PUD
10. A nurse has admitted a child to the hospital with a diagnosis of rule out
peptic ulcer disease. Which test will the nurse expect to be ordered to
confirm the diagnosis of a peptic ulcer?
a. A 24-hour dietary history
b. A positive Hematest result on a stool sample
c. A fiberoptic upper endoscopy
d. An abdominal ultrasound
ANS: C
Endoscopy provides direct visualization of the stomach lining and confirms
the diagnosis of peptic ulcer. Dietary history may yield information
suggestive of a peptic ulcer, but the diagnosis is confirmed through
endoscopy. Blood in the stool indicates a gastrointestinal abnormality, but it
does not conclusively confirm a diagnosis of peptic ulcer. An abdominal
ultrasound is used to rule out other gastrointestinal alterations such as
gallstones, tumor, or mechanical obstruction.
What should the nurse teach a school-age child and his parents about the
management of ulcer disease?
a. Eat a bland, low-fiber diet in small frequent meals.
b. Eat three balanced meals a day with no snacking between meals.
c. The child needs to eat alone to avoid stress.
d. Do not give antacids 1 hour before or after antiulcer medications.
ANS: D
Antacids can interfere with antiulcer medication if given less than 1 hour
before or after antiulcer medications. A bland diet is not indicated for ulcer
disease. The diet should be a regular diet that is low in caffeine, and the child
should eat a meal or snack every 2 to 3 hours. Eating alone is not indicated.
Which interventions should a nurse implement when caring for a child with
hepatitis? Select all that apply.
a. Provide a well-balanced low-fat diet.
b. Schedule play time in the playroom with other children.
c. Teach parents not to administer any over-the-counter medications.
d. Arrange for home schooling as the child will not be able to return to school.
e. Instruct parents on the importance of good hand washing.
ANS: A, C, E
The child with hepatitis should be placed on a well-balanced low-fat diet.
Parents should be taught to not give over-the-counter medications because
,of impaired liver function. Hand hygiene is the most important preventive
measure for the spread of hepatitis. The child will be in contact isolation in
the hospital so play time with other hospitalized children is not scheduled.
The child will be on contact isolation for at least 1 week after the onset of
jaundice, but after that period, will be allowed to return to school.
What is the primary purpose of a transitional object?
a. It helps the parents deal with the guilt they feel when they leave the child.
b. It keeps the child quiet at bedtime.
c. It is effective in decreasing anxiety in the toddler.
d. It decreases negativism and tantrums in the toddler.
ANS: C
Decreasing anxiety, particularly separation anxiety, is the function of a
transitional object; it provides comfort to the toddler in stressful situations
and helps make the transition from dependence to autonomy. A decrease in
parental guilt (distress) is an indirect benefit of a transitional object. A
transitional object may be part of a bedtime ritual, but it may not keep the
child quiet at bedtime. A transitional object does not significantly affect
negativity and tantrums, but it can comfort a child after tantrums.
A nurse is teaching parents of a toddler about language development. Which
statement best identifies the characteristics of language development in a
toddler?
a. Language development skills slow during the toddler period.
b. The toddler understands more than he or she can express.
c. Most of the toddlers speech is not easily understood.
d. The toddlers vocabulary contains approximately 600 words.
ANS: B
The toddlers ability to understand language (receptive language) exceeds
the childs ability to speak it (expressive language). Although language
development varies in relationship to physical activity, language skills are
rapidly accelerating by 15 to 24 months of age. By 2 years of age, 60% to
70% of the toddlers speech is understandable. The toddlers vocabulary
contains approximately 300 or more words.
6. Parents of a toddler ask the nurse when they should start toilet training.
Which statement best addresses their concerns
a. When the child is 18 months of age
b. When the child exhibits signs of physical and psychological readiness
c. When the child has been walking for 9 months
, d. When the child is able to sit on the potty for 10 to 15 minutes
ANS: B
Neurological development is completed at approximately 18 months of age.
Parents need to know that both physical and psychological readiness are
necessary for toilet training to be successful. The child needs to demonstrate
signs of bowel or bladder control before attempting toilet training. Waiting
until 24 to 30 months of age makes the task easier; toddlers are less
negative, more willing to control their sphincters, and want to please their
parents. One of the physical signs of readiness for toilet training is that the
child has been walking for 1 year. The ability to sit on the potty 10 to 15
minutes may demonstrate parental control rather than being a sign of
developmental readiness for toilet training.
7. Which statement by a mother of a toddler indicates a correct
understanding of the use of discipline?
a. I always include explanations and morals when I am disciplining my toddler.
I always try to be consistent when disciplining the children, and I correct my
b. time they are misbehaving.
c. I believe that discipline should be done by only one family member.
d. My rule of thumb is no more than one spanking a day.
ANS: B
Consistent and immediate discipline for toddlers is the most effective
approach. Unless disciplined immediately, the toddler will have difficulty
connecting the discipline with the behavior. The toddlers cognitive level of
development precludes the use of explanations and morals as a part of
discipline. Discipline for the toddler should be immediate; therefore, the
family member caring for the child should provide discipline to the toddler
when it is necessary. Discipline is required for unacceptable behavior, and
the one-spanking-a-day rule contradicts the concept of a consistent response
to inappropriate behavior. Additionally, spanking is an inappropriate method
of disciplining a child.
Which comment indicates that the mother of a toddler needs further
teaching about dental care?
a. We use well water so I give my toddler fluoride supplements.
b. My toddler brushes his teeth with my help.
c. My child will not need a dental checkup until his permanent teeth come in.
d. I use a small nylon bristle brush for my toddlers teeth.
ANS: C
Children should first see the dentist 6 months after the first primary tooth
erupts and no later than age 30 months. Toddlers need fluoride supplements
, when they use a water supply that is not fluorinated. Toddlers need
supervision with dental care. The parent should finish brushing areas not
reached by the child. A small nylon bristle brush works best for cleaning
toddlers teeth.
Which assessment finding in a preschooler would suggest the need for
further investigation?
a. The child is able to dress independently.
b. The child rides a tricycle.
c. The child has an imaginary friend.
d. The child has a 2-pound weight gain in 12 months.
ANS: D
Preschool children gain an average of 5 pounds a year. A gain of only 2
pounds is less than half of the expected weight gain and should be
investigated. A preschool child should be able to dress independently and be
able to ride a tricycle. Imaginary friends are common for preschoolers.
Which is the most appropriate action for the nurse to take when telling a
preschool child about an upcoming procedure?
a. Explain all the information in detail to the child.
b. Speak loudly and clearly to the child.
c. Inform the parents of the procedure and ask them to tell the child.
d. Use symbolic play to explain the procedure.
ANS: D
Symbolic play is important for emotional development because it allows the
child to work through distressing feelings and can be therapeutic. It is
inappropriate to give a preschooler all the information in detail. The child
needs to understand what is going to happen to him without explicit details
of the procedure. Speaking in clear sentences with simple words is
important, but the conversation should be conducted at a nonthreatening
normal sound level. The nurse has the most knowledge and best ability for
explaining the procedure to the child; however, the parents can be an
important resource when explaining the procedure.
In caring for a 4-year-old child with a diagnosis of suspected child abuse,
which is the best nursing intervention?
a. Avoid touching the child.
b. Provide the child with play situations that allow for disclosure.
10. A nurse has admitted a child to the hospital with a diagnosis of rule out
peptic ulcer disease. Which test will the nurse expect to be ordered to
confirm the diagnosis of a peptic ulcer?
a. A 24-hour dietary history
b. A positive Hematest result on a stool sample
c. A fiberoptic upper endoscopy
d. An abdominal ultrasound
ANS: C
Endoscopy provides direct visualization of the stomach lining and confirms
the diagnosis of peptic ulcer. Dietary history may yield information
suggestive of a peptic ulcer, but the diagnosis is confirmed through
endoscopy. Blood in the stool indicates a gastrointestinal abnormality, but it
does not conclusively confirm a diagnosis of peptic ulcer. An abdominal
ultrasound is used to rule out other gastrointestinal alterations such as
gallstones, tumor, or mechanical obstruction.
What should the nurse teach a school-age child and his parents about the
management of ulcer disease?
a. Eat a bland, low-fiber diet in small frequent meals.
b. Eat three balanced meals a day with no snacking between meals.
c. The child needs to eat alone to avoid stress.
d. Do not give antacids 1 hour before or after antiulcer medications.
ANS: D
Antacids can interfere with antiulcer medication if given less than 1 hour
before or after antiulcer medications. A bland diet is not indicated for ulcer
disease. The diet should be a regular diet that is low in caffeine, and the child
should eat a meal or snack every 2 to 3 hours. Eating alone is not indicated.
Which interventions should a nurse implement when caring for a child with
hepatitis? Select all that apply.
a. Provide a well-balanced low-fat diet.
b. Schedule play time in the playroom with other children.
c. Teach parents not to administer any over-the-counter medications.
d. Arrange for home schooling as the child will not be able to return to school.
e. Instruct parents on the importance of good hand washing.
ANS: A, C, E
The child with hepatitis should be placed on a well-balanced low-fat diet.
Parents should be taught to not give over-the-counter medications because
,of impaired liver function. Hand hygiene is the most important preventive
measure for the spread of hepatitis. The child will be in contact isolation in
the hospital so play time with other hospitalized children is not scheduled.
The child will be on contact isolation for at least 1 week after the onset of
jaundice, but after that period, will be allowed to return to school.
What is the primary purpose of a transitional object?
a. It helps the parents deal with the guilt they feel when they leave the child.
b. It keeps the child quiet at bedtime.
c. It is effective in decreasing anxiety in the toddler.
d. It decreases negativism and tantrums in the toddler.
ANS: C
Decreasing anxiety, particularly separation anxiety, is the function of a
transitional object; it provides comfort to the toddler in stressful situations
and helps make the transition from dependence to autonomy. A decrease in
parental guilt (distress) is an indirect benefit of a transitional object. A
transitional object may be part of a bedtime ritual, but it may not keep the
child quiet at bedtime. A transitional object does not significantly affect
negativity and tantrums, but it can comfort a child after tantrums.
A nurse is teaching parents of a toddler about language development. Which
statement best identifies the characteristics of language development in a
toddler?
a. Language development skills slow during the toddler period.
b. The toddler understands more than he or she can express.
c. Most of the toddlers speech is not easily understood.
d. The toddlers vocabulary contains approximately 600 words.
ANS: B
The toddlers ability to understand language (receptive language) exceeds
the childs ability to speak it (expressive language). Although language
development varies in relationship to physical activity, language skills are
rapidly accelerating by 15 to 24 months of age. By 2 years of age, 60% to
70% of the toddlers speech is understandable. The toddlers vocabulary
contains approximately 300 or more words.
6. Parents of a toddler ask the nurse when they should start toilet training.
Which statement best addresses their concerns
a. When the child is 18 months of age
b. When the child exhibits signs of physical and psychological readiness
c. When the child has been walking for 9 months
, d. When the child is able to sit on the potty for 10 to 15 minutes
ANS: B
Neurological development is completed at approximately 18 months of age.
Parents need to know that both physical and psychological readiness are
necessary for toilet training to be successful. The child needs to demonstrate
signs of bowel or bladder control before attempting toilet training. Waiting
until 24 to 30 months of age makes the task easier; toddlers are less
negative, more willing to control their sphincters, and want to please their
parents. One of the physical signs of readiness for toilet training is that the
child has been walking for 1 year. The ability to sit on the potty 10 to 15
minutes may demonstrate parental control rather than being a sign of
developmental readiness for toilet training.
7. Which statement by a mother of a toddler indicates a correct
understanding of the use of discipline?
a. I always include explanations and morals when I am disciplining my toddler.
I always try to be consistent when disciplining the children, and I correct my
b. time they are misbehaving.
c. I believe that discipline should be done by only one family member.
d. My rule of thumb is no more than one spanking a day.
ANS: B
Consistent and immediate discipline for toddlers is the most effective
approach. Unless disciplined immediately, the toddler will have difficulty
connecting the discipline with the behavior. The toddlers cognitive level of
development precludes the use of explanations and morals as a part of
discipline. Discipline for the toddler should be immediate; therefore, the
family member caring for the child should provide discipline to the toddler
when it is necessary. Discipline is required for unacceptable behavior, and
the one-spanking-a-day rule contradicts the concept of a consistent response
to inappropriate behavior. Additionally, spanking is an inappropriate method
of disciplining a child.
Which comment indicates that the mother of a toddler needs further
teaching about dental care?
a. We use well water so I give my toddler fluoride supplements.
b. My toddler brushes his teeth with my help.
c. My child will not need a dental checkup until his permanent teeth come in.
d. I use a small nylon bristle brush for my toddlers teeth.
ANS: C
Children should first see the dentist 6 months after the first primary tooth
erupts and no later than age 30 months. Toddlers need fluoride supplements
, when they use a water supply that is not fluorinated. Toddlers need
supervision with dental care. The parent should finish brushing areas not
reached by the child. A small nylon bristle brush works best for cleaning
toddlers teeth.
Which assessment finding in a preschooler would suggest the need for
further investigation?
a. The child is able to dress independently.
b. The child rides a tricycle.
c. The child has an imaginary friend.
d. The child has a 2-pound weight gain in 12 months.
ANS: D
Preschool children gain an average of 5 pounds a year. A gain of only 2
pounds is less than half of the expected weight gain and should be
investigated. A preschool child should be able to dress independently and be
able to ride a tricycle. Imaginary friends are common for preschoolers.
Which is the most appropriate action for the nurse to take when telling a
preschool child about an upcoming procedure?
a. Explain all the information in detail to the child.
b. Speak loudly and clearly to the child.
c. Inform the parents of the procedure and ask them to tell the child.
d. Use symbolic play to explain the procedure.
ANS: D
Symbolic play is important for emotional development because it allows the
child to work through distressing feelings and can be therapeutic. It is
inappropriate to give a preschooler all the information in detail. The child
needs to understand what is going to happen to him without explicit details
of the procedure. Speaking in clear sentences with simple words is
important, but the conversation should be conducted at a nonthreatening
normal sound level. The nurse has the most knowledge and best ability for
explaining the procedure to the child; however, the parents can be an
important resource when explaining the procedure.
In caring for a 4-year-old child with a diagnosis of suspected child abuse,
which is the best nursing intervention?
a. Avoid touching the child.
b. Provide the child with play situations that allow for disclosure.
