1.
A nurse is assessing a 7-month-old brought to the clinic for a well-baby checkup. Which behavior is expected to develop first in a healthy 7-month old?
Correct Answer
C. Sitting Up
Explanation
The ability to sit up should appear first. Development always occurs in the cephalocaudal direction (head first, then the trunk, then lower extremities). An infant first learns to hold up his head, then sit up, then stand up, then walk. The sequence of events doesn't vary. Controlled movements occur closest to the center of the body first then proceed outward. An infant would learn to sit up before learning to control the arm-hand coordination needed to place objects in containers or to throw a ball.
2.
A 5-year-old child is being prepared for a surgical revision of a ventriculoperitoneal shunt. Which developmental characteristic of a child this age most influences preoperative teaching?
Correct Answer
A. Concrete experiences are meaningful
Explanation
A 5-year-old should be encouraged to play with equipment that may be used in the procedure or to play-act the procedure with a doll to help make the experience concrete. Abstract understanding and cause-and-effect relationships aren't understood. Fantasy isn't clearly distinguished from reality in this age group.
3.
At a well-baby clinic, a mother of a 6-month-old asks the nurse if her baby is normal. Which response is appropriate?
Correct Answer
A. "Why do you ask?"
Explanation
The mother probably has a particular reason for asking this question, so the nurse should ask what concerns her about the baby. Asking the mother what she thinks is wrong may imply there is a problem. More info should be obtained before referring the mom to a physician. A blanket statement that the baby is normal doesn't address the mother's specific concern and may not be true.
4.
A 9-year-old girl with Wilms' tumor (a renal tumor) is admitted to the pediatric hospice unit. The mother asks about the degree of pain the child is experiencing. The nurse assures the mother that ...
Correct Answer
D. Pain medication will be given to keep the child comfortable.
Explanation
Pain medication should be given to keep the child as comfortable as possible. The child may sleep even when she's having pain. Addiction isn't the mom's concern. Neither the girl nor the mother should have to ask for the medication.
5.
A nurse is caring for a 9-year-old who has just undergone an appendectomy and she needs to assess if he's experiencing pain. Which statement most accurately describes pain assessment in children?
Correct Answer
C. Children may not admit to having pain to avoid an injection.
Explanation
If children believe that pain can only be relieved with an injection, they won't admit to having pain. Research shows that pain tolerance increases with age. There is no evidence that opioids are more dangerous for kids than adults. Instead of becoming accustomed to pain, many kids show less tolerance to pain with repeated painful procedures.
6.
A mother of an 8-month-old asks the nurse what to defy her infant because she wants to stop breast-feeding. The nurse should recommend:
Correct Answer
A. Formula
Explanation
The formula is the most appropriate when a mom decides to stop breast-feeding. 2% milk isn't recommended until the child is 2 years old and whole milk shouldn't be offered until 12 mos. OJ is only added after the first year because of the high incidence of allergies.
7.
A nurse is assessing an adolescent's development during a checkup. Which behavior demonstrates that the adolescent is in Piaget's stage of formal operations?
Correct Answer
D. Planning for the future
Explanation
Piaget's stage of formal operations is the ability of the adolescent to see the future and set goals. Understanding cause and effect occurs in the stage of concrete operation. During this stage, children reason logically but the reasoning is limited to the child's own experience. Assimilation and accommodation describe ways a preschooler learns to perform higher-level activities like transferring from riding a tricycle to a bicycle. Object permanence is the knowledge that something exists even when it isn't in view.
8.
Object permanence usually develops around 9-10 mos. Which example shows object permanence?
Correct Answer
C. Looking for an object hidden from view
Explanation
Object permanence is the realization that objects leave the visual field still exist. Playing pat-a-cake is imitative behavior usually seen in an infant around 12 most and isn't related to object permanence. Grasping for an object in view doesn't show object permanence. Realizing that others affect the environment occurs then infants learn to separate themselves from other objects in the environment.
9.
When teaching parents of a neonate, a nurse explains the pattern of normal weight gain. The nurse tells them the neonate should ...
Correct Answer
D. Double his birth weight by 6 mos.
Explanation
An infant should double his birth weight by 6 most and triple it by age 1. Parents should understand normal parameters for weight gain, even if the neonate seems to be a good eater.
10.
A mother brings her 6 mos old to the clinic for a well-baby checkup. What assessment finding indicates that a 6 most old's growth is developmentally appropriate?
Correct Answer
A. Weight has doubled since birth.
Explanation
Weight that doubles by 6 most is normal. Height usually increases 1" per month during the first 6 mos. Head circumference normally increases 1/2" per month during the first 6 mos. The posterior fontanel should close completely by age 2 mos.
11.
A nurse is caring for a 3 year old who is toilet trained but becomes incontinent when separated from his parents during a hospitalization. Which defense mechanism is the child using?
Correct Answer
D. Regression
Explanation
Regression occurs when a child returns to an earlier behavior under stress. Fantasy is the ability to create a scenario in ones mind to help deal with an unacceptable feat. Rationalization is an attempt to make an unacceptable feeling acceptable. Repression is involuntarily forgetting uncomfortable situations.
12.
A preschool boy has an untreated hypospadias (ventral placement of the urethral opening). He's likely to feel:
Correct Answer
C. Guilt about the body defect.
Explanation
Feeling of guilt, according to Erikson, are common for this age-group. Loss of control is a problem seen in adolescents. Lack of ritualistic behavior is a problem for toddlers. Fear of separation from parents is usually seen in toddlers, not preschoolers.
13.
A nurse is discussing growth and development with the parents of a 2-year-old. Which statement by the mom indicates understanding of normal growth and development?
Correct Answer
B. "My 2 year old should be able to speak in 2 word sentences"
Explanation
A critical milestone for a toddler is the ability to form 2 word sentences by age 2. A preschooler (age 3-5) can determine right from wrong based on parental rules. From ages 3-5, children may also copy diamonds, circles and triangles and share toys with other kids and siblings.
14.
Which screening test is the most widely used to assess a young child's development?
Correct Answer
A. Denver Developmental Screening Test-II (DDST-II)
Explanation
The Denver Developmental Screening Test-II (DDST-II) is the most widely used screening test to assess a young child's development. It is specifically designed to identify potential developmental delays in children from birth to 6 years old. The test evaluates various areas of development, including gross motor skills, fine motor skills, personal-social skills, and language skills. By administering this test, healthcare professionals can identify any developmental delays early on and provide appropriate interventions and support to promote optimal development in children.
15.
A nurse expects an infant to say words like "dada" and "mama" with meaning at which age?
Correct Answer
D. 10 mos
Explanation
At around 10 months of age, infants are expected to say words like "dada" and "mama" with meaning. This is because at this stage, infants have typically developed the necessary cognitive and motor skills to start imitating sounds and forming basic words. They begin to understand the meaning behind these words and may use them to refer to their parents or caregivers. It is important to note that the age at which infants start saying these words can vary, as each child develops at their own pace.
16.
A nurse is examining a 4 year old during a routine visit. Which finding gives the most concern?
Correct Answer
B. His speech is intelligible 80% of the time.
Explanation
A child's speech should be intelligible by age 4; if not, he may have a developmental delay or hearing defect. The other choices are normal at this age.
17.
Phenytoin (Dilantin), 50 mg orally, is ordered for a 9 most old diagnosed with seizures. The phenytoin comes in 50-mg chewable tablets. The nurse should:
Correct Answer
C. Crush the tablet and mix it with applesauce.
Explanation
Medications should be mixed with sweetened foods because the child may refuse to eat that food later, making applesauce a good choice and formula a bad one. A 9 most old can't chew a pill safely and couldn't keep it under his tongue.
18.
Which behavior indicates normal biological development?
Correct Answer
C. A 7 mos old transfers a toy from hand to hand.
Explanation
The average infant will begin to roll at 4 mos. An infant with sit without support between 8-9 mos. The infant usually begins to stand and walk between ages 10-12 mos.
19.
A nurse is performing the Denver Developmental Screening Test-II on a 4 1/2 year old. What behaviors should the nurse expect the child to demonstrate? Select all that apply.
Correct Answer(s)
C. He prepares his own cereal without help.
D. He copies a circle that is closed or very neatly closed.
E. He speaks clearly.
F. He draws a person with at least 3 body parts.
Explanation
Most kids don't achieve balancing on each foot for atlas 6 seconds until about age 5 1/2. Fewer than 25% of all kids can correctly copy a square by age 4.
20.
A nurse is assessing a 15 mos old toddler during a well child checkup. Most likely, the toddler will be able to...
Correct Answer
D. Walk backwards
Explanation
More than 75% of 15 mos old toddlers can walk backwards. Walking up steps usually happens by 18 mos. A 15 mos old should have a vocabulary of 4-6 words. Eating with a fork and gaining control of utensils happens closer to 18 mos.
21.
The Denver Developmental Screening Test is used to determine the...
Correct Answer
D. Degree to which a child is developmentally like other kids.
Explanation
The Denver Developmental Screening Test is used to determine the degree to which a child is developmentally like other kids. This means that the test assesses a child's developmental milestones and compares them to what is considered typical for their age group. It helps identify any delays or deviations from the expected developmental progression, allowing for early intervention and support if needed. The test does not assess physical ability, emotional maturity, or IQ, but rather focuses on overall development.
22.
When introducing solid foods to an infant, one food should be introduced at a time, usually at intervals of 4-7 days. The pattern is used because ...
Correct Answer
A. It helps to ID possible food allergies.
Explanation
Introducing one food at a time helps to ID foods that may cause a negative reaction, such as an allergic response or diarrhea. If the baby doesn't like the taste of one food, continue to introduce the food; he may acquire a taste for it. Infants can tolerate more than one type of food at a time. Mixing foods doesn't effect taste development.
23.
A 4-year-old boy who was admitted with croup wets the bed during his first night in the hospital. The mother is embarrassed and apologetic. Which response by the nurse is best?
Correct Answer
C. "It's common for children to regress while they're in the hospital."
Explanation
Recently gained skills, such as toilet training, are commonly temporarily lost during the stress of hospitalization. The nurse should tell the mother that this is a common response. The medications given to treat croup don't cause incontinence and the scenario doesn't mention signs of a bladder infection. Stating there may be a problem with toilet training belittles the moms concern and doesn't address the childs problem.
24.
An 11 mos old refuses to take the amoxicillin/clavulanate potassium (Augmentin) suspension prescribed to treat his otitis media. What should the nurse advise the mother to do?
Correct Answer
D. Use a medicine dropper and place the medicine inside the infants cheek.
Explanation
If the medicine is in the baby's formula and the baby doesn't finish the formula, the mom can't tell how much medicine the baby ingested. The oral form is best for infants. Scheduling times with a neighbor should be necessary if the patient is taught how to correctly hold the infant while administering the medication.
25.
When placing an infant in a crib to sleep, which position is best?
Correct Answer
B. Supine
Explanation
Place on back to reduce risk of SIDS
26.
A mother brings her 18 mos old to a well child checkup. The mom says that her child has several temper tantrums every day. The nurse explains that ...
Correct Answer
D. Temper tantrums are a common response to anger and frustration
Explanation
Giving in to a child's demands or scolding only exacerbates the behavior. Anticipating periods of fatigue, having a snack ready before a child gets hungry and offering the child choices when possible can minimize tantrums.
27.
A nurse is teaching the parents of a 6 mos old about usual growth and development. Which statements are true regarding infant development? Select all that apply.
Correct Answer(s)
B. A 6 mos old can usually roll from prone to supine and supine to prone positions.
C. A teething ring is appropriate for a 6 mos old.
F. Lack of visual coordination usually resolves by age 6 mos.
Explanation
Gross motor skills of a 6 mos old include rolling from front to back and back to front. Teething usually begins around age 6 mos and therefore, a teething ring is appropriate. Visual coordination is usually resolves by age 6 mos. At 6 mos, fine motor skills include purposeful grasps. Stranger anxiety peaks at 8 mos. A 6 mos old should have good head control and no longer displays head lag when pulled up into a sitting position.
28.
A nurse is assessing the development of a 2 year old at a day care center. The nurse expects the toddler to be able to ...
Correct Answer
B. Combine two words.
Explanation
According to the DDST-II, more than 75% of 2 year olds can combine 2 words. Most 2 year old can't put on their own clothing, throw a ball overhand or wash/dry their hands.
29.
During a well-baby checkup, a nurse assess the social development of an infant. At what age does the nurse expect to see the social smile?
Correct Answer
A. 2 mos
Explanation
Development of the social smile happens at 2 mos. An infant can laugh out loud at 4 mos. Between 6 and 8 mos, stranger anxiety develops.
30.
A child who has undergone an appendectomy complains of pain at the incision site. A common misconception of nurses and parents is the belief that...
Correct Answer
C. If children can be diverted from pain, they don't need pain meds.
Explanation
Many nurses and parents incorrectly believe that if a child can be diverted from complaining of pain, he doesn't need pain meds. Children are easily diverted for the moment but still experience pain. Children do remember painful experiences; research on male infants who have been circumcised show that they react to a second painful experience with more intensity than infants who haven't faced a painful experience. Planning for pain management using EBP includes admin of pharmacologic analgesics. Children, like adults, can become addicted to pain meds. The nurse should consider the parents input when giving pain meds because the parent is most familiar with the child.