MATERNAL AND CHILD PRACTICE EXAM 3 QUESTIONS AND
ANSWERS #5
When providing postoperative care for the child with a cleft palate, the nurse should
position the child in which of the following positions?
A On the side
B Prone
C In an infant seat
D Supine - correct answer Prone
Postoperatively children with cleft palate should be placed on their abdomens to
facilitate drainage. If the child is placed in the supine position, he or she may aspirate.
Using an infant seat does not facilitate drainage. Side-lying does not facilitate drainage
as well as the prone position.
Which of the following would the nurse expect to assess in a child with celiac disease
having a celiac crisis secondary to an upper respiratory infection?
A Watery diarrhea
B Respiratory distress
C Weight gain
D Lethargy - correct answer Watery diarrhea
Episodes of celiac crises are precipitated by infections, ingestion of gluten, prolonged
fasting, or exposure to anticholinergic drugs. Celiac crisis is typically characterized by
severe watery diarrhea. Respiratory distress is unlikely in a routine upper respiratory
infection. Irritability, rather than lethargy, is more likely. Because of the fluid loss
associated with the severe watery diarrhea, the child's weight is more likely to be
decreased.
Which of the following would the nurse do first for a 3-year-old boy who arrives in the
emergency room with a temperature of 105 degrees, inspiratory stridor, and
restlessness, who is learning forward and drooling?
A Auscultate his lungs and place him in a mist tent.
B Have him lie down and rest after encouraging fluids.
C Examine his throat and perform a throat culture
D Notify the physician immediately and prepare for intubation. - correct answer Notify
the physician immediately and prepare for intubation.
The child is exhibiting classic signs of epiglottitis, always a pediatric emergency. The
physician must be notified immediately and the nurse must be prepared for an
emergency intubation or tracheostomy. Further assessment with auscultating lungs and
placing the child in a mist tent wastes valuable time. The situation is a possible life-
threatening emergency. Having the child lie down would cause additional distress and
may result in respiratory arrest. Throat examination may result in laryngospasm that
could be fatal.
,Which of the following toys should the nurse recommend for a 5-month-old?
A A colorful busy box
B A big red balloon
C A teddy bear with button eyes
D A push-pull wooden truck - correct answer A colorful busy box
A busy box facilitates the fine motor development that occurs between 4 and 6 months.
Balloons are contraindicated because small children may aspirate balloons. Because
the button eyes of a teddy bear may detach and be aspirated, this toy is unsafe for
children younger than 3 years. A 5-month-old is too young to use a push-pull toy.
When assessing a child with a cleft palate, the nurse is aware that the child is at risk for
more frequent episodes of otitis media due to which of the following?
A Plugging of the Eustachian tubes with food particles
B Associated congenital defects of the middle ear.
C Lowered resistance from malnutrition
D Ineffective functioning of the Eustachian tubes - correct answer Ineffective functioning
of the Eustachian tubes
Because of the structural defect, children with cleft palate may have ineffective
functioning of their Eustachian tubes creating frequent bouts of otitis media. Most
children with cleft palate remain well-nourished and maintain adequate nutrition through
the use of proper feeding techniques. Food particles do not pass through the cleft and
into the Eustachian tubes. There is no association between cleft palate and congenial
ear deformities.
Which of the following best describes parallel play between two toddlers?
A Sharing crayons to color separate pictures
B Sitting near each other while playing with separate dolls
C Playing a board game with a nurse
D Sharing their dolls with two different nurses - correct answer Sitting near each other
while playing with separate dolls
Rationale:
Toddlers engaging in parallel play will play near each other, but not with each other.
Thus, when two toddlers sit near each other but play with separate dolls, they are
exhibiting parallel play. Sharing crayons, playing a board game with a nurse, or sharing
dolls with two different nurses are all examples of cooperative play.
The adolescent's inability to develop a sense of who he is and what he can become
results in a sense of which of the following?
A Role diffusion
, B Guilt
C Inferiority
D Shame - correct answer Role diffusion
Rationale:
According to Erikson, role diffusion develops when the adolescent does not develop a
sense of identity and a sense or where he fits in. Toddlers develop a sense of shame
when they do not achieve autonomy. Preschoolers develop a sense of guilt when they
do not develop a sense of initiative. School-agechildren develop a sense of inferiority
when they do not develop a sense of industry.
Which of the following would the nurse need to keep in mind as a predisposing factor
when formulating a teaching plan for child with a urinary tract infection?
A Frequent emptying of the bladder
B A shorter urethra in females
C Ingestion of acidic juices
D Increased fluid intake - correct answer A shorter urethra in females
Rationale:
In females, the urethra is shorter than in males. This decreases the distance for
organisms to travel, thereby increasing the chance of the child developing a urinary tract
infection. Frequent emptying of the bladder would help to decrease urinary tract
infections by avoiding sphincter stress. Increased fluid intake enables the bladder to be
cleared more frequently, thus helping to prevent urinary tract infections. The intake of
acidic juices helps to keep the urine ph acidic and thus decrease the chance of flora
development.
Which of the following is being used when the mother of a hospitalized child calls the
student nurse and states, "You idiot, you have no idea how to care for my sick child"?
A Displacement
B Psychosis
C Projection
D Repression - correct answer Projection
Rationale:
The mother is using projection, the defense mechanism used when a person attributes
his or her own undesirable traits to another. Displacement is the transfer of emotion
onto an unrelated object, such as when the mother would kick a chair or bang the door
shut. Repression is the submerging of painful ideas into the unconscious. Psychosis is a
state of being out of touch with reality.
ANSWERS #5
When providing postoperative care for the child with a cleft palate, the nurse should
position the child in which of the following positions?
A On the side
B Prone
C In an infant seat
D Supine - correct answer Prone
Postoperatively children with cleft palate should be placed on their abdomens to
facilitate drainage. If the child is placed in the supine position, he or she may aspirate.
Using an infant seat does not facilitate drainage. Side-lying does not facilitate drainage
as well as the prone position.
Which of the following would the nurse expect to assess in a child with celiac disease
having a celiac crisis secondary to an upper respiratory infection?
A Watery diarrhea
B Respiratory distress
C Weight gain
D Lethargy - correct answer Watery diarrhea
Episodes of celiac crises are precipitated by infections, ingestion of gluten, prolonged
fasting, or exposure to anticholinergic drugs. Celiac crisis is typically characterized by
severe watery diarrhea. Respiratory distress is unlikely in a routine upper respiratory
infection. Irritability, rather than lethargy, is more likely. Because of the fluid loss
associated with the severe watery diarrhea, the child's weight is more likely to be
decreased.
Which of the following would the nurse do first for a 3-year-old boy who arrives in the
emergency room with a temperature of 105 degrees, inspiratory stridor, and
restlessness, who is learning forward and drooling?
A Auscultate his lungs and place him in a mist tent.
B Have him lie down and rest after encouraging fluids.
C Examine his throat and perform a throat culture
D Notify the physician immediately and prepare for intubation. - correct answer Notify
the physician immediately and prepare for intubation.
The child is exhibiting classic signs of epiglottitis, always a pediatric emergency. The
physician must be notified immediately and the nurse must be prepared for an
emergency intubation or tracheostomy. Further assessment with auscultating lungs and
placing the child in a mist tent wastes valuable time. The situation is a possible life-
threatening emergency. Having the child lie down would cause additional distress and
may result in respiratory arrest. Throat examination may result in laryngospasm that
could be fatal.
,Which of the following toys should the nurse recommend for a 5-month-old?
A A colorful busy box
B A big red balloon
C A teddy bear with button eyes
D A push-pull wooden truck - correct answer A colorful busy box
A busy box facilitates the fine motor development that occurs between 4 and 6 months.
Balloons are contraindicated because small children may aspirate balloons. Because
the button eyes of a teddy bear may detach and be aspirated, this toy is unsafe for
children younger than 3 years. A 5-month-old is too young to use a push-pull toy.
When assessing a child with a cleft palate, the nurse is aware that the child is at risk for
more frequent episodes of otitis media due to which of the following?
A Plugging of the Eustachian tubes with food particles
B Associated congenital defects of the middle ear.
C Lowered resistance from malnutrition
D Ineffective functioning of the Eustachian tubes - correct answer Ineffective functioning
of the Eustachian tubes
Because of the structural defect, children with cleft palate may have ineffective
functioning of their Eustachian tubes creating frequent bouts of otitis media. Most
children with cleft palate remain well-nourished and maintain adequate nutrition through
the use of proper feeding techniques. Food particles do not pass through the cleft and
into the Eustachian tubes. There is no association between cleft palate and congenial
ear deformities.
Which of the following best describes parallel play between two toddlers?
A Sharing crayons to color separate pictures
B Sitting near each other while playing with separate dolls
C Playing a board game with a nurse
D Sharing their dolls with two different nurses - correct answer Sitting near each other
while playing with separate dolls
Rationale:
Toddlers engaging in parallel play will play near each other, but not with each other.
Thus, when two toddlers sit near each other but play with separate dolls, they are
exhibiting parallel play. Sharing crayons, playing a board game with a nurse, or sharing
dolls with two different nurses are all examples of cooperative play.
The adolescent's inability to develop a sense of who he is and what he can become
results in a sense of which of the following?
A Role diffusion
, B Guilt
C Inferiority
D Shame - correct answer Role diffusion
Rationale:
According to Erikson, role diffusion develops when the adolescent does not develop a
sense of identity and a sense or where he fits in. Toddlers develop a sense of shame
when they do not achieve autonomy. Preschoolers develop a sense of guilt when they
do not develop a sense of initiative. School-agechildren develop a sense of inferiority
when they do not develop a sense of industry.
Which of the following would the nurse need to keep in mind as a predisposing factor
when formulating a teaching plan for child with a urinary tract infection?
A Frequent emptying of the bladder
B A shorter urethra in females
C Ingestion of acidic juices
D Increased fluid intake - correct answer A shorter urethra in females
Rationale:
In females, the urethra is shorter than in males. This decreases the distance for
organisms to travel, thereby increasing the chance of the child developing a urinary tract
infection. Frequent emptying of the bladder would help to decrease urinary tract
infections by avoiding sphincter stress. Increased fluid intake enables the bladder to be
cleared more frequently, thus helping to prevent urinary tract infections. The intake of
acidic juices helps to keep the urine ph acidic and thus decrease the chance of flora
development.
Which of the following is being used when the mother of a hospitalized child calls the
student nurse and states, "You idiot, you have no idea how to care for my sick child"?
A Displacement
B Psychosis
C Projection
D Repression - correct answer Projection
Rationale:
The mother is using projection, the defense mechanism used when a person attributes
his or her own undesirable traits to another. Displacement is the transfer of emotion
onto an unrelated object, such as when the mother would kick a chair or bang the door
shut. Repression is the submerging of painful ideas into the unconscious. Psychosis is a
state of being out of touch with reality.
