Pediatric Nursing EXAM QUESTION
AND CORRECT ANSWERS ANSWERS
Female pubertal development - Answer-Breast development usually precedes other
changes, however pubic hair may occur first.
Tanner stages:
I. breast budding (8-14yrs)
Presence amount and distribution of pubic hair is an indication of sexual maturation.
Formal operational (Piaget) - Answer-11 to adulthood
Fully mature intellectual thought has now been attained. think abstractly consider
different alternatives or outcomes
Freud Stages - Answer-Oral- birth to 1 year
Pleasure from the mouth, sucking and eating primary
Anal- 1-3 years
Childs pleasure centred in anal area
Phallic- 3-6 years
Sexual energy center / child works out relationships with parents of same/opposite
sexes
Latency- 6-12 years
Sexual energy is at rest in passage between earlier stages and adolescence
Genital - 12- adulthood
Mature sexuality is achieved physical growth is completed/relationships with other
occure
General pedi assessment APPRAISAL - Answer-*Anthroppometric measurements:
Measure child's weight, length or height, and head circumference
INFANT/TODDLER: under 2 Year’s length in supine position; weight: infants
weighed with all clothes removed on a platform scale (supine or sitting); head
circumference: measured at regular intervals until 2 -3 years
PRESCHOOLER/SCHOOL AGE CHILDREN
Height: after 2 - 3 yrs stadiometer; weight: standing scale; BMI
Gross Motor milestones for age - Answer-Gross Motor Development (Table 5-15)
p199
Gross Motor Milestones Age Attained
Rolls over from prone to supine position 7 months
Sits without support 6 months
Pulls self to standing position 10 months
Creeps or crawls 10 months
Walks alone well 15 months
Climbs on furniture 24 months
Walks up stairs one step at a time 24 months
Rides tricycle 36 months
,Guidelines for acceptable behavior in children - Answer-*set realistic expectations
based on child's age
Consistently enforce the expected directions and behaviors
*focus on promoting appropriate and desirable behavior in child
Model behavior
Review expected behavior for special situations
Help distinguish between inside and outside voice
Praise or reward child
*Tell child of inappropriate behavior as soon as it begins
*when reprimanding, focus on behavior rather that the child
*be alert for when situations arise that may led to misbehaving (tired, hungry)
*friendly reminders to help child gain self control
Health promotion teaching for NB/infant - Answer-supervised tummy time
*free movement of arms and hands- allows flexion and extension; brings hands into
line of vision
*encourage appropriate toys mobile with contrasting colors and patterns; plastic
mirror; music boxes; soft music
*encourage witching positions when bottle feeding; muscle dev/
*beginning at birth prevents flat spots/alternate head position
Hearing assessment Bone and air conduction of sound - Answer-Tuning fork to
evaluate in school age children who can follow directions.
*****hold handle light tap tines to begin vibration
Bone conduction: place handle of the tuning fork on the child skull.
Air conduction: place vibrating tines close to the child's ear
Hearing assessment defined - Answer-essential for normal speech and learning
Hearing assessment infants and toddlers - Answer-*select noisemakers with different
frequencies (rattle, bell, tissue paper); stand behind infant (2ft) fr infant ear but
outside the infants vision; have parent observe for : widening the eyes, briefly
stopping active to listen, turning head toward the sound
Hearing assessment preschool and older children - Answer-*use whispered words
over 3 yrs of age: position your head 12 inches from child's ear, but out of range of
vision, use words easily recognized and ask child to repeat
Hearing loss indicators in infant/young child - Answer-INFANT
*no startle reaction loud noises
*does not turn toward sounds by 4 months of age
*babbles as young infant but stops babbling and does not develop speech sounds
after 6 months of age
YOUNG CHILD
*no speech by 2 yrs of age
*speech sounds are not distinct at appropriate ages
Hearing test for newborn - Answer-OAE- Otoacoustive Emission measures intensity
sound from the cochlear hair cells in response to clicks from a probe placed in the
ear canal
, Does not detect neural damage
Detects inner hearing loss
Does not detect damage to cranial nerve
Heart rate ranges - Answer-Heart Rate Ranges (Table 5-12) p 183
HR Range (bpm) Average HR (bpm) Age
100-170 120 Newborns
80-130 110 Infants- 2 years
70-120 100 2-6 years
60-110 90 6-10 years
60-100 80 10-16 years
Helping the infant sleep - Answer-*place baby to sleep in quiet/dark room
*consistent transitional object/favorite blanket ea night
*put baby to bet while still awake
Do not awaken baby in NREM (quiet sleep)
*regular sleep routine and time
*if trouble; remain in room; do not establish eye contact; place had on abd
How to build rapport with family (pedi assessment) - Answer-*introduce self
*explain the purpose of the interview
*provide privacy
*direct the focus of the interview with open-ended questions
*ask one question at a time
*involve the child in the interview
*be hones with the child when answering questions
*Choose the language style that is best understood
*Use an interpreter to improve comm if needed
Identify examples of collaborative efforts to assist toddlers with control and mobility -
Answer-1. Assist child with ambulation within their control
2. Throwing games, vent frustrations
3. Child life specialist, modified toys
4. Physical therapist, promote strength and flexibility
Identify nursing interventions used for pain management with a toddler - Answer-1.
Form of relaxation, deep breaths
2. Form of distraction
3. Transport to treatment room for treatments
4. Medical personnel restrains, not parents
5. The parent’s presence
6. Explain in a a few simple words
7. Administration of pain meds
2 methods of restraining for infant or toddler receiving IM injection in vastus lateralis -
Answer-1. Body of larger infant can be securely held between the nurses arm and
body
2. Swaddle baby leaving the part of the extremity out that is receiving the injection
AND CORRECT ANSWERS ANSWERS
Female pubertal development - Answer-Breast development usually precedes other
changes, however pubic hair may occur first.
Tanner stages:
I. breast budding (8-14yrs)
Presence amount and distribution of pubic hair is an indication of sexual maturation.
Formal operational (Piaget) - Answer-11 to adulthood
Fully mature intellectual thought has now been attained. think abstractly consider
different alternatives or outcomes
Freud Stages - Answer-Oral- birth to 1 year
Pleasure from the mouth, sucking and eating primary
Anal- 1-3 years
Childs pleasure centred in anal area
Phallic- 3-6 years
Sexual energy center / child works out relationships with parents of same/opposite
sexes
Latency- 6-12 years
Sexual energy is at rest in passage between earlier stages and adolescence
Genital - 12- adulthood
Mature sexuality is achieved physical growth is completed/relationships with other
occure
General pedi assessment APPRAISAL - Answer-*Anthroppometric measurements:
Measure child's weight, length or height, and head circumference
INFANT/TODDLER: under 2 Year’s length in supine position; weight: infants
weighed with all clothes removed on a platform scale (supine or sitting); head
circumference: measured at regular intervals until 2 -3 years
PRESCHOOLER/SCHOOL AGE CHILDREN
Height: after 2 - 3 yrs stadiometer; weight: standing scale; BMI
Gross Motor milestones for age - Answer-Gross Motor Development (Table 5-15)
p199
Gross Motor Milestones Age Attained
Rolls over from prone to supine position 7 months
Sits without support 6 months
Pulls self to standing position 10 months
Creeps or crawls 10 months
Walks alone well 15 months
Climbs on furniture 24 months
Walks up stairs one step at a time 24 months
Rides tricycle 36 months
,Guidelines for acceptable behavior in children - Answer-*set realistic expectations
based on child's age
Consistently enforce the expected directions and behaviors
*focus on promoting appropriate and desirable behavior in child
Model behavior
Review expected behavior for special situations
Help distinguish between inside and outside voice
Praise or reward child
*Tell child of inappropriate behavior as soon as it begins
*when reprimanding, focus on behavior rather that the child
*be alert for when situations arise that may led to misbehaving (tired, hungry)
*friendly reminders to help child gain self control
Health promotion teaching for NB/infant - Answer-supervised tummy time
*free movement of arms and hands- allows flexion and extension; brings hands into
line of vision
*encourage appropriate toys mobile with contrasting colors and patterns; plastic
mirror; music boxes; soft music
*encourage witching positions when bottle feeding; muscle dev/
*beginning at birth prevents flat spots/alternate head position
Hearing assessment Bone and air conduction of sound - Answer-Tuning fork to
evaluate in school age children who can follow directions.
*****hold handle light tap tines to begin vibration
Bone conduction: place handle of the tuning fork on the child skull.
Air conduction: place vibrating tines close to the child's ear
Hearing assessment defined - Answer-essential for normal speech and learning
Hearing assessment infants and toddlers - Answer-*select noisemakers with different
frequencies (rattle, bell, tissue paper); stand behind infant (2ft) fr infant ear but
outside the infants vision; have parent observe for : widening the eyes, briefly
stopping active to listen, turning head toward the sound
Hearing assessment preschool and older children - Answer-*use whispered words
over 3 yrs of age: position your head 12 inches from child's ear, but out of range of
vision, use words easily recognized and ask child to repeat
Hearing loss indicators in infant/young child - Answer-INFANT
*no startle reaction loud noises
*does not turn toward sounds by 4 months of age
*babbles as young infant but stops babbling and does not develop speech sounds
after 6 months of age
YOUNG CHILD
*no speech by 2 yrs of age
*speech sounds are not distinct at appropriate ages
Hearing test for newborn - Answer-OAE- Otoacoustive Emission measures intensity
sound from the cochlear hair cells in response to clicks from a probe placed in the
ear canal
, Does not detect neural damage
Detects inner hearing loss
Does not detect damage to cranial nerve
Heart rate ranges - Answer-Heart Rate Ranges (Table 5-12) p 183
HR Range (bpm) Average HR (bpm) Age
100-170 120 Newborns
80-130 110 Infants- 2 years
70-120 100 2-6 years
60-110 90 6-10 years
60-100 80 10-16 years
Helping the infant sleep - Answer-*place baby to sleep in quiet/dark room
*consistent transitional object/favorite blanket ea night
*put baby to bet while still awake
Do not awaken baby in NREM (quiet sleep)
*regular sleep routine and time
*if trouble; remain in room; do not establish eye contact; place had on abd
How to build rapport with family (pedi assessment) - Answer-*introduce self
*explain the purpose of the interview
*provide privacy
*direct the focus of the interview with open-ended questions
*ask one question at a time
*involve the child in the interview
*be hones with the child when answering questions
*Choose the language style that is best understood
*Use an interpreter to improve comm if needed
Identify examples of collaborative efforts to assist toddlers with control and mobility -
Answer-1. Assist child with ambulation within their control
2. Throwing games, vent frustrations
3. Child life specialist, modified toys
4. Physical therapist, promote strength and flexibility
Identify nursing interventions used for pain management with a toddler - Answer-1.
Form of relaxation, deep breaths
2. Form of distraction
3. Transport to treatment room for treatments
4. Medical personnel restrains, not parents
5. The parent’s presence
6. Explain in a a few simple words
7. Administration of pain meds
2 methods of restraining for infant or toddler receiving IM injection in vastus lateralis -
Answer-1. Body of larger infant can be securely held between the nurses arm and
body
2. Swaddle baby leaving the part of the extremity out that is receiving the injection
