PEDIATRIC NRS221 TEST WITH
CORRECT SOLUTION
A mother has just given birth to an infant with a cleft lip. Sensing that something is
wrong, she starts to cry and asks the nurse, "What is wrong with my baby?" The most
appropriate nursing action is to:
a.encourage mother to express her feelings.
b.explain in simple language that the baby has a cleft lip.
c.provide emotional support until practitioner can talk to mother.
d.tell mother a pediatrician will talk to her as soon as the baby is examined. - ANSWER
ANS: B
It is best to explain in simple terms the nature of the defect and to reinforce and help
clarify information given by the practitioner before the infant is shown to the parents.
Parents may not be ready to talk about their feelings during the first few days after birth.
The nurse should provide information about the child's condition while waiting for the
practitioner to speak with the family after the examination. The mother needs simple
explanations of what is wrong with her child during this period of waiting.
Which of the following factors will decrease iron absorption and therefore should not be
given at the same time as an iron supplement?
a.Milk
b.Fruit juice
c.Multivitamin
d.Meat, fish, poultry - ANSWER ANS: A
Many foods interfere with iron absorption and should be avoided when the iron is
consumed. These foods include phosphates found in milk, phytates found in cereals,
and oxalates found in many vegetables. Vitamin C-containing juices enhance the
absorption of iron. Multivitamins may contain iron; no contraindication exists to taking
the two together. Meat, fish, and poultry do not affect absorption.
The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for
their children. Which of the following is most likely lacking in their particular diet?
a.Fat
,b.Protein
c.Vitamins C and A
d.Complete protein - ANSWER ANS: D
The vegetarian diet can be extremely healthy, meeting the overall nutrition objectives
outlined in Healthy People 2010. Parents should be taught about food preparation to
ensure that complete proteins are available for growth. When parents use a strict
vegetarian diet, a likelihood exists of inadequate protein for growth and calories for
energy. Fat and vitamins C and A are readily available from vegetable sources. Plant
proteins are available. Foods must be combined to provide complete proteins for
growth.
The parent of an infant with colic tells the nurse, "All this baby does is scream at me; it is
a constant worry." The nurse's best action is which of the following?
a.Encourage parent to verbalize feelings.
b.Encourage parent not to worry so much.
c.Assess parent for other signs of inadequate parenting.
d.Reassure parent that colic rarely lasts past age 9 months. - ANSWER ANS: A
Colic is multifactorial, and no single treatment is effective for all infants. The parent is
verbalizing concern and worry. The nurse should allow the parent to put these feelings
into words. An empathetic, gentle, and reassuring attitude, in addition to suggestions
about remedies, will help alleviate the parent's anxiety. The nurse should reassure the
parent that he or she is not doing anything wrong. The infant with colic is experiencing
spasmodic pain that is manifested by loud crying, in some cases up to 3 hours each day.
Telling the parent that it will eventually go away does not help him or her through the
current situation.
Clinical manifestations of failure to thrive (FTT) in a 13-month-old may include which of
the following?
a.Irregularity in activities of daily living
b.Preferring solid food to milk or formula
c.Weight that is at or below the 10th percentile
d.Appropriate achievement of developmental landmarks - ANSWER ANS: A
One of the clinical manifestations of children with FTT is irregularity or low rhythmicity in
activities of daily living. Children with FTT often refuse to switch from liquids to solid
foods. Weight below the 5th percentile is indicative of FTT. Developmental delays,
including social, motor, adaptive, and language, exist.
,Which one of the following strategies might be recommended for an infant with failure to
thrive (FTT) to increase caloric intake?
a.Vary schedule for routine activities on a daily basis.
b.Be persistent through 10 to 15 minutes of food refusal.
c.Avoid solids until after the bottle is well accepted.
d.Use developmental stimulation by a specialist during feedings. - ANSWER ANS: B
Calm perseverance through 10 to 15 minutes of food refusal will eventually diminish
negative behavior. Children with FTT need a structured routine to help establish
rhythmicity in their activities of daily living. Many children with FTT are fed exclusively
from a bottle. Solids should be fed first. Stimulation is reduced during the mealtime to
maintain the focus on eating.
The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is
often prone (face down) while awake. The nurse's response should be based on
knowledge that this is:
a.acceptable to encourage head control and turning over.
b.acceptable to encourage fine motor development.
c.unacceptable because of the risk of sudden infant death syndrome (SIDS).
d.unacceptable because it does not encourage achievement of developmental
milestones. - ANSWER ANS: A
These parents are implementing the guidelines to reduce the risk of SIDS. Infants should
sleep on their backs to reduce the risk of SIDS and then be placed on their abdomens
when awake to enhance achievement of milestones such as head control. These
position changes encourage gross motor development, not fine motor.
An important nursing responsibility when dealing with a family experiencing the loss of
an infant from sudden infant death syndrome (SIDS) would be which of the following?
a.Discourage parents from making a last visit with the infant.
b.Make a follow-up home visit to parents as soon as possible after the child's death.
c.Explain how SIDS could have been predicted and prevented.
d.Interview parents in depth concerning the circumstances surrounding the child's
death. - ANSWER ANS: B
A competent, qualified professional should visit the family at home as soon as possible
after the death. Printed information about SIDS should be provided to the family.
Parents should be allowed and encouraged to make a last visit with their child. SIDS
, cannot always be prevented or predicted, but parents can take steps to reduce the risk
(such as supine sleeping, removing blankets and pillows from the crib, and not
smoking). Discussions about the cause only increase parental guilt. The parents should
be asked only factual questions to determine the cause of death.
Which of the following is an appropriate action when an infant becomes apneic?
a.Shake vigorously.
b.Roll head side to side.
c.Gently stimulate trunk by patting or rubbing.
d.Hold by feet upside down with head supported. - ANSWER ANS: C
If the infant is apneic, the infant's trunk should be gently stimulated by patting or
rubbing. If the infant is prone, turn onto the back. Vigorous shaking, rolling of the head,
and hanging the child upside down can cause injury and should not be done.
Decongestant nose drops are recommended for a 10-month-old infant with an upper
respiratory tract infection. Instructions for nose drops should include which of the
following?
a.Do not use for more than 3 days.
b.Keep drops to use again for nasal congestion.
c.Administer drops after feedings and at bedtime.
d.Give two drops every 5 minutes until nasal congestion subsides. - ANSWER ANS: A
Vasoconstrictive nose drops such as Neo-Synephrine should not be used for more than
3 days to avoid rebound congestion. Drops should be discarded after one illness and not
used for other children because they may become contaminated with bacteria. Drops
administered before feedings are more helpful. Two drops are administered to cause
vasoconstriction in the anterior mucous membranes. An additional two drops are
instilled 5 to 10 minutes later for the posterior mucous membranes. No further doses
should be given.
The parent of an infant with nasopharyngitis should be instructed to notify the health
professional if the infant:
a.has a cough.
b.becomes fussy.
c.shows signs of an earache.
d.has a fever higher than 37.5 C (99 F). - ANSWER ANS: C
If an infant with nasopharyngitis shows signs of an earache, it may indicate respiratory
CORRECT SOLUTION
A mother has just given birth to an infant with a cleft lip. Sensing that something is
wrong, she starts to cry and asks the nurse, "What is wrong with my baby?" The most
appropriate nursing action is to:
a.encourage mother to express her feelings.
b.explain in simple language that the baby has a cleft lip.
c.provide emotional support until practitioner can talk to mother.
d.tell mother a pediatrician will talk to her as soon as the baby is examined. - ANSWER
ANS: B
It is best to explain in simple terms the nature of the defect and to reinforce and help
clarify information given by the practitioner before the infant is shown to the parents.
Parents may not be ready to talk about their feelings during the first few days after birth.
The nurse should provide information about the child's condition while waiting for the
practitioner to speak with the family after the examination. The mother needs simple
explanations of what is wrong with her child during this period of waiting.
Which of the following factors will decrease iron absorption and therefore should not be
given at the same time as an iron supplement?
a.Milk
b.Fruit juice
c.Multivitamin
d.Meat, fish, poultry - ANSWER ANS: A
Many foods interfere with iron absorption and should be avoided when the iron is
consumed. These foods include phosphates found in milk, phytates found in cereals,
and oxalates found in many vegetables. Vitamin C-containing juices enhance the
absorption of iron. Multivitamins may contain iron; no contraindication exists to taking
the two together. Meat, fish, and poultry do not affect absorption.
The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for
their children. Which of the following is most likely lacking in their particular diet?
a.Fat
,b.Protein
c.Vitamins C and A
d.Complete protein - ANSWER ANS: D
The vegetarian diet can be extremely healthy, meeting the overall nutrition objectives
outlined in Healthy People 2010. Parents should be taught about food preparation to
ensure that complete proteins are available for growth. When parents use a strict
vegetarian diet, a likelihood exists of inadequate protein for growth and calories for
energy. Fat and vitamins C and A are readily available from vegetable sources. Plant
proteins are available. Foods must be combined to provide complete proteins for
growth.
The parent of an infant with colic tells the nurse, "All this baby does is scream at me; it is
a constant worry." The nurse's best action is which of the following?
a.Encourage parent to verbalize feelings.
b.Encourage parent not to worry so much.
c.Assess parent for other signs of inadequate parenting.
d.Reassure parent that colic rarely lasts past age 9 months. - ANSWER ANS: A
Colic is multifactorial, and no single treatment is effective for all infants. The parent is
verbalizing concern and worry. The nurse should allow the parent to put these feelings
into words. An empathetic, gentle, and reassuring attitude, in addition to suggestions
about remedies, will help alleviate the parent's anxiety. The nurse should reassure the
parent that he or she is not doing anything wrong. The infant with colic is experiencing
spasmodic pain that is manifested by loud crying, in some cases up to 3 hours each day.
Telling the parent that it will eventually go away does not help him or her through the
current situation.
Clinical manifestations of failure to thrive (FTT) in a 13-month-old may include which of
the following?
a.Irregularity in activities of daily living
b.Preferring solid food to milk or formula
c.Weight that is at or below the 10th percentile
d.Appropriate achievement of developmental landmarks - ANSWER ANS: A
One of the clinical manifestations of children with FTT is irregularity or low rhythmicity in
activities of daily living. Children with FTT often refuse to switch from liquids to solid
foods. Weight below the 5th percentile is indicative of FTT. Developmental delays,
including social, motor, adaptive, and language, exist.
,Which one of the following strategies might be recommended for an infant with failure to
thrive (FTT) to increase caloric intake?
a.Vary schedule for routine activities on a daily basis.
b.Be persistent through 10 to 15 minutes of food refusal.
c.Avoid solids until after the bottle is well accepted.
d.Use developmental stimulation by a specialist during feedings. - ANSWER ANS: B
Calm perseverance through 10 to 15 minutes of food refusal will eventually diminish
negative behavior. Children with FTT need a structured routine to help establish
rhythmicity in their activities of daily living. Many children with FTT are fed exclusively
from a bottle. Solids should be fed first. Stimulation is reduced during the mealtime to
maintain the focus on eating.
The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is
often prone (face down) while awake. The nurse's response should be based on
knowledge that this is:
a.acceptable to encourage head control and turning over.
b.acceptable to encourage fine motor development.
c.unacceptable because of the risk of sudden infant death syndrome (SIDS).
d.unacceptable because it does not encourage achievement of developmental
milestones. - ANSWER ANS: A
These parents are implementing the guidelines to reduce the risk of SIDS. Infants should
sleep on their backs to reduce the risk of SIDS and then be placed on their abdomens
when awake to enhance achievement of milestones such as head control. These
position changes encourage gross motor development, not fine motor.
An important nursing responsibility when dealing with a family experiencing the loss of
an infant from sudden infant death syndrome (SIDS) would be which of the following?
a.Discourage parents from making a last visit with the infant.
b.Make a follow-up home visit to parents as soon as possible after the child's death.
c.Explain how SIDS could have been predicted and prevented.
d.Interview parents in depth concerning the circumstances surrounding the child's
death. - ANSWER ANS: B
A competent, qualified professional should visit the family at home as soon as possible
after the death. Printed information about SIDS should be provided to the family.
Parents should be allowed and encouraged to make a last visit with their child. SIDS
, cannot always be prevented or predicted, but parents can take steps to reduce the risk
(such as supine sleeping, removing blankets and pillows from the crib, and not
smoking). Discussions about the cause only increase parental guilt. The parents should
be asked only factual questions to determine the cause of death.
Which of the following is an appropriate action when an infant becomes apneic?
a.Shake vigorously.
b.Roll head side to side.
c.Gently stimulate trunk by patting or rubbing.
d.Hold by feet upside down with head supported. - ANSWER ANS: C
If the infant is apneic, the infant's trunk should be gently stimulated by patting or
rubbing. If the infant is prone, turn onto the back. Vigorous shaking, rolling of the head,
and hanging the child upside down can cause injury and should not be done.
Decongestant nose drops are recommended for a 10-month-old infant with an upper
respiratory tract infection. Instructions for nose drops should include which of the
following?
a.Do not use for more than 3 days.
b.Keep drops to use again for nasal congestion.
c.Administer drops after feedings and at bedtime.
d.Give two drops every 5 minutes until nasal congestion subsides. - ANSWER ANS: A
Vasoconstrictive nose drops such as Neo-Synephrine should not be used for more than
3 days to avoid rebound congestion. Drops should be discarded after one illness and not
used for other children because they may become contaminated with bacteria. Drops
administered before feedings are more helpful. Two drops are administered to cause
vasoconstriction in the anterior mucous membranes. An additional two drops are
instilled 5 to 10 minutes later for the posterior mucous membranes. No further doses
should be given.
The parent of an infant with nasopharyngitis should be instructed to notify the health
professional if the infant:
a.has a cough.
b.becomes fussy.
c.shows signs of an earache.
d.has a fever higher than 37.5 C (99 F). - ANSWER ANS: C
If an infant with nasopharyngitis shows signs of an earache, it may indicate respiratory
