A nurse is assessing a 9 mo old for potential developmental delay. Which observation should the nurse
expect to find to support this condition? –inability to sit without support. Infant should be able to sit
alone with support, roll back and forth, reach for objects, and may even begin to crawl by 7 months.
The nurse is assessing a 4 mo old. Which assessment should prompt the nurse to conduct a further
evaluation? –head lag when pulled from a lying to sitting position. By 4-6 months, head control is well
established. Only a slight head lag should be evident.
Which reflex should the nurse expect to find on a 6 month old infant? –Babinski (stroking the bottom of
the foot causing toes to fan and the big toe to dorsiflex) is present until age 1.
Appropriate toy for 4 year old admitted to hospital? –plastic stethoscope
The nurse is caring for a 3 year old newly diagnosed with diabetes mellitus. When writing the care pla,
the nurse includes this goal: the child will be provided with opportunities for therapeutic play. Which
would be the most appropriate toy to help meet this goal? –doll and syringe with no needle.
Appropriate to tell parent? –Establish a set bedtime and follow a nightly routine. Preschool-aged children
test limits. Consistency in approach to the child is very important.
Nutrition for 12 month old: 4-6 oz of juice/day is recommended; apple slivers and cereal are good
snacks. Cereal is small and dissolves with infants’ saliva so it does not cause airway obstruction, and
apple slivers are good because infants need to be offered finger foods; child should be introduced to the
same food as the family is eating.
A nurse is caring for a child with bacterial endocarditis. The child with receive long-term antibiotics and
will require a PICC. Which statement is appropriate for the nurse to state to the parents? –the PICC line
will last several weeks with proper care. They may remain in place for up to 6 months or longer with
proper care.
Pain is a subjective experience even for a 3 year old. The FACES scale can be used to accurately
determine the presence of pain in children as young as 3.
A nurse is conducting a yearly health assessment of a 14-yr old girl. The nurse should understand which
finding will require further evaluation? –there is a lateral curvature to her spine (could indicate scoliosis)
A nurse is caring for an 8 year old child who has a fractured femur. The child is in skeletal traction. To
assist with the child’s developmental needs, which of the following would be an appropriate action for
the nurse to take? –have the hospital tutor visit daily to assist the child with homework. They are in the
industry vs inferiority stage. Children hospitalized for a long time in traction will often worry about falling
behind their peers in their school work. It’s important to make arrangements with the child’s school to
provide homework for the child and opportunity for the child to complete the work as well.
Which statement is true regarding non-organic failure to thrive? –disruption in the parent-child bond. It
is primarily a psychosocial diagnosis, made only after all organic causes for failure to thrive have been
ruled out.
A nurse is caring for an adolescent who has ingested 60 mL of bleach. Which statement by the nurse
would indicate an understanding of this ingestion? –the severity of alkaline burn depends on the pH of
the substance.
This study source was downloaded by 100000817935606 from CourseHero.com on 02-01-2022 11:03:03 GMT -06:00
https://www.coursehero.com/file/21946554/peds-test/
, A nurse is performing an assessment on a child at the clinic. When performing this assessment, the nurse
should do which of the following? –have the child sit in the parent’s lap, auscultate the heart and lungs,
and then examine the ears and throat. In young children, the exam should proceed from the lease
invasive to the most invasive.
Appropriate activity for 2 year old? –building block towers.
Best way to collect urine from an 18 mo old? –apply a pediatric urine collector. This is the method used
to obtain a routine urine specimen of any sort in a child who is not toilet trained.
Expected fine motor skill in 4 year old? –copying a square and circle.
Common allergen in infants? –cow’s milk.
A nurse is caring for a toddler who is scheduled for surgery. The parent asks the nurse for suggestions on
how to prepare her child for the upcoming surgery. Which statement is appropriate? –you could read
books to your child about being hospitalized.
A nurse is performing a PE on a 30 mo old todder. Which of the following nursing assessments should the
nurse NOT expect to find at this age? –birth weight tripled. This should have happened at 12 months. By
2 ½ years, birth weight should be quadrupled.
Contraindication to pertussis immunization? Know neurologic or seizure disorder; fever >105 or extreme
lethargy following previous pertussis vaccine.
A nurse is caring for an infant on droplet precautions. The nurse understands that she can best prevent
the spread of droplet pathogens by doing what? –wearing a gown and mask when feeding the infant.
Preschooler’s perception about death? –death is the same as going to sleep; death is caused by magical
thinking; death is the result of a wish; death is a punishment.
At 18 mo of age, fine motor skills should be developed well enough to allow the toddler to begin to hold
a crayon and scribble. If an 18-mo-old is not scribbling, further developmental assessment is needed.
The nurse should indicate to the parents that playing peek a boo will develop what concept? –object
permanence. This refers to the skill of knowing an object still exists even when it’s out of site.
A nurse is assessing an 8 yr old child’s psychosocial development. Which finding should the nurse
recognize as requiring further evaluation? –the child complains every day about going to school. They
are in industry vs inferiority stage. Children in this stage want to learn and master new concepts.
All incoming college students need meningitis vaccine.
Normal findings in 6 year old? –tonsils that touch eachother; small, brown maculae; a central incisor
that’s loose.
A nurse is caring for a 3 year old child who has a lead level of 15g/dL. When teaching the toddler’s
parent about nutrition and the correlation with lead poisoning, which suggestion is appropriate for the
nurse to state? –drink milk. Increased intake of calcium and iron prevents lead poisoning.
The nurse is assessing a 6 month old infant in the well child clinic. Which of the following assessments
would indicate the infant needs further evaluation? –legs stay crossed at the knees. The infant’s legs
This study source was downloaded by 100000817935606 from CourseHero.com on 02-01-2022 11:03:03 GMT -06:00
https://www.coursehero.com/file/21946554/peds-test/
expect to find to support this condition? –inability to sit without support. Infant should be able to sit
alone with support, roll back and forth, reach for objects, and may even begin to crawl by 7 months.
The nurse is assessing a 4 mo old. Which assessment should prompt the nurse to conduct a further
evaluation? –head lag when pulled from a lying to sitting position. By 4-6 months, head control is well
established. Only a slight head lag should be evident.
Which reflex should the nurse expect to find on a 6 month old infant? –Babinski (stroking the bottom of
the foot causing toes to fan and the big toe to dorsiflex) is present until age 1.
Appropriate toy for 4 year old admitted to hospital? –plastic stethoscope
The nurse is caring for a 3 year old newly diagnosed with diabetes mellitus. When writing the care pla,
the nurse includes this goal: the child will be provided with opportunities for therapeutic play. Which
would be the most appropriate toy to help meet this goal? –doll and syringe with no needle.
Appropriate to tell parent? –Establish a set bedtime and follow a nightly routine. Preschool-aged children
test limits. Consistency in approach to the child is very important.
Nutrition for 12 month old: 4-6 oz of juice/day is recommended; apple slivers and cereal are good
snacks. Cereal is small and dissolves with infants’ saliva so it does not cause airway obstruction, and
apple slivers are good because infants need to be offered finger foods; child should be introduced to the
same food as the family is eating.
A nurse is caring for a child with bacterial endocarditis. The child with receive long-term antibiotics and
will require a PICC. Which statement is appropriate for the nurse to state to the parents? –the PICC line
will last several weeks with proper care. They may remain in place for up to 6 months or longer with
proper care.
Pain is a subjective experience even for a 3 year old. The FACES scale can be used to accurately
determine the presence of pain in children as young as 3.
A nurse is conducting a yearly health assessment of a 14-yr old girl. The nurse should understand which
finding will require further evaluation? –there is a lateral curvature to her spine (could indicate scoliosis)
A nurse is caring for an 8 year old child who has a fractured femur. The child is in skeletal traction. To
assist with the child’s developmental needs, which of the following would be an appropriate action for
the nurse to take? –have the hospital tutor visit daily to assist the child with homework. They are in the
industry vs inferiority stage. Children hospitalized for a long time in traction will often worry about falling
behind their peers in their school work. It’s important to make arrangements with the child’s school to
provide homework for the child and opportunity for the child to complete the work as well.
Which statement is true regarding non-organic failure to thrive? –disruption in the parent-child bond. It
is primarily a psychosocial diagnosis, made only after all organic causes for failure to thrive have been
ruled out.
A nurse is caring for an adolescent who has ingested 60 mL of bleach. Which statement by the nurse
would indicate an understanding of this ingestion? –the severity of alkaline burn depends on the pH of
the substance.
This study source was downloaded by 100000817935606 from CourseHero.com on 02-01-2022 11:03:03 GMT -06:00
https://www.coursehero.com/file/21946554/peds-test/
, A nurse is performing an assessment on a child at the clinic. When performing this assessment, the nurse
should do which of the following? –have the child sit in the parent’s lap, auscultate the heart and lungs,
and then examine the ears and throat. In young children, the exam should proceed from the lease
invasive to the most invasive.
Appropriate activity for 2 year old? –building block towers.
Best way to collect urine from an 18 mo old? –apply a pediatric urine collector. This is the method used
to obtain a routine urine specimen of any sort in a child who is not toilet trained.
Expected fine motor skill in 4 year old? –copying a square and circle.
Common allergen in infants? –cow’s milk.
A nurse is caring for a toddler who is scheduled for surgery. The parent asks the nurse for suggestions on
how to prepare her child for the upcoming surgery. Which statement is appropriate? –you could read
books to your child about being hospitalized.
A nurse is performing a PE on a 30 mo old todder. Which of the following nursing assessments should the
nurse NOT expect to find at this age? –birth weight tripled. This should have happened at 12 months. By
2 ½ years, birth weight should be quadrupled.
Contraindication to pertussis immunization? Know neurologic or seizure disorder; fever >105 or extreme
lethargy following previous pertussis vaccine.
A nurse is caring for an infant on droplet precautions. The nurse understands that she can best prevent
the spread of droplet pathogens by doing what? –wearing a gown and mask when feeding the infant.
Preschooler’s perception about death? –death is the same as going to sleep; death is caused by magical
thinking; death is the result of a wish; death is a punishment.
At 18 mo of age, fine motor skills should be developed well enough to allow the toddler to begin to hold
a crayon and scribble. If an 18-mo-old is not scribbling, further developmental assessment is needed.
The nurse should indicate to the parents that playing peek a boo will develop what concept? –object
permanence. This refers to the skill of knowing an object still exists even when it’s out of site.
A nurse is assessing an 8 yr old child’s psychosocial development. Which finding should the nurse
recognize as requiring further evaluation? –the child complains every day about going to school. They
are in industry vs inferiority stage. Children in this stage want to learn and master new concepts.
All incoming college students need meningitis vaccine.
Normal findings in 6 year old? –tonsils that touch eachother; small, brown maculae; a central incisor
that’s loose.
A nurse is caring for a 3 year old child who has a lead level of 15g/dL. When teaching the toddler’s
parent about nutrition and the correlation with lead poisoning, which suggestion is appropriate for the
nurse to state? –drink milk. Increased intake of calcium and iron prevents lead poisoning.
The nurse is assessing a 6 month old infant in the well child clinic. Which of the following assessments
would indicate the infant needs further evaluation? –legs stay crossed at the knees. The infant’s legs
This study source was downloaded by 100000817935606 from CourseHero.com on 02-01-2022 11:03:03 GMT -06:00
https://www.coursehero.com/file/21946554/peds-test/
