NURS 400 Final Exam Study Guide Questions with
Complete Solutions
The nurse is aware that the age at which the posterior fontanelle closes is _____ months.
a. 2 to 3
b. 3 to 6
c. 6 to 9
d. 9 to 12 - Correct Answer A
The posterior fontanelle will close between 2-3 months
The mother of a 3-month-old breastfed infant asks about giving her baby water since it is summer
and very warm. The nurse should recommend that...
a. Water once or twice a day will make up for losses caused by environmental temperature
b. Fluids in addition to breast milk are not needed
c. Clear juices would be better than water to promote adequate fluid intake
d. Water should be given if the infant seems to nurse longer than usual - Correct Answer B
Additional fluids are not necessary for the breastfed baby. Supplemental water or juice should not be
given. It may cause water intoxication and hyponatremia. Clear juices do not provide sufficient caloric
or nutrient intake and may interfere with breastfeeding.
The parent of a 12-month-old infant says to the nurse, "He pushes the spoon right out of my hand
when I feed him. I can't let him feed himself; he makes too much of a mess." The nurse's BEST
response is...
a. You need to try different types of utensils, bowls, and plates. Some are specifically designed for
young children.
b. Its important to let him make a mess. Just try not to worry about it so much
c. Feeding himself will help foster his growth and development. Perhaps we can discuss ways to make
the messes more tolerable
d. Its important not to give in to this kind of temper tantrum at this age. Simply ignore the behaviour
and the mess - Correct Answer C
The child is developmentally ready for self-feeding. Ignoring the behaviour and not allowing the child
to self-feed do not foster the child's development. The parent should not force use of the spoon but
,should substitute finger foods. At 12 months the child should be self-feeding; this is part of learning.
Since children this age eat primarily finger foods, it is useful to offer the parent suggestions for
keeping the mess to a minimum.
The parents of a 5-month-old girl state to the nurse that they are exhausted because she still wakes
up as often as every 1 to 2 hours during the night. When she awakens, they change her diaper, and
her mother nurses her back to sleep. What should the nurse suggest to help them deal with this
problem?
a. Give her a bottle of formula instead of breastfeeding her so often at night
b. Put her in the parents bed to cuddle
c. Let her cry herself back to sleep
d. Begin to put her into her own crib while sleepy - Correct Answer D
The nurse needs to discuss the issue of cosleeping with parents. Having the infant in bed with them
may still interfere with their sleep. Parents need to develop bedtime rituals that involve putting the
child in bed when drowsy. This helps the child return to sleep more easily if she awakens at night.
Providing formula at night contributes to bottle-mouth caries.
During a well-baby visit, the mother of a 6-month-old asks the nurse for advice on how much sleep
her child should be getting each day. Based on the nurse's knowledge of sleep and rest, the nurse
suggests
a. 12 hours with one nap per day
b. 12 hours with no nap
c. 14 hours with two to three naps per day
d. 16 hours per day - Correct Answer C
Newborns may sleep as much as 16 hours per day. Sleeping 12 hours with one nap per day is usually
recommended for toddlers older than 2 years of age. Babies 2 to 6 months of age generally sleep 14
to 16 hours per day with two to three naps. Preschoolers aged 3 to 5 years of age on average sleep
10 to 12 hours per day and give up daytime naps.
The parents of an overweight school age child have participated in nutrition and lifestyle education
classes in an effort to improve their child's health. Which of the following statements indicates that
further teaching is required?
a. We are substituting lower-calorie and lower-fat alternatives where possible, especially for snacks.
b. We ensure regular meals and snacks are provided especially breakfast
,c. We have reduced portion sizes in an effort to reduce overall intake
d. We watch television during meals to provide a distraction - Correct Answer D
A realistic approach to weight concerns is to prevent an increase in body fat during periods of
growth. This can be accomplished via the following adjustments: Reducing the quantity eaten by
purchasing, preparing, and serving smaller portions; Substituting low-calorie and low-fat alternatives
for high calorie foods; Severing associations between eating and other stimuli such as watching tv;
Regular meals and snacks should still be provided, especially breakfast.
A mother is bringing her 4-month-old infant into the clinic for a routine well-baby check. The mother
is exclusively breastfeeding. There are no other liquids given to the infant. What vitamin does the
nurse anticipate the provider will prescribe for this infant?
a. Vitamin C
b. Vitamin B
c. Vitamin D
d. Vitamin K - Correct Answer C
The Canadian Paediatric Society recommends that infants who are exclusively breastfed receive 400
IU of vitamin D daily, beginning in the first few days of life to prevent rickets and vitamin D deficiency.
Vitamins B, C, and K are not needed. Indigenous infants and children, as well as those who live in
northern regions of Canada, require extra vitamin D.
When preparing parents to teach their preschool child about human sexuality, what should the nurse
emphasize?
a. Parents should avoid using correct anatomical terms because they are confusing to the
preschooler
b. Parents should determine exactly what the child wants to know before answering a question
about sex
c. Parents should allow children to satisfy their sexual curiosity by playing "doctor"
d. A parents words may have a greater influence on the childs understanding than the parents
actions - Correct Answer B
A parent's actions may have a greater influence because language is not fully developed in
preschoolers. It is important that the parent answer the question that the child is asking so it is
important to determine what the child wants to know. Using correct terminology lays the foundation
for later discussion. Parents should encourage the asking of questions to resolve curiosity without
undue investigation on the child's part.
, An appropriate intervention to provide comfort for the child with itching associated with chickenpox
is to
a. Give an antipruritic medication such as Benadryl
b. Give aspirin or acetaminophen
c. Apply thick coat of Caladryl lotion
d. Encourage frequent warm baths - Correct Answer A
Cool baths are recommended for relief of itching. Neither aspirin nor acetaminophen has anti-itching
effects. Use of aspirin can be associated with Reye syndrome and should be avoided. Antipruritic
medicines such as diphenhydramine (Benadryl) or hydroxyzine (Atarax) are useful for severe itching,
which interferes with sleep and may contribute to secondary infection from scratching. Caladryl
lotion (contains Benadryl) should be applied sparingly over open lesions to minimize absorption and
drug toxicity.
The causative agent for erythema infectiosum (fifth disease) is
a. Group A beta-hemolytic streptococci
b. Human parvovirus B19
c. Paramyxovirus
d. Human herpes virus types 1 and 2 - Correct Answer B
Paramyxovirus causes mumps. Human parvovirus B19 is the causative agent for erythema
infectiosum. Human herpes virus types I and 2 are the major causes of herpetic infections in humans.
Group A beta-hemolytic streptococci is the causative agent for scarlet fever.
Nursing interventions to promote health during middle childhood include
a. Stressing the need for increased calorie intake to meet incresed demands
b. Educating the child and parents regarding the need for good dental hygiene because these are the
years in which permanent teeth erupt
c. Advising parents that the child will need decreasing amounts of rest towards the end of this period
d. Instructing parents to defer questions about sex until the child reaches adolescence - Correct
Answer B
Energy needs during middle childhood are diminished; however, a balanced diet is important to
prepare for the adolescent growth spurt. Parents should approach sex education with a lifespan
Complete Solutions
The nurse is aware that the age at which the posterior fontanelle closes is _____ months.
a. 2 to 3
b. 3 to 6
c. 6 to 9
d. 9 to 12 - Correct Answer A
The posterior fontanelle will close between 2-3 months
The mother of a 3-month-old breastfed infant asks about giving her baby water since it is summer
and very warm. The nurse should recommend that...
a. Water once or twice a day will make up for losses caused by environmental temperature
b. Fluids in addition to breast milk are not needed
c. Clear juices would be better than water to promote adequate fluid intake
d. Water should be given if the infant seems to nurse longer than usual - Correct Answer B
Additional fluids are not necessary for the breastfed baby. Supplemental water or juice should not be
given. It may cause water intoxication and hyponatremia. Clear juices do not provide sufficient caloric
or nutrient intake and may interfere with breastfeeding.
The parent of a 12-month-old infant says to the nurse, "He pushes the spoon right out of my hand
when I feed him. I can't let him feed himself; he makes too much of a mess." The nurse's BEST
response is...
a. You need to try different types of utensils, bowls, and plates. Some are specifically designed for
young children.
b. Its important to let him make a mess. Just try not to worry about it so much
c. Feeding himself will help foster his growth and development. Perhaps we can discuss ways to make
the messes more tolerable
d. Its important not to give in to this kind of temper tantrum at this age. Simply ignore the behaviour
and the mess - Correct Answer C
The child is developmentally ready for self-feeding. Ignoring the behaviour and not allowing the child
to self-feed do not foster the child's development. The parent should not force use of the spoon but
,should substitute finger foods. At 12 months the child should be self-feeding; this is part of learning.
Since children this age eat primarily finger foods, it is useful to offer the parent suggestions for
keeping the mess to a minimum.
The parents of a 5-month-old girl state to the nurse that they are exhausted because she still wakes
up as often as every 1 to 2 hours during the night. When she awakens, they change her diaper, and
her mother nurses her back to sleep. What should the nurse suggest to help them deal with this
problem?
a. Give her a bottle of formula instead of breastfeeding her so often at night
b. Put her in the parents bed to cuddle
c. Let her cry herself back to sleep
d. Begin to put her into her own crib while sleepy - Correct Answer D
The nurse needs to discuss the issue of cosleeping with parents. Having the infant in bed with them
may still interfere with their sleep. Parents need to develop bedtime rituals that involve putting the
child in bed when drowsy. This helps the child return to sleep more easily if she awakens at night.
Providing formula at night contributes to bottle-mouth caries.
During a well-baby visit, the mother of a 6-month-old asks the nurse for advice on how much sleep
her child should be getting each day. Based on the nurse's knowledge of sleep and rest, the nurse
suggests
a. 12 hours with one nap per day
b. 12 hours with no nap
c. 14 hours with two to three naps per day
d. 16 hours per day - Correct Answer C
Newborns may sleep as much as 16 hours per day. Sleeping 12 hours with one nap per day is usually
recommended for toddlers older than 2 years of age. Babies 2 to 6 months of age generally sleep 14
to 16 hours per day with two to three naps. Preschoolers aged 3 to 5 years of age on average sleep
10 to 12 hours per day and give up daytime naps.
The parents of an overweight school age child have participated in nutrition and lifestyle education
classes in an effort to improve their child's health. Which of the following statements indicates that
further teaching is required?
a. We are substituting lower-calorie and lower-fat alternatives where possible, especially for snacks.
b. We ensure regular meals and snacks are provided especially breakfast
,c. We have reduced portion sizes in an effort to reduce overall intake
d. We watch television during meals to provide a distraction - Correct Answer D
A realistic approach to weight concerns is to prevent an increase in body fat during periods of
growth. This can be accomplished via the following adjustments: Reducing the quantity eaten by
purchasing, preparing, and serving smaller portions; Substituting low-calorie and low-fat alternatives
for high calorie foods; Severing associations between eating and other stimuli such as watching tv;
Regular meals and snacks should still be provided, especially breakfast.
A mother is bringing her 4-month-old infant into the clinic for a routine well-baby check. The mother
is exclusively breastfeeding. There are no other liquids given to the infant. What vitamin does the
nurse anticipate the provider will prescribe for this infant?
a. Vitamin C
b. Vitamin B
c. Vitamin D
d. Vitamin K - Correct Answer C
The Canadian Paediatric Society recommends that infants who are exclusively breastfed receive 400
IU of vitamin D daily, beginning in the first few days of life to prevent rickets and vitamin D deficiency.
Vitamins B, C, and K are not needed. Indigenous infants and children, as well as those who live in
northern regions of Canada, require extra vitamin D.
When preparing parents to teach their preschool child about human sexuality, what should the nurse
emphasize?
a. Parents should avoid using correct anatomical terms because they are confusing to the
preschooler
b. Parents should determine exactly what the child wants to know before answering a question
about sex
c. Parents should allow children to satisfy their sexual curiosity by playing "doctor"
d. A parents words may have a greater influence on the childs understanding than the parents
actions - Correct Answer B
A parent's actions may have a greater influence because language is not fully developed in
preschoolers. It is important that the parent answer the question that the child is asking so it is
important to determine what the child wants to know. Using correct terminology lays the foundation
for later discussion. Parents should encourage the asking of questions to resolve curiosity without
undue investigation on the child's part.
, An appropriate intervention to provide comfort for the child with itching associated with chickenpox
is to
a. Give an antipruritic medication such as Benadryl
b. Give aspirin or acetaminophen
c. Apply thick coat of Caladryl lotion
d. Encourage frequent warm baths - Correct Answer A
Cool baths are recommended for relief of itching. Neither aspirin nor acetaminophen has anti-itching
effects. Use of aspirin can be associated with Reye syndrome and should be avoided. Antipruritic
medicines such as diphenhydramine (Benadryl) or hydroxyzine (Atarax) are useful for severe itching,
which interferes with sleep and may contribute to secondary infection from scratching. Caladryl
lotion (contains Benadryl) should be applied sparingly over open lesions to minimize absorption and
drug toxicity.
The causative agent for erythema infectiosum (fifth disease) is
a. Group A beta-hemolytic streptococci
b. Human parvovirus B19
c. Paramyxovirus
d. Human herpes virus types 1 and 2 - Correct Answer B
Paramyxovirus causes mumps. Human parvovirus B19 is the causative agent for erythema
infectiosum. Human herpes virus types I and 2 are the major causes of herpetic infections in humans.
Group A beta-hemolytic streptococci is the causative agent for scarlet fever.
Nursing interventions to promote health during middle childhood include
a. Stressing the need for increased calorie intake to meet incresed demands
b. Educating the child and parents regarding the need for good dental hygiene because these are the
years in which permanent teeth erupt
c. Advising parents that the child will need decreasing amounts of rest towards the end of this period
d. Instructing parents to defer questions about sex until the child reaches adolescence - Correct
Answer B
Energy needs during middle childhood are diminished; however, a balanced diet is important to
prepare for the adolescent growth spurt. Parents should approach sex education with a lifespan
