NR 328 Exam #1
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1. Which topics should the nurse discuss with the parents of a young child to
promote health in their child?
a. Dental care needs to be started by age 7.
b. Immunization schedule and the importance of immunizations.
c. Human milk or iron fortified formula for the first 4 months of life.
d. Positioning the car seat in the front passenger seat.: Answer: B
Rationale: Immunizations have made a major impact in the prevention of disease in children. The nurse should review
individual immunization records at every clinic visit, avoid missing opportunities to vaccinate, and encourage parents
to keep immunizations current. Dental caries is the single most common chronic disease of childhood and may begin
before the first birthday. Human milk or iron fortified formula for should be given for the first year of life to prevent Iron
Deficiency anemia. Children younger than 1 year of age have the highest rate of death from motor vehicle accidents,
primarily from a failure to properly use car restraints.
2. What is the leading cause of death in children older than the age of 1 year?
a. Drowning
b. Burns
c. Motor vehicle accidents
d. Cancer: Answer(s): C
Rationale: a. Drowning is the second leading cause of death in children older than the age of 1 year. b. Burns cause
fewer deaths than motor vehicle accidents in children older than the age of 1 year. c. Motor vehicle accidents are the
leading cause of death in children older than the age of 1 year. d. Cancer causes fewer deaths than motor vehicle
accidents in children older than the age of 1 year.
3. The nurse makes sure that a toddler has a teddy bear and that a nightlight is
on in the hospital room at bedtime. What concept would these nursing actions
demonstrate?
a. Atraumatic care
b. Nonmaleficence
c. Justice
d. Advocacy: Answer(s): A
Rationale: A. Atraumatic care is the provision of therapeutic care in settings, by personnel, and through the use of
interventions that eliminate or minimize the psychological and physical distress experienced by children and their
families in the health care system. In this case, it is making sure that the toddler has a teddy bear and that a night
light is on to prevent a dark environment. B. Nonmaleficence is the obligation to minimize or prevent harm; there is no
, NR 328 Exam #1
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situation present that would require this. C. Justice is the concept of fairness and is not applicable to this situation. D.
Advocacy involves ensuring that families are aware of all available health services, adequately informed of treatments
and procedures, involved in the child's care, and encouraged to change or support existing health care practices.
4. True or False: Open ended questions are most likely to encourage parents to
talk about their feelings r/t their child's illness.: True
5. When the nurse interviews an adolescent, what is important to help establish
a relationship?
a. Use the same type of language as the adolescent.
b. Emphasize that confidentiality will always be maintained.
c. Focus the discussion on the peer group.
d. Display a genuine interest in the adolescent.: Answer: D.
Rationale: Display a genuine interest in the adolescent.Adolescents accept anyone who shows a genuine interest in
them. Although peers are important to this age-group, the focus of the interview should be on the adolescent. The
nurse should clarify which information will be shared with other members of the health care team and any limits to
confidentiality. The nurse should maintain a professional relationship with adolescents. To avoid misinterpretation of
words and phrases that the adolescent may use, the nurse should clarify terms frequently.
6. What approach is the most appropriate when performing a physical assess-
ment on a toddler?
a. Demonstrate use of equipment.
b. Perform traumatic procedures first.
c. Use minimum physical contact initially.
d. Always proceed in a head-to-toe direction.: Answer: C.
Rationale: Parents can remove clothing, and the child can remain on the parent's lap. The nurse should use minimum
physical contact initially to gain the cooperation of the child. The nurse should introduce the equipment slowly. The
child can inspect the equipment, but demonstrations are usually too complex for this age-group. Traumatic procedures
should always be performed last. These will most likely upset the child and inhibit cooperation. The head-to-toe
assessment can be done in older children but usually must be adapted in younger children.
7. What is the most consistent and commonly used indicator of pain in infants?
a. Thrashing of arms and legs.
b. Increased heart rate.
c. Increased respirations.
d. Facial expression of discomfort.: Answer: D.
, NR 328 Exam #1
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Rationale: Facial expression of discomfort. Facial expression has consistently been validated as an indicator of pain
in infants. Behavioral pain measures are most reliable for sharp procedural pain in infants. Increased heart rate and
respirations are indicative of a generalized and complex response to stress. They are not specific for pain in infants.
Thrashing of arms and legs is a reliable indicator in young children, not infants.
8. True or False: At age 1 month is the normal age for binocularity-ability to
fixate on one visual field with both eyes simultaneously.: Answer: False.
Rationale: Binocularity is usually achieved by age 3 to 4 months. One month is too young for binocularity. If binocularity
is not achieved by 6 to 12 months, the child must be observed for strabismus.
9. What self-report pain rating scales can be used in children as young as 3 years
of age?
a. FACES Pain Rating Scale
b. Visual Analog Scale
c. Word-Graphic Rating Scale
d. Who Cares?: Answer: A.
Rationale: The FACES Pain Rating Scale is for children as young as 3 years of age. The Visual Analog Scale can be used
for children older than 4 years of age but is most appropriate for ages 7 and older. The Word-Graphic Rating Scale
uses descriptive words and is recommended for children 4 to 17 years of age.
10. An intravenous line is needed in a school-age child. What medication is
appropriate analgesic for use with this patient?
a. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.
b. EMLA (eutectic mixture of local anesthetics) immediately before.
c. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
d. TAC (tetracaine, epinephrine [Adrenalin], cocaine) 15 minutes before.: Answer:
A.
Rationale: LMX is an effective analgesic agent when applied to the skin 30 minutes before a procedure. It eliminates or
reduces the pain from most procedures involving skin puncture. TAC provides skin anesthesia about 15 minutes after
application to nonintact skin. The gel can be placed on the wound for suturing. It is not useful for intact skin. Transderma
fentanyl patches are useful for continuous pain control, not rapid pain control. For maximum effectiveness, EMLA must
be applied approximately 60 minutes in advance. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
11. At what age does Erickson consider the infancy stage?: 0 - 18 months
, NR 328 Exam #1
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12. What is the basic conflict and important events of Erickson's infancy stage?-
: Trust vs. Mistrust
Feeding/Comfort
13. At what age does Erickson consider the Early Childhood stage?: 2 - 3 years
14. What is the basic comfort and important events of Erickson's early childhood
stage?: Autonomy vs. Shame and Doubt
Toilet training/Dressing
15. At what age does Erickson consider the preschool stage?: 3 - 5 years
16. What is the basic conflict and important events of Erickson's preschool
stage?: Initiative vs. Guilt
Exploration/Play
17. At what age does Erickson consider the school age?: 6 - 11 years
18. What is the basic conflict and important events of Erickson's school age?: In-
dustry vs. Inferiority
School/Activities
19. At what age does Erickson consider the adolescence stage?: 12 - 18 years
20. What is the basic comfort and important events of Erickson's adolescence
stage?: Identity vs. Role Confusion
Social relationships/Identity
21. What is the outcome of Erickson's infancy stage?: Children develop a sense of trust when
caregivers provide reliability, care and affection. A lack of this will lead to mistrust.
22. What is the outcome of Erickson's early childhood stage?: Children need to develop
a sense of personal control over physical skills and a sense of independence. Success leads to feeling of autonomy,
failure results in feelings of shame and doubt.
23. What is the outcome of Erickson's preschool stage?: Children need to begin asserting
control and power over the environment. Success in this state leads to a sense of purpose. Children who try to exert
too much power experience disapproval, resulting in a sense of guilt.
24. What is the outcome of Erickson's school age stage?: Children need to cope with new
social and academic demands. Success leads to a sense of competence, while failure results in feeling of inferiority.
25. What is the outcome of Erickson's adolescence stage?: Teens need to develop a sense
of self and personal identity. Success leads to an ability to stay true to yourself, while failure leads to role confusion and
a weak sense of self.
Study online at https://quizlet.com/_9ubwj3
1. Which topics should the nurse discuss with the parents of a young child to
promote health in their child?
a. Dental care needs to be started by age 7.
b. Immunization schedule and the importance of immunizations.
c. Human milk or iron fortified formula for the first 4 months of life.
d. Positioning the car seat in the front passenger seat.: Answer: B
Rationale: Immunizations have made a major impact in the prevention of disease in children. The nurse should review
individual immunization records at every clinic visit, avoid missing opportunities to vaccinate, and encourage parents
to keep immunizations current. Dental caries is the single most common chronic disease of childhood and may begin
before the first birthday. Human milk or iron fortified formula for should be given for the first year of life to prevent Iron
Deficiency anemia. Children younger than 1 year of age have the highest rate of death from motor vehicle accidents,
primarily from a failure to properly use car restraints.
2. What is the leading cause of death in children older than the age of 1 year?
a. Drowning
b. Burns
c. Motor vehicle accidents
d. Cancer: Answer(s): C
Rationale: a. Drowning is the second leading cause of death in children older than the age of 1 year. b. Burns cause
fewer deaths than motor vehicle accidents in children older than the age of 1 year. c. Motor vehicle accidents are the
leading cause of death in children older than the age of 1 year. d. Cancer causes fewer deaths than motor vehicle
accidents in children older than the age of 1 year.
3. The nurse makes sure that a toddler has a teddy bear and that a nightlight is
on in the hospital room at bedtime. What concept would these nursing actions
demonstrate?
a. Atraumatic care
b. Nonmaleficence
c. Justice
d. Advocacy: Answer(s): A
Rationale: A. Atraumatic care is the provision of therapeutic care in settings, by personnel, and through the use of
interventions that eliminate or minimize the psychological and physical distress experienced by children and their
families in the health care system. In this case, it is making sure that the toddler has a teddy bear and that a night
light is on to prevent a dark environment. B. Nonmaleficence is the obligation to minimize or prevent harm; there is no
, NR 328 Exam #1
Study online at https://quizlet.com/_9ubwj3
situation present that would require this. C. Justice is the concept of fairness and is not applicable to this situation. D.
Advocacy involves ensuring that families are aware of all available health services, adequately informed of treatments
and procedures, involved in the child's care, and encouraged to change or support existing health care practices.
4. True or False: Open ended questions are most likely to encourage parents to
talk about their feelings r/t their child's illness.: True
5. When the nurse interviews an adolescent, what is important to help establish
a relationship?
a. Use the same type of language as the adolescent.
b. Emphasize that confidentiality will always be maintained.
c. Focus the discussion on the peer group.
d. Display a genuine interest in the adolescent.: Answer: D.
Rationale: Display a genuine interest in the adolescent.Adolescents accept anyone who shows a genuine interest in
them. Although peers are important to this age-group, the focus of the interview should be on the adolescent. The
nurse should clarify which information will be shared with other members of the health care team and any limits to
confidentiality. The nurse should maintain a professional relationship with adolescents. To avoid misinterpretation of
words and phrases that the adolescent may use, the nurse should clarify terms frequently.
6. What approach is the most appropriate when performing a physical assess-
ment on a toddler?
a. Demonstrate use of equipment.
b. Perform traumatic procedures first.
c. Use minimum physical contact initially.
d. Always proceed in a head-to-toe direction.: Answer: C.
Rationale: Parents can remove clothing, and the child can remain on the parent's lap. The nurse should use minimum
physical contact initially to gain the cooperation of the child. The nurse should introduce the equipment slowly. The
child can inspect the equipment, but demonstrations are usually too complex for this age-group. Traumatic procedures
should always be performed last. These will most likely upset the child and inhibit cooperation. The head-to-toe
assessment can be done in older children but usually must be adapted in younger children.
7. What is the most consistent and commonly used indicator of pain in infants?
a. Thrashing of arms and legs.
b. Increased heart rate.
c. Increased respirations.
d. Facial expression of discomfort.: Answer: D.
, NR 328 Exam #1
Study online at https://quizlet.com/_9ubwj3
Rationale: Facial expression of discomfort. Facial expression has consistently been validated as an indicator of pain
in infants. Behavioral pain measures are most reliable for sharp procedural pain in infants. Increased heart rate and
respirations are indicative of a generalized and complex response to stress. They are not specific for pain in infants.
Thrashing of arms and legs is a reliable indicator in young children, not infants.
8. True or False: At age 1 month is the normal age for binocularity-ability to
fixate on one visual field with both eyes simultaneously.: Answer: False.
Rationale: Binocularity is usually achieved by age 3 to 4 months. One month is too young for binocularity. If binocularity
is not achieved by 6 to 12 months, the child must be observed for strabismus.
9. What self-report pain rating scales can be used in children as young as 3 years
of age?
a. FACES Pain Rating Scale
b. Visual Analog Scale
c. Word-Graphic Rating Scale
d. Who Cares?: Answer: A.
Rationale: The FACES Pain Rating Scale is for children as young as 3 years of age. The Visual Analog Scale can be used
for children older than 4 years of age but is most appropriate for ages 7 and older. The Word-Graphic Rating Scale
uses descriptive words and is recommended for children 4 to 17 years of age.
10. An intravenous line is needed in a school-age child. What medication is
appropriate analgesic for use with this patient?
a. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.
b. EMLA (eutectic mixture of local anesthetics) immediately before.
c. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
d. TAC (tetracaine, epinephrine [Adrenalin], cocaine) 15 minutes before.: Answer:
A.
Rationale: LMX is an effective analgesic agent when applied to the skin 30 minutes before a procedure. It eliminates or
reduces the pain from most procedures involving skin puncture. TAC provides skin anesthesia about 15 minutes after
application to nonintact skin. The gel can be placed on the wound for suturing. It is not useful for intact skin. Transderma
fentanyl patches are useful for continuous pain control, not rapid pain control. For maximum effectiveness, EMLA must
be applied approximately 60 minutes in advance. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
11. At what age does Erickson consider the infancy stage?: 0 - 18 months
, NR 328 Exam #1
Study online at https://quizlet.com/_9ubwj3
12. What is the basic conflict and important events of Erickson's infancy stage?-
: Trust vs. Mistrust
Feeding/Comfort
13. At what age does Erickson consider the Early Childhood stage?: 2 - 3 years
14. What is the basic comfort and important events of Erickson's early childhood
stage?: Autonomy vs. Shame and Doubt
Toilet training/Dressing
15. At what age does Erickson consider the preschool stage?: 3 - 5 years
16. What is the basic conflict and important events of Erickson's preschool
stage?: Initiative vs. Guilt
Exploration/Play
17. At what age does Erickson consider the school age?: 6 - 11 years
18. What is the basic conflict and important events of Erickson's school age?: In-
dustry vs. Inferiority
School/Activities
19. At what age does Erickson consider the adolescence stage?: 12 - 18 years
20. What is the basic comfort and important events of Erickson's adolescence
stage?: Identity vs. Role Confusion
Social relationships/Identity
21. What is the outcome of Erickson's infancy stage?: Children develop a sense of trust when
caregivers provide reliability, care and affection. A lack of this will lead to mistrust.
22. What is the outcome of Erickson's early childhood stage?: Children need to develop
a sense of personal control over physical skills and a sense of independence. Success leads to feeling of autonomy,
failure results in feelings of shame and doubt.
23. What is the outcome of Erickson's preschool stage?: Children need to begin asserting
control and power over the environment. Success in this state leads to a sense of purpose. Children who try to exert
too much power experience disapproval, resulting in a sense of guilt.
24. What is the outcome of Erickson's school age stage?: Children need to cope with new
social and academic demands. Success leads to a sense of competence, while failure results in feeling of inferiority.
25. What is the outcome of Erickson's adolescence stage?: Teens need to develop a sense
of self and personal identity. Success leads to an ability to stay true to yourself, while failure leads to role confusion and
a weak sense of self.
