1. To establish a good interview relationship with an adolescent, which
strategy is most appropriate?
1. Asking personal questions unrelated to the situation
2. Writing down everything the teen says
3. Asking open-ended questions
4. Discussing the nurse's own thoughts and feelings about the situation: 3.
Asking open-ended questions
RATIONALE: Open-ended questions allow the adolescent to share information
and feelings. Asking personal questions not related to the situation jeopardizes the
trust that must be established because the adolescent may feel as though he's
being interrogated with unnecessary questions. Writing everything down during
the interview can be a distraction and doesn't allow the nurse to observe how the
adolescent behaves. Discussing the nurse's thoughts and feelings may bias the
assessment and is inappropriate when interviewing any client
2. A chronically ill school-age child is most vulnerable to which stressor?
1. Mutilation anxiety
2. Anticipatory grief
3. Anxiety over school absences
4. Fear of hospital procedures: 3. Anxiety over school absences
RATIONALE: The school-age child is becoming industrious and attempts to
master school-related activities. Therefore, school absences are likely to cause
extreme anxiety for a school-age child who's chronically ill. Mutilation anxiety is
more common in adolescents. Anticipatory grief is rare in a school-age child. Fear
of hospital procedures is most pronounced in preschool-age children.
3. When developing a care plan for an adolescent, the nurse considers the
child's psychosocial needs. During adolescence, psychosocial development
focuses on:
1. becoming industrious.
2. establishing an identity.
3. achieving intimacy.
4. developing initiative.: 2. establishing an identity.
, Peds Exam 1 NCLEX style questions
RATIONALE: According to Erikson, the primary psychosocial task during
adolescence is to establish a personal identity while overcoming role or identity
confusion.
The adolescent attempts to establish a group identity by seeking acceptance and
approval from peers, and strives to attain a personal identity by becoming more
independent from his family. Becoming industrious is the developmental task of
the school-age child; achieving intimacy is the task of the young adult; and
developing initiative is the task of the preschooler.
4. A nurse notes that an infant develops arm movement before fine-motor
finger skills and interprets this as an example of which pattern of
development?
1. Cephalocaudal
2. Proximodistal
3. Differentiation
4. Mass-to-specific: 2. Proximodistal
RATIONALE: Proximodistal development progresses from the center of the body
to the extremities, such as from the arm to the fingers. Cephalocaudal
development occurs along the body's long axis; for example, the infant develops
control over the head, mouth, and eye movements before the upper body, torso,
and legs.
Mass-to-specific development, sometimes called differentiation, occurs as the child
masters simple operations before complex functions and moves from broad,
general patterns of behavior to more refined ones.
5. A teenage mother brings her 1-year-old child to the pediatrician's office for
a well-baby checkup. She says that her infant can't sit alone or roll over. An
appropriate response by the nurse would be:
1. "This is very abnormal. Your child must be sick."
2. "Let's see about further developmental testing."
3. "Don't worry, this is normal for her age."
4. "Maybe you just haven't seen her do it.": . "Let's see about further
developmental testing."
, Peds Exam 1 NCLEX style questions
RATIONALE: Stating that further developmental testing is necessary is appropriate
because at age 12 months a child should be sitting up and rolling over. Therefore,
this child may have developmental problems. Saying the infant's behavior is
abnormal or suggesting that the mother hasn't seen her infant do these milestones
isn't therapeutic and can cut off communication with the mother. Telling the mother
that the infant's behavior is normal misleads the mother with false reassurance.
6. The mother of an 11-month-old infant reports to the nurse that her infant
sleeps much less than other children. The mother asks the nurse whether her
infant is getting sufficient sleep. What should be the nurse's initial response?
1. Reassure the mother that each infant's sleep needs are individual.
2. Ask the mother for more information about the infant's sleep patterns.
3. Instruct the mother to decrease the infant's daytime sleep to increase his
nighttime sleep.
4. Inform the mother that her infant's growth and development are appropriate
for his age, so sleep isn't a concern.: 2. Ask the mother for more information
about the infant's sleep patterns.
RATIONALE: The nurse needs more information about the infant's sleep patterns
to rule out potential problems before determining whether the infant is getting
enough sleep. The nurse shouldn't offer advice or reassurance without knowing
more about the infant's specific sleep habits.
7. A nurse observes a 2½-year-old child playing with another child of the same
age in the playroom on the pediatric unit. What type of play should the nurse
expect the children to engage in?
1. Associative play
2. Parallel play
3. Cooperative play
4. Therapeutic play: 2. Parallel play
RATIONALE: Two-year-olds engage in parallel play, in which they play side by side
but rarely interact. Associative play is characteristic of preschoolers, in which they
are all engaged in a similar activity but there is little organization. School-age
children engage in cooperative play, which is organized and goal-directed.