Peds Exam #1 questions and answers 2022

A nurse is performing a developmental age assessment on a 10-month-old. Which will the nurse document as consistent with the infant's age? 1. Infant discriminates between pictures of objects. 2. Infant stands without support. 3. Infant builds a tower of 3 cubes. 4. Infant eats with fingers. 4. Infant eats with fingers Eating with fingers typically occurs between 10 and 12 months. The baby can build a tower of 3 cubes occurs between 16 and 18 months. Standing occurs at 15 months. Discrimination of pictures typically begins by 24 months. A nurse is performing an assessment on an infant. Which assessment should be performed last? 1. Check heart and respiratory rates. 2. Assess deep tendon reflexes. 3. Assess ears and mouth. 4. Evaluate genitalia. 3. Assess ears and mouth. Uncomfortable examinations may induce crying and should be done last. The nurse should perform auscultation and less upsetting assessments first while the patient is calm and quiet. 01:09 01:14 A pediatric clinic nurse teaches about behavior modification for young children. It is most important to emphasize which points? 1. Once the child has calmed down, review what occurred. 2. If a child cries and refuses time-out, add another time-out period. 3. Time-outs should be 1 minute for each year of age. 4. Explain to the child why an act is wrong. 3. Time-outs should be 1 minute for each year of age. One minute of time-out for each year of the child's age is the recommended practice for time-outs. For toddlers the concept of time is limited and 1 minute can seem like hours. For preschoolers, time is still not fully understood. A kitchen timer with an audible bell can be useful for timing time-outs. A 9-year-old girl is to receive amoxicillin/clavulanate. Which statement by the nurse is most likely to elicit cooperation from the child? 1. You can play after you take your medicine. 2. Would you like to take this medicine with juice? 3. This medicine tastes good. 4. Amoxicillin is antibiotic which will help you get well. 4. Amoxicillin is an antibiotic which will help you get well. Rationale: Discussion of facts is correct with school-age child. Medication should not be described as food or candy. Associating medication with food may cause the child to develop an aversion to that specific food. The mother of a 9-year-old boy with the mental age of 4 years old asks the clinic nurse, "what should my child be able to do?" Which is correct? 1. Your child should be able to load and start the dishwasher. 2. Your child should be able to join a baseball team. 3. Your child should be able to take care of his dog. 4. Your child should be able to dress himself. 4. Your child should be able to dress himself. Rationale: A child with moderate intellectual disorder should be able to perform ADLs with supervision. Moderate intellectual disorder is an IQ of 35-55. These children can learn self-care activities and simple manual skills. A nurse is leading a class about immunizations? Which statement by the student is correct? 1. Vaccinations do decrease hospitalizations. 2. Pneumococcal vaccine prevents all complications from lung disease. 3. Pneumococcal and influenza vaccine can be given together. 4. Influenza vaccine is contraindicated if the patient is allergic to eggs. 3. Pneumococcal and influenza vaccine can be given together. Rationale: Vaccines can be given simultaneously at different sites. The influenza vaccine can be given to persons with an allergy to eggs. Vaccines may decrease complications but it will not prevent complications. Immunizations decrease the rate of hospitalizations. The mother of an 8-year-old expresses surprise that her son is finally becoming more cooperative and understanding the consequences of his actions. This describes which of the following stages of development? 1. Trust vs. Mistrust 2. Identity role vs. Confusion 3. Industry vs. Inferiority 4. Initiative vs. Guilt 3. Industry vs. Inferiority Rationale: School-aged children become more cooperative and reasonable. They better understand cause and effect, and they feel the desire to win approval by becoming competent in ways that are valued by society. If their initiative is encouraged, they feel industrious and confident and begin to develop a sense of pride in their accomplishments (industry). If this initiative is restricted, the child begins to feel inferior, doubting his abilities (inferiority). A toddler's parents ask the nurse how long the child is required to use a front facing car seat. How should the nurse respond? 1. The child can stop using the front facing car seat when he is mature enough. 2. The child must be at least 6-years-old to use a regular seat belt. 3. Your child must be at least 2 years old. 4. Your child should use a car seat with a harness as long as possible until he outgrows the car seat. 4. Your child should use a car seat with a harness as long as possible until he outgrows the car seat. Rationale: Child should be rear-facing until 2 years old or until he or she has outgrown the maximum height and weight allowed by the manufacturer of their rear-facing car seat. Forward facing car seats with a harness should be used for the maximum time possible until the child outgrows the height and weight allowed by the manufacturer. A belt-positioning-booster seat should be used for children whose weight or height is about the forward facing limit, typically when they have reached 4 feet 9 inches in height and are between 8 and 12 years of age. A nurse is performing a developmental assessment on an 11-month-old. Which of the following findings is of the most concern? 1. Able to stand up alone. 2. Double the birth weight. 3. Head circumference greater than chest circumference. 4. Unable to walk alone. 2. Double the birth weight. Rationale: Birth weight should be doubled by 6 months and be tripled by 12 months. This is cause for concern and should be investigated. The ability to stand up alone may happen at this age, but is usually accomplished by 20-24 months. This is not worrisome. A head circumference is larger than chest is normal for this age and is not alarming. The nurse would not be worried about an 11-month-old unable to walk alone. A pediatric nurse is assessing children in a community outreach clinic. The nurse would expect an infant's first primary teeth to erupt at age: 1. 12 months. 2. 4 months. 3. 6 months. 4. 8 months. 3. 6 months Rationale: The first 2 primary teeth (central incisors) usually erupt around age 6 months, but this may vary. All primary teeth are usually visible by 3 years of age. A mother brings her 7-year-old daughter to the clinic after several nights of bedwetting. The mother explains that her daughter never wet the bed until her baby brother was born. The nurse explains that this situation is considered the use of which ego defense mechanism? 1. Dissociation 2. Projection 3. Regression 4. Repression 3. Regression Rationale: Regression is the reversion to an earlier stage of development that may have felt like a less demanding or safer time, or a time they received care and attention. This is common in children when exposed to new stressors, such as a new sibling. A nurse is performing a developmental assessment on a 4-and-a-half-year-old. Which of the following findings is of the most concern? 1. The child is unable to balance on each foot for 4 seconds. 2. The child is unable to brush teeth without help. 3. The child is unable to prepare cereal. 4. The child's speech is not completely understandable. 4. The child's speech is not completely understandable. According to the Denver II Developmental Screen: Speech should be completely understandable by age 4 and a half years. The child may be developmentally delayed, but further assessment is needed. All other developmental tasks should be achieved by age 5.