WONG’S NURSING CARE OF INFANTS
AND CHILDREN, 12TH EDITION
TEST BANK
1
Reference
Ch. 1 — Children, Their Families, and the Nurse — Perspectives
of Pediatric Nursing
Stem
A 6-month-old infant is brought to the clinic for a routine well-
child visit. The mother reports the infant has decreased feeding
and fewer wet diapers in the past 12 hours. On exam the infant
is listless, fontanelles are slightly sunken, mucous membranes
appear dry, and capillary refill is 3 seconds. The mother appears
anxious and asks what the nurse recommends. Based on
pediatric assessment and family-centered care principles, what
is the nurse’s best immediate action?
Options
A. Reassure the mother that mild decrease in feeding is
common and schedule a follow-up in 48 hours.
B. Instruct the mother to offer additional formula or breastfeeds
and observe the infant in the clinic for hydration status.
,C. Teach the mother signs of dehydration and provide oral
rehydration instructions for home management only.
D. Refer the infant for immediate clinician evaluation and
consider intravenous fluids if assessment confirms moderate
dehydration.
Correct Answer
D
Rationale — Correct (3–4 sentences)
The infant demonstrates clinical cues of dehydration (sunken
fontanelle, dry mucous membranes, prolonged capillary refill,
lethargy). These signs in a 6-month-old require prompt clinical
evaluation and potential IV access because infants can
deteriorate quickly. Family-centered care means acknowledging
parental concern and expediting clinician assessment rather
than delaying. Wong emphasizes early recognition and rapid
escalation for hydration issues in infants.
Rationale — Incorrect Options
A. Reassurance alone is inappropriate — objective signs indicate
more than a mild feeding change and require evaluation.
B. While offering feeds is reasonable, observation without
clinician evaluation underestimates risk; the infant may need
more than oral fluids.
C. Teaching is important, but advising home management only
misses the need for immediate medical assessment given
clinical signs.
,Teaching Point
Infants with sunken fontanelle + lethargy need urgent
evaluation—don't delay escalation.
Citation
Hockenberry, M. J., & Rodgers, C. C. (2024). Wong’s Nursing
Care of Infants and Children (12th ed.). Chapter 1.
2
Reference
Ch. 1 — Children, Their Families, and the Nurse — Health
Promotion
Stem
A 15-month-old toddler presents for a well visit. The nurse
notes the child is unsteady during walking but pulls up and
cruises. The parent asks whether the child should be walking
independently by now and expresses concern about
developmental delay. Which nursing response best integrates
developmental knowledge and family education?
Options
A. Explain that most toddlers walk steadily by 12 months, so
refer immediately for developmental services.
B. Reassure the parent that cruising and emerging independent
walking at 15 months can be within normal limits and provide
home activity suggestions to encourage walking.
C. Advise the parent to stop carrying the child so much and to
, enroll in formal physical therapy starting today.
D. Suggest the parent wait until 18 months to reassess and
schedule a routine follow-up then.
Correct Answer
B
Rationale — Correct (3–4 sentences)
At 15 months many toddlers are walking but some still show
emerging gait—cruising and unsteady steps can be within
normal variation. The nurse should provide anticipatory
guidance and directed play activities to encourage practice
(family-centered health promotion). Immediate referral for
services is not indicated unless persistent regression or other
red flags appear. Wong highlights individualized developmental
assessment and practical home strategies.
Rationale — Incorrect Options
A. Immediate referral without further assessment is premature;
12 months is an average, not an absolute cutoff.
C. Telling a parent to stop carrying without empathy and
immediate referral to PT is unnecessarily directive and may
alarm the family.
D. Waiting until 18 months without offering guidance leaves
parents unsupported; provide education now and monitor.
Teaching Point
Provide anticipatory guidance and targeted play to encourage
emerging motor milestones.
AND CHILDREN, 12TH EDITION
TEST BANK
1
Reference
Ch. 1 — Children, Their Families, and the Nurse — Perspectives
of Pediatric Nursing
Stem
A 6-month-old infant is brought to the clinic for a routine well-
child visit. The mother reports the infant has decreased feeding
and fewer wet diapers in the past 12 hours. On exam the infant
is listless, fontanelles are slightly sunken, mucous membranes
appear dry, and capillary refill is 3 seconds. The mother appears
anxious and asks what the nurse recommends. Based on
pediatric assessment and family-centered care principles, what
is the nurse’s best immediate action?
Options
A. Reassure the mother that mild decrease in feeding is
common and schedule a follow-up in 48 hours.
B. Instruct the mother to offer additional formula or breastfeeds
and observe the infant in the clinic for hydration status.
,C. Teach the mother signs of dehydration and provide oral
rehydration instructions for home management only.
D. Refer the infant for immediate clinician evaluation and
consider intravenous fluids if assessment confirms moderate
dehydration.
Correct Answer
D
Rationale — Correct (3–4 sentences)
The infant demonstrates clinical cues of dehydration (sunken
fontanelle, dry mucous membranes, prolonged capillary refill,
lethargy). These signs in a 6-month-old require prompt clinical
evaluation and potential IV access because infants can
deteriorate quickly. Family-centered care means acknowledging
parental concern and expediting clinician assessment rather
than delaying. Wong emphasizes early recognition and rapid
escalation for hydration issues in infants.
Rationale — Incorrect Options
A. Reassurance alone is inappropriate — objective signs indicate
more than a mild feeding change and require evaluation.
B. While offering feeds is reasonable, observation without
clinician evaluation underestimates risk; the infant may need
more than oral fluids.
C. Teaching is important, but advising home management only
misses the need for immediate medical assessment given
clinical signs.
,Teaching Point
Infants with sunken fontanelle + lethargy need urgent
evaluation—don't delay escalation.
Citation
Hockenberry, M. J., & Rodgers, C. C. (2024). Wong’s Nursing
Care of Infants and Children (12th ed.). Chapter 1.
2
Reference
Ch. 1 — Children, Their Families, and the Nurse — Health
Promotion
Stem
A 15-month-old toddler presents for a well visit. The nurse
notes the child is unsteady during walking but pulls up and
cruises. The parent asks whether the child should be walking
independently by now and expresses concern about
developmental delay. Which nursing response best integrates
developmental knowledge and family education?
Options
A. Explain that most toddlers walk steadily by 12 months, so
refer immediately for developmental services.
B. Reassure the parent that cruising and emerging independent
walking at 15 months can be within normal limits and provide
home activity suggestions to encourage walking.
C. Advise the parent to stop carrying the child so much and to
, enroll in formal physical therapy starting today.
D. Suggest the parent wait until 18 months to reassess and
schedule a routine follow-up then.
Correct Answer
B
Rationale — Correct (3–4 sentences)
At 15 months many toddlers are walking but some still show
emerging gait—cruising and unsteady steps can be within
normal variation. The nurse should provide anticipatory
guidance and directed play activities to encourage practice
(family-centered health promotion). Immediate referral for
services is not indicated unless persistent regression or other
red flags appear. Wong highlights individualized developmental
assessment and practical home strategies.
Rationale — Incorrect Options
A. Immediate referral without further assessment is premature;
12 months is an average, not an absolute cutoff.
C. Telling a parent to stop carrying without empathy and
immediate referral to PT is unnecessarily directive and may
alarm the family.
D. Waiting until 18 months without offering guidance leaves
parents unsupported; provide education now and monitor.
Teaching Point
Provide anticipatory guidance and targeted play to encourage
emerging motor milestones.
