NURS 221 FINAL EXAM 2025
ANSWER ALL QUESTIONS IN THIS SECTION
QUESTION 1
The nurse is assessing a 2-year-old child during a wellness checkup. Which
statement(s) by the parent indicate that the child needs to be screened for
autism
spectrum disorder? Select all that apply.
A. "My child rarely makes eye contact with me or siblings."
B. "My child loves to have a difference in routines daily."
C. "I notice that my child has very few facial expressions to situations."
D. "There is no spontaneous play at all and will only plays with one object.
E. "Will answer questions when asked with a one-word response."
Answer: A, C, D
Rationale: Children with autism display little eye contact with and make few facial
expressions toward others; they use limited gestures to communicate. They have
limited capacity to relate to peers or parents. They lack spontaneous enjoyment,
express no moods or emotional affect, and cannot engage in play or make-believe
with toys. These children engage in stereotyped motor behaviors such as hand
flapping, body twisting, or head banging. Children with autism spectrum disorder
prefer routines and tend not to respond to questioning.
QUESTION 2
A parent expresses concern to the nurse that the child's regularly scheduled
measles, mumps, and rubella (MMR) vaccines may not be safe and cause
autism.
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, NURS 221 FINAL EXAM 2025
Which is the most appropriate response by the nurse?
A. "It is recommended that you wait until the child is older to vaccinate."
B. "There are safer alternative immunizations available now."
C. "There has been no research to establish a relationship between vaccines
and
autism."
D. "The risks do not outweigh the benefits of immunization against childhood
diseases."
Answer: C
Rationale: The National Institute of Child Health and Human Development,
Centers
for Disease Control and Prevention (CDC), and the Academy of Pediatrics have all
conducted research studies for several years and have concluded that there is no
relationship between vaccines and autism and that the MMR vaccine is safe.
Consequently, there is no need for the nurse to recommend deviating from the
suggested vaccination schedule. The statement "The risks do not outweigh the
benefits of immunization against childhood diseases" suggests that there are indeed
risks of autism associated with vaccinations.
QUESTION 3
A parent informs the nurse that they are concerned that the parent's child
might
suffer from attention-deficit/hyperactivity disorder (ADHD). The child can sit
still, running all over the house, and having difficulty in school. Which is the
best
response by the nurse?
A. "From what you are describing, ADHD may be a possibility and we will
refer you
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PAGE
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, NURS 221 FINAL EXAM 2025
to a specialist for screening."
B. "All children can be like that and it may be a disciplinary issue and not a
symptom of ADHD."
C. "Not all children do well in school and parents have a very high
expectation of
achievement."
D. "You should be sure to talk to the health care provider about prescribing
medication for treatment."
Answer: A
Rationale: Although some of the characteristics of ADHD are described by the
parent, screening tools are appropriate to use to get a definitive diagnosis. The
nurse is responding in a generalized way when saying "all children." Stating that it
may be a disciplinary issue is stepping over the line of professional behavior and
criticizing parenting styles. Medication as treatment prior to adequate screening is
not an appropriate approach that is safe for the child.
QUESTION 4
The nurse is educating parents of a child with attention-deficit/hyperactivity
disorder (ADHD)about the prescription for atomoxetine. Which client
statement(s)
indicate that the education is effective? Select all that apply.
A. "We will need to bring our child in for routine liver function testing."
B. "Prior to the administration of the medication, a chest x-ray will be done."
C. "If our child reports a dry mouth, we can give sugar free candy or gum."
D. "It is better to give the medication with food."
E. "We need to monitor appetites since the medication may suppress
appetite."
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, NURS 221 FINAL EXAM 2025
Answer: A, C, D, E
Rationale: Atomoxetine is a serotonin and norepinephrine reuptake inhibitor
(SRNI)
and is prescribed for the treatment of ADHD. It is important for the parents and
health care team to monitor the growth of the child and the appetite to be sure that
growth is not being delayed. Appetite may be suppressed while taking the
medication. Atomoxetine is metabolized in the liver and transient elevation of liver
enzymes may occur so it requires testing periodically to be sure this is not
occurring. Sugar free candy and gum may be a choice when the child reports a dry
mouth. The medication does not require a chest x-ray prior to administration.
QUESTION 5
A child with attention-deficit/hyperactivity disorder (ADHD) arrives with a
parent
for a scheduled checkup. The nurse assesses that the child looks thin and has
lost
several pounds since the last visit 6 months ago. Which action will the nurse
take to
improve the child's nutritional status?
A. Stop all medication for treatment until the child regains the weight.
B. Have the child sit at the table for three large meals a day with the family.
C. Encourage the parents to include finger foods several times a day.
D. Add milk shakes and other foods high in sugar to increase weight gain.
Answer: C
Rationale: One of the problems that the child with ADHD faces is malnutrition.
They
do not have the ability to sit and eat a meal without fidgeting, so the expectation
that they will sit at the table and eat three meals is unrealistic. The parents can
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PAGE
4
ANSWER ALL QUESTIONS IN THIS SECTION
QUESTION 1
The nurse is assessing a 2-year-old child during a wellness checkup. Which
statement(s) by the parent indicate that the child needs to be screened for
autism
spectrum disorder? Select all that apply.
A. "My child rarely makes eye contact with me or siblings."
B. "My child loves to have a difference in routines daily."
C. "I notice that my child has very few facial expressions to situations."
D. "There is no spontaneous play at all and will only plays with one object.
E. "Will answer questions when asked with a one-word response."
Answer: A, C, D
Rationale: Children with autism display little eye contact with and make few facial
expressions toward others; they use limited gestures to communicate. They have
limited capacity to relate to peers or parents. They lack spontaneous enjoyment,
express no moods or emotional affect, and cannot engage in play or make-believe
with toys. These children engage in stereotyped motor behaviors such as hand
flapping, body twisting, or head banging. Children with autism spectrum disorder
prefer routines and tend not to respond to questioning.
QUESTION 2
A parent expresses concern to the nurse that the child's regularly scheduled
measles, mumps, and rubella (MMR) vaccines may not be safe and cause
autism.
END OF
PAGE
1
, NURS 221 FINAL EXAM 2025
Which is the most appropriate response by the nurse?
A. "It is recommended that you wait until the child is older to vaccinate."
B. "There are safer alternative immunizations available now."
C. "There has been no research to establish a relationship between vaccines
and
autism."
D. "The risks do not outweigh the benefits of immunization against childhood
diseases."
Answer: C
Rationale: The National Institute of Child Health and Human Development,
Centers
for Disease Control and Prevention (CDC), and the Academy of Pediatrics have all
conducted research studies for several years and have concluded that there is no
relationship between vaccines and autism and that the MMR vaccine is safe.
Consequently, there is no need for the nurse to recommend deviating from the
suggested vaccination schedule. The statement "The risks do not outweigh the
benefits of immunization against childhood diseases" suggests that there are indeed
risks of autism associated with vaccinations.
QUESTION 3
A parent informs the nurse that they are concerned that the parent's child
might
suffer from attention-deficit/hyperactivity disorder (ADHD). The child can sit
still, running all over the house, and having difficulty in school. Which is the
best
response by the nurse?
A. "From what you are describing, ADHD may be a possibility and we will
refer you
END OF
PAGE
2
, NURS 221 FINAL EXAM 2025
to a specialist for screening."
B. "All children can be like that and it may be a disciplinary issue and not a
symptom of ADHD."
C. "Not all children do well in school and parents have a very high
expectation of
achievement."
D. "You should be sure to talk to the health care provider about prescribing
medication for treatment."
Answer: A
Rationale: Although some of the characteristics of ADHD are described by the
parent, screening tools are appropriate to use to get a definitive diagnosis. The
nurse is responding in a generalized way when saying "all children." Stating that it
may be a disciplinary issue is stepping over the line of professional behavior and
criticizing parenting styles. Medication as treatment prior to adequate screening is
not an appropriate approach that is safe for the child.
QUESTION 4
The nurse is educating parents of a child with attention-deficit/hyperactivity
disorder (ADHD)about the prescription for atomoxetine. Which client
statement(s)
indicate that the education is effective? Select all that apply.
A. "We will need to bring our child in for routine liver function testing."
B. "Prior to the administration of the medication, a chest x-ray will be done."
C. "If our child reports a dry mouth, we can give sugar free candy or gum."
D. "It is better to give the medication with food."
E. "We need to monitor appetites since the medication may suppress
appetite."
END OF
PAGE
3
, NURS 221 FINAL EXAM 2025
Answer: A, C, D, E
Rationale: Atomoxetine is a serotonin and norepinephrine reuptake inhibitor
(SRNI)
and is prescribed for the treatment of ADHD. It is important for the parents and
health care team to monitor the growth of the child and the appetite to be sure that
growth is not being delayed. Appetite may be suppressed while taking the
medication. Atomoxetine is metabolized in the liver and transient elevation of liver
enzymes may occur so it requires testing periodically to be sure this is not
occurring. Sugar free candy and gum may be a choice when the child reports a dry
mouth. The medication does not require a chest x-ray prior to administration.
QUESTION 5
A child with attention-deficit/hyperactivity disorder (ADHD) arrives with a
parent
for a scheduled checkup. The nurse assesses that the child looks thin and has
lost
several pounds since the last visit 6 months ago. Which action will the nurse
take to
improve the child's nutritional status?
A. Stop all medication for treatment until the child regains the weight.
B. Have the child sit at the table for three large meals a day with the family.
C. Encourage the parents to include finger foods several times a day.
D. Add milk shakes and other foods high in sugar to increase weight gain.
Answer: C
Rationale: One of the problems that the child with ADHD faces is malnutrition.
They
do not have the ability to sit and eat a meal without fidgeting, so the expectation
that they will sit at the table and eat three meals is unrealistic. The parents can
END OF
PAGE
4
