Title: Quiz: Review of Growth and Development of the Pediatric Patient and Adaptation of Care for the Pediatric Patient
Course: PRN 0096 Practical Nursing III > Section: Nursing Care of Pediatric Client

Q: When the nurse notes that an infant can lift her head before she can sit, the nurse is assessing:
- Specific to general development
- Proximodistal development
- Cephalocaudal development
- General to specific development
A: Cephalocaudal development
If right: Cephalocaudal development proceeds from head to toe.
If wrong: Cephalocaudal development proceeds from head to toe.

Q: An infant’s birthweight is 7 pounds, 8 ounces. The nurse can project the weight at 6 months to be:
- 12 pounds
- 15 pounds
- 18 pounds
- 22 pounds
A: 15 pounds
If right: An infant usually doubles his or her birth weight by 5 to 6 months.
If wrong: An infant usually doubles his or her birth weight by 5 to 6 months.

Q: An assessment of a child’s nutritional status reveals the child is alert, with shiny hair, firm gums, firm mucous membranes, and regular elimination. This child’s nutritional status would be described as:
- Overnourished
- Undernourished
- Well nourished
- Borderline
A: Well nourished
If right: Well-nourished children show steady gains in height and weight and have shiny hair, firm gums and mucous membranes, and regular elimination.
If wrong: Well-nourished children show steady gains in height and weight and have shiny hair, firm gums and mucous membranes, and regular elimination.

Q: The nurse encourages a Puerto Rican family to bring food to a child because he is not eating the food served on his tray at the hospital. The nurse would expect the child to eat:
- Dried beans mixed with rice
- Crisp vegetables
- Spaghetti and meatballs
- Wild berries, roots, and seeds
A: Dried beans mixed with rice
If right: A common food choice of Americans of Puerto Rican descent is dried beans mixed with rice.
If wrong: A common food choice of Americans of Puerto Rican descent is dried beans mixed with rice.

Q: The mother of a 7-month-old states, “The baby is eating food now. Should I give him regular milk, too?” The nurse would respond:
- “You should give the baby low-fat milk.”
- “Try the milk. See if he has any digestive problems.”
- “Continue breast milk or iron-fortified formula until 1 year of age.”
- “At this age, infants can tolerate a lactose-free or soy-based milk.”
A: “Continue breast milk or iron-fortified formula until 1 year of age.”
If right: Whole milk should not be introduced before 1 year of age. Low-fat milk should not be introduced before 2 years of age.
If wrong: Whole milk should not be introduced before 1 year of age. Low-fat milk should not be introduced before 2 years of age.

Q: A mother tells the nurse, “My 11-month-old son is not as active as my other children were at this age. He is the youngest of four and the older children love to dote on him.” Which factor is influencing this child’s language development?
- Heredity
- Sex
- Mother’s health during pregnancy
- Ordinal position
A: Ordinal position
If right: Motor development of the youngest child may be prolonged if the child is babied by others in the family.
If wrong: Motor development of the youngest child may be prolonged if the child is babied by others in the family.

Q: Which child would have the most difficulty in coping with separation from parents because of hospitalization?
- The 3-month-old child
- The 16-month-old child
- The 4-year-old child
- The 7-year-old child
A: The 16-month-old child
If right: Separation anxiety occurs after age 6 months and is most pronounced in the toddler.
If wrong: Separation anxiety occurs after age 6 months and is most pronounced in the toddler.

Q: The parents of a hospitalized toddler are upset because she seems more interested in her toys when they come to visit her. The toddler is most likely in which stage of separation anxiety?
- Protest
- Despair
- Denial
- Attachment
A: Denial
If right: In the stage of denial or detachment, the child appears to deny the need for the parents and becomes uninterested in their visits.
If wrong: In the stage of denial or detachment, the child appears to deny the need for the parents and becomes uninterested in their visits.

Q: The nurse must make a room assignment for a 16-year-old teenager with cystic fibrosis. An optimal roommate might be:
- A 4-year-old child who had an appendectomy
- A 10-year-old child with sickle cell disease in vaso-occlusive crisis
- A 15-year-old teenager with type 1 diabetes mellitus
- To assign the adolescent to a private room
A: A 15-year-old teenager with type 1 diabetes mellitus
If right: Adolescents usually do better in rooms with one or more roommates than in single rooms. The adolescent would do best with a roommate who is closest to his or her age and also lives with a chronic illness.
If wrong: Adolescents usually do better in rooms with one or more roommates than in single rooms. The adolescent would do best with a roommate who is closest to his or her age and also lives with a chronic illness.

Q: The parents of a hospitalized 9-month-old infant ask if their preschool child may visit his younger sibling. The nurse understands that:
- Most facilities do not allow visitors under age 12 years for infection control purposes.
- Seeing his younger sibling would probably frighten the preschooler and thus should be avoided.
- The sibling could view the infant from the doorway but not enter the room to prevent the spread of microorganisms.
- The preschooler needs to visit his infant sister to reassure himself that she is all right.
A: The preschooler needs to visit his infant sister to reassure himself that she is all right.
If right: Siblings are affected by a child’s hospitalization. Their ability to cope is influenced by their age, experience, and intactness of the family.
If wrong: Siblings are affected by a child’s hospitalization. Their ability to cope is influenced by their age, experience, and intactness of the family.

Q: A hospitalized toddler was drinking from a cup at home, but now refuses to drink from anything except his favorite bottle. This is because the toddler is:
- Dealing with the anxiety of hospitalization by regressing
- Demonstrating attention-seeking behaviors because of an overabundance of attention in the hospital
- Attempting to refocus the attention of the adults around him to avoid further painful procedures
- Exhibiting normal behavior for his age, as children often stop new behaviors after they feel they have mastered them
A: Dealing with the anxiety of hospitalization by regressing
If right: Hospitalization is frustrating for toddlers. They show their displeasure when illness restricts satisfaction of their desires. It is not unusual for a toddler who was drinking from a cup to refuse it in the hospital.
If wrong: Hospitalization is frustrating for toddlers. They show their displeasure when illness restricts satisfaction of their desires. It is not unusual for a toddler who was drinking from a cup to refuse it in the hospital.

Q: A nurse encourages a school-age child to draw a picture after a painful procedure. The best rationale for this intervention is that the nurse is:
- Attempting to reestablish rapport
- Providing a way for the child to express his feelings
- Encouraging quiet play
- Distracting the child from thinking about the pain
A: Providing a way for the child to express his feelings
If right: Following treatments, the nurse should encourage children to draw and talk about their drawings or to act out their feelings through puppet play.
If wrong: Following treatments, the nurse should encourage children to draw and talk about their drawings or to act out their feelings through puppet play.

Q: The mother of a 3-year-old tells the nurse that she will be in to visit tomorrow around 12:00 PM. The next morning, the child asks the nurse, “When is my mommy coming?” The best response for the nurse to make is:
- “Your mommy will be here around noon.”
- “Your mommy will be here when you have lunch.”
- “Mommy will be here very soon.”
- “Your mommy is coming in 4 hours.”
A: “Your mommy will be here when you have lunch.”
If right: The toddler and preschooler do not understand time yet. They understand time relationships through activities in their experience, such as naptime and mealtimes.
If wrong: The toddler and preschooler do not understand time yet. They understand time relationships through activities in their experience, such as naptime and mealtimes.

Q: The strategy the nurse might use when administering oral medications to a young child who is reluctant to take it is:
- Mix the medication with chocolate milk.
- Tell the child that the medication is candy.
- Give the medication quickly if the child is crying.
- Offer the child fruit juice after the medication is swallowed.
A: Offer the child fruit juice after the medication is swallowed.
If right: The nurse can offer a chaser of water, fruit juice, or a carbonated beverage after the medication has been swallowed. Medications should not be mixed with important nutrients such as milk since the child may develop a distaste for the food.
If wrong: The nurse can offer a chaser of water, fruit juice, or a carbonated beverage after the medication has been swallowed. Medications should not be mixed with important nutrients such as milk since the child may develop a distaste for the food.

Q: When the 4-year-old asks tearfully if the IM injection will hurt, the nurse’s most effective response is:
- “No. It is over before you know it”
- “Yes. It will sting a little.”
- “No. Would you like to see the syringe?”
- “Yes. Your mom and I are going to hold you to help you be still.”
A: “Yes. It will sting a little.”
If right: Truthful answers will give a child a realistic expectation and help establish trust in the nurse.
If wrong: Truthful answers will give a child a realistic expectation and help establish trust in the nurse.

Q: The nurse selects the best site for giving an intramuscular injection to a 15-month-old child, which is the:
- Ventrogluteal muscle
- Dorsogluteal muscle
- Deltoid muscle
- Vastus lateralis muscle
A: Vastus lateralis muscle
If right: The vastus lateralis muscle is free of major blood vessels and nerves and can be used in children of any age.
If wrong: The vastus lateralis muscle is free of major blood vessels and nerves and can be used in children of any age.

Q: On entering the hospital room, the nurse takes note of all the options below. The observation that would indicate a need for the parents to receive safety education to prevent unintentional injury is:
- The blanket is not tucked into the mattress.
- Diapers and wipes are stacked at the foot of the crib.
- The crib side is locked in the up position.
- Pillows are stacked on the bedside table.
A: Diapers and wipes are stacked at the foot of the crib.
If right: Disposable diapers and supplies must be kept out of the infant’s reach to prevent accidental suffocation.
If wrong: Disposable diapers and supplies must be kept out of the infant’s reach to prevent accidental suffocation.

Q: The nurse prepares a 9-year-old child for a lumbar puncture by explaining that the position for this procedure is:
- “On your stomach with your head turned to the side.”
- “On your side, keeping the legs bent and the head arched back.”
- “On your back with your legs extended straight out.”
- “On your side with the knees bent and the head close to the knees.”
A: “On your side with the knees bent and the head close to the knees.”
If right: The child is positioned on its side with the knees flexed, and the head is brought down close to the flexed knees.
If wrong: The child is positioned on its side with the knees flexed, and the head is brought down close to the flexed knees.

Q: A teenage male refuses to wear the clothes his mother bought for him.  He states that internal  he wants to look like the other kids at school and wear the types of clothes they wear.  The nurse explains this behavior is an example of teenage rebellion related to conflcts of:
- Autonomy vs shame and doubt.
- Trust vs mistrust
- Identity vs role confusion.
- Initiative vs inferiority
A: Identity vs role confusion.

Q: The mother discusses with the nurse that her toddler asks every night for a bedtime story.  The mother asks why the child does this.  THe nurse would explain that theis behavior demonstrates:
- Ritualism
- Object permanence
- Dependency
- Conservation
A: Ritualism

Q: The mother of a 6 month old infant is concerned that the infant’s anterior fontanel is still open.  The nurse would explain to the mother that further evaluation is needed if the anterior fontanel is still open after:
- 6 months
- 10 months
- 18 months
- 12 months
A: 18 months

Q: The nurse has discussed with a group of new mothers appropriate support of the young infant to prevent injuries from falls.  The mother who needs further education is the mother who states:
- “My baby is not allowed to crawl or play near the stairs.”
- “I never leave my baby unattended on my bed.”
- “By the time my baby is 6 months old, he will be able to sit without support.”
- “Before my child is standing, I need to place the crib mattress at the lowest level.”
A: “By the time my baby is 6 months old, he will be able to sit without support.”

Q: In discussing sexual maturation with a health class. the nurse would include the information that secondary sex characteristics begin to appear at:
- 10 years in girls, 12 years in boys
- 12 years in girls, 16 years in boys
- 8 years in boys, 10 years in girls
- 12 years in girls and boys
A: 10 years in girls, 12 years in boys

Q: a recently hospitalized 2-year-old client screams that he wants a “bottle.”  His parents are puzzled, and state that he has been drinking from a cup for the past year.  The nurse explains that:
- Irritability is exhibited in all age groups.
- Temper tantrums often represent the child’s need for parental attention.
- Various forms of punishment are necessary when such behaviors occur.
- Regression to an earlier behavior often helps the child cope with stress and anxiety.
A: Regression to an earlier behavior often helps the child cope with stress and anxiety.

Q: The nurse is preparing an 8 year-old child for a procedure.  What is the most appropriate nursing interventionconsidering the child’s stage of growth and development?
- Provide visual aids, such as dolls, puppets, and diagrams in the explanation.
- Provide a written pamphlet for the child to review prior to the procedure.
- Discourage any display of emotional outbursts.
- Request that the parents wait outside while the nurse provides instructions to the child.
A: Provide visual aids, such as dolls, puppets, and diagrams in the explanation.