HESI EAQ PEDIATRICS 2022-EXAM NURSING

HESI EAQ PEDIATRICS 2022-EXAM NURSING1.Which behavior of a 3-year-old child indicates delayed development? Select all that apply. a.The child is unable to feed himself. b. The child is unable to climb the stairs. c. The child is unable to tie his or her shoes. d. The child is unable to name the colors. e. The child is unable to count when asked. Rational: 3-year-old child has the tendency to ask many questions, talk for long periods irrespective of someone listening, is able to climbs stairs, and can eat by him- or herself. If the child is unable to feed himself or climb the stairs, it indicates impaired gross motor skills and social development. Fine motor skills like tying the shoelaces develop by age 5. Language development like naming the colors develops by age 4. Cognitive function like counting develops by age 4. 2. A 3-year-old child feels a sense of rivalry with his father and wants him to die. Shortly after these feelings emerge, the child’s father dies in a road accident. The child then begins to feel intense guilt, believing that he caused the death. What is the best nursing intervention in this situation? a. Teach relaxation techniques to the child. b. Encourage the child to play with his siblings. c. Suggest that the child’s uncle spend time with him. d. Explain to the child that wishes do not make things happen. Rational: The nurse should clarify the child’s thoughts and help reduce feelings of guilt by explaining that wishes do not make events occur. Relaxation techniques help to reduce anxiety but do not reduce the feeling of guilt. Playing with siblings or spending time with an uncle may help relieve the child’s stress, but they do not address the feelings of guilt. 3. While teaching parents about the developmental milestones of a 15-month-old child, the nurse informs the parents about various activities that their child should be able to do. Which statement of the parent indicates effective learning? a. "My child can jump with both feet." b. "My child can walk up stairs with one hand held." c. "My child can creep up stairs and kneel without support." d. "My child goes up and down stairs alone with two feet on each step." Rational: A 15-month-old child has the ability to creep up stairs and kneel without support due to the development of gross motor skills. The child starts jumping with both feet at the age of 30 months. The child will start walking up stairs with one hand held at the age of 18 months. The calf muscles develop sufficiently for the child to walk up and down stairs alone at the age of 24 months. 4. A toddler wearing a diaper is impatient with the wet diaper and shows a desire to have it changed. Which toilet training readiness does this behavior indicate? a. Mental readiness b. Physical readiness c. Parental readiness d. Psychological readiness Rational: The toddler’s impatience with the wet diaper and desire for a change indicates psychological readiness for toilet training. Mental readiness is indicated when the toddler recognizes the urge to urinate. Physical readiness is indicated when the toddler is voluntarily able to control the sphincter and wakes up dry after a nap. Parental readiness is indicated when the parent is willing to invest the time required for toilet training. 5. While playing with a toy car a toddler accidentally hits the wall and falls down. The toddler then gets angry at the wall for making him fall. Which characteristic of preoperational thought does this behavior indicate? a. Animism b. Centration c. Egocentrism d. Irreversibility Rational: Animism is an act of attributing lifelike qualities to inanimate objects. When a toddler scolds the wall for making him or her fall, it indicates animism. Centration is focusing on one aspect rather than considering all possible alternatives. Egocentrism is the inability to envision situations from perspectives other than one’s own. Irreversibility is the inability of toddlers to reverse actions that are physically initiated. 6. The nurse is counseling the parents of an adolescent child on the benefits of social development in the child’s maturation process. Which statement by the nurse needs correction to convey an appropriate message to the parents? a. The family should encourage the child to make relationships outside the family. b. Feelings of immortality in the child are undesirable and should be condemned. c. Feelings of intense sociability and equally intense loneliness are normal in the child. d. The family should encourage the child to develop an identity independent of parental authority. Rational: Social development is a critical aspect of a child’s maturation process. The feelings of immortality and release from the results of risky behavior are common in adolescent children. Though such feelings are negative, they function as important developmental tools. These feelings help the child gain courage to build a separate self-identity by freeing him- or herself from family domination. Therefore the nurse should explain the significance of these feelings, although they seem negative. The nurse should instruct the parents to encourage the child to form social relationships outside the family. This helps in emancipating the child. The nurse should explain to the parents that adolescence is a transition period during which a child experiences various emotions ranging from intense sociability to intense loneliness. The parents should support and encourage the child to develop an independent identity apart from the family authority in order to achieve full maturity. 7. The nurse is teaching a mother about the developmental behaviors of a 7-month-old infant. Which statement by the mother indicates effective learning? Select all that apply. A. "I should start oral hygiene in my child." B. "I should not change my child’s diet." C. "I should call my child by her name." D. "I should not leave the child with an unfamiliar relative." E . "I should encourage my child to produce n, k, g, p, and b sounds." Rational: The upper central teeth begin to erupt in a 7-month-old infant; therefore, the mother can buy a toothbrush with soft bristles to maintain oral hygiene. A 7-month-old infant can remember and respond to his or her own name. A 7-month-old infant often has a fear of the strangers, so the mother should not leave the infant with new people. A 7-month-old infant has taste preferences, so the mother can expose the child to different foods. A 7- month-old infant is able to say words such as dada, baba, kaka, etc. Therefore, the parents should encourage the infant to produce these words, not specific sounds like n, k, g, p, and b. 8. The nurse instructs parents to avoid placing their infant in a prone position while sleeping. Which risk does the nurse seek to prevent with this instruction? a. Otitis media of the ear b. Conjunctivitis of the eye c. Infantile colic or baby colic d. Sudden infant death syndrome Rational: Infants should be placed on their backs while sleeping to prevent sudden infant death syndrome. Sleeping in the prone position can cause respiratory depression and death in infants. Otitis media does not result from sleeping in the prone position. The nurse instructs the parents about proper eye hygiene to prevent conjunctivitis. Infantile colic or baby colic is not caused by placing the infant in the prone position. 9. The nurse is teaching growth and development activities to the parents of a 3-month-old infant. Which statements does the nurse include in the teaching plan? Select all that apply. A . "Your child should be able to show the grasp reflex." B. "Your child should be able to coo, babble, and chuckle." C. "Your child should be able to pull at blankets or clothes." D. "Your child should be able to put feet into the mouth when supine." E. "Your child’s head can come up to a 45- to 90-degree angle from the table." Rational: Cooing, babbling, and chuckling in a 3-month-old infant indicate normal development. A 3-month-old infant can pull at blankets or clothes and can raise his or her head to a 45- to 90-degree angle from the table. The grasp reflex generally disappears by the age of 3 months. A 3-month-old infant may not able to put his or her feet in the mouth when lying in the supine position. Generally a 5-month-old infant can put his or her feet in the mouth when lying in the supine position. 10. What body weight is a normal finding in a 1-year-old infant whose birth weight was 3.2 kg? Record your answer to the nearest tenth of a kilogram. _____________ 9.6 Rational: The infant’s body weight generally triples by 1 year of age. Therefore, the infant’s normal body weight by 1 one year of age should be 3.2 x 3 = 9.6 kg. 11. Which type of play will help develop a leader-follower type of relationship? a. Solitary play b. Parallel play c. Associative play d. Cooperative play Rational: Children who are involved in cooperative play discuss and plan activities. Therefore, a leader-follower type of relationship will develop among the children. During solitary play, the child plays with toys alone. During parallel play, children play side by side but individually, with different toys. During associative play, the children borrow or lend play materials but do not control each other’s activities and therefore do not develop a leaderfollower type of relationship 12. The nurse is assessing the development of a child and observes family photographs of the child. The nurse finds that the child participates in play as seen in the image. Which type of play interaction does the child participate in as depicted in the image? a. Solitary play b. Parallel play c. Onlooker play d. Associative play Rational: The image depicts two children playing independently and parallel to each other with similar toys. Therefore, the children are involved in parallel play. The child who is involved in solitary play will play alone with toys that are different from those of the other children. While involved in onlooker play, the child observes how other children play but does not become involved in the games. While involved in associative play, children play together with the same toys. However, the children do not have proper organization. 13. While interacting with parents of children ranging in ages from 6 to 12 years old, the nurse suggests that the parents should avoid imposing too many expectations on their children. What is the rationale behind the nurse’s suggestion? a. To prevent role confusion in the children b. To reduce the feelings of guilt in the children c. To prevent inferiority complexes in the children d. To improve the decision-making abilities of the children Rational: Erikson’s life span approach in the development of children is categorized into eight stages relating to childhood. In the stage of industry versus inferiority, development is attained by children between 6 to 12 years of age. Children at this stage act as workers and producers: they initiate and complete work aiming at real achievement. The child may feel inferior if parents impose many expectations on him or her. Identity versus role confusion is seen in children between 12 to 18 years of age, and is the stage in which rapid and marked physical changes occur. Adolescents struggle to fit the roles they have played and those they expect to play. When the ability to solve these conflicts fails, it leads to role confusion. Initiative versus guilt is seen in children between 3 to 6 years old; children in this stage explore the physical world with all their senses and powers and may feel guilty when parents make them feel as though their behaviors are bad. Children in the age group of 1 to 3 years are in the stage of autonomy versus shame and doubt. Children in this stage increase their ability to develop, control their bodies and their environment, and use their mental powers for decision making. However, avoiding imposing too many expectations does not prevent role confusion or guilt, and does not improve the children’s decision-making abilities. 14. The nurse is educating the mother of an 8-year-old female about the sequences of maturational changes. Which response by the mother indicates effective learning? "Appearance of pubic hair is not a maturational change." "Appearance of axillary hair is the first stage of maturation." "Appearance of breast buds is an initial indication of puberty." "Abrupt deceleration of height is followed by the breast changes." Rational: Appearance of breast buds is the initial indication of puberty in the child. Appearance of pubic hair is a maturation change followed by the appearance of axillary hair and it is the second stage of maturation. Abrupt deceleration of height is the last stage of maturation, and it is not followed by any other maturational changes. 15. During a follow-up visit, the mother of a 10-month-old infant says, "My child lifts one foot to take a step, stands by holding the furniture, but does not attempt to stand alone without support, and walks while holding onto a hand." What is the accurate nursing response in this situation? a. "Your child may be in need of minor leg surgery." b. "Your child should be able to stand alone in another 2 months." c. "You should consult an orthopedic specialist immediately." d. "You should encourage physiotherapy for your child’s legs." Rational: The 10-month-old infant can lift one foot to step and stand by holding the furniture. A 12-month-old infant would be able to stand alone without support and walk while holding a hand, but not the 10-month-old infant. Therefore, the nurse should inform the mother to wait for 2 more months. As the 10-month-old infant is performing all the actions appropriate to his or her age, there is no need for leg surgery. The nurse should instruct the mother to consult the orthopedic specialist and to encourage physiotherapy if the infant fails to demonstrate appropriate developmental actions after 12 months of age. 16. The nurse is teaching a mother about the developmental behaviors of a 7-month-old infant. Which statement by the mother indicates the need for further teaching? a. "I can try foods of different tastes for my child." b. "I should encourage my child to play peek-a-boo games." c. "I can leave my child with my new friend for some time." d. "I should buy a toothbrush with soft bristles for my child." Rational: The fear of strangers increases in infants by 7 months of age. Therefore, the mother should not leave the infant with new people. The 7-month-old infant has taste preferences; therefore, the mother can try foods with different tastes for the child. The 7-month-old infant enjoys peak-a-boo games; therefore, the mother can play this game with the child. The 7- month-old infant has eruption of the upper central teeth; therefore, the mother can buy a toothbrush with soft bristles for the child to maintain oral hygiene. 17. Which statement by the student nurse indicates an understanding about children who engage in associative play? a. “Children play independently, but among other children.” b. “Children play together and are engaged in a similar activity.” c. “Children focus their attention on anything that strikes their interest.” d. “Children play alone with toys different from those used by other children.” Rational: In associative play children play together and are engaged in a similar or identical activity. For instance, children may borrow toys from each other or follow each other with tricycles. In parallel play children play independently, but among other children. In unoccupied play children focus their attention on anything that strikes their interest. In solitary play children play alone with toys different from those used by other children. 18. According to Erikson’s theory of psychosocial development, which attribute plays an important role in the development of a healthy personality from birth to 1 year of age? a. Trust versus mistrust b. Initiative versus guilt c. Autonomy versus shame d. Industry versus inferiority Rational: According to Erikson’s theory of psychosocial development, the first attribute that helps to develop a healthy personality after birth is trust. Mistrust develops if the care provided to the infant is inconsistent. Initiative versus guilt is seen at 3–6 years of age, when children explore their surroundings with their senses and power. If the child does something that contradicts the parents’ desires, then there are feelings of guilt. The need for autonomy and feelings of shame develop between 1–3 years of age, when the child acquires motor skills and learns new activities. If the child is made to feel self-conscious, then the child struggles with feelings of shame. Industry versus inferiority is seen in a child 6–12 years of age. In this stage children engage in activities that they can complete successfully. If too much is expected out of them, then there are feelings of inferiority. 19. An 8-year-old child is being prepared for surgery the next day. How should the nurse present preoperative instructions to this child? a. By repeating instructions often b. By providing time for needle play c. By using several abstract examples d. By focusing on simple anatomical diagrams Rational: According to Piaget, an 8-year-old child's level of development is in the stage of concrete operations; the child will benefit from simple, concrete examples. The preschooler and younger child, not the school-age child, require repetition. Therapeutic needle play is more appropriate if and when the child is to receive an injection. The child who is in the period of concrete operations cannot think in the abstract; the ability to do this develops during adolescence. 20. The nurse is instructing the parents of a 6-month-old infant about sleeping patterns and the best sleeping positions for their child. Which instruction regarding sleep position is most important? a. “Place the infant in a supine position for sleep.” b. “Avoid positioning the head on alternating sides.” c. “A prone position is more beneficial for sleeping.” d. “If the infant is restless, place it on one side to sleep.” Rational: The nurse instructs the parent to place the infant in a supine position so the infant does not roll over to a prone position. When the infant is less than 6 months old, the infant is placed in a supine position and the head is positioned on alternating sides to prevent positional plagiocephaly. There is a risk for sudden infant death syndrome (SIDS) if the infant is placed in a prone position. If the infant is restless, it should be assessed, but not put to sleep on one side, as the infant can easily roll over to the prone position if placed on the side. 21. The parents of a preschooler are worried, as the child is often seen talking to imaginary friends. The parents admit that they often scold the child for such behavior. What does the nurse inform the parents? a. “The child may develop severe psychological problems.” b. “You must involve the child in some spiritual activities.” c. “There may be some neurological or developmental issue.” d. “The behavior is normal at this age and it will help counter loneliness.” Rational: Sometimes children create imaginary friends to help counter the feelings of loneliness. Therefore, the nurse should tell the parents that it is a normal behavior. Speaking to imaginary friends is a habit that children overcome later in life and, therefore, there is no risk for developing any psychological problems. It is not necessary to involve the child in any spiritual activity if the parents do not desire to do so. A neurological problem is seen if the child exhibits jerking moments or experiences fainting spells. 22. While interacting with a 4-year-old child, the nurse observes that the child exhibits which behavior congruent with Piaget’s cognitive development theory? a. The child is beginning to use language to communicate. b. The child uses abstract symbols and draws conclusions. c. The child is unable to see things from others’ perspectives. d. The child is able to classify and sort facts to solve problems. Rational: A 4-year-old child has his or her own perspective and expects that others also think the same way. This behavior is seen in the preoperational stage of Piaget’s development theory. A 1- to 2-year-old child who is in the sensorimotor stage, according to Piaget’s theory, will begin to use language. An adolescent who is in the formal operations stage of Piaget’s developmental theory will use abstract symbols and draw conclusions. The ability to draw conclusions from abstract symbols is not a finding in a 4- year-old. The ability to classify and sort problems is developed between the ages of 7 and 11 years. A child who is in the concrete operations stage of Piaget’s development theory will exhibit the ability to classify and sort facts to solve problems. 23. The nurse observes dental caries in an 8-month-old infant. Which action of the parents is likely responsible for this condition? a. Giving the infant canned fruit b. Giving the infant 960 mL of milk daily c. Giving the infant fruit juice with a bottle d. Giving cheese as a finger food Rational: Giving an infant fruit juice with a bottle can result in dental caries. Giving an infant canned fruits and vegetables can result in lead poisoning, not dental caries. Giving an 8-month-old infant 960 mL of milk is appropriate and does not result in dental caries. Cheese can be given as a finger food to an 8- month-old infant and may not result in dental caries. 24. The nurse finds that a child has developed the qualities of independence, self-control, and self-governance. Which type of development does the nurse anticipate in the toddler? a. Social development b. Spiritual development c. Biologic development d. Psychosocial development Rational: Psychosocial development is indicated by the child’s awareness of the relationship between him- or herself and his or her environment. When the child develops independence, self-control, and self-governance, it indicates that the child has acquired a sense of autonomy, which is a component of psychosocial development. Social development is the ability to establish and maintain rewarding relationships with others. Spiritual development in children is heavily influenced by family members and others close to them; it is not specifically associated with the development of autonomy. Biologic development is the series of changes that occur at different stages of growth. 25. The nurse finds that a 2-year-old child has impaired fine motor skills. The nurse recommends toys that will be beneficial for the child. Which statement by the child’s parents needs correction? a. "I should provide musical toys." b. "I should provide straddle trucks." c. "I should provide battery-operated cars." d. "I should provide thick crayons and finger paints." Rational: Passive toys such as battery-operated cars should not be provided as they do not stimulate musculoskeletal development. Musical toys can improve coordination. Straddle trucks improve locomotive skills. Thick crayons and finger paints improve fine motor skills