TEST BANKS FOR CURRENT
DIAGNOSIS & TREATMENT
PEDIATRICS 26TH EDITION BY
MAYA BUNIK; WILLIAM W. HAY
ISBN 10; 1264269986 /ISBN-13; 978-
1264269983
TEST BANKS FOR CURRENT DIAGNOSIS & TREATMENT PEDIATRICS 26TH EDITION
Complete Answers with Rationales
Chapter 1: The Newborn Infant
1. Which milestone is developmentally appropriate for a 2-month-old infant when the nurse pulls the
infant to a sitting position?
a. Head lag is present when the infant's trunk is lifted.
b. The infant is able to support the head when the trunk is lifted.
c. The infant is briefly able to hold the head erect.
d. The infant is fully able to support and hold the head in a straight line.
ANS: C
Rationale: A 2-month-old infant is able to hold the head erect only briefly and continues to have some
head lag. It is not until 4 months of age that the infant can keep his or her head in a straight line when
pulled to a sitting position.
2. Approximately what should a newborn weigh at 1 year of age if the newborn's birth weight was 7
pounds 6 ounces?
a. 14 3/4 pounds
b. 22 1/8 pounds
c. 29 1/2 pounds
d. Unable to estimate weight at 1 year
ANS: B
,Rationale: An infant triples the birth weight by 1 year of age. An infant doubles the birth weight by 6
months of age. An infant quadruples the birth weight by 2 years of age. Weight at 6 months, 1 year, and
2 years of age can be estimated from the birth weight. 7 pounds 6 ounces × 3 = 22 pounds 2 ounces
(approximately 22 1/8 pounds).
3. Which statement made by a parent would be consistent with a developmental delay?
a. I have noticed that my 9-month-old infant responds consistently to the sound of his name.
b. I have noticed that my 12-month-old child does not get herself to a sitting position or pull to stand.
c. I am so happy when my 1 1/2-month-old infant smiles at me.
d. My 5-month-old infant is not rolling over in both directions yet.
ANS: B
Rationale: Critical developmental milestones for gross motor development in a 12 month old include
standing briefly without support, getting to a sitting position, and pulling to stand. If a 12-month-old
child does not perform these activities, it may be indicative of a developmental delay. An infant who
responds to his name at 9 months of age is demonstrating abilities to both hear and interpret sound. A
social smile is present by 2 months of age. Rolling over in both directions is not a critical milestone for
gross motor development until the child reaches 6 months of age.
4. At a healthy 2-month-old infant's well-child clinic visit, the nurse should give which immunizations?
a. DTaP, IPV, HepB, Hib, PCV, rotavirus
b. MMR, DTaP, PVC, and IPV
c. Hib, DTaP, rotavirus, and OPV
d. Hib and MMR, IPV, and rotavirus
ANS: A
Rationale: DTaP, IPV, HepB, Hib, PCV, and rotavirus are the appropriate sequence of immunizations for a
healthy 2-month-old infant. MMR is given at or after 12 months of age. Oral polio vaccine (OPV) is no
longer administered in the U.S.
5. The nurse advises the mother of a 3-month-old infant, exclusively breast-fed, to:
a. start giving the infant a vitamin D supplement.
b. start using an infant feeder and add rice cereal to the formula.
c. start feeding the infant rice cereal with a spoon at the evening feeding.
d. continue breast-feeding without any supplements.
,ANS: A
Rationale: Breast milk does not provide an adequate amount of dietary vitamin D. Infants who are
exclusively breast-fed need vitamin D supplements to prevent rickets. An infant feeder is an
inappropriate method of providing the infant with caloric intake. Solid foods and rice cereal are not
recommended for a 3-month-old infant. Solid feedings do not typically begin before 4 to 6 months of
age. Because breast milk is not an adequate source of fluoride, infants need to be given a fluoride
supplement.
6. At ______ months of age, an infant should first be expected to locate an object hidden from view.
a. 4
b. 6
c. 9
d. 20
ANS: C
Rationale: By 9 months of age an infant will actively search for an object that is out of sight. Four-
month-old infants are not cognitively capable of searching out objects hidden from their view. Infants at
this developmental level do not pursue hidden objects. Six-month-old infants have not developed the
ability to perceive objects as permanent and do not search out objects hidden from their view. Twenty-
month-old infants actively pursue objects not in their view and are capable of recalling the location of an
object not in their view. They first look for hidden objects around the age of 9 months.
7. The parents of a newborn infant state, "We will probably not have our baby immunized because we
are concerned about the risk of our child being injured." Which is the best response for the nurse to
make?
1. It is your decision.
2. Have you talked with your parents about this? They can probably help you think about this
decision.
3. The risks of not immunizing your baby are greater than the risks from the immunizations.
4. You are making a mistake.
ANS: C
Rationale: Although immunizations have been documented to have a negative effect in a small number
of cases, an unimmunized infant is at greater risk for development of complications from childhood
diseases than from the vaccines. It is the parents' decision not to immunize the child; however, the
, nurse has a responsibility to inform parents about the risks to infants who are not immunized.
Grandparents can be supportive but are not the primary decision makers for the infant. Telling parents
that they are making a mistake is an inappropriate response.
8. The mother of a 9-month-old infant is concerned because the infant cries when she leaves him.
Which is the best response for the nurse to make to the mother?
a. You could consider leaving the infant more often so he can adjust.
b. You might consider taking him to the doctor because he may be ill.
c. Have you noticed whether the baby is teething?
d. This can be a healthy sign of attachment.
ANS: D
Rationale: Healthy attachment is manifested by stranger anxiety in late infancy. An infant who manifests
stranger anxiety can be supported by the mother leaving the infant for only short periods of time.
Assessing developmental needs is appropriate before taking an infant to a physician. Pain from teething
expressed by the infant's cries would not occur only when the mother left the room.
9. Which statement concerning physiological factors of infancy is true?
a. The infant has a slower metabolic rate than an adult.
b. An infant is not able to digest protein and lactase.
c. Infants have a slower circulatory response than adults.
d. The kidneys of an infant are less efficient in concentrating urine than an adult's kidneys.
ANS: D
Rationale: The infant's kidneys are not as effective at concentrating urine compared with an adult's
kidneys because of immaturity of the renal system and a slower glomerular filtration rates. The infant's
metabolic rate is faster, not slower, than an adult's. Although the newborn infant's gastrointestinal
system is immature, it is capable of digesting protein and lactase, but the ability to digest and absorb fat
does not reach adult levels until approximately 6 to 9 months of age.
10. Which is a priority in counseling parents of a 6-month-old infant?
a. Increased appetite from secondary growth spurt
b. Allowing the infant to self-feed
c. Securing a developmentally safe environment for the infant
d. Strategies to teach infants to sit up
DIAGNOSIS & TREATMENT
PEDIATRICS 26TH EDITION BY
MAYA BUNIK; WILLIAM W. HAY
ISBN 10; 1264269986 /ISBN-13; 978-
1264269983
TEST BANKS FOR CURRENT DIAGNOSIS & TREATMENT PEDIATRICS 26TH EDITION
Complete Answers with Rationales
Chapter 1: The Newborn Infant
1. Which milestone is developmentally appropriate for a 2-month-old infant when the nurse pulls the
infant to a sitting position?
a. Head lag is present when the infant's trunk is lifted.
b. The infant is able to support the head when the trunk is lifted.
c. The infant is briefly able to hold the head erect.
d. The infant is fully able to support and hold the head in a straight line.
ANS: C
Rationale: A 2-month-old infant is able to hold the head erect only briefly and continues to have some
head lag. It is not until 4 months of age that the infant can keep his or her head in a straight line when
pulled to a sitting position.
2. Approximately what should a newborn weigh at 1 year of age if the newborn's birth weight was 7
pounds 6 ounces?
a. 14 3/4 pounds
b. 22 1/8 pounds
c. 29 1/2 pounds
d. Unable to estimate weight at 1 year
ANS: B
,Rationale: An infant triples the birth weight by 1 year of age. An infant doubles the birth weight by 6
months of age. An infant quadruples the birth weight by 2 years of age. Weight at 6 months, 1 year, and
2 years of age can be estimated from the birth weight. 7 pounds 6 ounces × 3 = 22 pounds 2 ounces
(approximately 22 1/8 pounds).
3. Which statement made by a parent would be consistent with a developmental delay?
a. I have noticed that my 9-month-old infant responds consistently to the sound of his name.
b. I have noticed that my 12-month-old child does not get herself to a sitting position or pull to stand.
c. I am so happy when my 1 1/2-month-old infant smiles at me.
d. My 5-month-old infant is not rolling over in both directions yet.
ANS: B
Rationale: Critical developmental milestones for gross motor development in a 12 month old include
standing briefly without support, getting to a sitting position, and pulling to stand. If a 12-month-old
child does not perform these activities, it may be indicative of a developmental delay. An infant who
responds to his name at 9 months of age is demonstrating abilities to both hear and interpret sound. A
social smile is present by 2 months of age. Rolling over in both directions is not a critical milestone for
gross motor development until the child reaches 6 months of age.
4. At a healthy 2-month-old infant's well-child clinic visit, the nurse should give which immunizations?
a. DTaP, IPV, HepB, Hib, PCV, rotavirus
b. MMR, DTaP, PVC, and IPV
c. Hib, DTaP, rotavirus, and OPV
d. Hib and MMR, IPV, and rotavirus
ANS: A
Rationale: DTaP, IPV, HepB, Hib, PCV, and rotavirus are the appropriate sequence of immunizations for a
healthy 2-month-old infant. MMR is given at or after 12 months of age. Oral polio vaccine (OPV) is no
longer administered in the U.S.
5. The nurse advises the mother of a 3-month-old infant, exclusively breast-fed, to:
a. start giving the infant a vitamin D supplement.
b. start using an infant feeder and add rice cereal to the formula.
c. start feeding the infant rice cereal with a spoon at the evening feeding.
d. continue breast-feeding without any supplements.
,ANS: A
Rationale: Breast milk does not provide an adequate amount of dietary vitamin D. Infants who are
exclusively breast-fed need vitamin D supplements to prevent rickets. An infant feeder is an
inappropriate method of providing the infant with caloric intake. Solid foods and rice cereal are not
recommended for a 3-month-old infant. Solid feedings do not typically begin before 4 to 6 months of
age. Because breast milk is not an adequate source of fluoride, infants need to be given a fluoride
supplement.
6. At ______ months of age, an infant should first be expected to locate an object hidden from view.
a. 4
b. 6
c. 9
d. 20
ANS: C
Rationale: By 9 months of age an infant will actively search for an object that is out of sight. Four-
month-old infants are not cognitively capable of searching out objects hidden from their view. Infants at
this developmental level do not pursue hidden objects. Six-month-old infants have not developed the
ability to perceive objects as permanent and do not search out objects hidden from their view. Twenty-
month-old infants actively pursue objects not in their view and are capable of recalling the location of an
object not in their view. They first look for hidden objects around the age of 9 months.
7. The parents of a newborn infant state, "We will probably not have our baby immunized because we
are concerned about the risk of our child being injured." Which is the best response for the nurse to
make?
1. It is your decision.
2. Have you talked with your parents about this? They can probably help you think about this
decision.
3. The risks of not immunizing your baby are greater than the risks from the immunizations.
4. You are making a mistake.
ANS: C
Rationale: Although immunizations have been documented to have a negative effect in a small number
of cases, an unimmunized infant is at greater risk for development of complications from childhood
diseases than from the vaccines. It is the parents' decision not to immunize the child; however, the
, nurse has a responsibility to inform parents about the risks to infants who are not immunized.
Grandparents can be supportive but are not the primary decision makers for the infant. Telling parents
that they are making a mistake is an inappropriate response.
8. The mother of a 9-month-old infant is concerned because the infant cries when she leaves him.
Which is the best response for the nurse to make to the mother?
a. You could consider leaving the infant more often so he can adjust.
b. You might consider taking him to the doctor because he may be ill.
c. Have you noticed whether the baby is teething?
d. This can be a healthy sign of attachment.
ANS: D
Rationale: Healthy attachment is manifested by stranger anxiety in late infancy. An infant who manifests
stranger anxiety can be supported by the mother leaving the infant for only short periods of time.
Assessing developmental needs is appropriate before taking an infant to a physician. Pain from teething
expressed by the infant's cries would not occur only when the mother left the room.
9. Which statement concerning physiological factors of infancy is true?
a. The infant has a slower metabolic rate than an adult.
b. An infant is not able to digest protein and lactase.
c. Infants have a slower circulatory response than adults.
d. The kidneys of an infant are less efficient in concentrating urine than an adult's kidneys.
ANS: D
Rationale: The infant's kidneys are not as effective at concentrating urine compared with an adult's
kidneys because of immaturity of the renal system and a slower glomerular filtration rates. The infant's
metabolic rate is faster, not slower, than an adult's. Although the newborn infant's gastrointestinal
system is immature, it is capable of digesting protein and lactase, but the ability to digest and absorb fat
does not reach adult levels until approximately 6 to 9 months of age.
10. Which is a priority in counseling parents of a 6-month-old infant?
a. Increased appetite from secondary growth spurt
b. Allowing the infant to self-feed
c. Securing a developmentally safe environment for the infant
d. Strategies to teach infants to sit up
