Peds Exam 1 and 2 Actual Questions With Correct Detailed Answers Verified Solutions.

A nurse on a pediatric unit is practicing family-centered care. Which is most descriptive of the care the nurse is delivering? A) Taking over total care of the child to reduce stress on the family B) Encouraging family dependence on health care systems C) Recognizing that the family is the constant in a child's life D) Excluding families from the decision-making process - correct answer C) Recognizing that the family is the constant in a child's life The three key components of family-centered care are respect, collaboration, and support. Family-centered care recognizes the family as the constant in the child's life. Taking over total care does not include the family in the process and may increase stress instead of reducing stress. The family should be enabled and empowered to work with the health care system. The family is expected to be part of the decision-making process. The nurse is preparing an in-service education to staff about atraumatic care for pediatric patients. Which intervention should the nurse include? A) Prepare the child for separation from parents during hospitalization by reviewing a video. B) Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal. C) Help the child accept the loss of control associated with hospitalization. D) Help the child accept pain that is connected with a treatment or procedure. - correct answer B) Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal. Preparing the child for any unfamiliar treatments, controlling pain, allowing privacy, providing play activities for expression of fear and aggression, providing choices, and respecting cultural differences are components of atraumatic care. In the provision of atraumatic care, the separation of child from parents during hospitalization is minimized. The nurse should promote a sense of control for the child. Preventing and minimizing bodily injury and pain are major components of atraumatic care. Which is the major cause of death for children older than 1 year? A) Cancer B) Heart disease C) Unintentional injuries D) Congenital anomalies - correct answer C) Unintentional injuries Unintentional injuries (accidents) are the leading cause of death after age 1 year through adolescence. Congenital anomalies are the leading cause of death in those younger than 1 year. Cancer ranks either second or fourth, depending on the age group, and heart disease ranks fifth in the majority of the age groups. Parents of a firstborn child are asking whether it is normal for their child to be extremely competitive. The nurse should respond to the parents that studies about the ordinal position of children suggest that firstborn children tend to: A) be praised less often. B) be more achievement oriented. C) be more popular with the peer group. D) identify with peer group more than parents. - correct answer B) Be more achievement oriented Firstborn children, like only children, tend to be more achievement-oriented. Being praised less often, being more popular with the peer group, and identifying with peer groups more than parents are characteristics of later-born children. An infant gains head control before sitting unassisted. The nurse recognizes that this is which type of development? A) Cephalocaudal B) Proximodistal C) Mass to specific D) Sequential - correct answer A) Cephalocaudal The pattern of development that is head-to-tail, or cephalocaudal, direction is described by an infant's ability to gain head control before sitting unassisted. The head end of the organism develops first and is large and complex, whereas the lower end is smaller and simpler, and development takes place at a later time. Proximodistal, or near to far, is another pattern of development. Limb buds develop before fingers and toes. Postnatally, the child has control of the shoulder before achieving mastery of the hands. Mass to specific is not a specific pattern of development. In all dimensions of growth, a definite, sequential pattern is followed. An infant who weighs 7 pounds at birth would be expected to weigh how many pounds at age 1 year? A) 14 B) 16 C) 18 D) 21 - correct answer D) 21 In general, birth weight triples by the end of the first year of life. For an infant who was 7 pounds at birth, 21 pounds would be the anticipated weight at the first birthday; 14, 16, or 18 pounds is below what would be expected for an infant with a birth weight of 7 pounds. The nurse observes some children in the playroom. Which play situation exhibits the characteristics of parallel play? A) Kimberly and Amanda sharing clay to each make things B) Brian playing with his truck next to Kristina playing with her truck C) Adam playing a board game with Kyle, Steven, and Erich D) Danielle playing with a music box on her mother's lap - correct answer B) Brian playing with his truck next to Kristina playing with her truck Playing with trucks next to each other but not together is an example of parallel play. Both children are engaged in similar activities in proximity to each other; however, they are each engaged in their own play. Sharing clay to make things is characteristic of associative play. Friends playing a board game together is characteristic of cooperative play. A child playing with something by herself on her mother's lap is an example of solitary play. At what age should the nurse expect the anterior fontanel to close? A) 2 months B) 2 to 4 months C) 6 to 8 months D) 12 to 18 months - correct answer D) 12-18 months The anterior fontanel normally closes between ages 12 and 18 months. Two to 8 months is too early. The expected closure of the anterior fontanel occurs between ages 12 and 18 months; if it closes between ages 2 and 8 months, the child should be referred for further evaluation The nurse is meeting a 5-year-old child for the first time and would like the child to cooperate during a dressing change. The nurse decides to do a simple magic trick using gauze. This should be interpreted as: A) inappropriate, because of child's age. B) a way to establish rapport. C) too distracting, when cooperation is important. D) acceptable, if there is adequate time. - correct answer B) A way to establish rapport A magic trick or other simple game may help alleviate anxiety for a 5-year-old. It is an excellent method to build rapport and facilitate cooperation during a procedure. Magic tricks appeal to the natural curiosity of young children. The nurse should establish rapport with the child. Failure to do so may cause the procedure to take longer and be more traumatic. What is the single most important factor to consider when communicating with children? A) The child's physical condition B) Presence or absence of the child's parent C) The child's developmental level D) The child's nonverbal behaviors - correct answer C) The child's developmental level The nurse must be aware of the child's developmental stage to engage in effective communication. The use of both verbal and nonverbal communication should be appropriate to the developmental level. Although the child's physical condition is a consideration, developmental level is much more important. The parents' presence is important when communicating with young children but may be detrimental when speaking with adolescents. Nonverbal behaviors will vary in importance, based on the child's developmental level. The nurse should teach parents that which age is safe to give infants whole milk instead of commercial infant formula? A) 6 months B) 9 months C) 12 months D) 18 months - correct answer C) 12 months The American Academy of Pediatrics does not recommend the use of cow's milk for children younger than 12 months. At 6 and 9 months, the infant should be receiving commercial infant formula or breast milk. At age 18 months, milk and formula are supplemented with solid foods, water, and some fruit juices. What is the best age for solid food to be introduced into the infant's diet? A) 3 months B) 6 months C) When birth weight has tripled D) after their 1st birthday - correct answer B) 6 months Physiologically and developmentally, the 4- to 6-month-old infant is in a transition period. The extrusion reflex has disappeared, and swallowing is a more coordinated process. In addition, the gastrointestinal tract has matured sufficiently to handle more complex nutrients and is less sensitive to potentially allergenic food. Infants of this age will try to help during feeding; 2 to 3 months is too young. The extrusion reflex is strong, and the child will push food out with the tongue. No research indicates that the addition of solid food to a bottle has any benefit. Infant birth weight doubles at 1 year. Solid foods can be started earlier. Tooth eruption can facilitate biting and chewing; most infant foods do not require this ability. Which information should the nurse give a mother regarding the introduction of solid foods during infancy? A) Solid foods should not be introduced until 8 to 10 months, when the extrusion reflex begins to disappear. B) Foods should be introduced one at a time, at intervals of 4 to 7 days. C) Solid foods can be mixed in a bottle to make the transition easier for the infant. D) Fruits and vegetables should be introduced into the diet first. - correct answer B) Foods should be introduced one at a time, at intervals of 4-7 days One food item is introduced at intervals of 4 to 7 days to allow the identification of food allergies. Solid foods can be introduced earlier. The extrusion reflex usually disappears by age 6 months. Mixing solid foods in a bottle has no effect on the transition to solid food. Iron-fortified cereal should be the first solid food introduced into the infant's diet. A nurse is preparing to feed a 12-month-old infant with failure to thrive. Which intervention should the nurse implement? A) Provide stimulation during feeding. B) Avoid being persistent during feeding time. C) Limit feeding time to 10 minutes. D) Maintain a face-to-face posture with the infant during feeding. - correct answer D) Maintain a face to face posture with the infant during feeding The nurse preparing to feed an infant with failure to thrive should maintain a face-to-face posture with the infant when possible. Encourage eye contact and remain with the infant throughout the meal. Stimulation is not recommended; a quiet, unstimulating atmosphere should be maintained. Persistence during feeding may need to be implemented. Calm perseverance through 10 to 15 minutes of food refusal will eventually diminish negative behavior. Although forced feeding is avoided, "strictly encouraged" feeding is essential. The length of the feeding should be established (usually 30 minutes); limiting the feeding to 10 minutes would make