Updated A+ Guide Solution
/. Holding a soft rattle - Answer-3-6 months
/.Watching black-and-white mobiles - Answer-birth to 3 months
/.Playing peek-a-boo - Answer-6-9 months
/.Drawing, painting, riding a tricycle - Answer-preschooler
/.Team sports - Answer-school age children
/.Banging large block - Answer-9-12 months
/.Loud, harsh murmur that is not usually audible until pulmonary pressures drop at about
4 to 8 weeks of age; Heart failure; Failure to thrive; Small, possibly asymptomatic
defects. - Answer-Ventricular septal defect (VSD)
/.Systolic ejection murmur; Right ventricular enlargement; Exercise intolerance;
Cyanosis with severe narrowing. - Answer-pulmonary stenosis
/.Murmur; Cyanosis, severe dyspnea, clubbing of the fingers, hypercyanotic spells, and
acidosis; Polycythemia, clot formation; Frequently sits in a squatting position (decreases
venous return); Failure to thrive and growth retardation. - Answer-tetralogy of fallot
/.Increased blood pressure and oxygen saturation in the upper extremities compared to
the lower extremities; Nosebleeds; Headaches, vertigo, leg pain, weak or absent lower
extremity pulses (indicate decreased cardiac output). - Answer-coarctation of the aorta
/.Loud, harsh murmur; Mild heart failure; Possible enlarged right atrium; Increased
oxygen saturations in the right atrium; Asymptomatic (possibly). - Answer-atrial septal
defects (ASD)
/.Murmur (machine-hum); Wide pulse pressure; Bounding pulses; Asymptomatic
(possibly). - Answer-patent ductus
/.Industry vs Inferiority - Answer-toddler 1-3 years
/.Initiative vs. Guilt - Answer-preschooler 3-6 years
/.Autonomy vs. Shame and Doubt - Answer-toddler 1-3 years
/.Identity vs Role Confusion - Answer-adolescent 13-20 years
, /.Trust vs. Mistrust - Answer-infant birth- 1 year
/.View dying as temporary because they have no concept of time and because the dead
person may still have attributes of the living (sleeping, eating, breathing). - Answer-
preschool children
/.Have egocentric thinking that prevents them from understanding death. - Answer-
toddlers
/.Experience fear of the disease process, the death process, the unknown, and loss of
control. - Answer-school age children
/.May have difficulty accepting death because they are discovering who they are,
establishing an identity, and dealing with issues of puberty. - Answer-adolescents
/.A nurse is caring for a 6-month-old infant following surgery. Which of the following
should the nurse use to measure pain in this client?
Select one:
a. Oucher numeric scale.
b. Wong-Baker faces pain rating scale.
c. FLACC pain scale.
d. There is no special pain scale for infants. - Answer-FLACC pain scale
The FLACC scale is used for infants and children 2 months to 7 years. It is based on
assessment of the following behavior indicators: Facial expressions, Position of legs,
Activity, Crying, Ability to be consoled.
/.A nurse is caring for an infant following a cleft lip and palate repair. Which of the
following actions should the nurse take in the post-operative period?
Select one:
a. Encourage the use of a pacifier.
b. Provide hard toys.
c. Administer analgesics.
d. Assess incision using tongue blade. - Answer-administer analgesics
/.A nurse is caring for a child with a closed head injury. Which of the following
interventions should the nurse institute to decrease intracranial pressure? Select all that
apply.
Select one or more:
a. Provide a calm, restful environment.
b. Keep the body in alignment.
c. Keep the head of the bed flat.
d. Avoid extreme flexion, extension or rotation of the head.