60 Items pediatric Nursing questions with Rationale by: Jeddah

60 Items pediatric Nursing questions with Rationale by: Jeddah Situation 1: Raphael, a 6 year’s old prep pupil is seen at the school clinic for growth and development monitoring (Questions 1-5) 1. Which of the following is characterized the rate of growth during this period? a. most rapid period of growth b. a decline in growth rate c. growth spurt d. slow uniform growth rate Correct answer is letter B. During the Preschooler stage growth is very minimal. Weight gain is only 4.5lbs (2kgs) per year and Height is 3.5in (6-8cm) per year. Review: Most rapid growth and development- Infancy Slow growth- Toddler hood and Preschooler Slower growth- School age Rapid growth- Adolescence 2. In assessing Raphael’s growth and development, the nurse is guided by principles of growth and development. Which is not included? a. All individuals follow cephalo-caudal and proximo-distal b. Different parts of the body grows at different rate c. All individual follow standard growth rate d. Rate and pattern of growth can be modified Growth and development occurs in cephalo-caudal meaning development occurs through out the body’s axis. Example: the child must be able to lift the head before he is able to lift his chest. Proximo-distal is development that progresses from center of the body to the extremities. Example: a child first develops arm movement before fine-finger movement. Different parts of the body grows at different range because some body tissue mature faster than the other such as the neurologic tissues peaks its growth during the first years of life while the genital tissue doesn’t till puberty. Also G&D is predictable in the sequence which a child normally precedes such as motor skills and behavior. Lastly G&D can never be modified “Haller? (Pwede mo bang turuan mag basa ang Infant? Or patayuin sya bago pa nakakagapang?) 3. What type of play will be ideal for Raphael at this period? a. Make believe b. Hide and seek c. Peek-a-boo d. Building blocks Correct answer is Letter A, make believe is most appropriate because it enhances the imitative play and imagination of the preschooler. C and D are for infants while letter A is B is recommended for schoolers because it enhances competitive play. 4. Which of the following information indicate that Raphael is normal for his age? a. Determine own sense self b. Develop sense of whether he can trust the world c. Has the ability to try new things d. Learn basic skills within his culture The correct answer is letter C; because Erickson defines the developmental task of a preschool period is learning Initiative vs. Guilt. Children can initiate motor activities of various sorts on their own and no longer responds to or imitate the actions of other children or of their parents. Letter A and B is.. for you!! 5. Based on Kohlberg’s theory, what is the stage of moral development of Raphael? a. Punishment-obedience b. “good boy-Nice girl” c. naïve instrumental orientation d. social contact Correct answer is letter C: According to Kohlber, a preschooler is under Pre-conventional where a child learns about instrumental purpose and exchange, that is they will something do for another if that that person does something with the child in return. Letter A is applicable for Toddlers and letter B is for a School age child. Situation 2 Baby boy Lacson delivered at 36 weeks gestation weighs 3,400 gm and height of 59 cm (6-10) 6. Baby boy Lacson’s height is a. Long b. Short c. Average d. Too short Correct answer is Letter A because the normal length of a newborn is 47.5-53.75 cm (19.5-21in) with an average of 50cm (Filipino standards po ito, pag kay Pilliteri nyo tinignan, 53cm for female and 54cm for male) 7. Growth and development in a child progresses in the following ways EXCEPT a. From cognitive to psychosexual b. From trunk to the tip of the extremities c. From head to toe d. From general to specific Growth and development occurs in cephalo-caudal (head to toe), proximo-distal (trunk to tips of the extremities and general to specific, but it doesn’t occurs in cognitive to psychosexual because they can develop at the same time. 8. As described by Erikson, the major psychosexual conflict of the above situation is a. Autonomy vs. Shame and doubt b. Industry vs. Inferiority c. Trust vs. mistrust d. Initiation vs. guilt According to Erikson, children 0-18 months are under the developmental task of Trust vs. Mistrust. 9. Which of the following is true about Mongolian Spots? a. Disappears in about a year b. Are linked to pathologic conditions c. Are managed by tropical steroids d. Are indicative of parental abuse Mongolian spots are stale grey or bluish patches of discoloration commonly seen across the sacrum or buttocks due to accumulation of melanocytes and they disappears in 1 year. They are not linked to steroid use and pathologic conditions. 10. Signs of cold stress that the nurse must be alert when caring for a Newborn is: a. Hypothermia b. Decreased activity level c. Shaking d. Increased RR Correct answer is letter D. Hypothermia is inaccurate cause normally, temperature of a newborn drop, Also a child under cold stress will kick and cry to increase the metabolic rate thereby increasing heat so B isn’t a good choice. A newborn doesn’t have the ability to shiver (Pag ikaw ay nag pa anak at ang beybe ay nanga-ngatog, naku itapon mo yan..di yan beybe itik yan.. hehe). So letter B and C is wrong. A newborn will increase its RR because the NB will need more oxygen because of too much activity. Situation 3 Nursing care after delivery has an important aspect in every stages of delivery 11. After the baby is delivered, the cord was cut between two clamps using a sterile scissors and blade, then the baby is placed at the: a. Mother’s breast b. Mother’s side c. Give it to the grandmother d. Baby’s own mat or bed Of course, place it at the mother’s breast for latch-on. (Note: for NSD breast feed ASAP while for CS delivery, breast feed after 4 hours) Lol, syempre d naman pwede sa grandma dba? Kasi naman hindi gatas ang ipapadede nyan, yogurt na sosyal. ewwww. LOL 12. The baby’s mother is RH(-). Which of the following laboratory tests will probably be ordered for the newborn? a. Direct Coomb’s b. Indirect Coomb’s c. Blood culture d. Platelet count ......................................