish her ideas
c) Asking the girl to slow down and to think before she talks
d) Looking at the child while she is speaking


Answer: Asking the girl to slow down and to think before she talks

The nurse is conducting a health screening of a 5-year-old boy as required for kindergarten. The boy is fearful about going to a new school. The mother asks for the nurse's advice. Which response by the nurse is best?

The nurse is conducting a health screening of a 5-year-old boy as required for kindergarten. The boy is fearful about going to a new school. The mother asks for the nurse's advice. Which response by the nurse is best?

a) "Kindergarten is a big step for a child. Be patient with him."
b) "Talk to your son's new teacher and schedule a tour with him."
c) "Be aware that he may have difficulty adjusting being away from home 5 days a week."
d) "Remind him that kindergarten will be a lot of fun and he'll make new friends."


Answer: "Talk to your son's new teacher and schedule a tour with him."

Telling tall tales is harmless and should be encouraged in preschoolers because it helps them develop their imaginations.

Telling tall tales is harmless and should be encouraged in preschoolers because it helps them develop their imaginations.

a) False
b) True


Answer: False

The parents of a 5-year-old call the nurse for advice about night terrors. The child has had them nightly for almost 2 weeks. What is the most appropriate intervention?

The parents of a 5-year-old call the nurse for advice about night terrors. The child has had them nightly for almost 2 weeks. What is the most appropriate intervention?

a) Wake the child up nightly 30 to 45 minutes after going to sleep.
b) Tell the parents to be sure to wake the child up during the next episode.
c) Encourage the parents to let the child fall asleep in a safe place such as their bed.
d) Explain that this is a developmental phase that will not last.


Answer: Wake the child up nightly 30 to 45 minutes after going to sleep.

The father of a preschool boy reports concerns about the short stature of his son. The nurse reviews the child's history and notes the child is 4 years old and is presently 41 in (104 cm) tall and has grown 2.5 in (6.35 cm) in the past year. Which response by the nurse is most appropriate?

The father of a preschool boy reports concerns about the short stature of his son. The nurse reviews the child's history and notes the child is 4 years old and is presently 41 in (104 cm) tall and has grown 2.5 in (6.35 cm) in the past year. Which response by the nurse is most appropriate?

a) "Both your son's height and rate of growth are within normal limits for his age."
b) "Is there a reason you are concerned about your child's height?"
c) "Your son is slightly below the normal height for his age but he had demonstrated a normal growth rate this year."
d) "Your son is slightly below the normal height for his age group but may still grow to be a normal height in the coming year."


Answer: "Both your son's height and rate of growth are within normal limits for his age."

At a physical examination, a nurse asks the father of a 4-year-old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to which of the following?

At a physical examination, a nurse asks the father of a 4-year-old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to which of the following?

a) The fact that preschoolers have a harder time sharing than toddlers
b) Playing in an even-number group of children (four)
c) Testing and identification of group role
d) Regression


Answer: Testing and identification of group role

Teaching a group of caregivers about the topic of nutrition, one caregiver tells the group, "I use desserts as a reward for good behavior." A person in the group asks the nurse what she thinks about that idea. Which of the following statements by the nurse would be the most appropriate? Using dessert as a reward for good behavior may cause the child to

Teaching a group of caregivers about the topic of nutrition, one caregiver tells the group, "I use desserts as a reward for good behavior." A person in the group asks the nurse what she thinks about that idea. Which of the following statements by the nurse would be the most appropriate? Using dessert as a reward for good behavior may cause the child to

a) Learn to use food to manipulate others' behavior
b) Only behave on days when dessert is something she likes
c) Cause the child to be overweight
d) Learn to choose sweets over nutritious food


Answer: Learn to use food to manipulate others' behavior

The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. After discussing various types of play, the following examples are given. Which is the best example of cooperative play?

The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. After discussing various types of play, the following examples are given. Which is the best example of cooperative play?

a) Children are playing together in an activity without organization.
b) Children are playing in an organized group with each other.
c) Children are playing independently and are side-by-side.
d) Children are playing apart from others without being part of a group.


Answer: Children are playing in an organized group with each other

Nursing students are reviewing information about the emotional development of the preschooler. They demonstrate understanding of the information when they identify which of the following as the task of the preschooler?

Nursing students are reviewing information about the emotional development of the preschooler. They demonstrate understanding of the information when they identify which of the following as the task of the preschooler? 

a) Industry
b) Initiative
c) Trust
d) Autonomy


Answer: Initiative

The mother of a 4-year-old girl reports her daughter has episodes of wetting her pants. The nurse questions the mother about the frequency. The nurse determines these episodes occur about once every 1 to 2 weeks. Which response by the nurse is indicated?

The mother of a 4-year-old girl reports her daughter has episodes of wetting her pants. The nurse questions the mother about the frequency. The nurse determines these episodes occur about once every 1 to 2 weeks. Which response by the nurse is indicated?

a) "At this age it is helpful to remind children to go to the bathroom."
b) "Consider restricting your daughter's fluid intake."
c) "The frequency of these wetting episodes may be consistent with a low-grade urinary tract infection."
d) "Discipline should be applied after these times."


Answer: "At this age it is helpful to remind children to go to the bathroom."

The nurse is discussing development of motor skills in the preschool-age group with a group of nursing students. Which of the following statements is most accurate regarding the gross motor skills of a 4-year-old?

The nurse is discussing development of motor skills in the preschool-age group with a group of nursing students. Which of the following statements is most accurate regarding the gross motor skills of a 4-year-old?

a) The child can hop on one foot.
b) The child can walk backwards with heel to toe.
c) The child can jump rope.
d) The child can throw and catch a ball.


Answer: The child can hop on one foot

A nurse is describing growth and development during the preschool period. Which of the following would the nurse identify as a predominant and heightened characteristic for this age group?

A nurse is describing growth and development during the preschool period. Which of the following would the nurse identify as a predominant and heightened characteristic for this age group? 

a) Gross motor skills
b) Vocabulary
c) Imagination
d) Fine motor skills


Answer: Imagination

When planning how to respond to a child about telling stories, you would base your statement on the fact that

When planning how to respond to a child about telling stories, you would base your statement on the fact that

a) preschoolers have a limited vocabulary.
b) a 3-year-old knows the word two but not the concept 2.
c) imagination in a 3-year-old is at its peak.
d) a preschooler is in an insecure period.


Answer: imagination in a 3-year-old is at its peak.

The nurse is providing teaching to the mother of a 4-year-old girl about bike safety. Which statement indicates a need for further teaching?

The nurse is providing teaching to the mother of a 4-year-old girl about bike safety. Which statement indicates a need for further teaching?

a) "The balls of her feet should reach both pedals while sitting."
b) "She should always ride on the sidewalk."
c) "She can ride on the street if I am riding with her."
d) "Pedal back brakes are better for her age group."


Answer: "She can ride on the street if I am riding with her."

The nurse is providing teaching about car seat safety for a parents' meeting at the preschool their children attend. Choose the points the nurse should make. Select all that apply.

The nurse is providing teaching about car seat safety for a parents' meeting at the preschool their children attend. Choose the points the nurse should make. Select all that apply.

a) Many car seats are installed improperly, making them unsafe.
b) The back seat remains the safest place for children to ride.
c) Children who weigh less than 40 pounds should use a car seat with harness and top tether.
d) Booster seats should be used with both a shoulder and lap belt.


Answer:

• Many car seats are installed improperly, making them unsafe.
• The back seat remains the safest place for children to ride.
• Children who weigh less than 40 pounds should use a car seat with harness and top tether.
• Booster seats should be used with both a shoulder and lap belt.

Parents of a 3½-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize:

Parents of a 3½-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize:

a) having the child wear a personal flotation device whenever near or on the water.
b) enrolling the child in swimming lessons.
c) using and renewing sunscreen regularly.
d) adults learning infant/child cardiopulmonary resuscitation (CPR).


Answer: having the child wear a personal flotation device whenever near or on the water.

The nurse is providing teaching about good nondairy sources of calcium for preschoolers. Which of these fruits contains the most calcium?

The nurse is providing teaching about good nondairy sources of calcium for preschoolers. Which of these fruits contains the most calcium?

a) Peach
b) Apple
c) Orange
d) Banana


Answer: Orange

A 4 year old is going to finger paint for the first time. Which of the following is the best action for the adult supervisor of this activity?

A 4 year old is going to finger paint for the first time. Which of the following is the best action for the adult supervisor of this activity?

a) Make a model for the child to follow so it will be easy to copy.
b) Support whatever the child paints.
c) Tell the child that it will be fun but that he or she should not make a mess.
d) Draw a picture first for the child to see how to do it.


Answer: Support whatever the child paints.

The mother and father of a 5-year-old boy are discussing bicycle safety with the nurse. What comment indicates further teaching is needed?

The mother and father of a 5-year-old boy are discussing bicycle safety with the nurse. What comment indicates further teaching is needed?

a) "He never rides in the street."
b) "He is able to ride without training wheels."
c) "Our son always wears a helmet."
d) "We just got him a new bike he can grow into."


Answer: "We just got him a new bike he can grow into."

The mother of a 3-year-old child reports her son is afraid of the dark. She asks the nurse for help. Which advice is best for the nurse to offer?

The mother of a 3-year-old child reports her son is afraid of the dark. She asks the nurse for help. Which advice is best for the nurse to offer?

a) Encourage the parent to consider allowing the child to sleep with her
b) Encourage the parent to leave on the television in the child's room
c) Encourage the mother to check for monsters under the bed in the presence of the child
d) Encourage the parent to allow a small night light


Answer: Encourage the parent to allow a small night light

The nurse is conducting a well child assessment of a 4-year-old. Which assessment finding warrants further investigation?

The nurse is conducting a well child assessment of a 4-year-old. Which assessment finding warrants further investigation?

a) Presence of 20 deciduous teeth
b) Presence of 10 deciduous teeth
c) Absence of dental caries
d) Presence of 19 deciduous teeth


Answer: Presence of 10 deciduous teeth

The nurse is conducting a well-child exam of a 4-year-old boy. Which statement would alert the nurse that the child is at risk for iron deficiency?

The nurse is conducting a well-child exam of a 4-year-old boy. Which statement would alert the nurse that the child is at risk for iron deficiency?

a) "He loves milk and drinks it every time he is thirsty."
b) "He does not like spinach, but he does like chicken and beef."
c) "He eats a well-balanced diet."
d) "He enjoys eggs and fortified cereal for breakfast."


Answer: "He loves milk and drinks it every time he is thirsty."

The nurse is conducting a well child examination of a 4-year-old and is assessing the child's height. By how much should the nurse expect the child's height to have increased since last year's examination?

The nurse is conducting a well child examination of a 4-year-old and is assessing the child's height. By how much should the nurse expect the child's height to have increased since last year's examination?

a) 1 to 2 inches (2.54 to 5.07 cm)
b) 2.5 to 3 inches (6.35 to 7.62 cm)
c) 3.5 to 4 inches (8.89 to 10.16 cm)
d) 0.5 to 1 inch (1.27 to 2.54 cm)


Answer: 2.5 to 3 inches (6.35 to 7.62 cm)

The nurse is caring for a 4-year-old girl following an appendectomy. The girl becomes fearful and starts to cry as soon as the nurse walks into the room. When the nurse asks about the crying, the girl says, "Nurses who wear shirts with flowers give shots." The nurse understands that this statement is an example of:

The nurse is caring for a 4-year-old girl following an appendectomy. The girl becomes fearful and starts to cry as soon as the nurse walks into the room. When the nurse asks about the crying, the girl says, "Nurses who wear shirts with flowers give shots." The nurse understands that this statement is an example of:

a) beginning empathy.
b) magical thinking.
c) animism.
d) transduction.


Answer: transduction

The nurse realizes that the 5-year-old's growth chart and BMI indicate the child is at risk for obesity. What other findings reinforce this risk? Select all that apply.

The nurse realizes that the 5-year-old's growth chart and BMI indicate the child is at risk for obesity. What other findings reinforce this risk? Select all that apply.

a) A father who is overweight
b) Expectations to eat everything on plate
c) Fast food eaten once a month
d) Mealtimes organized and regular
e) Television on during meals
f) Food used as reward or punishment


Answer:

• A father who is overweight
• Expectations to eat everything on plate
• Television on during meals
• Food used as reward or punishment

Nursing students are reviewing information about the cognitive development of preschoolers. The students demonstrate understanding of the information when they identify that a 3 year old is in which of the following stages as identified by Piaget?

Nursing students are reviewing information about the cognitive development of preschoolers. The students demonstrate understanding of the information when they identify that a 3 year old is in which of the following stages as identified by Piaget? 

a) Tertiary circular reaction
b) Primary circular reaction
c) Preoperational thought
d) Coordination of secondary schema


Answer: Preoperational thought

The nurse is organizing an indoor play area for preschoolers. What play materials are least important?

The nurse is organizing an indoor play area for preschoolers. What play materials are least important?

a) Dress-up clothes and hats and puppets
b) Balls, blocks, and puzzles
c) Cut, paste, drawing, and painting materials
d) CD player with music and musical instruments
e) Electronic teaching toys

Answer: Electronic teaching toys

Parents of a preschooler tell the nurse that their child often refuses to go to sleep at night. Which suggestion by the nurse would be helpful? Select all that apply.

Parents of a preschooler tell the nurse that their child often refuses to go to sleep at night. Which suggestion by the nurse would be helpful? Select all that apply.

a) "Try reading a favorite story before bedtime."
b) "Set up some familiar bedtime rituals for your child."
c) "Try using a night light in the child's room."
d) "Keep the door closed and the lights off so that your child can fall asleep faster."
e) "Avoid having your child watch frightening shows on TV before bedtime."


Answer:

• "Try reading a favorite story before bedtime."
• "Set up some familiar bedtime rituals for your child."
• "Try using a night light in the child's room."
• "Avoid having your child watch frightening shows on TV before bedtime."

The parents of a 4-year-old girl tell the nurse that their daughter is having frequent nightmares. Which statement indicates that the girl is having night terrors instead of nightmares?

The parents of a 4-year-old girl tell the nurse that their daughter is having frequent nightmares. Which statement indicates that the girl is having night terrors instead of nightmares?

a) "She is scared after she wakes up."
b) "She screams and thrashes when we try to touch her."
c) "She comes and wakes us up after she awakens."
d) "She has a hard time going back to sleep."


Answer: "She screams and thrashes when we try to touch her."

Which of the following actions by a preschooler would suggest that his thinking is inconsistent with normal preschooler growth and development?

Which of the following actions by a preschooler would suggest that his thinking is inconsistent with normal preschooler growth and development?

a) Refusal to go to bed without his friend
b) Refusal to play with "real" children
c) Insistence that his imaginary friend watch television with him
d) Insistence that this imaginary friend have dinner with the family


Answer: Refusal to play with "real" children

The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching?

The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching?

a) "He is allowed out of time-out when he is calm."
b) "I put him in time-out when the problem occurs."
c) "The time-out doesn't just have to be in his room."
d) "I usually have him in time-out for about 10 minutes."


Answer: "I usually have him in time-out for about 10 minutes."

The nurse is conducting a physical examination of a young preschooler and detects the odor of tobacco smoke on the parents' hair and clothing. How should the nurse respond?

The nurse is conducting a physical examination of a young preschooler and detects the odor of tobacco smoke on the parents' hair and clothing. How should the nurse respond?

a) "Are you aware that exposure to tobacco smoke can be associated with behavioral difficulties?"
b) "Tell me about your child's exposure to tobacco smoke."
c) "Tobacco smoke is linked with an increased number of ear infections."
d) "You should stop smoking around your child."


Answer: "Tell me about your child's exposure to tobacco smoke."

A 4-year-old tells you he has an imaginary friend. His parents are concerned because he refuses to do anything without his friend's help. Which of the following nursing diagnoses is most applicable for his family?

A 4-year-old tells you he has an imaginary friend. His parents are concerned because he refuses to do anything without his friend's help. Which of the following nursing diagnoses is most applicable for his family?

a) Social isolation related to unwillingness to relate except through imaginary friend
b) Compromised family coping related to abnormal behavior of child
c) Deficient knowledge of normal preschool development
d) Disturbed thought processes related to deep-set psychological need


Answer: Deficient knowledge of normal preschool development

The father of a 4½-year-old boy has contacted the nurse because he is concerned that his son is frequently touching his genitals. The nurse explains that this is normal during the preschool years. Which statement by the father would indicate a need for further teaching?

The father of a 4½-year-old boy has contacted the nurse because he is concerned that his son is frequently touching his genitals. The nurse explains that this is normal during the preschool years. Which statement by the father would indicate a need for further teaching?

a) "I have heard that both boys and girls often touch themselves at this age."
b) "I will need to find an appropriate punishment for him if this continues."
c) "This is probably a good time to talk about safety and who can touch him."
d) "I should teach him certain rules about this activity."


Answer: "I will need to find an appropriate punishment for him if this continues."

A 4-year-old is hospitalized with a urinary tract infection. Based on what you know of her cognitive development, which approach would be best to prepare her for a radiograph?

A 4-year-old is hospitalized with a urinary tract infection. Based on what you know of her cognitive development, which approach would be best to prepare her for a radiograph?

a) Tell her a radiograph is a picture of the dark inside her body.
b) Help her pretend the x-ray machine is a camera.
c) Explain that she must behave because the technician is busy.
d) Tell her she must follow directions or she will be hurt.


Answer: Help her pretend the x-ray machine is a camera.

A mother tells a nurse that her child has recently established some friendships for the first time. In which age group do you expect this child to be?

A mother tells a nurse that her child has recently established some friendships for the first time. In which age group do you expect this child to be?

a) adolescence
b) preschool
c) school age
d) toddler


Answer: preschool

The nurse is conducting a health screening for a 3-year-old boy as required by his new preschool. Which statement by the parents warrants further discussion and intervention?

The nurse is conducting a health screening for a 3-year-old boy as required by his new preschool. Which statement by the parents warrants further discussion and intervention?

a) "The school is quite structured and advocates corporal punishment."
b) "The school requires processed foods and high sugar foods be avoided."
c) "The school has a looser environment which is a good match for his temperament."
d) "There is a very low student teacher ratio and they do a lot of hands on projects."


Answer: "The school is quite structured and advocates corporal punishment."

A 5-year-old child is not gaining weight appropriately. Organic problems have been ruled out. What is the priority action by the nurse?

A 5-year-old child is not gaining weight appropriately. Organic problems have been ruled out. What is the priority action by the nurse?

1. Allow the child unlimited access to the sippy cup to ensure adequate hydration.
2. Encourage sweets for the extra caloric content.
3. Teach the mother about nutritional needs of the preschooler.
4. Assess the child's usual intake pattern at home.


Answer: Assess the child's usual intake pattern at home.

The mother of a 4-year-old asks for advice on using time-out for discipline with her child. What advice should the nurse give the mother?

The mother of a 4-year-old asks for advice on using time-out for discipline with her child. What advice should the nurse give the mother?

1. If spanking is not working, then time-out is not likely to be helpful either.
2. Place the child in time-out for 4 minutes.
3. Use time-out only if removing privileges is unsuccessful.
4. The child should stay in time-out until crying ceases.


Answer: Place the child in time-out for 4 minutes.

The mother of a 3-year-old is concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response?

The mother of a 3-year-old is concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response?

1. Hesitancy and dysfluency are normal during this period of development.
2. Reading to the child will help model appropriate speech.
3. Expressive language concerns warrant a developmental evaluation.
4. The mother should ask her child's physician for a speech therapy evaluation.


Answer: Hesitancy and dysfluency are normal during this period of development.

The nurse is caring for a hospitalized 4-year-old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment or intervention done to herself. The nurse identifies this preschooler's behavior as

The nurse is caring for a hospitalized 4-year-old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment or intervention done to herself. The nurse identifies this preschooler's behavior as

1. Problematic; the child is old enough to begin to have a basis in reality.
2. Normal, because the child is hospitalized and out of her routine.
3. Normal for this stage of growth and development.
4. Problematic, as it interferes with needed nursing care.


Answer: Normal for this stage of growth and development.

A toddler's parents want to begin toilet training him. As a rule, the best instruction you could give them is:

A toddler's parents want to begin toilet training him. As a rule, the best instruction you could give them is:

a) toilet training is a 12-month process.
b) children can remain dry during the night before they can do so during the day.
c) all children should be toilet trained by age 2 years.
d) bowel training is easier than urine training.


Answer: bowel training is easier than urine training.

A toddler insists on brushing his own teeth and being left alone in the bathtub. What advice would you give his parents regarding this?

A toddler insists on brushing his own teeth and being left alone in the bathtub. What advice would you give his parents regarding this?

a) It is unusual for 2-year-olds to have such strong opinions.
b) Helping with his own tooth brushing allows him to experience autonomy.
c) His mother should continue to give full care in all aspects.
d) Leaving him alone in the bathtub is a good way to encourage autonomy.


Answer: Helping with his own tooth brushing allows him to experience autonomy.

The nurse is discussing proper discipline with the mother of a 15-month-old boy. Which statement is most important?

The nurse is discussing proper discipline with the mother of a 15-month-old boy. Which statement is most important?

a) Never spank the child for any reason.
b) Use praise when the child is doing something right.
c) Toddlers are unable to learn rules easily.
d) Rules and limits should be simple and few.

Answer: Never spank the child for any reason.

Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay?

Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay?

a) Asks "why" often
b) Uses two-word sentences or phrases
c) Half of speech understood by outsider
d) Talks about a past event


Answer: Uses two-word sentences or phrases

Parents are proud of their toddler's fast-developing fine motor skills. Which skill they describe should the nurse point out as a safety risk?

Parents are proud of their toddler's fast-developing fine motor skills. Which skill they describe should the nurse point out as a safety risk?

a) Turn book pages
b) Hold crayon to write
c) Ability to turn knobs
d) Put shapes into matching openings


Answer: Ability to turn knobs

The nurse is providing anticipatory guidance to the parents of an 18-month-old girl. Which recommendation should be the most helpful to the parents?

The nurse is providing anticipatory guidance to the parents of an 18-month-old girl. Which recommendation should be the most helpful to the parents?

a) Giving the child time out for 1 ½ minute
b) Ignoring bad behavior and praising good behavior
c) Describing proper behavior when she misbehaves
d) Slapping her hand using one or two fingers

Answer: Describing proper behavior when she misbehaves

Which gross motor developmental milestone is least likely for a 2 year old?

Which gross motor developmental milestone is least likely for a 2 year old?

a) Rides a tricycle
b) Jumps in place
c) Climbs
d) Stands on one foot with help


Answer: Rides a tricycle

Parents who just moved into their "dream home" are concerned because their toddler boy, who had achieved daytime bowel and bladder control, has begun wetting and defecating in his underwear. The nurse explains this is called:

Parents who just moved into their "dream home" are concerned because their toddler boy, who had achieved daytime bowel and bladder control, has begun wetting and defecating in his underwear. The nurse explains this is called:

a) regression.
b) egocentrism.
c) autonomy.
d) ritualism.


Answer: regression

It is naptime and the caregiver of a 2-year-old says to her child, "I will help you put all of your stuffed animals in a row next to your bed just like we do every day." This statement is an example of:

It is naptime and the caregiver of a 2-year-old says to her child, "I will help you put all of your stuffed animals in a row next to your bed just like we do every day." This statement is an example of:

a) discipline.
b) ritualism.
c) dawdling.
d) negativism.


Answer: ritualism

The nurse is teaching the mother of a 2-year-old boy about age-appropriate toys. Which would be of most interest plus stimulating to the growth and development of this child?

The nurse is teaching the mother of a 2-year-old boy about age-appropriate toys. Which would be of most interest plus stimulating to the growth and development of this child?

a) Providing a brightly colored plastic bucket and shovel
b) Offering the child a variety of large stuffed toys
c) Giving the child bowls, pot, pans, and large spoons
d) Giving the child a toy vacuum cleaner


Answer: Giving the child bowls, pot, pans, and large spoons

Parents of 3-year-old son ask the nurse for suggestions on how to deal with their son's nightmares. Which suggestion would be least effective?

Parents of 3-year-old son ask the nurse for suggestions on how to deal with their son's nightmares. Which suggestion would be least effective?

a) Talk to him that night about the details of the dreams.
b) Search the room to show him that there aren't any monsters.
c) Try reassuring him that it was a dream and not real.
d) Try having him sleep with a nightlight on in his room.


Answer: Talk to him that night about the details of the dreams.

A mother reports her 2-year-old daughter has gradually eaten more and more poorly since her 1-year-old well-child visit. The nurse assesses the child's growth and development as normal. What concept explains the mother's concern?

A mother reports her 2-year-old daughter has gradually eaten more and more poorly since her 1-year-old well-child visit. The nurse assesses the child's growth and development as normal. What concept explains the mother's concern?

a) Improper snacking
b) Poor role modeling
c) Physiologic anorexia
d) Iron-deficiency anemia


Answer: Physiologic anorexia

The mother of a 2-year-old boy has asked for some ideas for snack foods that would be less likely to cause dental caries. Which of the following items would the nurse most likely suggest?

The mother of a 2-year-old boy has asked for some ideas for snack foods that would be less likely to cause dental caries. Which of the following items would the nurse most likely suggest?

a) A handful of unsalted peanuts
b) A handful of organic raisins
c) Fruit strips cut into pieces
d) Whole grain chips broken into pieces


Answer: Whole grain chips broken into pieces

A mother is concerned because her 2-year-old daughter is not speaking much. What should the nurse suggest to the mother? Select all that apply.

Using fluoride toothpaste prior to age 2 years promotes development of fluorosis.

A mother is concerned because her 2-year-old daughter is not speaking much. What should the nurse suggest to the mother? Select all that apply.

a) Read books aloud to her.
b) Name aloud the objects that she is playing with.
c) Use baby talk when speaking to her.
d) Have her watch educational television.
e) Use pronouns when speaking to her.
f) Always answer her questions.



Answer:


• Read books aloud to her.
• Name aloud the objects that she is playing with.
• Always answer her questions.

Which suggestion by the nurse meant to promote good dental health in the 15-month-old is inappropriate?

Which suggestion by the nurse meant to promote good dental health in the 15-month-old is inappropriate?

a) Wean the child from the bottle.
b) Avoid grazing (continual snacking) throughout the day.
c) Arrange for your child's first dental visit as soon as possible.
d) Brush your child's teeth with a pea-sized amount of fluoride-containing toothpaste.


Answer: Brush your child's teeth with a pea-sized amount of fluoride-containing toothpaste.

The nurse is teaching parents how to avoid a power struggle with their 2-year-old girl. Which comment indicates that more teaching is needed?

The nurse is teaching parents how to avoid a power struggle with their 2-year-old girl. Which comment indicates that more teaching is needed?

a) "Childproofing our home will make it less necessary to say 'No!'"
b) "We will make sure she shares her toys with cousins her age."
c) "Both of us, as parents, will agree on and consistently enforce the limits we set."
d) "We will give her a choice whenever possible."


Answer: "We will make sure she shares her toys with cousins her age."

A father brings his 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which of the following findings should concern the nurse?

A father brings his 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which of the following findings should concern the nurse?

a) Prominent abdomen
b) Forward curve of the spine at the sacral area
c) Total weight gain of 15 lb in the past year
d) Increase in height of 5 inches in the past year


Answer: Total weight gain of 15 lb in the past year

The nurse is assessing the development of a 15-month-old girl during a regular visit. Which of the following skills would the nurse expect to see?

The nurse is assessing the development of a 15-month-old girl during a regular visit. Which of the following skills would the nurse expect to see?

a) Stands alone
b) Feeds herself with a spoon
c) Runs to her mother
d) Points to her nose and mouth


Answer: Stands alone

A 15-month-old boy has been brought to the clinic because he is pale and listless. Which of the following findings and observations would lead the nurse to suspect iron deficiency anemia as the cause of the clinical manifestations?

A 15-month-old boy has been brought to the clinic because he is pale and listless. Which of the following findings and observations would lead the nurse to suspect iron deficiency anemia as the cause of the clinical manifestations?

a) The nurse hears a grade 2 heart murmur.
b) The child eats a vegetarian diet.
c) The child drinks four cups of milk per day.
d) The child drinks very little fruit juice.


Answer: The child drinks four cups of milk per day

The parents of a 2-year-old girl are concerned with her behavior. For which behavior would the nurse share their concern?

The parents of a 2-year-old girl are concerned with her behavior. For which behavior would the nurse share their concern?

a) Likes to change toys frequently
b) Plays by herself even when other children are present
c) Frequently babbles to herself when playing
d) Refuses to share toys with her sister


Answer: Frequently babbles to herself when playing

The nurse is presenting an inservice training to a group of pediatric nurses on the topic of play. After discussing various types of play, the following examples are given. Which is the best example of parallel play?

The nurse is presenting an inservice training to a group of pediatric nurses on the topic of play. After discussing various types of play, the following examples are given. Which is the best example of parallel play?

a) Children are playing in an organized group with each other
b) Children are playing apart from others without being part of a group
c) Children are playing together in an activity without organization
d) Children are playing independently and are side by side


Answer: Children are playing independently and are side by side

A mother of a 2-year-old asks the nurse, "What would be a good between-meal snack?" Which of the following would be appropriate for the nurse to suggest? Select all that apply.

A mother of a 2-year-old asks the nurse, "What would be a good between-meal snack?" Which of the following would be appropriate for the nurse to suggest? Select all that apply.

a) Cookies
b) Orange slices
c) Yogurt
d) Cheese
e) Pieces of apples


Answer:

• Orange slices
• Yogurt
• Cheese
• Pieces of apples

The nurse is teaching a first-time mother with a 14-month-old boy about child safety. Which is the most effective overall safety information to provide guidance for the mother?

The nurse is teaching a first-time mother with a 14-month-old boy about child safety. Which is the most effective overall safety information to provide guidance for the mother?

a) "Put chemicals in a locked cabinet."
b) "Place a gate at the top of each stairway."
c) "Never let him out of your sight when outdoors."
d) "Don't smoke in the house or car."


Answer: "Never let him out of your sight when outdoors."

Parents who just moved into their "dream home" are concerned because their toddler boy, who had achieved daytime bowel and bladder control, has begun wetting and defecating in his underwear. The nurse explains this is called:

Parents who just moved into their "dream home" are concerned because their toddler boy, who had achieved daytime bowel and bladder control, has begun wetting and defecating in his underwear. The nurse explains this is called:

a) Egocentrism
b) Ritualism
c) Autonomy
d) Regression


Answer: Regression

Which of the following is appropriate with reference to enhancing a child's self-esteem?

Which of the following is appropriate with reference to enhancing a child's self-esteem?

a) Utilize belittling techniques as opposed to time-outs.
b) Avoid applauding for unsuccessful attempts.
c) Include the child in activities that interest the adult.
d) Utilize negative criticism as well as positive reinforcement.


Answer: Include the child in activities that interest the adult.

A toddler's father is concerned because his son refuses to share. What is your best response concerning this?

A toddler's father is concerned because his son refuses to share. What is your best response concerning this?

a) His son is probably reacting to some family crisis.
b) This is normal toddler behavior; sharing is learned later.
c) Behavior modification techniques can change the child's behavior.
d) Play time with other children should be cut back until he learns to share.


Answer: This is normal toddler behavior; sharing is learned later.

By which age should the child know his/her own gender?

By which age should the child know his/her own gender?

a) 1
b) 3
c) 4
d) 2


Answer: 3

The nurse is observing a 36-month-old boy during a well visit. Which motor skill has he most recently acquired?

The nurse is observing a 36-month-old boy during a well visit. Which motor skill has he most recently acquired?

a) Kick a ball
b) Undress himself
c) Push a toy lawnmower
d) Pull a toy while walking


Answer: Undress himself

During a well-child visit, the nurse observes the child saying "no" to her mother quite frequently. The mother asks the nurse, "How do I deal with her saying no all the time?" Which of the following would be appropriate for the nurse to suggest? Select all that apply.

During a well-child visit, the nurse observes the child saying "no" to her mother quite frequently. The mother asks the nurse, "How do I deal with her saying no all the time?" Which of the following would be appropriate for the nurse to suggest? Select all that apply. 

a) "Offer her two options from which to choose."
b) "Offer her something she would like, such as ice cream, to distract her."
c) "Use timeout every other time she tells you no."
d) "Make a statement instead of asking a question."
e) "Limit the number of questions you ask of her."


Answer:

• "Offer her two options from which to choose."
• "Make a statement instead of asking a question."
• "Limit the number of questions you ask of her."

When observing a group of toddlers playing in a child care setting it is noted that the toddlers are all playing with buckets and shovels but are not playing with each other. This type of play is referred to as which of the following?

When observing a group of toddlers playing in a child care setting it is noted that the toddlers are all playing with buckets and shovels but are not playing with each other. This type of play is referred to as which of the following?

a) Onlooker play
b) Associative play
c) Solitary play
d) Parallel play

Answer: Parallel play

The parent reports the 13-month-old infant was using auditory expressive language. The vocalizations have been diminished over the last month and the child no longer says words. Select the best rationale for the infant's language behavior.

The parent reports the 13-month-old infant was using auditory expressive language. The vocalizations have been diminished over the last month and the child no longer says words. Select the best rationale for the infant's language behavior.

a) This behavior is common in children when autism is developing.
b) Biological factors such as otitis media could be causing hearing loss.
c) The environment has changed since the grandparents moved in with the family.
d) The parent has decreased the usual sensory stimulation for the child.


Answer: Biological factors such as otitis media could be causing hearing loss

The nurse finds the diet of a 30-month-old girl to be low in calcium. What suggestion can significantly increase this toddler's calcium intake?

The nurse finds the diet of a 30-month-old girl to be low in calcium. What suggestion can significantly increase this toddler's calcium intake?

a) Offer chocolate milk to increase milk intake.
b) Include dark greens and spinach in her meals.
c) Use unsweetened applesauce as a dessert.
d) Give her slices of cheddar cheese as a snack.


Answer: Give her slices of cheddar cheese as a snack