Maternity Midterm Review. ( 2021 LATEST UPDATE ) Q&A

Maternity Midterm Review. ( 2021 LATEST UPDATE ) Q&AMaternity Midterm Review. Name: Date: 1. The developmental task of the school- aged period, according to Erikson, is gaining a sense of: A) autonomy versus shame. B) independence versus dependence. C) industry versus inferiority. D) identity versus failure. 2. A 9-year-old is hospitalized for a long- term illness. The best project to give her to help achieve her developmental task would be: A) a scrapbook that will take 3 weeks to complete. B) a puppet show that will take 2 weeks to plan. C) watching her favorite program on television. D) sewing a purse that will take one afternoon. 3. When caring for hospitalized school-aged children, it is important to: A) consistently reinforce their worth. B) discourage their participation in care. C) correct mistakes with harsh penalties. D) structure a competitive environment for them. 4. Typical development for the school-aged child includes playing games with friends. At what age are children typically ready for games that include playing on a team that has a winner or loser? A) 5 years B) 7 years C) 10 years D) 13 years 5. The Boy Scouts is an organization that continues to be a favorite with school- aged boys because: A) fathers participate in Boy Scouts. B) no girls are included in the organization. C) merit badges require completing small tasks for rewards. D) hiking is a favorite school-aged activity. 6. Once children are able to tell time, they can be much more independent. The age at which school-aged children learn to tell time is usually: A) 6 years. B) 7 years. C) 8 years. D) 9 years. 7. When the nurse is cleaning the bedside stand of a hospitalized 10-year-old, the nurse finds 48 packages of sugar. The nurse's best action is which? A) Put them back in the drawer as they were. B) Ask the child's mother if he has a history of craving sweets. C) Advise the child's mother to have him tested for diabetes. D) Throw out the sugar; sugar is not nutritious. 8. A mother tells you her 6-year-old has been biting his fingernails since he began first grade. After analyzing the cause of this as increased stress, the advice the nurse would give the mother regarding this problem would be to: A) encourage the child to drink more milk for stronger nails. B) distract the child by teaching him a new skill, such as whistling. C) allow some time every day for the child to talk about new experiences. D) allow the child to choose a reward for not biting his nails. 9. On physical examination, you discover that a 6-year-old's palatine tonsils are somewhat enlarged in the back of his throat. Your best action would be to: A) record this as a normal early school-age finding. B) suggest a resident examine him for breathing difficulty. C) take the child's temperature; this must be tonsillitis. D) give the child something for pain. 10. A 7-year-old has taken money from his brother's dresser on two occasions. When counseling his mother about this, the nurse would advise her that: A) she may need to remind him of property rights. B) she should buy his brother a bank that cannot be opened. C) stealing is unusual for a 7-year-old. D) she should talk to the child's teacher about putting less pressure on him. 11. The nurse is caring for a 9-year-old who belongs to a spite club. The chief characteristics of a 9-year-old spite club are: A) they have a secret word; they exclude someone. B) they have a president and collect dues. C) members enjoy completing charity projects. D) the members whisper a lot; there are strict rules. 12. A school-aged child develops school phobia. When counseling her mother, the nurse would advise her that the accepted action is to: A) keep her child home until this fear passes. B) make her child attend school every day. C) allow her child to decide daily if she wants to go to school or not. D) ask the teacher to decide if the child should come to school or not each day. 13. The parents of a school-aged child with school phobia have received professional guidance by the school psychologist, pediatrician and three different psychiatrists. Based on this, which nursing diagnosis would be most appropriate? A) Disturbed thought processes related to delusional behavior B) Compromised parental coping related to inability to assist with school fears C) Noncompliance with expected school behavior related to school phobia D) Ineffective tissue perfusion, cerebral, related to anxiety over attending school 14. A 10-year-old spends 2 hours by herself every afternoon before her parents arrive home. What would be the most appropriate safety measure to suggest that the parents teach the child? A) Telling people at school she is by herself for added safety B) Wearing the house key prominently around her neck C) Lighting candles in case there is a power failure D) Preparing a no-cook snack for herself 15. While planning care for a 7-year-old patient, the nurse reminds the parents that children at this age are experiencing the “eraser” year. What does this mean? A) The child wants to perform well. B) The child believes in magical thinking. C) The child is learning to write during this year. D) The child tends to “erase” misdeeds or lie excessively. 16. The school nurse is reviewing content to include in an assembly planned for school-age children that focuses on the 2020 National Health Goals for safety. What should the school nurse include in this presentation? Select all that apply. A) Encourage the children to play outdoors and get exercise every day. B) Stress the need to sit in age-appropriate seats in cars and wear seatbelts. C) Remind children how important it is to brush the teeth and see the dentist. D) Explain how important it is for children to wear safety helmets when bicycling. E) Offer suggestions to ensure an adequate intake of fruits and vegetables each day. 17. The nurse is caring for a 9-year-old patient in the hospital. Which project should the nurse provide to help this child achieve the developmental task of industry? A) Sew a purse that will take one afternoon. B) Watch favorite programs on the television. C) Design a puppet show that will take 2 weeks to plan. D) Work on a scrapbook that will take 3 weeks to complete. 18. While making a visit to the home of a family with a school-age child, the nurse observes a hunting rifle leaning against the wall in the dining room. Which nursing diagnosis should the nurse use to guide interventions for the family at this time? A) Anxiety B) Risk for injury C) Health-seeking behaviors D) Readiness for enhanced parenting 19. When planning activities for school-age children, the nurse organizes games that include competition. At which age are these kinds of games preferred by children? A) 7 years old B) 8 years old C) 10 years old D) 12 years old 20. Why should the nurse carry information about the Boy Scouts when visiting families with male school-age children? A) No girls are included in the organization. B) Hiking is a favorite school-age activity. C) Merit badges are rewarded for completing small tasks. D) It strengthens relationships with fathers who participate in Boy Scouts. 21. The nurse knows that being able to tell time helps a child become more independent. At which age should the nurse expect a school-age child to begin to tell time? A) 6 years old B) 7 years old C) 8 years old D) 9 years old 22. While straightening the top drawer of a 10-year-old patient the nurse finds 48 packets of sugar. What should the nurse do at this time? A) Advise the mother to have the child tested for diabetes. B) Throw out the sugar because this will promote dental caries. C) Place the sugar packets in the drawer as they were found. D) Ask the mother if the child has a history of craving sweets. 23. The nurse is talking with a mother who is concerned that a school-age child is experiencing stress and has been biting the fingernails since beginning the first grade. What should the nurse advise the mother to do about this problem? A) Encourage the child to drink more milk for stronger nails. B) Allow the child to choose a reward for not biting the nails. C) Distract the child by teaching a new skill such as whistling. D) Allow some time every day for the child to talk about new experiences. 24. The nurse observes a school-age child categorize specific desk and clothing items in his hospital room. What cognitive behavior has this child mastered? A) Decentering B) Conservation C) Class inclusion D) Accommodation 25. A mother is concerned that a 7-year-old child has taken money from a sibling's dresser several times. What should the nurse advise the mother about this behavior? A) The child needs to be reminded of property rights. B) Stealing is unusual for a 7-year-old and needs to be investigated. C) The mother should purchase a bank for the other child that cannot be opened. D) The mother should talk to the child's teacher about putting less pressure on the child. 26. A 9-year-old girl tells the nurse about belonging to a spite club. How does belonging to this group support the child's development? A) Fulfills peer group needs B) Teaches the child leadership skills C) Helps the child develop autonomy D) Encourages the child to learn rules 27. The mother of a school-age child is distraught because the child has been diagnosed with obesity. What actions should the nurse suggest to the mother to help the child with this problem? Select all that apply. A) Explain that obesity will lead to an early death. B) Maintain a balanced eating approach in the home. C) Purchase books explaining the latest ways to lose weight. D) Seek out a preteen weight loss group for the child to participate. E) Encourage increased activity such as walking the dog after school. 28. The nurse has been caring for a family with a school-age child who has school phobia. Which observation indicates that interventions have been successful? A) The child stays home from school. B) The child attends school every day. C) The child decides daily about attending school. D) The child's teacher is asked if attending school is a requirement. 29. A 10-year-old child spends 2 hours alone every afternoon before the parents arrive home from work. Which safety measure should the nurse suggest the parents teach the child? A) Preparing a no-cook snack after school B) Lighting candles in case there is a power failure C) Wearing the house key prominently around the neck D) Telling people at school about being home alone for added safety 30. A mother is concerned that a school-age child will pick up the habit of smoking because so many children in the school smoke. What should the nurse instruct the mother about this behavior? A) Be a role model and do not smoke. B) Remind the child that smoking costs money. C) Discuss other tobacco choices that can be used instead. D) Explain that the child can experiment with smoking when older. 1. A 15-year-old is seen at a health care facility for facial acne. When counseling him, the nurse would teach him that the basic cause of his acne is: A) lack of showering adequately after gym class. B) activation of androgen hormones. C) vitamin deficiency from an inadequate diet. D) thyroid-gland secretions increasing with adolescence. 2. An adolescent is prescribed retinoic acid cream as therapy for his acne. About which of the following would you caution him? A) Not putting the medication on just prior to bedtime B) Applying the cream while his face is wet C) Avoiding staying in the sun for extended periods of time D) Not applying the cream directly on lesions 3. An adolescent is concerned that although he has pubic hair, he has no facial hair yet. He wishes facial hair would grow to cover acne lesions. The nurse would advise him that facial hair: A) usually grows before pubic hair. B) is rarely present before 20 years of age. C) is delayed in boys with acne. D) usually follows pubic hair growth. 4. An adolescent is concerned that he is going to be unusually short. The nurse would advise him that the epiphyseal lines of long bones in boys that govern growth usually close between ages: A) 13 and 14 years. B) 14 and 15 years. C) 17 and 18 years. D) 20 and 22 years. 5. Based on the most frequent cause of death in adolescents, what preventive measure would the nurse most want to teach an adolescent? A) Home safety B) Motor vehicle safety C) Firearm safety D) Water safety 6. A 17-year-old writes a suicide note and then swallows aspirin. The client is found and brought to the emergency department Upon completing an assessment, which factor does the nurse identify as placing the client at risk of attempting suicide again? A) The client has always been introverted. B) The client states feeling sad lately. C) The client took only six aspirins, so there are some remaining. D) The client's parents were recently divorced and one parent moved away. 7. Which intervention would probably be most effective in preventing an adolescent from attempting suicide with an overdose again? A) Assessing his financial level B) Helping him learn better problem solving C) Teaching his parents to keep medicine in a locked cabinet D) Helping him locate a close friend at school 8. A 16-year-old who drives a car he bought with money earned from working after school is seen in an emergency room after being arrested for driving while intoxicated. The teaching method that probably will be most effective in getting him to discontinue alcohol use is to: A) review the long-term effects of alcohol on the liver. B) tell him he should know better. C) teach that alcohol eventually will lead to other drug abuse. D) stress that he will lose his driving license if he does not stop. 9. A 16-year-old uses marijuana daily. To help her do better in school, what advice would you offer that would be most important? A) Marijuana causes memory gaps that interfere with learning. B) The effect of marijuana fades fastest if she eats after use. C) Marijuana leads to muscle laxness, so it should not be used close to gym class. D) Marijuana increases blood pressure; she should not run after smoking it. 10. The developmental task of the adolescent period, according to Erikson, is to form a sense of: A) autonomy versus shame or doubt. B) initiative versus guilt. C) identity versus role confusion. D) decisiveness versus indecisiveness. 11. The activity that would best foster the developmental task of an adolescent who is physically challenged would be: A) deciding whether she wants her bath before or after lunch. B) watching television on the set in her room. C) talking to another adolescent who has a similar disorder. D) having a teacher bring her school homework in for her. 12. A 16-year-old girl who has been confined to a wheelchair since early childhood has been acting rebellious and rude. Her parents ask the nurse, “Are all adolescents like this?” What is the nurse's best response? A) “Yes. Although your daughter's behaviors are more like those of an adolescent boy.” B) “No. Your daughter must need some help in dealing with her feelings.” C) “Your daughter's behavior seems to be typical adolescent behavior. Let's talk more about it.” D) “Your daughter's behavior results from feelings about her disability; ignore them.” 13. Which action would provide an indication that an adolescent's parents understand their daughter's need for increased independence? A) Verbalizing, “We try to do everything we can to make things easier for her.” B) Telling you that they now understand that their daughter's chief need is for increased privacy C) Telling you that they are encouraging their daughter in her search for an after-school job D) Saying, “We will always be here for her whenever she needs us.” 14. An adolescent asks the nurse what the term “puberty” means. What is the nurse's best response? A) “It is the age at which one first becomes capable of sexual reproduction.” B) “It denotes the beginning of secondary sex characteristics.” C) “It is the time span between 12 and 18 years.” D) “It is the time span that denotes the onset of maturity.” 15. An adolescent shares with you that she wishes her breasts would grow larger. Which initial nursing response is best? A) “It is unlikely that your breasts will grow any more. I wouldn't spend time thinking about it.” B) “You look fine to me. Why would you want larger breasts?” C) “Breast growth usually stops by the age of 16 years. What is the reason you were hoping yours would grow more?” D) “Let's talk about your concern. You know that breast size has nothing to do with ability to reproduce.” 16. An adolescent client is concerned about the presence of facial acne. What should the nurse teach the client about the cause of this skin disorder? A) Caused by thyroid gland secretions B) Develops because of poor personal hygiene C) Caused by the activation of androgen hormones D) Appears when there is a vitamin deficiency from an inadequate diet 17. An adolescent is prescribed tretinoin cream as therapy for acne. What should the nurse instruct the client about this medication? A) Avoid unprotected sun exposure. B) Apply the cream while the face is wet. C) Avoid using the medication prior to bedtime. D) Avoid applying the cream directly on lesions. 18. The school nurse is preparing an educational session for adolescents to address the 2020 National Health Goals for healthy habits. What should the nurse include in this presentation? Select all that apply. A) Abstaining from alcohol B) Avoidance of tobacco products C) Maintaining a healthy body weight D) Attending college preparation programs E) Refusing to participate in substance abuse 19. During a physical assessment, a 15-year- old male expresses concern about being short in height. Which should the nurse respond to this client's concern? A) Most male adolescents stop growing by age 17 years. B) Maximum height is typically achieved by age 14 years. C) The epiphyseal lines of long bones close when signs of puberty occur. D) The epiphyseal lines of long bones close at about 18 to 20 years of age in males. 20. The nurse is preparing to discuss the most frequent causes of death in adolescents with a group of high school students. On which area should the nurse focus during this discussion? A) Water safety B) Home safety C) Firearm safety D) Motor vehicle safety 21. The nurse is caring for a 17-year-old client recovering from a failed suicide attempt. Which factor should the nurse recognize as potentially causing the client to reattempt suicide? A) Patient states feeling sad. B) Patient has three other siblings. C) Patient performs in the school band. D) Patient is on the honor roll at school. 22. The nurse is identifying outcomes for an adolescent client who has been avoiding bread products and grains in order to lose weight. Which outcome should the nurse identify as appropriate for this client's nutritional needs? A) Patient will ingest bread and grain products during breakfast. B) Patient will have no further signs of calcium, iron, and zinc deficiency. C) Patient will have no further signs of thiamine and riboflavin deficiency. D) Patient will ingest bread and grain products when eating out with high school friends. 23. The nurse is caring for a 16-year-old adolescent who was arrested for driving while intoxicated. Which teaching method is most effective in changing the adolescent's behavior? A) Scolding the client for such irresponsible behavior B) Reviewing the long-term effects of alcohol on the liver C) Teaching that alcohol eventually will lead to other drug abuse D) Stressing that the driver's license can be lost if drinking continues 24. An adolescent admits to using marijuana on a daily basis. What should the nurse explain to the patient to help improve performance in school? A) The effect of marijuana fades fastest if eating occurs after use. B) Marijuana causes memory gaps that interfere with learning. C) Marijuana leads to muscle laxness, so it should not be used close to gym class. D) Marijuana increases blood pressure; running should not be done after smoking it. 25. The nurse is caring for an adolescent who has been diagnosed with obesity. Which nursing diagnosis would be best for the nurse to use when planning this client's care? A) Risk for low self-esteem B) Ineffective individual coping by overeating C) Anxiety related to concerns about normal growth and development D) Health-seeking behaviors related to normal growth and development 26. The nurse is caring for an adolescent who is physically challenged. Which activity should the nurse suggest that will foster the developmental task of adolescence? A) Watching television B) Deciding when to have a bath C) Having a teacher bring school homework to the hospital D) Talking to another adolescent who has a similar disorder 27. The nurse instructs an adolescent on the hazards of body piercings and tattoos. Which outcome indicates that teaching has been effective? A) The patient gets a small tattoo on the inner ankle. B) The patient refuses to get eyebrow pierced with girlfriends. C) The patient observes a tattoo being done and decides to get one with an older brother. D) The patient limits body piercings and tattoos to areas on the trunk. 28. An adolescent comes into the emergency department with a foot wound. Upon assessment, the nurse learns that the patient is a runaway and has been living on the streets. Which is the most appropriate care for the nurse to provide to the client at this time? A) Recommend returning to live with parents. B) Treat the wound and provide wound care supplies. C) Discuss the importance of a diet high in protein and vitamin C. D) Explain how the wound needs to be flushed with water every 4 hours. 29. During a routine health checkup, an adolescent patient expresses concern about being sexually active at such a young age. What can the nurse instruct the patient with sexual issues? Select all that apply. A) Do not be influenced by friends to have sex. B) There is no 100% method to prevent pregnancy. C) Learn about and practice safe sexual techniques. D) Sexual activity does not harm routine physical activity. E) Adolescence is the time when all sexual activity begins. 30. The nurse is caring for a chronically ill adolescent client. What can the nurse do to maintain stimulation and support the client's sense of identity while hospitalized? A) Plan activities around scheduled rest periods. B) Explain food choices appropriate to the prescribed diet. C) Teach the name and indications for use of all medications. D) Encourage communicating with friends through social media. 1. The nurse examines a 3-year-old girl in a health maintenance setting. What is the first question the nurse would ask her mother to obtain a health history? A) “Has your daughter been ill in the past?” B) “Do you have any concerns about your daughter?” C) “Is your daughter ill in any way?” D) “Tell me about your daughter.” 2. The nurse is interviewing the parents of a 3-year-old child brought to the emergency department for fever and fussiness. Which question is the best example to use when completing a health history about pain? A) "Sarah doesn't have any pain, does she?" B) "Does Sarah have pain?" C) "So Sarah has been fussy?" D) "Tell me about Sarah's temperament." 3. The nurse seeks to know how much time a preschooler's parents spend playing with the child every day. Which is the best way to obtain this kind of information? A) Ask the parents how many hours they play with the child each day. B) Ask the child how much time the parents spend with her. C) Ask the parents for a day history. D) Ask the parents how many games the child knows. 4. All infants should have their head circumference measured at health- assessment visits. This measurement is made from: A) just above the eyebrows through the prominent part of the occiput. B) the center of the forehead to the base of the occiput. C) the hairline in front to the hairline in back. D) the middle of the forehead through the parietal prominences. 5. Which technique would you begin with to assess a child's abdomen? A) Palpation B) Inspection C) Percussion D) Auscultation 6. Which finding would the nurse interpret as least significant when assessing a child's lungs? A) Stridor B) Crackles C) Rhonchi D) Wheezing 7. When auscultating bowel sounds, which of the following frequencies would the nurse identify as normal? A) One to two per minute B) Five to 10 per minute C) Thirty to 40 per minute D) Sixty per minute 8. Which assessment would the nurse expect to introduce for the first time in the physical examination of a 3-year-old child? A) Observation of walking gait B) Snellen vision testing C) Blood pressure recording D) Standing height measurement 9. When assessing children using a Snellen eye chart, you should be aware that the first number of the vision report (20/20) represents: A) the distance the child stands from the chart. B) the optic depth of a normal child's eye. C) the distance the child can see clearly. D) a Snellen chart conversion factor. 10. The nurse is assessing eye alignment in a 6-year-old. Which assessment method is most appropriate? A) Asking the child to stare at a distant mark. B) Asking the child to touch the finger to the nose. C) Covering one eye and then removing the cover. D) Turning a bright light on and then off. 11. The nurse administers a Denver Developmental Screening Test to a preschooler. Which statement is the best introduction to this test for her mother? A) “This test will identify different developmental skills your child can perform.” B) “It will be best if you do not watch your child during the test.” C) “The test will be important in determining your child's future IQ level.” D) “The test may be inaccurate because it is not well standardized.” 12. Which of the following statements best explains the principle behind a Rinne test for determining hearing loss? A) Air conduction of sound is normally better than bone conduction of sound. B) Conduction of sound is intensified in the middle of the forehead. C) A tuning-fork vibration will not be heard as sound in a child under 2 years of age. D) Bone conduction of sound is normally better than air conduction of sound. 13. While caring for a child recovering from viral pneumonia, the nurse examines his lungs for evidence of exudate and fluid. Which finding would suggest cause for concern? A) A respiratory rate of 20 heard on auscultation B) Dullness of his lower lobes heard on percussion C) A longer inspiratory than expiratory rate noticed by inspection D) Fine rhonchi heard in the upper lobe on auscultation 14. A 6-month-old is admitted to the hospital because of a fever. When you obtain a health history, what data would you obtain first? A) Details about the fever B) Family profile C) History of past illnesses D) Review of systems 15. When assessing for bowel sounds, which statement is true? A) All four quadrants should be auscultated in a consistent pattern. B) The presence of high-frequency sounds at 5- to 10-second intervals is abnormal. C) Bowel sounds should be heard at a rate of 80 to 90 per minute in the lower quadrants. D) Bowel sounds should be audible by the naked ear unless distention is present. 16. The nurse is beginning a health history with a 3-year-old child. Which question would the nurse ask the mother first? A) "Is your child ill in any way?" B) "Tell me about your child." C) "Has your child been ill in the past?" D) "Do you have any concerns about your child?" 17. The nurse is identifying ways to support the 2020 National Health Goals during the upcoming preschool health screening program. What should the nurse include when conducting the program? Select all that apply. A) Conduct vision tests. B) Conduct hearing tests. C) Listen to heart sounds. D) Measure gait and balance. E) Review immunizations received. 18. The nurse wants to find out how much time a preschooler spends in various activities throughout the day. What should the nurse do to learn this information? A) Ask the parents to complete a day history. B) Ask the parents to name the games the child knows. C) Ask the child how much time the mother is with the child. D) Ask the parents how many hours is spent playing with the child each day. 19. The nurse is preparing to measure the head circumference of a 6-month-old child. How should the nurse make this measurement? A) From the hairline in front to the hairline in back B) From the center of the forehead to the base of the occiput C) Above the eyebrows through the prominent part of the occiput D) From the middle of the forehead through the parietal prominences 20. The nurse is preparing to assess the abdomen of a preschool-aged child. Which technique should the nurse use first? A) Palpation B) Inspection C) Percussion D) Auscultation 21. The nurse is listening to the breath sounds of a 4-year-old child. Which sound should the nurse determine as being normal for this client? A) Stridor B) Crackles C) Rhonchi D) Wheezing 22. The nurse is preparing care for a preschool-age child scheduled for a health history and physical assessment. At which point will the nurse determine a nursing diagnosis that is appropriate for the child's care? A) Prior to the assessment B) At the time of assessment C) After completing the review of systems D) After specific problems have been identified 23. The nurse is preparing to conduct a physical examination of a 3-year-old child. Which assessment will the nurse introduce for the first time to this client? A) Snellen vision testing B) Blood pressure recording C) Observation of walking gait D) Standing height measurement 24. During a previous well-child visit, the nurse reviews the importance of immunizations for the preschool-age child with the parents. Which outcome indicates that the nurse's instruction to the parents has been effective? A) Child has all immunizations up to date. B) Parents plan to have the child receive needed immunizations within a year. C) Child began to cry during an immunization, and the decision was made to try again later. D) Primary care physician changed the appointment for immunizations to another day in a month. 25. The nurse is preparing to conduct the cover test with a preschool-age child. Which body system is the nurse preparing to assess? A) Ears B) Eyes C) Nose D) Neck 26. The nurse is preparing to administer the Denver II Developmental Screening Test to a preschooler. Which areas of the child's development should the nurse explain to the mother that this test measures? Select all that apply. A) Social B) Language C) Fine motor D) Intelligence E) Gross motor skills 27. When conducting the Rinne test for hearing with a school-age child, the nurse learns that the child is unable to hear the sound when the tuning fork is moved to the auditory meatus. What does this finding suggest to the nurse? A) The child is totally deaf. B) The child has normal hearing. C) The child has minimal air conduction for hearing. D) The child has minimal bone conduction for hearing. 28. The nurse is preparing to assess a school- age child who is experiencing pain in the left femur area. When conducting this assessment, at which point should the nurse assess the painful region? A) Last B) First C) After measuring vital signs D) Before the abdominal assessment 29. When beginning a physical examination of a toddler, the nurse notes that the child has halitosis. On which body areas should the nurse focus when conducting the assessment? Select all that apply. A) Lungs B) Urinary C) Reflexes D) Abdomen E) Oral cavity 30. The nurse is planning an education session for adolescent males on health promotion activities. Which topic should the nurse include as being the most applicable for this population? A) Reproductive cycle B) Immunization schedule C) Importance of socialization D) Testicular self-examination 1. A school nurse plans to teach children in the fourth grade some basic first-aid skills before they take a field trip. Which fact would make the nurse believe the children will learn this information most readily? A) The topic is new to them. B) The topic will have direct application. C) The material is review information. D) The topic concerns actions, not ideas. 2. Following a principle of learning, you can anticipate that the children will best learn a skill such as bandaging if they: A) are allowed to practice it. B) have it demonstrated to them by a teacher. C) are shown a photo of someone important doing it. D) are criticized for not learning it well. 3. Based on school-aged cognitive development, which teaching technique could you anticipate as being received the best? A) Using containers of water to demonstrate how hemorrhage leads to decreased body fluid B) Asking children to conceptualize the effect of falling blood pressure C) Asking children to think through “what if” situations and blood pressure D) Explaining elevated and decreased blood pressure as a concept 4. Preschool children do not understand the cognitive step of accommodation. This means that they A) cannot appreciate two different ways of doing the same thing resulting in the same outcome. B) cannot adapt because they have a poor imagination. C) will have trouble being appreciative about new learning. D) have difficulty manipulating material with their hands. 5. Behavior modification is a teaching technique frequently used with children who are cognitively challenged. Which of the following represents this technique? A) Giving a child a sticker for sitting still for 10 minutes B) Taking away television-watching privileges for running C) Giving the child an extra chore to do for talking in class D) Not allowing the child to play outside for rude behavior 6. The nurse is preparing to teach a 9-year- old how to do active range-of-motion exercises. Which technique would be most appropriate to use? A) Tell her different ways to perform the technique so she can choose. B) Demonstrate the technique by performing it consistently the same each time. C) Allow her to review instructional pamphlets as you are teaching her. D) Suggest she tell you how she wants her range-of-motion exercises to be done. 7. The nurse is teaching injection techniques to a school-aged child newly diagnosed with type 1 diabetes. Which observation would be the best evaluation that learning was successful? A) She developed a schedule for injection times and sites as a guide for the refrigerator. B) She needs occasional cuing during return demonstration of the injection technique. C) She shows an eagerness to learn more about type 1 diabetes. D) She explains the importance of performing the injections to keep her feeling good. 8. A school-aged child learns how to do range-of-motion exercises but has been unable to perform them the same from day to day. Which approach would be best for the nurse to take to encourage compliance? A) Reprimand her so that she sees how important the exercises are. B) Tell her parents so they can withhold privileges. C) Praise her for doing them when you see her doing them. D) Impress upon her the importance of the exercises to prevent disfiguring complications. 9. The nurse is caring for an adolescent with a newly diagnosed disease process. The adolescent states that he does not want to learn about the disease. Which technique to encourage active involvement in the disease is best? A) Help him understand how new information about the disease will improve health status now. B) Help him understand how new information about the disease will improve future health. C) Urge him to listen attentively to what information that the nurse wants to teach. D) Help him to realize that he is different from peers and needs teaching while they do not. 10. When planning to teach a toddler about coughing and deep breathing, which would be most effective? A) Showing an audiovisual B) Demonstrating the technique C) Discussing the importance of coughing D) Playing a game with coughing and breathing 11. Preschool children tend to “center” on information. The nurse understands the child may A) learn only the middle part of a procedure. B) concentrate on one part of a procedure and appear not to hear another. C) have to have printed material directly in front of him or her to understand it. D) not retain information longer than a week. 12. A 6-year-old child who does not speak English is in the hospital for an appendectomy. It is late at night when the nurse needs to catheterize the child for a distended bladder. Which action by the nurse would be most helpful in relaying this information? A) Draw a picture of the procedure using an anatomically correct figure. B) Call the interpreter on the phone and have her explain the procedure to the child. C) A child of this age does not require a detailed explanation; just perform the procedure. D) Tell the parents to tell the child what will be happening. 13. A 9-year-old girl is newly diagnosed with asthma. The nurse plans to teach her about triggers related to her diagnosis. The best approach for this child would be to: A) play an allergy trivia game with her. B) show her a video about allergic-reactions planning. C) give her a list of foods she cannot have. D) have the doctor teach her this information. 14. The nurse is planning activities to support the 2020 National Health Goals that address health teaching. Which action should the nurse take to ensure these goals are supported? A) Develop a teaching plan for a school-age child. B) Examine available teaching materials to use when conducting training sessions. C) Work with a school district to develop appropriate health teaching for the students. D) Assess the learning leads of parents of a preschool-age child with type 1 diabetes mellitus. 15. The nurse is preparing to teach a school- age child how to apply gauze wrap to a leg dressing. Which approach is the best for the nurse to use with this patient? A) Talk about the procedure. B) Demonstrate the procedure. C) Show pictures of the procedure. D) Review the written steps of the procedure. 16. The nurse provided a preschool-age child with instructions prior to having a surgical procedure. The parents of the child were in attendance, and the child was alert and participated in the education session. During postoperative care, the child is unable to recall anything that was instructed. What does this finding suggest to the nurse about the communication process? A) The code was not received. B) The feedback was not truthful. C) The decoder did not receive the message. D) The encoder failed to communicate the message. 17. A school-age child is newly diagnosed with type 1 diabetes mellitus. Which behavior indicates to the nurse that the child might be interested in learning how to self-administer insulin injections? A) The child cries and calls for the mother with every insulin injection. B) The child watches the nurse fill and asks to hold the insulin syringe. C) The child asks how many “shots” are needed before the illness is “all better.” D) The child tells the nurse that a parent will give the injection so the parent needs the teaching. 18. The mother of a child newly diagnosed with muscular dystrophy appears overwhelmed the care the child will need once discharge occurs. Which nursing diagnosis is the most appropriate for the nurse to select to help guide this mother's learning needs? A) Health-seeking behaviors related to ways to care for the child at home B) Effective coping related to understanding the home care needs of the child C) Deficient knowledge related to type and amount of care needed for the child D) Anxiety related to perceived amount of material needed to be learned for home care of child 19. The nurse is implementing the teaching technique of behavior modification for a cognitively challenged child. Which nursing action should the nurse use when implementing this technique? A) Giving the child a sticker for sitting still for 10 minutes B) Taking away television-watching privileges for running C) Giving the child an extra chore to do for talking in class D) Not allowing the child to play outside for rude behavior 20. The nurse is preparing to teach a 9-year- old how to do active range-of-motion exercises. Which technique is the most appropriate for the nurse to use for this teaching? A) Allow the child to listen to the radio during instruction. B) Demonstrate the technique by performing it consistently the same each time. C) Suggest the child he or she tell you how the range-of-motion exercises are to be done. D) Tell the child different ways to perform the technique so that they can be varied. 21. After teaching a school-age child how to apply a gauze wrap to a lower extremity, which observation indicates that teaching has been successful? A) The child shows an eagerness to learn more things. B) The child returns an adequate demonstration of wrapping the limb. C) The child consistently wraps the lower extremity as instructed each time. D) The child explains the importance of wrapping the lower extremity with gauze. 22. A school-age child was instructed on transfer techniques after having spinal surgery. For which outcome should the nurse assess when making a home visit to this patient? A) Patient transfers from bed to a chair unassisted. B) Patient stands up and walks to a chair with parental assistance. C) Patient transfers from the bed to a chair with one person assisting. D) Patient unable to move from the bed to a chair without assistance. 23. Which technique should the nurse use to teach an adolescent about a newly diagnosed disease process? A) Urge the adolescent to listen attentively during teaching. B) Help the adolescent understand how this information will improve future health. C) Help the adolescent realize that teaching is needed above what peers need to learn. D) Help the adolescent understand how this information will improve health status now. 24. Which teaching approach should the nurse use to teach a toddler about coughing and deep breathing? A) Showing a videotape B) Demonstrating the technique C) Discussing the importance of coughing D) Playing a game with coughing and breathing 25. While teaching a preschool-age child how to do postoperative exercises, the nurse recalls that the child will “center” on information. What impact does this have on the child's learning? A) The child will learn only the middle part of a procedure. B) The child will not retain information longer than a week. C) The child will need printed material to understand the teaching. D) The child will concentrate on one part of a procedure and appear not to hear another. 26. The nurse is caring for a school-age child who does not speak English. During the night, a procedure needs to be done and an interpreter is not available. What should the nurse do to teach the patient about this procedure? A) Tell the parents to tell the child what will be happening. B) Draw a picture of the procedure using an anatomically correct figure. C) Call the interpreter on the phone to explain the procedure to the child. D) A child of this age does not require a detailed explanation, just perform the procedure. 27. The nurse is preparing to teach a 9-year- old patient with asthma about triggers related to the disease. Which approach should the nurse use for this teaching? A) Play an allergy trivia game with the patient. B) Show the patient a video about allergic reactions. C) Have the doctor teach the patient this information. D) Give the patient a list of foods that must be avoided. 28. The nurse is planning to incorporate teaching while caring for a preschool-age child. Which statement would be appropriate for the nurse to use when caring and teaching this patient? A) “Your pulse is 88.” B) “I need to put a needle in your arm.” C) “You have to try to eat all of your dinner.” D) “It's important to put a pillow under your leg so the swelling will go down.” 29. The mother of an infant child only speaks Spanish. The 8-year-old sibling speaks English, and the mother wants to communicate through the sibling. How should the nurse best handle teaching to the mother? A) Provide a Spanish-speaking nurse. B) Obtain an interpreter. C) Teach the 8-year-old. D) Use a translation app on a phone. 30. The nurse educator is providing a class to the nurses on how to communicate with children who have hearing impairments. What communication techniques should be taught in this class? Select all that apply. A) Face the child when speaking. B) Write out instructions for the older child. C) Use dolls to communicate. D) Provide a sign language interpreter. E) Use pictures to communicate. Name: Date: 1. An 8-month-old will be hospitalized for surgery. Which preparation by her parents would be most important? A) Buy a new pair of soft pajamas. B) Pack her favorite toy. C) Let her watch her suitcase being packed. D) Read her a story on hospitalization. 2. An infant's mother does not visit her in the hospital for 3 days. The infant cries relentlessly for her during this time and then becomes extremely quiet and withdrawn. This reaction best indicates A) the infant's temperament is resistant. B) the infant is denying she is hospitalized. C) beginning fatigue from illness. D) development of a sense of despair. 3. A 3-year-old is admitted to the hospital suddenly after an automobile accident. His mother cannot stay with him because she is injured herself. A personal object you would suggest his mother leave with him when she leaves is A) her key ring emblem he has noticed many times. B) her driver's license because her picture is on it. C) a picture she draws of a boy in a hospital. D) her shoe because he would recognize it as hers. 4. Visiting is limited to 10 minutes every hour in the intensive-care unit where a child is receiving care. You would plan to arrange your care when possible to A) perform procedures during visiting hours to assure the parents that their child is receiving continual care. B) leave the immediate care area while the parents are visiting. C) avoid performing procedures during family visits. D) tell the parents to perform all care while they are visiting. 5. Children differ from adults in body composition. The difference that makes diarrhea so devastating in an infant is that an infant has a(n) A) higher proportion of fluid than an adult. B) intestine shorter in length than an adult. C) high proportion of extracellular fluid. D) fluid content that is proportionally less than that of an adult. 6. When caring for a 4-year-old confined to bed, which play experiences would the nurse plan as being most age appropriate? A) Supplying a tray of dry oatmeal for “sand” play. B) Teaching the child to play checkers. C) Helping the child learn to print words. D) Allowing the child to watch unlimited television. 7. A school-aged child needs 5 units of regular insulin administered. She is in the playroom when you are ready to give the injection. Your best action would be to A) inject it in the playroom; insulin injections do not hurt. B) tell her to come outside the playroom for the injection. C) ask the other children if they would mind if you gave the injection in the playroom. D) ask the girl if she would mind if you gave the injection in the playroom. 8. The nurse is caring for a 5 year who is receiving daily antibiotic injections due to a wound infection. Which toy provides the most therapeutic play? A) An anatomically correct puppet B) A doll who is in a patient gown C) A play syringe and doll D) A stuffed bear with Band-Aids 9. During therapeutic play, a 4-year-old child draws a girl with a head and body but no arms or legs. Your best action in response to this would be to A) alert the girl's physician that she must not be adjusting well to the hospital. B) urge nurses not to give the girl injections in her legs or arms after this. C) tell the girl to finish the drawing. D) appreciate that 4-year-olds often draw people with only three or four body parts. 10. A 3-year-old girl is admitted to the hospital for eye surgery. You provide her with a doll and syringe for therapeutic play. She sticks the doll in the eye with the syringe and says, “You won't watch TV again when I tell you not to!” What is your best response to this? A) Ask her if she ever accidentally stuck herself in the eye. B) Explain that nurses never give injections into eyes. C) Pretend that you are the doll and say, “Ouch!” D) Ask her if she thinks having surgery is punishing her. 11. You see a 2-year-old girl playing roughly with a truck. What is your best interpretation of this? A) She may wish that she were a boy. B) She is not comfortable with a boy's toy. C) She should not be allowed to have the truck anymore. D) She may be using the toy to express emotion. 12. A 3-year-old girl is admitted to the hospital for treatment of cellulitis of the right thigh. She is accompanied by her parents, who appear to be upset and frightened. Which question would be most effective in eliciting information concerning the parents' understanding of why their daughter is being admitted to the hospital? A) “Are you worried? I'll tell you everything you need to know.” B) “Why are you so concerned? We take good care of children here.” C) “You seem concerned; do you have questions about your child's admission?” D) “Has the doctor told you why your daughter requires hospitalization?” 13. A school-aged child's parents are very upset about having to leave her alone in the hospital. How would you respond to their concern? A) “Don't worry. Your child will be just fine.” B) “Just sneak out; that will make it easier.” C) “If you can't stay, visiting as often as possible is the next best thing.” D) “If you can't stay, then not visiting at all is best.” 14. Because a school-aged child's admission was an emergency, she was not prepared for a hospital stay and the procedures to be performed. Which approach would be most appropriate to help her comply with the need for warm soaks on her leg? A) Describe the way that warm water acts to relieve pain. B) Read her a story about soaks and dressings. C) Let her apply a warm soak to the leg of a doll. D) Ask her parents to explain why the soaks are necessary. 15. Which technique would be most effective in encouraging a preschooler to take fluids by mouth? A) Developing a chart for her to check off after she has taken five glasses of fluid B) Promising a reward for complying with your requests C) Leaving her favorite drink at the bedside to drink when thirsty D) Playing “tea party” and drinking “tea” with imaginary friends 16. The nurse is discussing a pending hospitalization of an 8-month-old infant with the parents. What should the nurse encourage the parents to do when preparing the child for this hospitalization? A) Pack her favorite toy. B) Buy a new pair of soft pajamas. C) Read her a story on hospitalization. D) Let her watch her suitcase being packed. 17. The mother of an infant is unable to visit the child in the hospital for 3 days. At first, the baby cries relentlessly but then becomes quiet and withdrawn. What reaction does the nurse identify as occurring with this child? A) The infant is fatigued. B) The infant is developing a sense of denial. C) The infant is confused about being hospitalized. D) The infant is ill, which is causing the change in behavior. 18. The nurses on a pediatric unit are planning an open house for parents and children to visit the unit in an attempt to reduce the stress when hospitalized. In order to support the 2020 National Health Goals regarding childhood hospitalization and stress, what type of materials should the nurses prepare for the families? A) Location of the hospital cafeteria B) Best places to park when visiting the hospital C) Checklist of preventive services needed by children D) Suggested times during the day to visit when the child is hospitalized 19. The nurse is assessing a preschool-age child who is being hospitalized for the first time for a surgical procedure. The child expresses the desire to go home and is scared. Which nursing diagnosis should the nurse identify as appropriate for the child at this time? A) Anxiety related to pending hospital admission B) Risk for social isolation related to hospitalization C) Fear related to being away from home for first time D) Health-seeking behaviors related to lack of knowledge regarding illness 20. The mother of an infant is upset to learn that the baby's diarrhea caused the infant to become quite ill. What should the nurse explain about an infant that makes diarrhea an important problem to treat? A) Infants have shorter intestines than adults. B) Infants have a high proportion of extracellular fluid. C) Infants have a higher proportion of fluid than an adult. D) Infants have a fluid content that is proportionally less than that of an adult. 21. The nurse is caring for a 4-year-old confined to bed. Which play experience should the nurse use as being the most age appropriate for the patient? A) Helping the patient learn to write B) Teaching the patient to play checkers C) Encouraging watching unlimited television D) Supplying a tray of dry oatmeal for “sand” play 22. A school-age child who is in the playroom is prescribed to receive an injection. What should the nurse do when preparing to administer this medication to the child? A) Inject it in the playroom. B) Ask to see the patient outside the playroom for the injection. C) Ask the patient if the injection can be given in the playroom. D) Ask the other children if they would mind if you give the injection in the playroom. 23. Which items should the nurse select as the best to support therapeutic play for a child who receives daily injections of medication? A) A doll with a cast in place B) A syringe to practice injections C) A stuffed bear with Band-Aids D) An anatomically correct puppet 24. The nurse is completing the teaching for parents of a toddler recovering from a fracture. Which outcome should the nurse identify to help determine if teaching has been effective? A) The child resumes normal activity level at home. B) The parents encourage the child to be independent. C) The parents place a locked gate at the top of the stairs. D) The child waits for the parent to assist before walking down a set of stairs. 25. The nurse is planning care for a school- age child being admitted to the hospital for a chronic illness. Which hazards of hospitalization for children will the nurse use to plan this patient's care? (Select all that apply.) A) Meeting new people B) Unsure of acceptable behavior C) Losing control over the environment D) Experiencing physical discomfort and pain E) Being separated from family, school, and friends 26. The nurse is helping the parents explain to a toddler the need to go to the hospital for a tonsillectomy. When explaining the procedure to the child, which phrase should the nurse and parents avoid using? A) “You will be able to eat popsicles.” B) “Your mommy and daddy will be with you.” C) “The bad tissue will be cut out of your throat.” D) “You will get medicine so that you feel better.” 27. A preschool-age child is being admitted to the hospital for treatment of cellulitis. The child's parents appear upset and frightened. Which question should the nurse use to elicit information concerning the parents' understanding of why the child is being admitted to the hospital? A) “Are you worried? I'll tell you everything you need to know.” B) “Why are you so concerned? We take good care of children here.” C) “Has the doctor told you why your daughter requires hospitalization?” D) “You seem concerned; do you have questions about your child's admission?” 28. While hospitalized, a school-age child began sleepwalking. The nurse teaches the parents how to handle sleepwalking once the child is discharged. Which statement indicates that this teaching has been effective? A) “We should not wake up the child.” B) “We should shake the child to wake up immediately.” C) “We should wake the child up gently and return the child to bed.” D) “We should keep the child awake in the living room to play before going to bed.” 29. The nurse is planning to meet the spiritual needs of a 6-year-old child who is hospitalized. Which child behavior should the nurse encourage to provide security to the child who is in a strange environment? A) Saying bedtime prayers B) Hanging a religious picture over the bed C) Giving the child a Bible to keep at the bedside D) Asking the hospital chaplain to visit with the child 30. The nurse is identifying ways to increase the oral fluid intake of a preschool-age child. Which interventions should the nurse use with this patient? (Select all that apply.) A) Provide fluids ice cold. B) Offer small full glasses of fluid. C) Provide the child's favorite fluid. D) Encourage popsicles if permitted. E) Provide a straw if not contraindicated. Name: Date: 1. You see a school-aged child in an ambulatory setting because of rheumatic fever. Which of the following would you expect to find revealed by the health history? A) Knee pain, abdominal rash, subcutaneous nodules B) An elevated temperature, back pain, loss of hair C) Fatigue, slow pulse, frequent urination D) Loss of weight, abdominal pain, chest pain 2. Which nursing diagnosis would best apply to a child with rheumatic fever? A) Ineffective breathing pattern related to cardiomegaly B) Activity intolerance related to inability of heart to sustain extra workload C) Disturbed sleep pattern related to hyperexcitability D) Risk for self-directed violence related to development of cerebral anoxia 3. When reviewing the record of a child with tetralogy of Fallot, what would the nurse expect to discover? A) Leukopenia B) Polycythemia C) Increased platelet level D) Anemia 4. Coarctation of the aorta demonstrates few symptoms in newborns. What is an important assessment to make on all newborns to help reveal this condition? A) Observing for excessive crying B) Assessing for the presence of femoral pulses C) Recording an upper extremity blood pressure D) Auscultating for a cardiac murmur 5. The nurse would teach the mother of a boy with tetralogy of Fallot that if the child suddenly becomes cyanotic and dyspneic, the mother should: A) place him in a semi-Fowler's position in an infant seat. B) have him lie supine with the head turned to one side. C) have him lie prone, being sure he can breathe easily. D) place him in a knee-chest position. 6. At 3 years of age, a child has a cardiac catheterization. After the procedure, which interventions would be most important? A) Assuring the child that the procedure is now over B) Allowing the child to adapt to the light room gradually C) Taking pedal pulses for the first 4 hours D) Allowing the child to talk about the procedure 7. When a child is scheduled for a cardiac catheterization, an important health teaching point for parents is that the: A) procedure is noninvasive and not frightening for children. B) child will return with a bulky pressure dressing over the catheter insertion area. C) child will require a general anesthetic and needs to be prepared for this. D) child will have to remain NPO for 6 to 8 hours after the procedure to prevent vomiting. 8. An 8-month-old has a ventricular septal defect. Which nursing diagnosis would best apply? A) Ineffective airway clearance related to altered pulmonary status B) Ineffective tissue perfusion related to inefficiency of the heart as a pump C) Impaired gas exchange related to a right- to-left shunt D) Impaired skin integrity related to poor peripheral circulation 9. An infant girl is prescribed digoxin. The nurse would teach her parents that the action of this drug is to: A) slow and strengthen her heartbeat. B) increase her heart rate. C) thicken the walls of the myocardium. D) prevent subacute bacterial endocarditis. 10. You take an infant's apical pulse before administering digoxin. What is the usually accepted level of pulse rate considered safe for administering digoxin to an 8- month-old infant? A) 60 beats per minute B) 80 beats per minute C) 100 beats per minute D) 150 beats per minute 11. What would be the most important measure to implement for an infant who develops heart failure? A) Restricting milk intake daily B) Planning ways to reduce salt intake C) Placing her in a semi-Fowler's position D) Keeping her supine and playing quiet games 12. After cardiac surgery, a child has chest tubes inserted that are attached to an underwater-seal drainage system. You should be prepared to clamp chest tubes when A) a clot obstructs the tubing. B) a tube becomes disconnected. C) red-stained drainage appears in a tube. D) you sit the child up to help with coughing. 13. On assessment immediately following cardiac surgery, which condition would the nurse expect to find in an infant? A) Hypothermia B) Hypovolemia C) Hypertension D) Hyperexcitability 14. You care for a toddler who has a functional heart murmur. You would advise the child's parents that A) this type of murmur is insignificant. B) mild activity restrictions are indicated. C) more frequent health appraisals are indicated. D) corrective surgery may be required later in life. 15. The nurse is caring for a newborn diagnosed with patent ductus arteriosus. Which finding will the nurse assess that is consistent with this diagnosis? A) Slow heart rate B) Expiratory grunt C) Wide pulse pressure D) Absent femoral pulses 16. Which of the following nursing diagnoses would best apply to a child during the acute phase of rheumatic fever? A) Disturbed sleep pattern related to hyperexcitability B) Ineffective breathing pattern related to cardiomegaly C) Risk for self-directed violence related to development of cerebral anoxia D) Activity intolerance related to inability of heart to sustain extra workload 17. The nurse is planning a program for community family members that focuses on the 2020 National Health Goals to improve cardiovascular health. Which content should the nurse include in this program? (Select all that apply.) A) Measures to reduce obesity B) Importance of daily exercise C) Starting reduced-fat diets upon birth D) Engaging in stress-reduction activities E) Following a diet that supports heart function 18. A newborn is diagnosed with coarctation of the aorta. Which assessment should the nurse make when caring for this infant? A) Observing for excessive crying B) Auscultating for a cardiac murmur C) Assessing for the presence of femoral pulses D) Recording an upper extremity blood pressure 19. What should the nurse teach the parents of a child with tetralogy of Fallot to do if the child suddenly becomes cyanotic and dyspneic? A) Place in a knee–chest position. B) Lie prone and