1 >>Which of the following assessment fi ndings would indicate that the neonate may be in respiratory distress immediately after birth? ?
- (A) Periodic respirations. Respiratory rate of 50 breaths per minute with occasional pauses of respirations (less than 20 seconds)-NO, this is considered normal respirations for a newborn
- (B) Respiratory rate of 55 breaths per minute with apnea and bradycardia-YES, although the respiratory rate is within normal limits, periods of apnea greater than 20 seconds per minute and bradycardia are signs of respiratory distress.
- (C) Diaphragmatic breathing and a rise in the abdomen during breathing-NO, this type of breathing is typically seen in the newborn period.
- (D) Bronchovesicular breath sounds-NO, these are soft breath sounds over the smaller airway passages in the newborn.
2 >>What is hooking technique? ?
- (A) Pull the lower pinna of the ear downward and backward. The lower pinna is pulled downward in the young child to allow for proper visualization of the tympanic membrane
- (B) Ask the parent to restrain Suzy’s arms and pull her face close to the parent’s chest. Once the child’s legs are restrained, it is necessary to immobilize the child’s face and upper extremities
- (C) Hold the otoscope and infl ator in the examiner’s dominant hand. This step is done once immobilization and positioning of the child are complete.
- (D) To assess of Michael’s liver, you place your fi ngers over and under the costal margins. The liver is palpated as the child takes a deep breath.
3 >>You document that there is rebound tenderness over the abdomen. Which of the following best describes this finding? ?
- (A) The child, who is fearful, contracts the abdominal muscles when assessed
- (B) The child complains of severe pain when pressure is released
- (C) The child will be able to accurately point to the painful area
- (D) The child will shield the area that is being examined
4 >>You have just completed patient education with 15-year-old Kristen and her mother about scoliosis. Which statement, if made by her mother, indicates that additional teaching is needed? ?
- (A) “My daughter will need to wear a corrective device 23 hours per day.”
- (B) “Exercise will be the only treatment needed to correct her scoliosis.”
- (C) “My daughter was referred for further evaluation because her curvature was greater than 7 degrees.”-
- (D) “Kristen’s curve seemed to decrease when she had her growth spurt, which is typical of scoliosis.-
5 >>You complete a cardiac assessment on Marcus and document, “Murmur still auscultated at the left sternal border.” Based on an understanding of cardiac murmurs in a child, you base patient education on which of the following factors? ?
- (A) This murmur is benign and is often heard in the left lower sternal border when the child is lying supine
- (B) This is a serious murmur heard in the left upper sternal border during activity
- (C) This is a benign systolic ejection murmur heard in the clavicular region
- (D) This is a serious murmur that is audible without the stethoscope in direct contact with the chest
6 >>What is Kawasaki disease? ?
- (A) A disorder characterized by vasculitis in the small vessels and the potential for cardiac aneurysms.
- (B) An acquired cardiac disease that typically follows an untreated streptococcal infection such as pharyngitis.
- (C) A disorder manifested by cyanosis, cough, shortness of breath, and fatigue.
- (D) Pericarditis Inflammation of the sac that surrounds the myocardium and may lead to heart failure.
7 >>What is Rheumatic fever? ?
- (A) An acquired cardiac disease that typically follows an untreated streptococcal infection such as pharyngitis.
- (B) A disorder characterized by vasculitis in the small vessels and the potential for cardiac aneurysms.
- (C) Pericarditis Inflammation of the sac that surrounds the myocardium and may lead to heart failure.
- (D) Pericarditis Inflammation of the sac that surrounds the myocardium and may lead to heart failure.
8 >>Based on this assessment, you suspect he has which of the following fungal infections? ?
- (A) Folliculitis
- (B) Tinea versicolor
- (C) Atopic dermatitis
- (D) Contact dermatitis
9 >>How do nutritional patterns differ between the toddler and the preschooler? ?
- (A) Food jags are common but temporary
- (B) Limit the amount of social interaction with peers during mealtime
- (C) Introduce no-fat milk
- (D) Parents continue to make all food choices for the preschooler
10 >>Which of the following statements is accurate about Joan’s, an adolescent, nutritional requirements? ?
- (A) The need for calcium does not increase until menopause
- (B) Adolescents have a heightened need for folic acid
- (C) Sufficient vitamin D levels can be achieved by sun exposure
- (D) Macronutrient defi ciencies are typically a problem only in developing countries
11 >>Which of the following blood tests would most likely be ordered for a child who engages in pica? ?
- (A) Lead levels
- (B) Ferritin levels
- (C) Platelets
- (D) White blood count
12 >>Which of the following assessments would indicate that the parent�child attachment process may be disturbed? ?
- (A) Elyse’s mother seems nervous when she changes the baby’s diaper
- (B) Elyse’s mother looks to you for validation that she is bathing the baby correctly
- (C) Elyse’s mother is sending numerous text messages when she is feeding her baby
- (D) Elyse’s mother states her mother will be a good source of support when Elyse is discharged
13 >>Which of the following gross motor skills should Francesca display during this visit? ?
- (A) Walks up stairs
- (B) Walks with a wide-based stance
- (C) Jumps
- (D) Rides a tricycle
14 >>The toddler’s awareness of a causal relationship between a light switch and a light is an example of: ?
- (A) Sensorimotor phase of cognitive development
- (B) Gross motor skill acquisition
- (C) Preconceptual phase of development
- (D) Magical thinking
15 >>Based on an understanding of growth and development, your best response would be: ?
- (A) Yes. I would gradually start to make efforts to leave the blanket behind.”-NO, this is normal behavior for a toddler who fi nds the blanket a source of comfort in otherwise stressful situations.
- (B) “No. It sounds as though she may have some issues with regression.”-NO, this is normal behavior for a toddler who fi nds the blanket a source of comfort in otherwise stressful situations.
- (C) “Yes. This behavior is interfering with her ability to separate and individuate.”-NO, separation and individuation from a parent emerges as the child realizes she is unique and not fused with a parent.
- (D) “No. This is normal behavior because the blanket is a transitional object to the parents.”-YES, a transitional object is a child’s possession that serves as a linkage to the parent and often provides comfort in stressful situations
16 >>The 4-year-old, who plays chef in a preschool kitchen, is exemplifying play. ?
- (A) Parallel
- (B) Associative
- (C) Dramatic play
- (D) Magical thinking
17 >>Anthony, age 4 years, weighs 50 pounds and is 42 inches tall. Based on stature for age and weight for age, Anthony is in the greater than 95th percentile for weight and greater than 75th percentile for length.Based on the fi ndings related to Anthony’s height and weight assessment, which of the following nursing interventions is appropriate? ?
- (A) There is no need for intervention, the fi ndings are normal
- (B) Conduct a nutritional assessment
- (C) Initiate a weight loss program
- (D) Discuss the seriousness of the child’s obesity with his mother
18 >>Which of the following foods does not have a high amount of folate? ?
- (A) Bread products
- (B) Beans
- (C) Poultry
- (D) Green, leafy vegetables
19 >>Cooper’s parents are concerned that he will become upset when they leave him. In order to help the parents deal with the issues related to separation when they leave their toddler at the hospital, Alexis should make the following suggestion: ?
- (A) Place a clock at the child’s bedside so the child can anticipate their return
- (B) Quietly leave when the child is asleep
- (C) Use associations such as “I will be back when Sid the Science Kid comes on television in the morning”-
- (D) Assure the parents that toddlers adapt well and it should not be a concern-NO, toddlers experience separation anxiety.
20 >>Cooper has been hospitalized for over a week and now has been urinating in the bed. Alexis addresses his mother’s concerns, basing her response on her understanding of growth and development. This temporary loss of a developmental milestone in response to stress is due to: ?
- (A) Regression
- (B) Anger at the parent
- (C) Self-assertion
- (D) Detachment
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