Pediatrics

1.The mother asks the nurse about her 9-year-old child's apparent need for between-meal snacks, especially after school. When developing a sound nutritional plan for the child with the mother, which of the following would the nurse need to keep in mind? Select one: A. Neurologic development B. Social development C. Motor development D. Language development 2.Which of the following would the nurse use as the primary underlying concept for developing a teaching plan for a group of teenagers about safety? Select one: A. tendency for overexertion B. use of drugs and alcohol C. increased peer pressure D. feelings of being invulnerable 3.A healthy, 2 yea-old toddler is brought to the well-baby clinic for a checkup. When assessing the infant's anterior fontanel the nurse expects it to be: Select one: A. sunken. B. bulging. C. closed. D. open. 4.Which of the following signs in present in the newborn indicates presence of Hirschsprung disease? Select one: A. Presence of gastric peristaltic wave from left to right across epigastric area during or immediately after feeding B. Failure to pass meconium stools 24 – 48 hours after birth C. Complaint of severe abdominal pain and passage of bile stained fecal emesis contact: D. Passage of bulky foul smelling fatty stools 5.Metro Manila Developmental test or MMDST is done to children ages: Select one: A. 2 weeks to 6 ½ years old B. 1 month to 6 years old C. 1 year old to 7 years old D. Immediately after birth to 7 years old 6.A nurse-midwife has documented that the fetus is at positive 1 (+1) station. This means that the fetal presenting part is: Select one: A. 2 cms above the symphysis pubis B. 1 cm below the symphysis pubis C. 1 cm below the ischial spines D. 2 cms above the ischial spines 7.Approximately 90 minutes after birth, the nurse encourages the mother of a term neonate to do which of the following? Select one: A. Feed the neonate. B. Povidone-iodine (Detadine) solution. C. Change the neonate's diaper. D. Allow the neonate to sleep. 8.The nurse is conducting teaching characteristics of Toddlers to parents. Included in the description of a Toddler is that: Select one: A. The child starts exploring the inside and outside world with supervision (exploratory stage) B. Children follows the rules and regulations set by parents and significant others (age of conformity) C. Child starts to act, talk and dress like people they know (imitative stage) D. The child starts to justify answers to questions asked ( age of reason) 9.In assessing the patient condition using the IMCI strategy, the first thing that the nurse should do is to: Select one: A. check the level of consciousness B. ask what are the child's problem C. check for the general danger signs D. check for the main symptoms 10.The nurse is planning the care of a newborn diagnosed with cleft lip and palate. Which of the following is a priority for the nurse to focus on in the period immediately following diagnosis? Select one: A. Assessment of parental understanding of treatment options B. Referral to craniofacial malformation specialist C. Referral to counselor to assist with adjustment to diagnosis D. Assessment of newborn feeding 11.Susie asks you, "When should I expect my daughter to begin to walk?" Which of the following is an appropriate response? Select one: A. "It varies so much I couldn't even guess." B. "Probably by 9 months." C. "Most children walk around 12 months." D. "Try not to worry. When she's ready she'll walk." 12.While making a home visit to a primiparous client and her 3-day-old son, the nurse observes the mother changing the baby's disposable diaper. Before putting the clean diaper on the neonate, the mother begins to apply baby powder to the neonate's buttocks. Which of the following statements about baby powder would the nurse relate to the mother? Select one: A. It keeps the diaper from adhering to the skin. B. It may cause pneumonia to develop. C. It may not cause pneumonia to develop. D. It can result in allergies later in life. 13.Situation: Brian Ward, age 3 is diagnosed with Hirschprung's disease after undergoing a series of X-rays and examination by a pediatric gastrointestinal specialist. Brian is scheduled for a bowel biopsy. Which of the following is absent in Hirschsprung's Disease? Select one: A. Intestinal fibers B. Ganglion cells C. Elastic fibers D. Bile 14.The nurse knows that the most effective strategies that parents can use to teach a 4 year old about safety is to: Select one: A. Discuss with them potential dangers to avoid B. Tell them that they are bad when they do something dangerous C. Provide good examples for safe behavior D. Show them pictures of children who are involved in accidents 15.The mother of a 4-year-old expresses concern that her child may be hyperactive. She describes the child as always in motion, constantly dropping and spilling things. Which of the following actions would be most appropriate at this time? Select one: A. Determine whether there have been any changes at home B. Explore the possibility that the child is being abused C. Explain that this is not unusual behavior D. Suggest that the child be seen by a pediatric neurologist 16.Sperm survival is dependent on its accompanying secretions. The thick viscous alkalinic fluid that is high in fructose that may contribute to its nutrition and activation come from what part of the male reproductive organ? Select one: A. Prostrate glands B. Bulbourethral glands C. Seminiferous tubules D. Seminal Vesicles 17.Pathognomonic sign for the child with dysentery: Select one: A. 3 or more watery stool in a day B. Diarrhea of 14 days or more C. Abdominal pain D. Blood in the stool 18.The rural health physician is assessing an infant and he holds the newborn in ventral suspension and stroking along the one side of the spine. The newborn laterally flex toward the stimulated side. Aurora knows that the physician is trying to assess the child's? Select one: A. Landau reflex B. Galant reflex C. Parachute reaction D. Moro reflex 19.Situation: The parents of a 4-year-old child tell the nurse that the child has an invisible friend named ‘Felix'. The child blames ‘Felix' for any misbehavior and is often heard scolding ‘Felix', calling him a ‘bad boy'. The nurse understands that the best interpretation of thins behavior is which of the following? Select one: A. Inconsistent parental discipline strategies B. A delay in moral development C. A way for the child to assume control D. Impaired parent-child relationship 20.When reading more about Tetralogy of Fallot, which of the following would you expect to discover a child may have? Select one: A. Increased platelet level. B. Leukopenia. C. Polycythemia. D. Anemia. 21.Which of the following techniques would be inappropriate when interviewing adolescents? Select one: A. frequent use of validation B. concern for teen's perspective C. closed-ended questions primarily D. confidentiality 22.Which of these assessment findings is not occurring in a client diagnosed with placenta previa? Select one: A. Soft, relaxed, non-tender uterus B. Bright red vaginal bleeding C. Severe abdominal pain D. Fundal height greater than expected 23.The nurse assesses the client who has chronic renal failure and notes the following: crackles in the lung bases, elevated blood pressure, and weight gain of 2 pounds in 1 day. Based on these data, which of the following nursing diagnoses is appropriate? Select one: A. Ineffective Tissue Perfusion related to interrupted arterial blood flow. B. Ineffective Therapeutic Regimen Management related to lack of knowledge about therapy. C. Excess Fluid Volume related to the kidney's inability to maintain fluid balance. D. Increased Cardiac Output related to fluid overload. 24.Upon the delivery of the baby, essential newborn care is done by immediately wiping the newborn skin dry to conserve heat and will do the next step by: Select one: A. Applying ophthalmic ointment to prevent opthalmia neonatorum B. Suctioning the airway to prevent respiratory distress C. Promotion of mother and child bonding through skin – to – skin contact D. Immediate cord clamping to prevent contamination of fetal blood 25.Cervical effacement of 100% will mean that: Select one: A. The cervix is now 2 centimeters in thickness B. The cervix is 4 centimeters in thickness C. The cervix is paper thin in consistency D. The cervix is now 1/2 centimeter in thickness 26.A mother is upset that a 34-month-old child has begun to wet the bed and thumb-suck after being admitted to the hospital. The mother asks the nurse to explain why this is happening. The nurse's best response is which of the following? Select one: A. "Your toddler is angry and this is a way of letting the unhappiness become known." B. "Your child probably does not like the nurse who has been assigned." C. "This behavior is a defense mechanism when normal routines are changed." D. "Bedwetting and thumb-sucking are the child's way of getting even for abandonment." 27.A nurse is monitoring a client who is receiving oxytocin (Pitocin) by intravenous infusion to augment labor pains. Which assessment finding would indicate that the infusion needs to be discontinued? Select one: A. Six contractions in a 10 minute period B. An increase in urinary output of 120 ml in 24 hours C. A fetal heart rate of 150 beats per minute D. A decrease in blood pressure of 30 mm/Hg 28.After observing signs of placental separation, the placenta was expelled with the maternal side of the placenta evident. This type of placental separation is called as: Select one: A. Schultze Placenta B. Duncan Placenta C. None of the above D. Calkins Placenta 29.If you recorded 1+ in the moulding, this means: Select one: A. The bones are touching each other B. The bones are separated and sutures can be felt easily C. The bones are overlapping D. The bones are severely overlapping 30.When performing Ortolani's maneuver to assess a 1-day-old term neonate for congenital hip dysplasia, which of the following would the nurse do? Select one: A. Flex both of the knees and adduct the legs until the examiner's thumbs touch one another. B. Flex the knees while holding the thumbs at midthigh and the fingers over the greater trochanters. C. Measure the legs to determine whether one leg is longer than the other with the neonate supine. D. Compare the symmetry of the gluteal folds on the right and left legs with the neonate prone. 31.In using MMDST, the examiner evaluates the four aspects of child's development which are: Select one: A. All of the above B. Fine motor development, gross motor development, language – speech development, interpersonal development C. Personal development, social development, psychological development, cognitive development D. Personal –social, fine motor adaptive, language, gross motor behavior 32.The stools of a child with Intussusception are best describe as: Select one: A. Currant jelly-like B. Bulky and poorly formed C. Fatty and foul smelling D. Ribbon or pellet like 33.When observing the parent instilling prescribed ear drops ordered twice a day for a toddler, the nurse decides that the teaching about positioning of the pinna for instillation of the drops is effective when the parent pulls the toddler's pinna in which of the following directions? Select one: A. Up and forward B. Down and forward C. Up and backward D. Down and backward 34.Situation: Philip, age 10 months, is brought to the emergency department by his parents, who report that he has experienced nonprojectile, nonbilious vomiting off and on for 1 day. He cries and pulls his legs up to his abdomen, then appears normal for awhile. To confirm the diagnosis of intussusception, the nurse would expect to prepare the child for: Select one: A. barium enema B. barium swallow C. upper GI ultrasound D. rectal biopsy 35.Upon the delivery of the baby, essential newborn care is done by immediately wiping the newborn skin dry to conserve heat and will do the next step by: Select one: A. Applying ophthalmic ointment to prevent opthalmia neonatorum B. Promotion of mother and child bonding through skin – to – skin contact C. Suctioning the airway to prevent respiratory distress D. Immediate cord clamping to prevent contamination of fetal blood 36.In the third trimester, transfer of maternal immunoglobulin provides the fetus with passive immunity to certain diseases for the first few months after birth. This type of antibodies are the: Select one: A. Immunoglobulin D (IgD) B. Immunoglobulin M (IgM) C. Immunoglobulin A (IgA) D. Immunoglobulin G (IgG) 37.Susie asks the nurse when she can start feeding her baby solid food. Which of the following should the nurse include in teaching this mother about the nutritional needs of infants? Select one: A. Infant formula or breast milk provides adequate nutrients for the first year. B. Solid foods should be given as soon as the infant's first tooth erupts. C. Infant cereal can be introduced by spoon when the extrusion reflex fades. D. Pureed food can be offered when the infant has tripled his birth weight. 38.When performing an initial assessment of a post-term male neonate weighing 4000 g (9 pounds) who was admitted to the observation nursery after a vaginal delivery with low forceps, the nurse detects Ortolani's sign. Which of the following would the nurse do next? Select one: A. Obtain a blood sample to check for hypoglycemia. B. Notify the pediatrician immediately. C. Determine the length of the mother's labor. D. Keep the neonate under the radiant warmer for 2 hours. 39.A child has stridor if the following evidences are present: Select one: A. A calm child produces harsh noise as he breaths out B. An agitated child produces wheezing noise as he breaths in C. A calm child produces harsh noise as he breaths in D. A calm child produces wheezing noise as he breaths out 40.Proper latching-on is needed to stimulate hormonal release needed for breastfeeding. Which of these hormones is responsible for the let down reflex? Select one: A. Prolactin B. Estrogen C. Oxytocin D. Prostaglandin 41.Newborn screening (NBS) is a public health program aimed at the early identification of infants who are affected by certain genetic/metabolic/infectious conditions which can lead to significant reduction of morbidity, mortality, and associated disabilities in affected infants. Newborn Screening Act of 2004 known as: Select one or more: A. Republic Act (RA) 9173 B. Republic Act (RA) 9262 C. Republic Act (RA) 9288 D. Republic Act (RA) 7600 42.Situation: Brian Ward, age 3 is diagnosed with Hirschprung's disease after undergoing a series of X-rays and examination by a pediatric gastrointestinal specialist. The nurse must administer enemas to clear Brian's bowel of stool before surgery. Which type of enema is appropriate? Select one: A. Isotonic saline solution B. Hypertonic phosphate solution C. Soap suds solution D. Tap water 43.Which of the following indications of negative resolution would pertain to the psychosocial crisis of Identity versus Role confusion by Erick Erikson? Select one: A. Avoidance of intimacy, of relationship and career B. Indecisiveness and personality confusion C. Pseudo-intimacy and lack of interest and commitment D. Withdrawal from peers and school 44.At 1300 hours or 1 pm, what is the frequency and duration of Mrs. H uterine contraction when one box is shaded using lines? Select one: A. 1 contraction in 10 minutes lasting more than 40 seconds B. 4 contractions in 15 minutes lasting more than 40 seconds C. 1 contraction in 10 minutes lasting more than 20 seconds D. 2 contractions in 10 minutes lasting less than 20 seconds 45.During assessment of a client in active labor, it reveals a meconium stained amniotic fluid and the FHB is auscultated at the right upper quadrant (RUQ). Before referring the woman to the obstetrician, she has to gather more information. The most likely cause of this situation is: Select one: A. Indicates the presence of breech presentation B. Is a sign indicating fetal distress C. Indicates presence of multiple gestation D. Signifies the onset of second stage of labor 46.Which of the following assessments made by the nurse is an area of concern indicating a need for further evaluation? Select one: A. Three pound weight gain in 2 months. B. Closed posterior fontanel. C. Moderate head lag when pulled to sitting position. D. Absence of Moro reflex. 47.After a successful repair of a tracheoesophageal fistula, and the parents will need discharge teaching and anticipatory guidance related to signs of esophageal constriction at the repair site. Which of the following clinical manifestations of esophageal constriction should the nurse include in the teaching plan? Select one: A. Decreased salivation B. Recurrent otiitis media C. Constipation D. Dysphagia 48.SITUATION: Mark Foster, a 10-month-old infant with a cleft lip and palate, is admitted to the pediatric unit for the first stage of surgical correction on his lip. Primarily breast-fed, he occasionally receives a supplemental bottle. Feeding an infant with a cleft lip or palate offers a special challenge to the nurse because: Select one: A. The nurse must discourage the infant from trying to suck B. Bottle-feeding disrupts the maternal-infant bond C. The infant has difficulty maintaining suction around a nipple D. The infant has no desire to suck 49.A woman with polyhydramnios is on active labor. Nora has to be very keen for the possibility of the following complications that can occur during labor EXCEPT: Select one: A. Malpresentation B. Abruptio placenta C. Uterine Inertia D. Abortion 50.Situation: Michael, age 13, has been admitted to the pediatric unit for an elective tonsillectomy; this is his first hospitalization. Other than multiple episodes of tonsillitis, he is a healthy and active adolescent. However, he appears apprehensive and has several questions regarding hospital rules. In writing discharge instructions, the nurse reminds Michael that he is restricted from playing football. Which form of exercise would be appropriate to recommend? Select one: A. Basket ball B. Baseball C. Swimming D. Racquetball 51.When developing the discharge teaching plan for the parents of a child who has undergone a cardiac catheterization for ventricular septal defect, which of the following would the nurse expect to include? Select one: A. Maintenance of a pressure dressing until a return visit with the physician. B. Use of sponge baths until the stitches are removed. C. Restriction of the child's activities for the next 3 weeks. D. Use of prophylactic antibiotics before receiving any dental work. 52.LOA position will mean which of the following? Select one: A. The cephalic prominence is on the left opposite of the back during the 4th maneuver B. The back occupies the right side anteriorly while the extremities in the left side of the abdomen C. The cephalic prominence is on the right opposite of the back during the 4th maneuver D. The back occupies the left side anteriorly while the extremities in the right side of the abdomen 53.The nurse is caring for a 10-year-old child during the acute phase of rheumatic fever. Bed rest is part of the child's plan of care. Which of the following diversional activities is developmentally appropriate and meets the health needs of this child in the acute phase of rheumatic fever? Select one: A. Playing basketball with a hoop suspended from the bed B. Sorting and organizing baseball cards in a notebook C. Using art supplies to make drawings about the hospital experience D. Using handheld computer video games 54.The mother of a toddler with cerebral palsy comes to the clinic for developmental screening. The nurse explains that the major reason that these tests are done is to recognize primary delays early so as to accomplish which of the following? Select one: A. Prevent secondary developmental delays. B. Facilitate communication. C. Encourage health maintenance. D. Maintain current development. 55.A school-age child is admitted to the hospital with a vaso-occlusive sickle cell crisis. Which measure in his care should be given priority? Select one: A. Seeing that he ingests a protein-rich diet. B. Encouraging him to take deep breaths hourly. C. Maintaining a fluid intravenous line. D. Beginning active range-of-motion exercises. 56. Assessment of a term neonate at 8 hours after birth reveals tachypnea, dyspnea, sternal retractions, diminished femoral pulses, poor lower body perfusion, and cyanosis of the lower body and extremities, with a pink upper body. The nurse notifies the pediatrician based on the interpretation that these symptoms are associated with which of the following? Select one: A. Transposition of the great arteries. B. Atrioventricular septal defect. C. Coarctation of the aorta. D. Pulmonary atresia. 57.The nurse notes that an infant stares at an object placed in her hand and takes it to her mouth, coos and gurgles when talked to, and sustains part of her own weight when held in a standing position. The nurse correctly interprets these findings as characteristic of an infant at which of the following ages? Select one: A. 7 months B. 9 months C. 4 months D. 2 months 58.A newborn is noticeably jaundiced on the third day of life. Which of the following would you explain to his mother: Select one: A. This is a normal breakdown of red blood cells. B. No one understands why newborn jaundice occurs. C. He will need an evaluation for bile duct disease D. He may have blood incompatibility 59.The fetus occupies breech presentation during labor. You will interpret this as any of the following. EXCEPT: Select one: A. The fetal part is not movable during the third manuever indicating it is engaged. B. The fetal head is palpated occupying the fundus during the 1st manuever C. Fetus is in good flexion as palpated in the 4th manuever D. Fetal heart tones is heard above the level of the umbilical region 60. The nurse is teaching parents about Erik Erikson's psychosocial theory of development. According this theory, a child who is between 3 and 6 years of age is going through which of the following stages? Select one: A. Identity versus role confusion B. Autonomy versus shame and doubt. C. Initiative versus guilt D. Industry versus inferiority 61.In one your assessments on a seven-year old child, you noticed that the child would describe anything that is colored yellow as banana regardless of its shape. You concluded that the child is able to classify objects according to one trait alone. This cognitive characteristic of the child is: Select one: A. Reversibility B. Egocentrism C. Conservation D. Centering 62.Which of the following would the nurse identify as the priority nursing diagnosis during a toddler's vasoocclusive sickle cell crisis? Select one: A. Ineffective Coping related to presence of a life-threatening disease. B. Pain related to tissue anoxia. C. Excess Fluid Volume related to infection. D. Decreased Cardiac Output related to abnormal hemoglobin formation. 63.You are asked by a mother to describe to her the body proportion and musculoskeletal system of a toddler. Which of the following statements is based on knowledge of growth and development of a toddler? Select one: A. There is an increase in size of both limbs and trunks but the head growth slows down during the toddler period. B. They appear to have protuberant abdomen due to the immaturity of their abdominal muscles. C. They have lordotic posture and walks with a wide distance. D. Subcutaneous tissues are developing rapidly and their fat tissues are already diminished. 64.Which of the following nursing diagnoses would the nurse include as the priority in the plan of care for a preschooler who has been physically abused? Select one: A. Self-Care Deficit related to child's developmental level. B. Impaired Physical Mobility related to physical maltreatment. C. Anticipatory Grieving related to the cycle of abuse. D. Risk for Trauma related to the characteristics of the child and caregiver. 65.Mrs. Santos asked the nurse, "My baby looks dirty with this entire slimy thing on her. Can I bather my baby now?" The nurse's best response is: Select one: A. "Sure, you can do what you wish since she is your baby. Let me help you" B. "The slimy thing actually protects her from infection. We will bathe the baby after 4 hours" C. "It sure looks dirty but unfortunately, we cannot remove it yet until tomorrow" D. "The slimy thing is part of the baby. So it's not really dirty" 66.The nurse determines that the client under her care understands that the signs of true labor if she makes the following statements Select one: A. “My contractions have a shorter interval and is more frequent” B. “My contractions will not be as painful as I walk around” C. “My contractions will increase in interval and duration” D. “My contraction will be felt in the abdominal area” 67.The stools of a child with Hirschsprung's disease are best described as: Select one: A. Currant jelly-like B. Bulky and poorly formed C. Ribbon- or pellet-like D. Fatty and foul-smelling 68.The nurse instructs a primiparous client about bottle-feeding her neonate. Which of the following demonstrates that the mother has understood the nurse's instructions? Select one: A. Pointing the nipple toward the neonate's palate. B. Putting three fourths of the bottle nipple into the baby's mouth. C. Bubbling the baby after 1 ounce of formula. D. Placing the neonate on the back after the feeding. 69.School-age children are less egocentric, no longer have the intense erotic fantasizing and now are free to develop new interests and social abilities beyond home ground. According to Freudian theory of psychosexual development, this is: Select one: A. Phalic Stage B. Latency Stage C. Oral Stage D. Anal Stage 70.All except one is the characteristics of play of a toddler. Which of the following is incorrect? Select one or more: A. Toddler play is more solitary than social. B. There is much variation and little repetition in toddler play. C. There is an increase in locomotive skills. D. Toddlers have less emphasis on stereotyped toys. 71.Considering Erickson's psychosocial theory of development, which of the following instructions is appropriate to give the parents of a hospitalized infant? Select one: A. Limit visits to official visiting hours. B. Schedule visits around nursing care. C. Avoid visiting to prevent upsetting the infant when leaving. D. Spend as much time as possible with the infant. 72.Nina is bottle fed. When assessing her stools, which of the following data would be NOT COMMON? Select one: A. Bottle fed infants are less likely to be constipated than breast-fed infants. B. Bottle fed infants usually have fewer stools than breast-fed infants. C. Stools of bottle fed infants are usually harder than those of breast-fed infants. D. Stools of bottle fed infants tend to have a strong odor. 73.The mother asks the nurse why her child's hemoglobin was normal at birth but now the child has S hemoglobin. Which of the following responses by the nurse would be most appropriate? Select one: A. "The newborn has a high concentration of fetal hemoglobin in the blood for some time after birth." B. "The placenta bars passage of the hemoglobin S from the mother to the fetus." C. "The red bone marrow does not begin to produce hemoglobin S until several months after birth." D. "Antibodies transmitted from you to the fetus provide the newborn with temporary immunity." 74.During process of childbirth, you noticed several positional changes occurring in the fetal head. When the fetal occiput is now visible, followed by the forehead, nose and chin, this positional change is called as: Select one: A. Extension B. Flexion C. Internal Rotation D. External rotation 75.When assessing a 2-year-old child brought by his mother to the clinic for a routine checkup, which of the following would the nurse expect the child to be able to do? Select one: A. Kick a ball forward B. Tie his shoelaces C. Ride a tricycle D. Use blunt scissors 76.A nurse is monitoring a client in labor and suspects uteroplacental insufficiency. In which of the following is noted in the external monitor tracing during a contraction will indicate this? Select one: A. Variable decelerations B. Late decelerations C. Short term variability D. Early decelerations 77.Situation No.1 Liza, a 19 year old 4th year student is assigned at the Newborn Intensive Care Unit (NICU) next month. To prepare herself for the coming exposure, she reviews the concepts of growth and development across the lifespan. One principle of growth and development states that, "Development proceeds from gross to refined skills." Which of the following sentences below best describes this principle? Select one: A. The nervous system develops the fastest at 2-5 years old while reproductive system develops during adolescence. B. There is total head control first before a child can lift his shoulders leading to his/her ability to sit alone. C. A grade one pupil would use larger size of pencil as compared to a grade three pupil using a size 2 pencil. D. Majority of children sit before they creep, creep before they stand, and stand before they walk 78.The nurse is caring for a neonate at 38 weeks' gestation when the nurse observes marked peristaltic waves on the neonate's abdomen. After this observation, the neonate exhibits projectile vomiting. The nurse notifies the pediatrician because these signs are indicative of which of the following? Select one: A. Ineffective Airway Clearance to impaired swallowing. B. Bowel Incontinence related to abdominal pain. C. Deficient Fluid Volume related to prolonged vomiting. D. Unbalanced Nutrition: Less Than Body Requirements related to prolonged vomiting. 79.Situation: Jennifer, a full-term neonate, is transferred to the neonatal intensive care unit. Her diagnosis is esophageal atresia; surgery is scheduled for the next morning. Which physical findings are commonly associated with esophageal atresia? Select one: A. Decreased bowel sounds B. Visible gastric and peristaltic waves C. Choking, coughing, and cyanosis D. Jaundice and drooling 80.In caring for newborns, nurses have to respond immediately to the baby’s need. Which of the following senses is most highly developed and need to be enhanced after birth? Select one: A. Hearing B. Sight C. Touch D. Smell 81.A mother asks how pre- schoolers perceive illness. The nurse should explain that they generally regard it as: Select one: A. A punishment for wrongdoing B. The will of GOD C. A necessary part of life D. A test of self-worth 82.Which of the following assessments would be the priority for an infant who has had surgery to correct an intussusception and is now at risk for development of a paralytic ileus postoperatively? Select one: A. Measurement of gastric output. B. Inspection of the first stool passed. C. Auscultation of bowel sounds. D. Measurement of urine specific gravity. 83.Situation: Michael, age 13, has been admitted to the pediatric unit for an elective tonsillectomy; this is his first hospitalization. Other than multiple episodes of tonsillitis, he is a healthy and active adolescent. However, he appears apprehensive and has several questions regarding hospital rules. During early adolescence, a child typically: Select one: A. Develops a sense of community awareness B. Begins to develop formal, abstract thinking C. Forms close attachments to peers of the opposite sex D. Focuses much attention on body changes 84.Meat based formula and soya are milk preparation for what type of clients? Select one: A. Maple syrup urine Disease B. G6PD C. Phenylketonuria D. Galactosemia 84.Which of the following groups of laboratory tests is most important for assessing the client's renal status? Select one: A. Arterial blood gases and hemoglobin. B. Serum blood urea nitrogen (BUN) and creatinine levels. C. Urinalysis and urine culture. D. Serum sodium and potassium levels. 86.The client complains of shortness of breath and episodes of dyspnea. In identifying and evaluating the client’s problem, the nurse is aware that this problem is seen during the: Select one: A. Third trimester B. During labor process C. Second trimester D. First trimester 87.During physical assessment of a 4-month-old with Hirschsprung's disease, the nurse would most likely note which of the following? Select one: A. Hyperactive deep tendon reflexes. B. Scaphoid-shaped abdomen. C. Clubbing and cyanosis of the fingers and toes. D. Weight less than expected for height and age. 88.The nurse has assessed four children of varying ages in the health center; which one requires further evaluation? Select one: A. A 16-year-old male who had nocturnal emissions B. A 9-year-old with enuresis C. A 7-month-old who is afraid of strangers D. A 4-year-old who talks to an imaginary playmate 89.Which of the following responses by the nurse would be most appropriate for the mother of a 4- yearold son who voices concern about her child's stuttering? Select one: A. The majority of children do this until they are about 6 years of age. B. The child needs to see a speech therapist before school starts. C. You need to help the child complete the words giving him problems. D. This behavior is normal and the child probably will stop soon. 90.Which of the following statements best describe a child with Tetralogy of Fallot? Select one: A. They experience hypercyanosis or "Tet Spells" B. The condition is commonly referred to as "blueberries" C. They experience decreased or absent pulses in the lower extremities D. They experience frequent respiratory distress 91.Postpartum mothers have a lower resistance to infection. Nursing care should focus in the prevention of infection. The usual site of infection among postpartum women is the: Select one: A. Cervical Region B. Endometrial lining C. Vaginal area D. Perineal – anal area 92.Early evaluation of ectopic pregnancy is paramount in preventing a life threatening rupture. Which of the following symptoms, a nurse should be alert for the possibility of ectopic pregnancy? Select one: A. One-sided abdominal pain, vaginal bleeding and a positive pregnancy test B. Excessive vomiting, weight loss and a positive pregnancy test C. Amenorrhea and a negative pregnancy test D. Vaginal discharges of clear vesicles 93.The mother of a preschooler reports that her child creates a scene every night at bedtime. The nurse and the mother decide that the best course of action would be to do which of the following? Select one: A. Allow the child to stay up later one or two nights a week B. Give the child a cookie if bedtime is pleasant C. Establish a set bedtime and follow a routine D. Encourage active play before bedtime 94.When discussing a 7-month-old infant's motor skill development with the mother, the nurse should explain that most children at age 7 months most likely will be able to Select one: A. eat with a spoon B. stand alone while holding onto furniture C. walk independently D. sit alone using the hands for support 95.The parent of a 3-year-old child brings the child to the clinic for a well-child checkup. The history and assessment findings reveal the following findings. Which of these assessment findings made by the nurse is an area of concern and requires further investigation? Select one: A. Has ability to hop on one foot B. Unable to ride a bicycle C. Uses gestures to indicate wants D. Weight gain of 4 pounds in last year 96.Situation: Brian Ward, age 3 is diagnosed with Hirschprung's disease after undergoing a series of Xrays and examination by a pediatric gastrointestinal specialist. Mrs. Ward tells the nurse that Brian is in pain. Which symptom indicates that Brian is in pain? Select one: A. All OPTIONS are true B. Restlessness C. Inability to be comforted D. Tense body position 97.At 1 pm, you recorded C after observing the amniotic fluid as of Mrs. M as: Select one: A. Ruptured blood stained amniotic fluid B. Completely Intact amniotic fluid C. Ruptured watery clear amniotic fluid D. Ruptured meconium stained amniotic fluid 98.Metro Manila Developmental test or MMDST is done to children ages: Select one: A. 2 weeks to 6 ½ years old B. Immediately after birth to 7 years old C. 1 year old to 7 years old D. 1 month to 6 years old 98.Situation: Jennifer, a full-term neonate, is transferred to the neonatal intensive care unit. Her diagnosis is esophageal atresia; surgery is scheduled for the next morning. Which intervention is appropriate when the nurse suspects esophageal atresia in a neonate? Select one: A. withholding all oral feedings B. initiating nasogastric tube feedings of dextrose in water, as ordered C. feeding the neonate a bottle in an upright position D. initiating oral feedings of dextrose 100.The obstetrician decides to artificially rupture the bag of waters. Following the procedure, the nurse monitors the fetal heart tones for which of the following reasons? Select one: A. To assess for fetal position B. To assess for the prolapsed of the umbilical cord C. To prepare for an immediate delivery D. To determine the maternal and fetal well being 101.The sister of Michael, Mitch, 8-month-old infant was diagnosed with viral nasopharyngitis, the parents should be taught to notify the health care provider: Select one: A. For temperature above 98.6F B. If the infant develops a cough C. For increased fussiness D. If the infant develops signs of ear infection 102.Mrs. Luna is concerned about feeding her baby about solid foods. The nurse explains that the correct sequence of introducing food is: Select one: A. Table foods, fruits, vegetables, meats B. Cereal, Vegetables, table foods, meats, fruits C. Meats, fruits, vegetables, table foods D. Cereal, Fruits, vegetables, meat, table foods 103.You are assigned to the following patients listed below. Which of the following patients should be evaluated first? Select one: A. A patient with H- MOLE on her 20th week of gestation with a fundic height of 28 cms. B. A woman suspected of ectopic pregnancy having (+) cullen’s sigh and (+) blood during culdocentesis C. A 28th week pregnant woman with PIH with a BP of 140 / 90, with pedal edema and proteinuria D. A 32nd week pregnant woman having on and off painless bleeding 104.The nurse is assessing a pregnant woman for signs that places the woman at risk for complications. She reviews clients records for a sign indicative of H-mole which is: Select one: A. Slow uterine fetal growth B. Lack of symptoms of pregnancy C. Rapid heart beat D. Abnormally high HCG titer 105.Situation: Aurora is a nurse assigned at the barangay health center attending to a well-baby clinic. There are several infants for immunization schedule and follow-up check-up. When examining a neonate, the nurse measures and palpates the anterior fontanel. What information can be determined from this examination? Select one: A. Cognitive status B. Hydration status C. Neurologic status D. None of the above 106.The following signs of ovulation are enumerated EXCEPT one: Select one: A. Presence of slight pain on one side of the lower abdomen B. Increased in thin, slippery vaginal discharges and pH C. Presence of clear vesicles with watery vaginal discharges D. Rise in basal body temperature of 0.2 – 0.5 degrees centigrade 107.When doing health assessment, at which of the following location will you expect to palpate the fundus of a woman eight hours after delivery? Select one: A. Midway between the umbilicus and symphysis pubis B. One fingerbreadth below the umbilicus C. At the level of the umbilicus D. At the level of the symphysis pubis 108.Which of the following characteristics does not relate to the school age child? Select one: A. Child can tie shoelaces but cannot tie a bow B. Makes judgment based on reason C. Conforms to peer rules D. Permanent teeth erupt 109.The nurse is educating a group of students about the "Unang Yakap" campaign. Which of the following statements if made by the student require further teaching? Select one: A. Emphasizes a core sequence of actions, performed methodically B. Is flexible so that interventions may vary according to patient's desire C. Lesser cost that can improve neonatal as well as maternal care D. It is an evidence – Based intervention 110.You as a credible pediatric nurse assigned in a private room with good background on nutrition for babies. Which finger food is appropriate for an 8 month old infant? Select one: A. Caramelized popcorn B. Grilled hotdog C. Crackers D. Mixed nuts 111.The nurse knows the studies have shown that waiting for the pulsations to stop before clamping the cord prevents that fetus from having which of the following? Select one: A. Congenital heart defects B. Hyperbilirubinemia C. Rh incompatibility D. Anemia 112.The client's blood urea nitrogen (BUN) concentration is elevated in acute renal failure. What is the likely cause of this finding? Select one: A. High calcium, high potassium, high protein. B. Low protein, low sodium, low potassium. C. Low protein, high potassium. D. High carbohydrate, high protein. 113.The nurse observes Susie feeding her baby in the infant seat with the bottle propped. The appropriate intervention for the nurse is to Select one: A. congratulate Susie for finding a safe place for the baby to take the bottle. B. inform Susie that this procedure encourages independence in the newborn. C. instruct Susie about the importance of holding and cuddling in the attachment process. D. encourage the Susie to let the older children hold the bottle for the baby in the infant seat. 114.Which of the following observations by the nurse would strongly suggest that a 15-month-old toddler has been abused? Select one: A. The child appears happy when personnel work with him. B. The child sucks his thumb. C. The child plays alongside others contentedly. D. The child is underdeveloped for his age 116.Few months later, Michael develops nasopharyngitis or common colds. The primary goal of nursing care is directed toward: Select one: A. Administering antibiotics B. Promoting nutrition C. Relieving symptoms D. Preventing injury 117.Which of the following conditions during pregnancy would warrant an assessment of tracheoesophageal anomalies? Select one: A. Rubella infection B. Syphilis C. Hydramnios D. Oligohydramnios 118.The client with acute renal failure asks the nurse for a snack. Because the client's potassium level is elevated, which of the following snacks would be most appropriate? Select one: A. A gelatin dessert. B. Yogurt. C. Peanuts. D. An orange. 119.The school nurse develops a plan with an adolescent to provide relief of dysmenorrhea to aid in her development of which of the following? Select one: A. Positive self-identity B. A sense of independence C. Positive peer relations D. A sense of autonomy 120.Signs in a child with severe pneumonia or very severe disease includes: Select one: A. All options are correct B. Any general danger signs C. Stridor in a calm child D. Chest indrawing and fast breathing 121.When obtaining the nursing history from the mother of an infant with suspected intussusception, which of the following questions would be most helpful? Select one: A. "What do the stools look like?" B. "Has your child had any episodes of vomiting?" C. "Is your child eating normally?" D. "When was the last time your child urinated?" 122.The nurse ensures that Philip has adequate kidney function before adding potassium to his I.V. fluids. She does this because hyperkalemia can lead to: Select one: A. Hemodilution B. Cardiac arrest C. Fatigue D. Hepatic Failure 123.Assessing the child further for presence of general danger signs. The following are included except: Select one: A. look if the baby has difficulty of breathing B. ask if the child had convulsion C. look if the child is unable to drink or breastfeed D. look if the child is abnormally sleepy 124.The mother of Michael brings her daughter to the pediatric clinic because she is concerned that the child has otitis media. On examination, the nurse would recognize which of the following findings as the most common positive sign of otitis media? Select one: A. Pearly gray tympanic membrane and rhinorrhea B. Pain on pressure on the tragus and edema within the canal C. Feeling of ‘fullness' in the ear and a popping sensation during swallowing D. Temperature of 39C and loss of appetite 125.When preparing a teaching plan for the parents of a group of 4- to 6-year-old children about recommended immunizations for school entrance, the nurse would expect to include which of the following? Select one: A. Polio, measles, and pertussis B. Measles, mumps, rubella, and polio C. Tetanus, diphtheria, and rubella D. Diphtheria, tetanus, pertussis, and polio 126.A child who is 14 months old has fast breathing if he has: Select one: A. 60 breaths per minute or more B. 30 breaths per minute or more C. 40 breaths per minute or more D. 50 breaths per minute or more 127.The school nurse is invited to attend a meeting with several parents who express frustration with the amount of time their adolescents spend in front of the mirror and the length of time it takes them to get dressed. The nurse explains that this behavior is indicative of which of the following? Select one: A. An abnormal narcissism B. A method of procrastination C. A result of developing self-concept D. A way of testing the parents' limit-setting 128.SITUATION: Mark Foster, a 10-month-old infant with a cleft lip and palate, is admitted to the pediatric unit for the first stage of surgical correction on his lip. Primarily breast-fed, he occasionally receives a supplemental bottle. After cleft lip repair, Mark should be fed with Select one: A. TPN B. Rubber dropper C. Rubber nipple D. NGT 130.The mother relates that an adolescent is beginning to identify behaviors that please others as "good" behaviors. The child's behavior is a characteristic of which of Kohlberg's level of moral development? Select one: A. Conventional morality B. Pre-conventional coordination C. Pre-autonomous morality D. Autonomous morality 131.When assessing for pain in a toddler, which of the following methods would be the most appropriate? Select one: A. Observe the child for restlessness B. Ask the child about the pain C. Assess for changes in vital signs D. Use a numeric pain scale E. Assess for changes in vital signs 132.A 4-week-old infant admitted with the medical diagnosis of hypertrophic pyloric stenosis presents with a history of vomiting. The nurse would anticipate that the infant's vomitus would contain gastric contents and which of the following? Select one: A. Bile and streaks of blood. B. Mucus and bile. C. Mucus and streaks of blood. D. Stool and bile. 133The nurse noticed a small built pregnant woman with a height of 4 feet 10 inches is in labor, she immediately refer this woman to the obstetrician for further evaluation. Below 5 feet tall pregnant woman is prone to abnormal labor (dystocia) due to: Select one: A. Uterine inertia B. Cephalo-pelvic disproportion C. Delivery of a microcephalic baby D. Precipitate delivery 135.Situation: Susie, 28-year old mother brings her child Nina 6 month-old to the health center for well baby check-up. The following questions apply: Susie is concerned that the infant's anterior fontanel is still open. The nurse would inform the mother that further evaluation is needed if the anterior fontanel is still open after: Select one: A. 10 months B. 6 months C. 24 months D. 18 months 136.The mother of a 3-month-old is concerned because her daughter does not yet sit by herself. Which of the following statements best reflects average sitting ability? Select one: A. Most babies sit steadily at 4 months; she is normal. B. Sitting ability and the age of first tooth eruption are correlated. C. Most babies do not sit steadily until 8 months; she is normal. D. Most babies sit steadily at 3 months; she is slightly delayed. 137.The nurse is caring for a newborn with cleft lip and palate who has feeding difficulties. The parent asks the nurse how to feed the infant. Which of the following instructions are the most appropriate for the nurse to give the parent? Select one: A. Place the newborn in an upright position to feed B. Obtain a newborn nipple with a small opening to facilitate sucking C. Place the newborn supine to feed D. Burp infrequently to ensure that infant continues sucking 138.The nurse notes a swelling on the scalp of a 12 hours old neonate and it crosses the suture line. The nurse interprets this findings as: Select one: A. caput succedanum B. cranial edema C. cephalohematoma D. craniotabes 139.Based on evidences, which of the following situations female adolescents will suffer from toxic shock syndrome? Select one: A. Uses oral contraceptive pills for 1 year B. If they fail to change perineal pads every 4 hours C. Have insertion of Intrauterine Device (IUD) during menstrual period D. Based on evidences, which of the following situations female adolescents will suffer from toxic shock syndrome? 140.It is during this stage in Piaget's Cognitive Development when the child tends to be self-centered and uses symbolism. The child's perception of time is only now and their perception of distance is only as far as they can see. What stage is of cognitive development is this? Select one: A. Intuitive Stage B. Tertiary Circular Reactions C. Pre-operational Stage D. Concrete Operations 141.SITUATION: Mark Foster, a 10-month-old infant with a cleft lip and palate, is admitted to the pediatric unit for the first stage of surgical correction on his lip. Primarily breast-fed, he occasionally receives a supplemental bottle. Mrs. Foster is concerned about Mark's dental development. The nurse knows that an infant's first teeth, which usually erupt between ages 6 and 8 months, are the: Select one: A. Lower lateral incisors B. Upper lateral incisors C. Upper central incisors D. Lower central incisors 142.The parents of a 9-month-old bring the infant to the clinic for a regular checkup. The infant has received no immunizations. Which of the following would be appropriate for the nurse to administer at this visit? Select one: A. PPD, MMR, Hep B, and OPV B. HEP B, IPV, Hib and varicella C. DTaP, Hib, IPV, and PPD D. DTaP, Hib, OPV, and MMR 143.You see a school-age child in an ambulatory setting because of rheumatic fever. Reading more about Rheumatic fever which of the following assessment data best illustrates the presence of rheumatic fever? Select one: A. Loss of weight, abdominal pain, chest pain. B. Knee pain, abdominal rash, subcutaneous nodules. C. Fatigue, slow pulse, frequent urination. D. An elevated temperature, back pain, loss of hair. 144.The nurse is working with an adolescent who complains of being lonely and lacking a sense of fulfillment with life. This adolescent shies away from intimate relationships at times, yet at other times, appears promiscuous. Which of the following is the priority for the nurse to focus on with this adolescent? Select one: A. loneliness B. isolation C. identity D. lack of fulfillment 145.Applying the essential newborn care, the nurse will do which of the following interventions first upon the delivery of the baby? Select one: A. Immediate cord clamping to prevent contamination of fetal blood B. Suctioning the airway to prevent respiratory distress C. Immediate drying of the newborn to conserve heat D. Promotion of mother and child bonding through skin – to – skin contact 146.After teaching the parents of an infant diagnosed with Hirschsprung's disease, the nurse determines that the parents understand the diagnosis when the father states which of the following? Select one: A. "There is no rectal opening for stool to pass." B. "There is a tube between the trachea and esophagus." C. "The nerves to the end of the large colon are missing." D. "The muscle below the stomach is too tight." 147.When developing the teaching plan for the mother of a preschooler about illness, which of the following would the nurse expect to include about how a preschooler perceives illness? Select one: A. Punishment for wrongdoing B. A necessary part of life C. Test of self-worth D. The will of God 148.Which of the following conditions included in screening needs to be repeated if the screening was done before forty eight (48) hours after birth? Select one: A. Congenital Hemoglobinopathies B. Phenylketonuia C. Congenital Hypothyroidism D. Congenital Adrenal Hyperplasia 149.The nurse has discussed appropriate support of the young infant to prevent injuries from falls. The mother who needs further education is the mother who states: Select one: A. "My child is not allowed to have his walker near the stairs." B. "Before my child is standing, I need to place the crib mattress at its own level." C. "I never leave my baby unattended on my bed." D. "By the time my infant is 6 months old, he will be able to sit without support." 150.The nurse is caring for a 2-day-old neonate in the recovery room 30 minutes after surgical correction for the cardiac defect, transposition of the great vessels. Which of the following would alert the nurse to notify the physician? Select one: A. Femoral pulse of 90 bpm. B. Oxygen saturation of 90%. C. Pale pink extremities. D. Warm, dry skin. 151.Philip has a nasogastric (NG) tube in place after surgery. Which finding indicates that the tube should not be removed? Select one: A. Passage of flatus B. Decreased amount of drainage from the NG tube C. Return of bowel sounds D. Passage of normal stool 152.If the child has chronic ear problem, what would be the best thing that you should do as a nurse? Select one: A. Refer urgently B. Dry the ear by wicking and follow-up visit C. Give an antibiotic for 5 days D. Instruct mother when to return immediately 153.A mother who brings her 4-month-old infant to the clinic for a regular check-up is concerned that her infant is not developing appropriately. When assessing the infant, which of the following would the nurse expect to find? Select one: A. Ability to reach for a toy B. Ability to say mama or dada C. Ability to sit up with support D. Fine motor finger-to-thumb grasp 154.The nurse's priority in the care of a neonate diagnosed with esophageal atresia is the risk for impaired gas exchange related to: Select one: A. Excessive oropharyngeal severetions B. Change in hemodynamics C. Altered bowel elimination D. Fluid overload 155.Situation: Brian Ward, age 3 is diagnosed with Hirschprung's disease after undergoing a series of Xrays and examination by a pediatric gastrointestinal specialist. On Brian's first day of admission, the physician prescribes a clear liquid diet. Which food is permitted with this type of diet? Select one: A. Kool-Aid B. Whole milk C. Chicken noodle soup D. Orange juice 156.An elevated level of alpha fetoprotein level in the amniotic fluid will mean that: Select one: A. Enzyme defect is present in the fetus B. Respiratory distress syndrome will occur C. Fetus has an open body defect like meningocele D. Lungs maturity is present 157.After instructing how pre-eclampsia can affect both the client and the growing fetus, the nurse realizes that the client needs additional instruction when she says that pre-eclampsia can lead to which of the following? Select one: A. Intrauterine growth retardation B. Microcephalic infant C. Poor placental perfusion D. Abruptio placenta 158.Referring to the IMCI chart, a classification that signifies a mild condition; Select one: A. Pink B. Yellow C. Green D. None of the options 159.Situation: Michael, age 13, has been admitted to the pediatric unit for an elective tonsillectomy; this is his first hospitalization. Other than multiple episodes of tonsillitis, he is a healthy and active adolescent. However, he appears apprehensive and has several questions regarding hospital rules. When a Michael can tolerate cool water after tonsillectomy, the nurse can begin offering: Select one: A. cold milk B. fruit juice C. grape or cherry soda D. apple juice 160.While gently adducting the hips the nurse feels the femoral head slip out of the acetabulum. The nurse documents the finding as a positive Select one: A. Ortolanis sign B. Barlow's test C. Trendelenburg's sign D. Allis or Galeazzi's sign 161.Which of the following information would be important in developing play therapy for an 8 year old? Select one: A. Boys prefer to play with boys and girls with girls B. Girls prefer to play with boys C. Each prefer mixed group play D. Boys prefer to play with girls 162.In child with TOF, cyanosis results from: Select one: A. a left to right shunt through a Blalock Taussig shunt B. a left to right shunt through a ventricular septal defect C. a right to left shunt through a ventricular septal defect D. an increased pulmonary blood flow 163.Situation: Philip, age 10 months, is brought to the emergency department by his parents, who report that he has experienced nonprojectile, nonbilious vomiting off and on for 1 day. He cries and pulls his legs up to his abdomen, then appears normal for awhile. Which sign is the most reliable indicator of intussusception? Select one: A. Distended abdomen B. Constipation C. Currant jelly stools D. Diarrhea 164.The school age child can be distinguished by all of the following EXCEPT: Select one: A. Peak development of lymphatic tissues B. Can distinguish left from right especially in marching commands C. Shedding of deciduous teeth occurs D. Begin to live independently and look outside the home for goals 165,After the physician explains the prognosis and medical management for atrial septal defect to a primiparous client whose 2-day-old female neonate was diagnosed with this condition, the nurse determines that the mother needs further instructions when she says which of the following? Select one: A. "This condition occurs more often in females than in males." B. "As my child grows, she may have increased fatigue and difficulty breathing." C. "My child may need to have antibiotics if she develops an infection." D. "About half of the children born with this defect heal spontaneously." 166.A woman who is scheduled to deliver via cesarian section asked the nurse about how the essential newborn care about could be applied. The nurse's best response to the client is: Select one: A. "This must be difficult for you; unfortunately, ENC may not be applicable to your situation" B. "The ENC may still be applied to you and your baby especially the skin – to – skin contact" C. "I will tell your doctor about your concern since you will operated" D. "Why are you concerned about the Essential Newborn Care?" 167.At a home visit, the nurse assesses a neonate delivered vaginally at 41 weeks' gestation 5 days ago, noting the following findings: frequent hiccups; loose, watery stool in diaper; red rash on face; and dry, peeling skin. Which of these findings warrants further assessment? Select one: A. Loose, watery stool in diaper. B. Frequent hiccups. C. Pink papular vesicles on the face. D. Dry, peeling skin. 168.You discover that a toddler's mother is propping a bottle at bedtime to help her fall asleep. You would advise her against this practice because Select one: A. the bottle could break, injuring the child. B. it promotes tooth decay. C. calcium is drained from the bones. D. it can cause a facial rash. 169.While you are having your lunch in a fast food, you saw a mother with her three years old child arguing because the child would always say NO to her mother if she is asked to eat. You would know that the mother is exhibiting a good approach to the negativistic behavior of the child when she uses which of the following approaches? Select one: A. "You really have to eat because your tummy will become painful if you will not eat your lunch. You don't like that to happen, don't you?" B. "It's twelve o'clock therefore it is time for lunch. I will buy you a sundae if you finish everything on your plate." C. "Do you want to eat or not? I will just give this food to your brother if you will not eat it." D. "It is time to eat now! What part of the chicken do you want to eat? Is it the wing part of the leg part?" 170.The health care team determines that the family of an infant with failure to thrive who is to be discharged will need follow-up care. Which of the following would be the most effective method of follow-up? Select one: A. Twice-weekly clinic appointments. B. Daily phone calls from the hospital nurse. C. Weekly visits by a community health nurse. D. Enrollment in community parenting classes. 171.A clinic nurse is carefully examined a pregnant woman. Which of the following information obtained after assessment places a woman at high risk for abruptio placenta? Select one: A. A primiparous client in the active stage of labor B. The client has a history of hypertension C. A multigravida client D. The client is 30 years old 172.Amniocentesis was also done at 24th week of gestation to test for fetal condition. The Lecithin / Sphingomyelin ratio was 2:1 ratio. This will indicate: Select one: A. Respiratory distress syndrome will occur B. Fetus has an open body defect like meningocele C. Enzyme defect is present in the fetus D. Lungs maturity is present 173.Situation: Jennifer, a full-term neonate, is transferred to the neonatal intensive care unit. Her diagnosis is esophageal atresia; surgery is scheduled for the next morning. Prevent aspiration of secretions, the nurse must suction Jennifer every 2 to 4 hours as needed. Prolonged and vigorous suctioning of a neonate can cause: Select one: A. Laryngospasm B. Tachycardia C. Pneumonia D. Pallor 174.SITUATION: Mark Foster, a 10-month-old infant with a cleft lip and palate, is admitted to the pediatric unit for the first stage of surgical correction on his lip. Primarily breast-fed, he occasionally receives a supplemental bottle. The physician orders elbow restraints postoperatively. The nurse should: Select one: A. Put the restraints on Mark's dominant hand B. Use the restraints only when Mark is awake C. Release the restraints every 2 to 4 hours D. Use the restraints only when Mark is asleep 175.The mother tells the nurse that her 8-year-old child is continually telling jokes and riddles to the point of driving the other family members crazy. The nurse explains that this behavior is a sign of which of the following? Select one: A. Mastery of language ambiguities B. Inappropriate peer influence C. Excessive television watching D. Inadequate parental attention 176.A 2 '/2-year-old brought to the clinic by her parents is uncooperative when the nurse tries to look in her ears. Which of the following would the nurse try first? Select one: A. Wait until the child calms down B. Restrain the child's arms C. Allow a parent to assist D. Ask another nurse to assist 177.The following are drugs given in a client with Pregnancy Induced Hypertension with Severe- Preeclampsia. Which of these drugs is an anticonvulsant agent and can prevent incidence of eclampsia? Select one: A. Valium B. Indomethacin (Indocin) C. Magnesium Sulfate (MgSO4) D. Hydralazine (Apresoline) 178.Which of the following is the MOST important TASK during the third trimester of pregnancy Angel will face? Select one: A. Preparing for the coming of the baby B. Accepting the baby C. Preparing for the coming of the baby D. Accepting the baby 179.One principle of growth and development states that, “Development proceeds from gross to refined skills.” Which of the following sentences below best describes this principle? Select one: A. The nervous system develops the fastest at 2-5 years old while reproductive system develops during adolescence. B. Majority of children sit before they creep, creep before they stand, and stand before they walk. C. A grade one pupil would use larger size of pencil as compared to a grade three pupil using a size 2 pencil. D. There is total head control first before a child can lift his shoulders leading to his/her ability to sit alone. 180.The grandmother has brought an infant to the clinic for a checkup and has signed the consent for immunization administration. Which of the following would the nurse do first? Select one: A. Notify the physician immediately B. Call the infant's mother for verbal consent C. Ask who is the infant's legal guardian D. Administer the immunizations as ordered 181.Baby April is brought to the health center for his well baby check up. He is already on his 6th months and his weight reads at 18 lbs. His mother asked you if baby James' weight is normal. Knowing that his birth weight is 8 lbs, which of the following statements based on evidences would be your best response to the mother? Select one: A. "Your baby's weight is within normal because at 5 months, birth weight is doubled." B. "I cannot say if it is normal or not because I have to check yet the growth chart to compare this