Question 1

The registered nurse has completed a well-baby assessment of an 18-month-old.  Which assessment findings prompted the nurse to make a referral for a formal developmental screening test?

Accepted Answer

A) Cannot climb steps by self, pulls a toy, turns the pages of a book 
B) Is bottle fed, can hold a spoon, creeps down stairs 
C) Throws a ball, is able to point to 2 or 3 body parts, cannot draw a picture 
D) Uses 2 words, cannot hold a cup, can seat self in a small chair

Question 2

A 3-month-old child with developmental dysplasia of the hip (DDH) is being fitted for a Pavlik harness.  Which statement made by the parent indicates a need for further instruction?

Accepted Answer

A) "I should leave the harness on during diaper changes." 
B) "I will adjust the harness straps every 3-5 days." 
C) "I will inspect the skin under the straps 2-3 times daily." 
D) "The harness should keep my baby's legs bent and spread apart."

Question 3

A child is brought to the school nurse after having a permanent tooth knocked out during gym class.  Which action by the nurse is appropriate?

Accepted Answer

A) Gently rinse the tooth with sterile saline and reinsert it into the gingival cavity 
B) Gently scrub the root of the tooth to remove any debris, and wrap it in sterile gauze 
C) Place the tooth in water and transport the client to the nearest emergency department 
D) Wrap the tooth in sterile gauze and advise the parent to arrange for a dental appointment

Question 4

The nurse taught the caregiver of a child with a ventriculoperitoneal (VP) shunt about when to contact the health care provider (HCP).  The caregiver shows understanding of the instructions by contacting the HCP about which symptom?

Accepted Answer

A) A temperature of 99 F (37 
C)  that occurs during the evening 
B) The child cannot recall items eaten for lunch the previous day 
C) The child vomits after awakening from a nap and 1 hour later 
D) The VP shunt is palpated along the posterior-lateral portion of the skull

Question 5

The nurse is reviewing the plan of care for a 4-year-old client who will receive daily dressing changes for an infected leg wound.  Which of the following interventions should the nurse include in the plan of care for a preschool-age child?  Select all that apply.

Accepted Answer

A) Allow the child's parents to stay during the procedure 
B) Emphasize that dressing changes are not punishment for misbehavior 
C) Encourage the child to voice questions and concerns about the procedure 
D) Have the child place bandages on a doll when reinforcing education 
E) Introduce the child to other clients with the same health condition

Question 6

The nurse prepares a 7-year-old client for an influenza injection.  The nurse explains that the client will receive "medicine under the skin," and the client is visibly anxious.  Which nursing intervention is appropriate?

Accepted Answer

A) Ask the child to count to 10 during injection 
B) Ask the parent to hold the child's arms tightly 
C) Explain to the child that the injection will not hurt 
D) Keep the injection needle out of the child's view

Question 7

The nurse is providing teaching for parents of a child diagnosed with fifth disease.  Which statement by a parent indicates a need for further teaching?

Accepted Answer

A) "Our child should be feeling much better in 7-10 days." 
B) "Our child's condition is communicable until the rash disappears." 
C) "We will ensure our child covers the mouth and nose when coughing or sneezing." 
D) "We will give our child ibuprofen to treat the joint pain."

Question 8

The nurse is reinforcing education to the caregivers of a 9-year-old client diagnosed with scarlet fever.  The client has a history of type 1 diabetes mellitus.  Which statement by the caregivers indicates that further teaching is needed?

Accepted Answer

A) "We will encourage extra fluid intake while our child is sick." 
B) "We will increase the frequency of blood glucose checks." 
C) "We will monitor our child's urine for ketones with each void." 
D) "We will not administer insulin if our child is unable to eat."

Question 9

The parent of an 11-month-old child calls the pediatric outpatient clinic and tells the nurse that the child was exposed to measles 2 days ago during a family trip to a theme park.  What is the best response by the nurse?

Accepted Answer

A) Bring the baby into the clinic for the measles, mumps, rubella (MMR) vaccine 
B) Check the baby's temperature twice a day 
C) Do not allow the child to have contact with other children 
D) Does your child have a fever or rash?

Question 10

The parents of a 5-year-old ask the school nurse for advice on how to tell their child about being adopted.  Which developmentally appropriate thought about adoption by the child does the nurse counsel the parents to anticipate?

Accepted Answer

A) Feels responsible for being placed for adoption 
B) Imagines what life would be like with a different family 
C) Is unable to conceptualize differences between adoptive and biological parents 
D) Worries about what peers will say or think

Question 11

The nurse is assessing an infant with intussusception.  Which of the following clinical findings should the nurse expect?  Select all that apply.

Accepted Answer

A) Palpable olive-shaped mass in epigastrium 
B) Palpable sausage-shaped abdominal mass 
C) Projectile vomiting without visualized blood 
D) Screaming and drawing of the knees up to the chest 
E) Stool mixed with blood and mucus

Question 12

A nurse is caring for a 1-month-old client who is being evaluated for congenital hypothyroidism.  The nurse should recognize which of the following as clinical manifestations of hypothyroidism in infants?  Select all that apply.

Accepted Answer

A) Difficult to awaken 
B) Dry skin 
C) Frequent, loose stools 
D) Hoarse cry 
E) Tachycardia

Question 13

A nurse is speaking with the parent of a toddler who believes the child has a hearing deficit.  Which findings support this suspected diagnosis?  Select all that apply.

Accepted Answer

A) Behavior appears withdrawn 
B) Intelligible speech began at age 12 months 
C) Monotone speech 
D) Seems attentive, nods, and smiles when given directions 
E) Speaks with a loud voice

Question 14

The nurse is admitting a 4-year-old diagnosed with Wilms tumor.  The child is scheduled for a right nephrectomy in the morning.  Which action is a priority in the preoperative care plan?

Accepted Answer

A) Assessment of the child's emotional maturity level 
B) Auscultating for adventitious breath sounds 
C) Instructions not to palpate the abdomen 
D) Monitoring blood pressure closely

Question 15

The nurse is caring for a 4-year-old who was hospitalized with influenza.  Which nursing action would be most effective to maintain psychosocial integrity?

Accepted Answer

A) Encouraging use of puzzles for play 
B) Offering the child stacking blocks for diversion 
C) Providing crayons to draw noses on facemasks 
D) Suggesting that playmates visit the child

Question 16

The parents of a 2-year-old client ask how they can help their child cope with hospitalization.  Which of the following suggestions should the nurse give the parents?  Select all that apply.

Accepted Answer

A) Follow as many home routines as possible 
B) Organize a visit from a playgroup friend 
C) Sleep in the child's hospital room at night 
D) Take child on regular visits to the playroom 
E) Tell the child they did not cause the illness

Question 17

A 4-year-old boy is diagnosed with Duchenne muscular dystrophy.  Which nursing teaching is most appropriate to reinforce for this child's parents?

Accepted Answer

A) Increase intake of foods high in iron 
B) Lift weights to strengthen weak muscles 
C) Remove throw rugs from the home 
D) Take the muscle relaxant baclofen on time

Question 18

A 10-year-old weighs 99 lb (44.9 kg) and has a BMI of 24.8 kg/m2 (>95th percentile).  Which is the most important assessment for the nurse to make before initiating a weight loss plan?

Accepted Answer

A) Child's pattern of daily physical activity 
B) Family's eating habits 
C) Family's financial resources for purchasing healthy foods 
D) Family's readiness for change

Question 19

A 2-month-old recently diagnosed with developmental dysplasia of the hip (DDH) is beginning treatment with a Pavlik harness.  Which instructions should the nurse provide to the parents?  Select all that apply.

Accepted Answer

A) "Apply lotion under the straps to protect the skin." 
B) "Dress the child in a shirt and knee socks under the straps." 
C) "Lightly massage the skin under the straps daily." 
D) "Place the diaper under the straps." 
E) "Remove the harness during diaper changes."

Question 20

The nurse assesses a pediatric client who was diagnosed with diarrhea caused by Escherichia coli.  The nurse is most concerned with which finding?

Accepted Answer

A) Blood-streaked stools 
B) Client drank fruit juice 
C) Dry mucous membranes 
D) Petechiae noted on the trunk

Exam 2: Child Health

The registered nurse has completed a well-baby assessment of an 18-month-old. Which assessment findings prompted the nurse to make a referral for a formal developmental screening test?

A 3-month-old child with developmental dysplasia of the hip (DDH) is being fitted for a Pavlik harness. Which statement made by the parent indicates a need for further instruction?

A child is brought to the school nurse after having a permanent tooth knocked out during gym class. Which action by the nurse is appropriate?

The nurse taught the caregiver of a child with a ventriculoperitoneal (VP) shunt about when to contact the health care provider (HCP) . The caregiver shows understanding of the instructions by contacting the HCP about which symptom?

The nurse is reviewing the plan of care for a 4-year-old client who will receive daily dressing changes for an infected leg wound. Which of the following interventions should the nurse include in the plan of care for a preschool-age child? Select all that apply.

The nurse prepares a 7-year-old client for an influenza injection. The nurse explains that the client will receive "medicine under the skin," and the client is visibly anxious. Which nursing intervention is appropriate?

The nurse is providing teaching for parents of a child diagnosed with fifth disease. Which statement by a parent indicates a need for further teaching?

The nurse is reinforcing education to the caregivers of a 9-year-old client diagnosed with scarlet fever. The client has a history of type 1 diabetes mellitus. Which statement by the caregivers indicates that further teaching is needed?

The parent of an 11-month-old child calls the pediatric outpatient clinic and tells the nurse that the child was exposed to measles 2 days ago during a family trip to a theme park. What is the best response by the nurse?

The parents of a 5-year-old ask the school nurse for advice on how to tell their child about being adopted. Which developmentally appropriate thought about adoption by the child does the nurse counsel the parents to anticipate?

The nurse is assessing an infant with intussusception. Which of the following clinical findings should the nurse expect? Select all that apply.

A nurse is caring for a 1-month-old client who is being evaluated for congenital hypothyroidism. The nurse should recognize which of the following as clinical manifestations of hypothyroidism in infants? Select all that apply.

A nurse is speaking with the parent of a toddler who believes the child has a hearing deficit. Which findings support this suspected diagnosis? Select all that apply.

The nurse is admitting a 4-year-old diagnosed with Wilms tumor. The child is scheduled for a right nephrectomy in the morning. Which action is a priority in the preoperative care plan?

The nurse is caring for a 4-year-old who was hospitalized with influenza. Which nursing action would be most effective to maintain psychosocial integrity?

The parents of a 2-year-old client ask how they can help their child cope with hospitalization. Which of the following suggestions should the nurse give the parents? Select all that apply.

A 4-year-old boy is diagnosed with Duchenne muscular dystrophy. Which nursing teaching is most appropriate to reinforce for this child's parents?

A 10-year-old weighs 99 lb (44.9 kg) and has a BMI of 24.8 kg/m² (>95th percentile) . Which is the most important assessment for the nurse to make before initiating a weight loss plan?

A 2-month-old recently diagnosed with developmental dysplasia of the hip (DDH) is beginning treatment with a Pavlik harness. Which instructions should the nurse provide to the parents? Select all that apply.

The nurse assesses a pediatric client who was diagnosed with diarrhea caused by Escherichia coli. The nurse is most concerned with which finding?