The parents of a child with an autosomal dominant genetic C) not giving the interpreter too much information so the

mation so the interview

disorder ask the nurse, “What are the chances of our next evolves.
child having this disorder?"
1. Each child has a 25% chance of being born with the disorder. Which statement explains why it can be difficult to assess a
2. Each child has a 50% chance of being born with the disorder. child's dietary intake?
3. Your sons will be affected.
A) No systematic assessment tool has been developed for this
When assessing a client from a culture different than the purpose.
nurse's own, which of the following should the nurse do first? B) Biochemical analysis for assessing nutrition is expensive.
1. Be sensitive to the family's belief C) Families usually do not understand much about nutrition.
2. Understand her own beliefs D) Recall of children's food consumption is frequently unreliable.
3. Enact Western values on the family
The most accurate method of determining the length of a child
The nurse is beginning the examination of a 2 y/o child; what less than 12 months of age is:
should the nurse do first? A) standing height.
1. chest auscultation B) estimation of length to the nearest centimeter or ½ inch.
2. abdominal palpation C) recumbent length measured in the prone position.
3. otoscopic exam D) recumbent length measured in the supine position.
4. oral exam
The nurse needs to take the blood pressure of a small child. Of
When assessing family structure, which of the following would the cuffs available, one is too large, and one is too small. The
be inappropriate? BEST nursing action is to:
1. Composition of family and community environment
2. occupation and education of family members A) use the small cuff.
3. cultural and religious background B) use the large cuff.
4. intrafamily communication patterns C) use either cuff, using palpation method.
D) locate the proper size cuff before taking the blood pressure.
When assessing a child with Downs what should the nurse expect
to find? The nurse is assessing skin turgor in a child. The nurse grasps
1. cat cry, microcephaly, wide spaced eyes the skin on the abdomen between the thumb and index finger,
2. Low set ears, small jaw, cardiac defects pulls it taut, and quickly releases it. The tissue remains
3. maladaptive behaviors, long face, prominent jaw suspended, or tented, for a few seconds, then slowly falls back
4. oblique palpebral fissures, small nose, high arched palate on the abdomen. Which evaluation can the nurse correctly
assume?
Which of the following should the nurse suspect when noting
that a 3-year-old is engaging in explicit sexual behavior during A) The tissue shows normal elasticity.
doll play? B) The child is properly hydrated.
A. The child is exhibiting normal pre-school curiosity C) The assessment is done incorrectly.
B. The child is acting out personal experiences D) The child has poor skin turgor.
C. The child does not know how to play with dolls
What explains the importance of detecting strabismus in young
Which of the following statements by the parents of a child children?
with school phobia would indicate the need for further teaching?
A. “We’ll keep him at home until phobia subsides.” A) Color vision deficit may result.
B. “We’ll work with his teachers and counselors at school.” B) Amblyopia, a type of blindness, may result.
C. “We’ll try to encourage him to talk about his problem.” C) Epicanthal folds may develop in affected eye.

The nurse is interviewing the mother of Adam, 9 years old. As During an otoscopic examination on an infant, in which direction
the nurse begins to assess Adam's school performance, the is the pinna pulled?
MOST appropriate question to ask is:
A) Down and back
A) "Did Adam go to preschool?" B) Down and forward
B) "Does Adam have problems at school?"
C) "How is Adam doing in school?" Which method should the nurse use to view the tonsils and
Guidelines for a nurse using an interpreter in developing a care oropharynx of a cooperative 6-year-old child?
plan for an 8-year-old admitted to rule out epilepsy include:
A) Ask child to open mouth wide and say "aah."
A) explaining to the interpreter what information is necessary to B) Ask child to open mouth wide and then place the tongue blade in
obtain from the patient and family. the center back area of the tongue.
B) encouraging the interpreter to ask several questions at a time to C) Examine the mouth when the child is crying to avoid use of
make the best use of time. tongue blade.
When assessing a preschooler's chest, the nurse would expect: Which of the following is a parasite that causes acute diarrhea?
a. Shigella organisms
A) respiratory movements to be chiefly thoracic. b. Salmonella organisms
anteroposterior diameter to be equal to the transverse diameter. c. Giardia lamblia
B) intercostal retractions on respiratory movement. d. Escherichia coli
C) movement of the chest wall to be symmetric
D) bilaterally and coordinated with breathing. A school-age child with diarrhea has been rehydrated. The
nurse is discussing the child's diet with the family. Which of
Superficial palpation of the abdomen is often perceived by the the following may be tolerated the best?
child as tickling. Which measure by the nurse is MOST likely to a .Clear fluids
minimize this sensation and promote relaxation? b. Carbonated drinks
c. Applesauce and milk
A) Palpating another area simultaneously d. Easily digested foods
B) Asking the child not to laugh or move if it tickles
C) Beginning with deeper palpation and gradually progressing to A school-age child with acute diarrhea and mild dehydration is
superficial palpation being given oral rehydration solutions (ORS). The child's mother
D) Having the child "help" with palpation by placing his or her hand calls the clinic nurse because he is also occasionally vomiting.
over the palpating hand The nurse should recommend which of the following?
a. Bring the child to the hospital for intravenous fluids.
The nurse needs to give an injection in the deltoid to a 4-year- b. Alternate giving ORS and carbonated drinks.
old child. The BEST approach to use is to: c. Continue to give ORS frequently in small amounts.

A) smile while giving the injection to help child relax. A 7-year-old child with acute diarrhea has been rehydrated
B) tell the child that you will be so quick that the injection will not with oral rehydration solution (ORS). The nurse should
even hurt. recommend that the child's diet be advanced to include which of
C) explain that the child will experience a little stick in the arm. the following?
D) explain with concrete terms, such as putting medicine under the a. Regular diet
skin. b. Clear liquids
c. High carbohydrate diet
A nurse is conducting a health history on an adolescent. The psychosocial developmental tasks of toddlerhood include
Components of the health history include: (Select all that which of the following?
apply.)
a. Development of a conscience
A) sexual history. b. Recognition of sex differences
B) review of systems. c. Ability to get along with age-mates
C) physical assessment. d. Ability to delay gratification
D) growth measurements.
E) family medical history. Although a 14-month-old girl received a shock from an
electrical outlet recently, her parent finds her about to place a
paper clip in another outlet. Which of the following is the best
The charge nurse is observing a student nurse obtain a interpretation of this behavior?
temperature on a pediatric patient. The nurse should intervene
when observing the student: (Select all that apply.) a. Her cognitive development is delayed.
b. This is typical behavior because toddlers are not very developed.
A) obtain a rectal thermometer probe for a child with diarrhea. c. This is typical behavior because of inability to transfer
B) attempt to take an oral temperature on a child who is receiving knowledge to new situations.
oxygen.
C) take an oral temperature on a 12-year-old child who ate ice A toddler, age 16 months, falls down a few stairs. He gets up
cream 2 hours ago. and "scolds" the stairs as if they caused him to fall. This is an
D) documenting an axillary temperature for a 3-year-old child. example of which of the following?

The health care provider has prescribed a medical treatment a. Animism

for a child with an injury. Which is the priority nursing action in b. Ritualism
this case? c. Irreversibility
1. Assess other potential risk factors of the child.
2. Explain about injury prevention to the family and the child. Which of the following is a characteristic of a toddler's
3. Explain the treatment at the family's level of understanding. language development at age 18 months?

Which of the following conditions is often associated with a. Vocabulary of 25 words

severe diarrhea? b. Use of holophrases
a. Metabolic acidosis c. Increasing level of comprehension
b. Metabolic alkalosis
Which of the following characteristics best describes the gross b. Tell the toddler frequently, "You are a big kid now."
motor skills of a 24-month-old child? c. Explain to the toddler that baby talk is for babies.

a. Skips Parents tell the nurse that their toddler eats little at mealtime,
b. Broad jumps only sits at the table with the family briefly, and wants snacks
c. Rides tricycle "all the time." Which of the following should the nurse
d. Walks up and down stairs recommend?

Which of the following developmental characteristics does not a. Give her nutritious snacks.
occur until a child reaches age 2 1/2 years? b. Offer rewards for eating at mealtimes.
c. Avoid snacks so she is hungry at mealtimes.
a. Birth weight has doubled.
b. Anterior fontanel is open. A father tells the nurse that his daughter wants the same plate
c. Primary dentition is complete. and cup used at every meal, even if they go to a restaurant.
The nurse should explain that this is which of the following?
When assessing a 2-year-old child brought by his mother to the
clinic for a routine checkup, which of the following would the a. A sign the child is spoiled
nurse expect the child to be able to do? b. An attempt to exert unhealthy control
A. Ride a tricycle. c. Regression, which is common at this age
B. Tie his shoelaces. d. Ritualism, an expected behavior at this age
C. Kick a ball forward.
A toddler's parents have been using a rear-facing convertible
A 2½-year-old child brought to the clinic by her parents is car seat since she was born. The seat can be safely switched to
uncooperative when the nurse tries to look in her ears. Which the forward-facing position when she weighs how many pounds?
of the following would the nurse try first?
a.10
A. Ask another nurse to assist. b.20
B. Allow a parent to assist. c.30
C. Wait until the child calms down.
The most common type of burn in the toddler age-group is:
Which of the following statements is correct about toilet
training? a. electric burn from electrical outlets.
b. flame burn from playing with matches.
a. Bladder training is usually accomplished before bowel training. c. hot object burn from cigarettes or irons.
b. Wanting to please the parent helps motivate the child to use the d. scald burn from high-temperature tap water.
toilet.
c. Watching older siblings use the toilet confuses the child. The nurse is assessing a 20-month-old toddler during a well-
child visit and notices tooth decay. The nurse should understand
A toddler's parent asks the nurse for suggestions on dealing that early childhood caries are caused by which of the
with temper tantrums. Which of the following is the most following?
appropriate recommendation?
a. Allowing the child to eat citrus foods at bedtime
a. Punish the child. b. A hereditary factor that cannot be prevented
b. Explain to child that this is wrong. c. Poor fluoride supply in the drinking water
c. Leave the child alone until the tantrum is over. d. Giving the child a bottle of juice or milk at naptime
d. Remain close by the child but without eye contact.
The nurse is providing guidance strategies to a group of parents
A parent asks the nurse about negativism in toddlers. The most with toddlers at a community outreach program. Which of the
appropriate recommendation is which of the following? following statements by a parent would indicate a correct
understanding of the teaching?
a. Punish the child.
b. Provide more attention. a. "I should expect my 24-month-old child to express some signs of
c. Ask child not to always say "no." readiness for toilet training."
d. Reduce the opportunities for a "no" answer. b. "I should be firm and structured when disciplining my 18-month-
old child."
The parents of a 2-year-old tell the nurse they are concerned c. "I should expect my 12-month-old child to start to develop a fear
because the toddler has started to use "baby talk" since the of darkness and to need a security blanket."
arrival of their new baby. The nurse should recommend which of
the following?

a. Ignore the baby talk.

SELECT ALL THAT APPLY a. Asks meanings of words
The nurse is preparing a staff education program about growth b. Follows directional commands
and development of an 18-month-old toddler. Which of the c. Can describe an object according to its composition
following characteristics should the nurse include in the staff d. Talks incessantly regardless of whether anyone is listening
education program?
During a well-child visit the father of a 4-year-old boy tells
a. Eats well with a spoon and cup the nurse that he is not sure if his son is ready for
b. Runs clumsily and can walk up stairs kindergarten. The boy's birthday is close to the cut-off date,
c. Points to common objects and he has not attended preschool. Which of the following is
d. Builds a tower of three or four blocks the nurse's best recommendation?

In terms of fine motor development, what could the 3-year-old a. Start kindergarten.
child be expected to do? b. Observe a kindergarten class.
c. Perform developmental screening.
a. Tie shoelaces.
b. Copy (draw) a circle. Parents tell the nurse they found their 3-year-old daughter and
c. Use scissors or a pencil very well. a male cousin of the same age inspecting each other closely as
they used the bathroom. Which of the following is the most
According to Piaget, magical thinking is the belief that: appropriate recommendation for the nurse to make?

a. thoughts are all-powerful. a. Punish children, so this behavior stops.

b. God is an imaginary friend. b. Neither condone nor condemn the curiosity.
c. events have cause and effect. c. Get counseling for this unusual and dangerous behavior.

Which one of the following dysfunctional speech patterns is a

In terms of cognitive development, the 5-year-old child would normal characteristic of the language development of a
be expected to do which of the following? preschool child?

a. Think abstractly. a.Lisp

b. Use magical thinking. b.Echolalia
c. Understand conservation of matter. c.Stammering
d.Repetition without meaning
The nurse is caring for a hospitalized 4-year-old boy. His
parents tell the nurse they will be back to visit at 6 PM. When The parent of a 4-year-old boy tells the nurse that the child
he asks the nurse when his parents are coming, the nurse's best believes "monsters and bogeymen" are in his bedroom at night.
response would be which of the following? The nurse's best suggestion for coping with this problem is
which of the following?
a. "They will be here soon."
b. "They will come after dinner." a.Let the child sleep with his parents.
c. "Let me show you on the clock when 6 PM is." b.Keep a night light on in the child's bedroom.
c.Help the child understand that these fears are illogical.
A 4-year-old boy is hospitalized with a serious bacterial
infection. He tells the nurse that he is sick because he was Which of the following is descriptive of the nutritional
"bad." Which of the following is the nurse's best interpretation requirements of preschool children?
of this comment?
a.Quality of the food consumed is more important than the
a. Sign of stress quantity.
b. Common at this age b.Average daily intake of preschoolers should be about 3000
c. Suggestive of maladaptation calories.
c.Nutritional requirements for preschoolers are very different
A 4-year-old child tells the nurse that she doesn't want from requirements for toddlers.
another blood sample drawn because "I need all of my insides
and I don't want anyone taking them out." Which of the A child age 4 1/2 years sometimes wakes her parents up at
following is the nurse's best interpretation of this? night screaming, thrashing, sweating, and apparently frightened.
Yet she is not aware of her parents' presence when they check
a. Child is being overly dramatic. on her. She lies down and sleeps without any parental
b. Child has a disturbed body image. intervention. This is most likely which of the following?
c. Preschoolers have poorly defined body boundaries.
a.Nightmare
Which of the following characteristics best describes the b.Sleep terror
language skills of a 3-year-old child? c.Sleep apnea
During the preschool period the emphasis of injury prevention b. Muscles become functionally mature.
should be placed on which of the following? c. Boys and girls double strength and physical capabilities.

a.Limitation of physical activities The parents of 9-year-old twin children tell the nurse, "They
b.Punishment for unsafe behaviors have filled up their bedroom with collections of rocks, shells,
c.Constant vigilance and protection stamps, and bird nests." The nurse should recognize that this is
d.Teaching about safety and potential hazards which of the following?

The nurse is talking to the parent of a 5-year-old child who a. Indicative of giftedness
refuses to go to sleep at night. Which of the following b. Indicative of typical twin behavior
interventions should the nurse suggest in helping the parent to c. Characteristic of cognitive development at this age
cope with this sleep disturbance?
Which of the following statements characterizes moral
a.Establish a consistent punishment if the child does not go to bed development in the older school-age child?
when told.
b.Allow child to fall asleep in a different room, then gently move a. Rule violations are viewed in an isolated context.
the child to his or her bed. b. Judgments and rules become more absolute and authoritarian.
c.Establish limited rituals that signal readiness for bedtime. c. The child has knowledge of the rules, but cannot understand the
d.Allow the child to watch television until almost asleep. reasons behind them.
d. The child is able to judge an act by the intentions that prompted
At a seminar for parents with preschool-age children the nurse it rather than just by the consequences.
has discussed anticipatory tasks during the preschool years.
Which of the following statements by a parent would indicate a An 8-year-old girl tells the nurse that she has cancer because
correct understanding of the teaching? God is punishing her for "being bad." The nurse should interpret
this as being which of the following?
a."I should be worried if my 4-year-old child has an increase in
sexual curiosity, since this is a sign of sexual abuse." a. A common belief at this age
b."I should expect my 5-year-old to change from a tranquil child to b. Indicative of excessive family pressure
an aggressive child when school starts." c. Faith that forms the basis for most religions
c."I should be concerned if my 4-year-old child starts telling
exaggerated stories and has an imaginary playmate, since these What is the role of the peer group in the life of school-age
could be signs of stress." children?
d."I should expect my 3-year-old child to have a more stable
appetite and an increase in food selections." a. Decreases their need to learn appropriate sex roles
b. Gives them an opportunity to learn dominance and hostility
Which if the following developmental achievements are c. Allows them to remain dependent on their parents for a longer
demonstrated by a 4-year-old child? Select all that apply. time
d. Provides them with security as they gain independence from their
a.Cares for self totally parents
b.Throws a ball overhead
c.Has a vocabulary of 1500 words Which of the following is descriptive of the social development
d.Can skip and hop on alternate feet of school-age children?
e.Tends to be selfish and impatient
f.Commonly has an imaginary playmate a. Identification with peers is minimum.
b. Children frequently have "best friends."
Which of the following suggestions should the nurse offer the c. Boys and girls play equally with each other.
parents of a 4-year-old boy who resists going to bed at night?
Which of the following statements best describes the
a."Allow him to fall asleep in your room, then move him to his own relationship school-age children have with their families?
bed."
b. "Tell him that you will lock him in his room if he gets out of bed a. Ready to reject parental controls
one more time." b. Desire to spend equal time with family and peers
c. "Encourage active play at bedtime to tire him out so he will fall c. Need and want restrictions placed on their behavior by the family
asleep faster." d. Peer group replaces the family as the primary influence in setting
d. "Read him a story and allow him to play quietly in his bed until he standards of behavior and rules
falls asleep."
A parent asks about whether a 7-year-old is able to care for a
Which of the following statements accurately describes physical dog. Based on the child's age, the nurse suggests:
development during the school-age years?
a. caring for an animal requires more maturity than the average 7-
a. Child's weight almost triples. year-old possesses.
b. this will help the parent identify the child's weaknesses.
c. a dog can help the child develop confidence and emotional health.
d. cats are better pets for school-age children.

Which of the following is descriptive of the play of school-age

children?

a. They like to invent games, making up the rules as they go.

b. Individuality in play is better tolerated than at earlier ages.
c. Knowing the rules of a game gives an important sense of
belonging.
d. Team play helps children learn the universal importance of
competition and winning.

Which of the following is characteristic of dishonest behavior in

children ages 8 to 10 years?

a. Cheating during games is now more common.

b. Stealing can occur because their sense of property rights is
limited.
c. Lying is used to meet expectations set by others that they have
been unable to attain.
d. Dishonesty results from the inability to distinguish between fact
and fantasy.

A 9-year-old girl often comes to the school nurse complaining

of stomach pains. Her teacher says she is completing her
schoolwork satisfactorily, but lately has been somewhat
aggressive and stubborn in the classroom. The school nurse
should recognize this as which of the following?

a. Signs of stress
b. Developmental delay
c. Lack of adjustment to school environment
d. Physical problem that needs medical intervention

Which one of the following statements best describes fear in

the school-age child?

a. Increasing concerns about bodily safety overwhelm them.

b. They should be encouraged to hide their fears to prevent ridicule
by peers.
c. Most of the new fears that trouble them are related to school
and family.
d. Children with numerous fears need continuous protective
behavior by parents to eliminate these fears.

Which of the following is an important consideration in

preventing injuries during middle childhood?

a. Achieving social acceptance is a primary objective.

b. Incidence of injuries in girls is significantly higher than it is in
boys.
c. Injuries from burns are the highest at this age because of
fascination with fire.

When teaching injury prevention during the school-age years,

the nurse should include which of the following?

a. Teach child about need to fear strangers.

b. Teach basic rules of water safety.
c. Avoid letting child cook in microwave ovens.