NR 328 Exam #1
Which topics should the nurse discuss with the parents of a young child to promote
health in their child?
a. Dental care needs to be started by age 7.
b. Immunization schedule and the importance of immunizations.
c. Human milk or iron fortified formula for the first 4 months of life.
d. Positioning the car seat in the front passenger seat. - Answer Answer: B
Rationale: Immunizations have made a major impact in the prevention of disease in
children. The nurse should review individual immunization records at every clinic visit,
avoid missing opportunities to vaccinate, and encourage parents to keep immunizations
current. Dental caries is the single most common chronic disease of childhood and may
begin before the first birthday. Human milk or iron fortified formula for should be given
for the first year of life to prevent Iron Deficiency anemia. Children younger than 1 year
of age have the highest rate of death from motor vehicle accidents, primarily from a
failure to properly use car restraints.
What is the leading cause of death in children older than the age of 1 year?
a. Drowning
b. Burns
c. Motor vehicle accidents
d. Cancer - Answer Answer(s): C
Rationale: a. Drowning is the second leading cause of death in children older than the
age of 1 year. b. Burns cause fewer deaths than motor vehicle accidents in children
older than the age of 1 year. c. Motor vehicle accidents are the leading cause of death
in children older than the age of 1 year. d. Cancer causes fewer deaths than motor
vehicle accidents in children older than the age of 1 year.
The nurse makes sure that a toddler has a teddy bear and that a nightlight is on in the
hospital room at bedtime. What concept would these nursing actions demonstrate?
a. Atraumatic care
b. Nonmaleficence
c. Justice
d. Advocacy - Answer Answer(s): A
Rationale: A. Atraumatic care is the provision of therapeutic care in settings, by
personnel, and through the use of interventions that eliminate or minimize the
psychological and physical distress experienced by children and their families in the
health care system. In this case, it is making sure that the toddler has a teddy bear and
that a night light is on to prevent a dark environment. B. Nonmaleficence is the
obligation to minimize or prevent harm; there is no situation present that would require
this. C. Justice is the concept of fairness and is not applicable to this situation. D.
Advocacy involves ensuring that families are aware of all available health services,
adequately informed of treatments and procedures, involved in the child's care, and
encouraged to change or support existing health care practices.
True or False: Open ended questions are most likely to encourage parents to talk about
their feelings r/t their child's illness. - Answer True
,NR 328 Exam #1
When the nurse interviews an adolescent, what is important to help establish a
relationship?
a. Use the same type of language as the adolescent.
b. Emphasize that confidentiality will always be maintained.
c. Focus the discussion on the peer group.
d. Display a genuine interest in the adolescent. - Answer Answer: D.
Rationale: Display a genuine interest in the adolescent.Adolescents accept anyone who
shows a genuine interest in them. Although peers are important to this age-group, the
focus of the interview should be on the adolescent. The nurse should clarify which
information will be shared with other members of the health care team and any limits to
confidentiality. The nurse should maintain a professional relationship with adolescents.
To avoid misinterpretation of words and phrases that the adolescent may use, the nurse
should clarify terms frequently.
What approach is the most appropriate when performing a physical assessment on a
toddler?
a. Demonstrate use of equipment.
b. Perform traumatic procedures first.
c. Use minimum physical contact initially.
d. Always proceed in a head-to-toe direction. - Answer Answer: C.
Rationale: Parents can remove clothing, and the child can remain on the parent's lap.
The nurse should use minimum physical contact initially to gain the cooperation of the
child. The nurse should introduce the equipment slowly. The child can inspect the
equipment, but demonstrations are usually too complex for this age-group. Traumatic
procedures should always be performed last. These will most likely upset the child and
inhibit cooperation. The head-to-toe assessment can be done in older children but
usually must be adapted in younger children.
What is the most consistent and commonly used indicator of pain in infants?
a. Thrashing of arms and legs.
b. Increased heart rate.
c. Increased respirations.
d. Facial expression of discomfort. - Answer Answer: D.
Rationale: Facial expression of discomfort. Facial expression has consistently been
validated as an indicator of pain in infants. Behavioral pain measures are most reliable
for sharp procedural pain in infants. Increased heart rate and respirations are indicative
of a generalized and complex response to stress. They are not specific for pain in
infants. Thrashing of arms and legs is a reliable indicator in young children, not infants.
True or False: At age 1 month is the normal age for binocularity-ability to fixate on one
visual field with both eyes simultaneously. - Answer Answer: False.
Rationale: Binocularity is usually achieved by age 3 to 4 months. One month is too
young for binocularity. If binocularity is not achieved by 6 to 12 months, the child must
be observed for strabismus.
What self-report pain rating scales can be used in children as young as 3 years of age?
,NR 328 Exam #1
a. FACES Pain Rating Scale
b. Visual Analog Scale
c. Word-Graphic Rating Scale
d. Who Cares? - Answer Answer: A.
Rationale: The FACES Pain Rating Scale is for children as young as 3 years of age.
The Visual Analog Scale can be used for children older than 4 years of age but is most
appropriate for ages 7 and older. The Word-Graphic Rating Scale uses descriptive
words and is recommended for children 4 to 17 years of age.
An intravenous line is needed in a school-age child. What medication is appropriate
analgesic for use with this patient?
a. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.
b. EMLA (eutectic mixture of local anesthetics) immediately before.
c. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
d. TAC (tetracaine, epinephrine [Adrenalin], cocaine) 15 minutes before. - Answer
Answer: A.
Rationale: LMX is an effective analgesic agent when applied to the skin 30 minutes
before a procedure. It eliminates or reduces the pain from most procedures involving
skin puncture. TAC provides skin anesthesia about 15 minutes after application to
nonintact skin. The gel can be placed on the wound for suturing. It is not useful for intact
skin. Transdermal fentanyl patches are useful for continuous pain control, not rapid pain
control. For maximum effectiveness, EMLA must be applied approximately 60 minutes
in advance. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
At what age does Erickson consider the infancy stage? - Answer 0 - 18 months
What is the basic conflict and important events of Erickson's infancy stage? - Answer
Trust vs. Mistrust
Feeding/Comfort
At what age does Erickson consider the Early Childhood stage? - Answer 2 - 3 years
What is the basic comfort and important events of Erickson's early childhood stage? -
Answer Autonomy vs. Shame and Doubt
Toilet training/Dressing
At what age does Erickson consider the preschool stage? - Answer 3 - 5 years
What is the basic conflict and important events of Erickson's preschool stage? - Answer
Initiative vs. Guilt
Exploration/Play
At what age does Erickson consider the school age? - Answer 6 - 11 years
What is the basic conflict and important events of Erickson's school age? - Answer
Industry vs. Inferiority
, NR 328 Exam #1
School/Activities
At what age does Erickson consider the adolescence stage? - Answer 12 - 18 years
What is the basic comfort and important events of Erickson's adolescence stage? -
Answer Identity vs. Role Confusion
Social relationships/Identity
What is the outcome of Erickson's infancy stage? - Answer Children develop a sense of
trust when caregivers provide reliability, care and affection. A lack of this will lead to
mistrust.
What is the outcome of Erickson's early childhood stage? - Answer Children need to
develop a sense of personal control over physical skills and a sense of independence.
Success leads to feeling of autonomy, failure results in feelings of shame and doubt.
What is the outcome of Erickson's preschool stage? - Answer Children need to begin
asserting control and power over the environment. Success in this state leads to a
sense of purpose. Children who try to exert too much power experience disapproval,
resulting in a sense of guilt.
What is the outcome of Erickson's school age stage? - Answer Children need to cope
with new social and academic demands. Success leads to a sense of competence,
while failure results in feeling of inferiority.
What is the outcome of Erickson's adolescence stage? - Answer Teens need to develop
a sense of self and personal identity. Success leads to an ability to stay true to yourself,
while failure leads to role confusion and a weak sense of self.
What PPE is included in standard/universal precautions? - Answer Hand hygiene
Gloves when touching blood, body fluids, secretions, mucous membranes, and non-
intact skin.
What PPE is included in standard/universal precautions with anticipated splashing? -
Answer Hand hygiene
Gown
Mask
Goggles or shield
Gloves
What PPE is included in contact precautions? - Answer Hand hygiene
Gown
Gloves
What PPE is included in droplet precautions? - Answer Hand hygiene
Gown
Which topics should the nurse discuss with the parents of a young child to promote
health in their child?
a. Dental care needs to be started by age 7.
b. Immunization schedule and the importance of immunizations.
c. Human milk or iron fortified formula for the first 4 months of life.
d. Positioning the car seat in the front passenger seat. - Answer Answer: B
Rationale: Immunizations have made a major impact in the prevention of disease in
children. The nurse should review individual immunization records at every clinic visit,
avoid missing opportunities to vaccinate, and encourage parents to keep immunizations
current. Dental caries is the single most common chronic disease of childhood and may
begin before the first birthday. Human milk or iron fortified formula for should be given
for the first year of life to prevent Iron Deficiency anemia. Children younger than 1 year
of age have the highest rate of death from motor vehicle accidents, primarily from a
failure to properly use car restraints.
What is the leading cause of death in children older than the age of 1 year?
a. Drowning
b. Burns
c. Motor vehicle accidents
d. Cancer - Answer Answer(s): C
Rationale: a. Drowning is the second leading cause of death in children older than the
age of 1 year. b. Burns cause fewer deaths than motor vehicle accidents in children
older than the age of 1 year. c. Motor vehicle accidents are the leading cause of death
in children older than the age of 1 year. d. Cancer causes fewer deaths than motor
vehicle accidents in children older than the age of 1 year.
The nurse makes sure that a toddler has a teddy bear and that a nightlight is on in the
hospital room at bedtime. What concept would these nursing actions demonstrate?
a. Atraumatic care
b. Nonmaleficence
c. Justice
d. Advocacy - Answer Answer(s): A
Rationale: A. Atraumatic care is the provision of therapeutic care in settings, by
personnel, and through the use of interventions that eliminate or minimize the
psychological and physical distress experienced by children and their families in the
health care system. In this case, it is making sure that the toddler has a teddy bear and
that a night light is on to prevent a dark environment. B. Nonmaleficence is the
obligation to minimize or prevent harm; there is no situation present that would require
this. C. Justice is the concept of fairness and is not applicable to this situation. D.
Advocacy involves ensuring that families are aware of all available health services,
adequately informed of treatments and procedures, involved in the child's care, and
encouraged to change or support existing health care practices.
True or False: Open ended questions are most likely to encourage parents to talk about
their feelings r/t their child's illness. - Answer True
,NR 328 Exam #1
When the nurse interviews an adolescent, what is important to help establish a
relationship?
a. Use the same type of language as the adolescent.
b. Emphasize that confidentiality will always be maintained.
c. Focus the discussion on the peer group.
d. Display a genuine interest in the adolescent. - Answer Answer: D.
Rationale: Display a genuine interest in the adolescent.Adolescents accept anyone who
shows a genuine interest in them. Although peers are important to this age-group, the
focus of the interview should be on the adolescent. The nurse should clarify which
information will be shared with other members of the health care team and any limits to
confidentiality. The nurse should maintain a professional relationship with adolescents.
To avoid misinterpretation of words and phrases that the adolescent may use, the nurse
should clarify terms frequently.
What approach is the most appropriate when performing a physical assessment on a
toddler?
a. Demonstrate use of equipment.
b. Perform traumatic procedures first.
c. Use minimum physical contact initially.
d. Always proceed in a head-to-toe direction. - Answer Answer: C.
Rationale: Parents can remove clothing, and the child can remain on the parent's lap.
The nurse should use minimum physical contact initially to gain the cooperation of the
child. The nurse should introduce the equipment slowly. The child can inspect the
equipment, but demonstrations are usually too complex for this age-group. Traumatic
procedures should always be performed last. These will most likely upset the child and
inhibit cooperation. The head-to-toe assessment can be done in older children but
usually must be adapted in younger children.
What is the most consistent and commonly used indicator of pain in infants?
a. Thrashing of arms and legs.
b. Increased heart rate.
c. Increased respirations.
d. Facial expression of discomfort. - Answer Answer: D.
Rationale: Facial expression of discomfort. Facial expression has consistently been
validated as an indicator of pain in infants. Behavioral pain measures are most reliable
for sharp procedural pain in infants. Increased heart rate and respirations are indicative
of a generalized and complex response to stress. They are not specific for pain in
infants. Thrashing of arms and legs is a reliable indicator in young children, not infants.
True or False: At age 1 month is the normal age for binocularity-ability to fixate on one
visual field with both eyes simultaneously. - Answer Answer: False.
Rationale: Binocularity is usually achieved by age 3 to 4 months. One month is too
young for binocularity. If binocularity is not achieved by 6 to 12 months, the child must
be observed for strabismus.
What self-report pain rating scales can be used in children as young as 3 years of age?
,NR 328 Exam #1
a. FACES Pain Rating Scale
b. Visual Analog Scale
c. Word-Graphic Rating Scale
d. Who Cares? - Answer Answer: A.
Rationale: The FACES Pain Rating Scale is for children as young as 3 years of age.
The Visual Analog Scale can be used for children older than 4 years of age but is most
appropriate for ages 7 and older. The Word-Graphic Rating Scale uses descriptive
words and is recommended for children 4 to 17 years of age.
An intravenous line is needed in a school-age child. What medication is appropriate
analgesic for use with this patient?
a. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.
b. EMLA (eutectic mixture of local anesthetics) immediately before.
c. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
d. TAC (tetracaine, epinephrine [Adrenalin], cocaine) 15 minutes before. - Answer
Answer: A.
Rationale: LMX is an effective analgesic agent when applied to the skin 30 minutes
before a procedure. It eliminates or reduces the pain from most procedures involving
skin puncture. TAC provides skin anesthesia about 15 minutes after application to
nonintact skin. The gel can be placed on the wound for suturing. It is not useful for intact
skin. Transdermal fentanyl patches are useful for continuous pain control, not rapid pain
control. For maximum effectiveness, EMLA must be applied approximately 60 minutes
in advance. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
At what age does Erickson consider the infancy stage? - Answer 0 - 18 months
What is the basic conflict and important events of Erickson's infancy stage? - Answer
Trust vs. Mistrust
Feeding/Comfort
At what age does Erickson consider the Early Childhood stage? - Answer 2 - 3 years
What is the basic comfort and important events of Erickson's early childhood stage? -
Answer Autonomy vs. Shame and Doubt
Toilet training/Dressing
At what age does Erickson consider the preschool stage? - Answer 3 - 5 years
What is the basic conflict and important events of Erickson's preschool stage? - Answer
Initiative vs. Guilt
Exploration/Play
At what age does Erickson consider the school age? - Answer 6 - 11 years
What is the basic conflict and important events of Erickson's school age? - Answer
Industry vs. Inferiority
, NR 328 Exam #1
School/Activities
At what age does Erickson consider the adolescence stage? - Answer 12 - 18 years
What is the basic comfort and important events of Erickson's adolescence stage? -
Answer Identity vs. Role Confusion
Social relationships/Identity
What is the outcome of Erickson's infancy stage? - Answer Children develop a sense of
trust when caregivers provide reliability, care and affection. A lack of this will lead to
mistrust.
What is the outcome of Erickson's early childhood stage? - Answer Children need to
develop a sense of personal control over physical skills and a sense of independence.
Success leads to feeling of autonomy, failure results in feelings of shame and doubt.
What is the outcome of Erickson's preschool stage? - Answer Children need to begin
asserting control and power over the environment. Success in this state leads to a
sense of purpose. Children who try to exert too much power experience disapproval,
resulting in a sense of guilt.
What is the outcome of Erickson's school age stage? - Answer Children need to cope
with new social and academic demands. Success leads to a sense of competence,
while failure results in feeling of inferiority.
What is the outcome of Erickson's adolescence stage? - Answer Teens need to develop
a sense of self and personal identity. Success leads to an ability to stay true to yourself,
while failure leads to role confusion and a weak sense of self.
What PPE is included in standard/universal precautions? - Answer Hand hygiene
Gloves when touching blood, body fluids, secretions, mucous membranes, and non-
intact skin.
What PPE is included in standard/universal precautions with anticipated splashing? -
Answer Hand hygiene
Gown
Mask
Goggles or shield
Gloves
What PPE is included in contact precautions? - Answer Hand hygiene
Gown
Gloves
What PPE is included in droplet precautions? - Answer Hand hygiene
Gown
