1. The number of deaths of infants younger than age 28 days per 1000 live births is termed the:

a. Birth rate

b. Neonatal birth rate

c. Neonatal morbidity rate

d. Neonatal mortality rate

2. Which nursing action is the priority when a patient arrives at the clinic?

a. Prepare a plan of care.

b. Select the appropriate NANDA-I diagnosis(es)

c. Administer medications as ordered.

d. Determine and document history and vital signs.

3. An organization that sets standards of practice for nursing is the;

a. American Medical Association (AMA)

b. American Nurses Association (ANA)

c. Utilization review committee

d. American Academy of Pediatrics (AAP)

4. One advantage of electronic charting, which is used in most hospitals, is that it:

a. Relieves the nurse of responsibilities to write.

b. Enables many caregivers to access the chart at the same time

c. Prevents all medication errors

d. Can be accessed from the nurse’s home

5. Which source would the nurse use to determine if a specific nursing activity is within the scope of practice of an LPN/LVN.

a. Doctor’s prescription record

b. Nursing procedure manual

c. Head nurse or nurse manager

d. The nurse practice act.

Chapter 2

1. Spermatozoa are produced in the:

a. Vas deferens

b. Seminiferous tubules

c. Prostate gland

d. Leydig cells

2. A woman can keep a diary of her menstrual cycles to help determine her fertile period. She understands that after ovulation she will remain fertile for:

a. 2 hours

b. 24 hours

c. 3 to 5 days

d. 7 to 14 days.

3. Which data indicate that the woman may have pelvic demensions that would be inadequate for a normal vaginal delivery? A woman with a(n):

a. Anthropoid-shaped pelvis with a history of pelvic inflammatory disease

b. Gynecoid-shaped pelvis with a history of rickets

c. Anthropoid-shaped pelvis that previously delivered a 9-lb infant

d. Gynecoid-shaped pelvis with a history of poor nutrition

4. The muscular layer of the uterus that is the functional unit in pregnancy and labor is the:

a. Perimetrium

b. Myometrium

c. Endometrium

d. Cervix

5. During a prenatal clinic visit, a woman states that she probably will not plan to breastfeed her infant because she has very small breasts and believes she cannot provide adequate milk for a full-term infant. The best response of the nurse would be:

a. “Ask the physician if he or she will prescribe hormones to build up the breasts”

b. “I can provide you with exercises that will build up your breast tissue”

c. “The fluid intake of the mother will determine the milk output”

d. “The size of the breast has no relationship to the ability to produce adequate milk”

Chapter 3

1. The child’s sex is determined by the:

a. Dominance of either the X or Y chromosome

b. Number of X chromosomes in the ovum

c. Ovum, which contributes either an X or a Y chromosome

d. Sperm, which contains either an X or a Y chromosome

2. A woman who wants to become pregnant should avoid all medications unless they are prescribed by a physician who knows she is pregnant, because:

a. The placenta allows most medications to cross into the fetus

b. Medications often have adverse effects when taken during pregnancy

c. Fetal growth is likely to be slowed by many medications

d. The pregnancy is likely to be prolonged by some medications

3. The umbilical cord normally contains:

a. One artery and one vein

b. Two arteries and two veins

c. Two arteries and one vein

d. Two veins

4. The purpose of the foramen ovale is to:

a. Increase fetal blood flow to the lungs

b. Limit blood flow to the liver

c. Raise the oxygen content of fetal blood

d. Reduce blood flow to the lungs

5. Why are twins often born early?

a. The uterus becomes overdistended

b. The placenta becomes distended

c. The woman’s body cannot tolerate the weight

d. The fetuses become too large to deliver vaginally.

Chapter 4

1. A woman is having a prenatal visit at 18 weeks of gestation. Why is it important to ask her about fetal movement?

a. Absence of fetal movement at this time suggests that the pregnancy is more advanced than her dates indicate.

b. Denial of fetal movement at this stage in pregnancy may indicate that the woman is not accepting her pregnancy

c. If she has started feeling fetal movement, the fetal heartbeat will be checked with a fetoscope to confirm that the fetus is living.

d. Fetal movement is first felt by the mother about this time and provides a marker for approximate gestational age.

2. A pregnant woman complains that she has a large amount of vaginal secretions. The next most appropriate nursing action is to:

a. Consult her nurse-midwife for a cream or douche

b. Ask her if the discharge is irritating or causes itching

c. Advise her to change cotton panties twice daily

d. Tell her to reduce sexual intercourse for a few weeks

3. During a prenatal examination at 30 weeks of gestation, a woman is lying on her back on the examining table. She suddenly complains of dizziness and feeling faint. The most appropriate response of the nurse would be to:

a. Reassure the woman and take measures to reduce her anxiety level.

b. Offer the woman some orange juice or other rapidly absorbed from of glucose.

c. Place a pillow under the woman’s head

d. Turn the woman onto her side

4. A woman being seen for her first prenatal care appointment has a positive home pregnancy test, and her chart shows a TPALM recording of 40120. The nurse would anticipate that:

a. Minimal prenatal teaching will be required because this is her fourth pregnancy

b. The woman will need help in planning the care of her other children at home during her labor and delivery

c. The woman should experience minimal anxiety because she is familiar with the progress of pregnancy

d. This pregnancy will be considered high risk, and measures to reduce anxiety will be needed.

5. Prenatal nursing care for the father should emphasize:

a. Giving him guidance so he can focus on the mother getting through pregnancy

b. Involving him in the pregnancy as much as he and the mother desire

c. Encouraging him to attend all prenatal visits with the mother

d. Making the fact of fatherhood as reas as possible to him.

Chapter 5

1. A woman has an incomplete abortion followed by vacuum aspiration. She is now in the recover room with her husband and is crying softly. Select the most appropriate nursing action:

a. Leave the couple alone, except for necessary recovery room care.

b. Tell the couple that most abortions are for te best because the infant would have been abnormal

c. Tell the couple that spontaneous abortion is very common and does not mean they cannot have other children

d. Express your regret at their loss and remain nearby if they want to talk about it

2. A woman is admitted with a diagnosis of “possible ectopic pregnancy” Select the nursing assessment that should be promptly reported.

a. Absence of vaginal bleeding

b. Complaint of shoulder pain

c. Stable pulse and respiratory rate: rise in blood pressure more than 10 mm Hg systolic

d. Temperature of 37.6 C (99.6 F)

3. It is important to emphasize that a woman who has gestational trophoblastic disease (hydatidiform mole) should continue to have follow-up medical care after initial treatment because:

a. Choriocarcinoma sometimes occurs after the initial treatment

b. She has lower levels of immune factors and is vulnerable to infection

c. Anemia complicates most cases of hydatidiform mole

d. Permanent elevation of her blood pressure is more likely

4. Select the primary difference between the symptoms of placenta previa and abruption placentae

a. Fetal presentation

b. Presence of pain

c. Abnormal blood clotting

d. Presence of bleeding

5. During the prenatal clinic visit, your intervention with an abused woman is successful if you have assessed the status of the woman and:

a. Persuaded her to leave her abusive partner

b. Informed her of her safety options

c. Convinced her to notify the police

d. Placed her in a shelter for abused women

Chapter 6

1. To determine the frequency of uterine contractions, the nurse should note the time from the:

a. Beginning to end of the same contraction

b. End of one contraction to the beginning of the next contraction

c. Beginning of one contraction to the beginning of the next contraction

d. Contraction’s peak until the contraction begins to relax

2. Excessive anxiety and fear during labor may result in a(n):

a. Ineffective labor pattern

b. Abnormal fetal presentation or position

c. Release of oxytocin from the pituitary gland

d. Rapid labor and uncontrolled birth

3. A woman who is pregnant with her first child phones an intrapartum facility and says her “water broke” the nurse should tell her to:

a. Wait until she has contractions every 5 minutes for 1 hour

b. Take her temperature every 4 hours and come to the facility if it is over 38 C (100.4 F)

c. Come to the facility promptly, but safely

d. Call an ambulance to bring her to the facility

4. A laboring woman suddenly begins making grunting sounds and bearing down during a strong contraction. The nurse should initially:

a. Leave the room to find an experienced nurse to assess the woman

b. Look at her perineum for increased bloody show or perineal bulging

c. Ask her if she needs pain medication

d. Tell her that these are common sensations in late labor

5. A woman in active labor has contractions every 3 minutes lasting 60 seconds, and her uterus relaxes between contractions. The electronic fetal monitor shows the FHR to reach 90 beats/min for periods lasting 20 seconds during a uterine contraction. The appropriate priority nursing action is to:

a. Continue to monitor closely

b. Administer oxygen by mask at 10 L/min

c. Notify the health care provider

d. Prepare for a cesarean section

Chapter 7

1. What is the narcotic drug of choice for pain relief during labor when the cervix is less than 4 cm dilated?

a. Morphine

b. Meperidine

c. Lidocaine

d. Narcan

2. Which technique is likely to be most effective for “back labor”?

a. Stimulating the abdomen by effleurage

b. Applying firm pressure in the sacral area

c. Blowing out short breaths during each contraction

d. Rocking from side to side at the peak of each contraction

3. What drug should be immediately available for emergency use when a woman receives narcotics during labor?

a. Fentanyl (Sublimaze)

b. Diphenhydramine (Benadryl)

c. Lidocaine (Xylocaine)

d. Naloxone (Narcan)

4. Choose the most important nursing assessment immediately after a woman receives an epidural block:

a. Bladder distention

b. Condition of intravenous site

c. Respiratory rate

d. Blood pressure

5. Spinal headache after epidural anesthesia may be relieved by:

a. Positioning woman on her side supported by pillows

b. Epidural injection of a blood patch at the puncture site

c. Avoiding ambulation for 12 hours

d. Paced breathing techniques

Chapter 8

1. The nurse notes that a woman’s contractions during oxytocin induction of labor are every 2 minutes. The contractions last 95 seconds, and the uterus remains tense between contractions. What action is expected on the basis of these assessments?

a. No action is expected; the contractions are normal

b. The rate of oxytocin administration will be increased slightly

c. Pain medication or an epidural block will be offered

d. Infusion of oxytocin will be stopped

2. Select the appropriate nursing intervention during the early recovery period to increase the woman’s comfort if she had a forceps-assisted birth and a median episiotomy

a. Application of a cold pack to her perineal area

b. Encouragement of perineal stretching exercises

c. Application of warm, moist heat to the perineum

d. Administration of stool softners

3. A woman has an emergency cesarean delivery after the umbilical cord was found to be prolapsed. She repeatedly asks similar questions about what happened at birth. The nurse’s interpretation of the woman’s behavior is that she:

a. Cannot accept that she did not have the type of delivery she planned

b. Is trying to understand her experience and move on with postpartum adaptation

c. Thinks the staff is not telling her the truth about what happened at birth

d. Is confused about events because of the effects of the general anesthetic are persisting

4. What nursing intervention during labor can increase space in the woman’s pelvis?

a. Promote adequate fluid intake

b. Position her on the left side

c. Assist her to take a shower

d. Encourage regular urination

5. A woman is being observed in the hospital because her membranes ruptured at 30 weeks of gestation. While giving morning care, the nursing student notices that the draining fluid has a strong odor. The priority nursing action is to:

a. Caution the woman to remain in bed under her physician visits

b. Ask the woman if she is having any more contractions than usual

c. Take the woman’s temperature; report it and the fluid odor to the registered nurse

d. Help to prepare the woman for an immediate cesarean delivery.

Chapter 9

1. Which assessment is an expected finding 24 hours after birth?

a. Scant amount of lochia alba on the perineal pad

b. Fundus firm and in the midline of the abdomen

c. Breasts distended and hard with flat nipples

d. Slight separation of a perineal laceration

2. Nursing the infant promotes uterine involution because it:

a. Uses material fat stores accumulated during pregnancy

b. Stimulates additional secretion of colostrums

c. Causes the pituitary to secrete oxytocin to contract the uterus

3. The best way to maintain the newborns temperature immediately after birth is to:

a. Dry the infant thoroughly, including the hair

b. Give the infant a bath using warm water

c. Feed 1 to 2 oz of warmed formula

d. Limit the length of time parents hold the infant

4. Eight hours postpartum the woman states she prefers the nurse to take care of the infant. The woman talks in detail about her birthing experience on the phone and to anyone who enters her room. She complains of being hungry, thirsty, and sleepy and is unable to focus on the infant care teaching offered to her. The nurse would interpret this behavior as:

a. Inability to bond with the infant

b. Development of postpartum psychosis

c. Inability to assume the parenting role

d. The normal taking-in phase of the puerperium

5. A new mother asks how often she should nurse her infant. The nurse should tell her to feed the infant:

a. On a regular schedule, every 2 hours

b. On demand, about ever 2 to 3 hours

c. At least every 4 hours during the day

d. Whenever the infant is interested

Chapter 10

1. The earliest finding in hypovolemic shock is usually:

a. Low blood pressure

b. Rapid pulse rate

c. Pale skin colr

d. Soft uterus

2. A bleeding laceration is typically manifested by:

a. A soft uterus that is difficult to locate

b. Low pulse rate and blood pressure

c. Bright red bleeding and a firm uterus

d. Profuse dark red bleeding and large clots

3. During the postpartum period the white blood cell (leukocyte) count is normally:

a. Higher than normal

b. Lower than normal

c. Unchanged

d. Unimportant

4. A postpartum mother who is breastfeeding has developed mastitis. She states that she does not think it is good for her infant to drink milk from her infected breast. The best response from the nurse would be to:

a. Instruct her to nurse the infant from only the unaffected breast until the infection clears up

b. Suggest that she discontinue breastfeeding and start the infant on formula

c. Encourage breastfeeding the infant to prevent engorgement.

d. Apply a tight breastbinder to the infected breast until the infection subsides

5. A woman is having her checkup with her nurse-midwife 6 weeks after birth. The mother seems uninterested in others, including her infant. She tells the nurse that she feels she is not a very good mother. The nurse should:

a. Reassure her that almost all new mothers feel let down after birth

b. Ask her how her partner feels about the infant

c. Explore her feelings with sensitive questioning

d. Refer her to a psychiatrist

1. Choose the correct teaching for breast self-examination (BSE):

1. Monthly BSE eliminates the need for a professional examination until after age 40 years.

2. BSE should be done 1 week after the beginning of each menstrual period.

3. Dry fingers make it easier to feel very small lumps that are under the skin.

4. Use the palm of the hand to palpate the breast.

2. The women’s health nurse practitioner recommends ibuprofen to relieve a patient’s menstrual cramps. He nurse should teach her to take the drug:

1. With a full glass of water and wait 30 minutes before taking any food.

2. On a full stomach, but only if her cramps seem to be getting more severe.

3. Three times per day for 1 week before she expects her period to begin.

4. With food, just before her period begins or soon after it begins.

3. What is a reliable temporary (reversible) birth control method?

1. Douching

2. Breastfeeding

3. Transdermal patch

4. Vasectomy

4. To relieve or reduce symptoms of premenstrual dysphoric syndrome, what should the nurse recommend that the woman do?

1. Avoid simple sugars and caffeine consumption

2. Use oral contraceptive medication.

3. Avoid physical exercise

4. Limit water intake to 1000 mL/day.

5. Patient teaching to prevent osteoporosis in the menopausal woman should take:

1. Limiting total calcium intake to 1000 mg/day

2. Using pillows to maintain good body alignment when sleeping

3. Take alendronate (Fosamax) with the evening meal.

4. Doing low-impact weight bearing exercise several times each week.

Chapter 12 – The Term Newborn

1. The mother of a newborn reports to the nurse that her infant has had a black tarry stool. The nurse would tell the mother that:

1. This is most likely caused by blood the infant may have swallowed during the birthing process.

2. The health care provider will be promptly notified.

3. The infant will be given nothing by mouth (remain NPO) until a stool culture is taken.

4. This is a normal stool in newborn infants

2. The soft spots on a newborn’s head are termed:

1. Hematomas

2. Fontanelles

3. Sutures

4. Petechiae

3. Infections in the newborn require prompt intervention because:

1. They spread more quickly

2. Infections that are relatively harmless to an adult can be fatal to the newborn.

3. The portals of entry and exit are more numerous

4. The newborn has no defenses against infection.

4. The mother states that her newborn has white pinpoint “pimples” on his nose and chin and she plans to squeeze them to make them disappear. The best response of the nurse would be:

1. “Be sure to wipe the area with an alcohol sponge to avoid infection.”

2. “Ask your health care provider to prescribe an antibiotic ointment for the pimples.”

3. “These pimples are called ‘Epstein’s pearls’ and are a normal occurrence.”

4. “These pimples are called ‘milia’ and will disappear on their own in a week or two.”

5. Which observation of the newborn should be reported to the health care provider as soon as possible?

1. A swelling beneath the scalp on one side of the head

2. A respiratory rate of 55 breaths/min

3. A unilateral Moro reflex

4. Cyanosis of the hands and feet

Chapter 13 – Preterm and Postterm Newborns

1. A standardized method of determining gestational age based on appearance and neuromuscular criteria is the:

1. Gesell graph

2. Ballard score

3. Washington guide

4. Friedman curve

2. Some preterm infants are fed by gavage because of:

1. Poor digestion

2. Overdeveloped gag and cough reflex

3. Refusal of formula

4. Weak sucking and swallowing reflexes

3. A characteristic sign of necrotizing enterocolitis (NEC) in the newborn is:

1. Bloody diarrhea

2. Necrosis of the abdomen

3. Projectile vomiting

4. High fever

4. The actual time that the fetus remains in the uterus is termed:

1. Gestational age

2. Intrauterine growth rate

3. Neurological age

4. Level of maturation

5. Administering high oxygen concentrations to a preterm newborn may result in:

1. Rupture of the alveoli

2. Cyanosis

3. Retinopathy of prematurity

4. Primary atelectasis

Chapter 14 – The Newborn with a Perinatal Injury or Congenital Malformation

1. The practice of suctioning the nose and mouth of the newborn when the head is born and before the rest of the infant’s body is delivered is advisable because:

1. It prevents the aspiration of amniotic fluid in the newborn

2. There is more time to suction because many procedures must be done after delivery

3. The physician is available to suction rather than the nurse

4. The newborn will have a cleaner appearance when first seen by the mother

2. A congenital defect that results in enlargement of the infant’s head and pressure changes within the brain is:

1. Hydrocephalus

2. Microcephalus

3. Hydrocele

4. Anencephaly

3. Meningomyelocele is:

1. A protrusion of the meninges through an opening in the spine

2. Primarily a disorder of the muscular tissue of the body

3. A protrusion of the membranes and cord through an opening in the spine

4. A tumor in the meningocele space

4. A Pavlik harness is often used to correct:

1. Clubfoot

2. Juvenile arthritis

3. Developmental hip dysplasia

4. Fractured femur

5. When bathing an infant, the nurse observes the hips for dislocation. What observation may indicate developmental hip dysplasia?

1. Toes turned inward

2. Limitation of abduction of legs

3. Asymmetry of epicanthal folds

4. Shortening of patella

Chapter 15 – An Overview of Growth, Development, and Nutrition

1. How many erupted teeth would the nurse expect a healthy 8 month old infant to have?

1. 2

2. 4

3. 6

4. 8

2. During the first week of life, the newborn’s weight:

1. Increases about 5% to 10%

2. Decreases about 5% to 10%

3. Stabilizes

4. Fluctuates widely

3. The nurse should encourage the parent to introduce toothbrushing to her child by age:

1. 6 months

2. 1 year

3. 3 years

4. 7 years

4. To meet the needs (as described by Erikson) of a school age child diagnosed with diabetes, the nurse should:

1. Explain carefully to the mother the need to rigidly adhere to dietary modifications

2. Allow the child to eat whatever he or she wants and administer insulin to maintain optimum glucose levels

3. Allow the child to perform his own Accuchecks and administer his own insulin

4. Perform Accuchecks four times a day and at bedtime

5. It is most appropriate to first introduce competitive games at age

1. 3 to 5 years

2. 5 to 6 years

3. 7 to 9 years

4. 12 to 15 years

Chapter 16 – The infant

1. The startle reflex is also known as the:

1. Moro reflex

2. Rooting reflex

3. Pincer reflex

4. Grasp reflex

2. A car seat for an infant under age 1 year:

1. Is not needed if the infant is held securely in the lap of an adult

2. Should be placed close to the driver in the front passenger seat

3. Should face the rear and be placed in the center of the back seat

4. Should face forward and be placed on the driver’s side of the back seat.

3. To detect allergies when feeding new foods:

1. Introduce single-ingredient foods

2. Mix the food with one the infant likes

3. Mix the food with formula

4. Offer two new foods at a time

4. The nurse is discussing home safety with the mother of a 4 month old infant. Which of the following is a priority topic?

1. Placing locks on cabinet doors that contain cleaning supplies

2. Covering electrical outlets

3. Raising and securing crib side rails

4. Encouraging reading and talking to infant

5. A mother expresses concern that her 1 year old infant is overweight. She states that her family has a tendency to be overweight and wishes to discontinue formula feedings and start the infant on low-fat milk. The nurse assesses that the present weight of the infant is 24 lb. The infant’s birth weight was 8 lb, 2oz. The best response of the nurse would be:

1. To place the infant on low-fat milk because the infant is slightly overweight at this time

2. To place the infant on regular whole milk because the infant’s weight is appropriate for his age

3. To indicate that the infant is underweight for his age and needs to have supplemental formula added to the diet

4. To note that infancy is a period of rapid growth and weight loss will occur as the infant becomes more active

Chapter 17 - The Toddler

1. A parent states she is having a conflict with her toddler who seems to “always want to do things his way.” He insists on putting on his right sock and shoe before his left and has a tantrum if the parent tries to put on the left sock and shoe first. The parent asks the nurse why the child is acting this way. The best response of the nurse would be to:

1. Explain to the child it really doesn’t make a difference which sock and shoe is donned first

2. Put the child in a “time-out” for the appropriate time

3. Explain that this is normal ritualistic behavior at this age and should be respected

4. Let the child walk barefoot and take the shoes away

2. The nurse assesses the vital signs of a 2 year old. A normal respiratory rate (per minute) would be:

1. 18 to 20

2. 25 to 30

3. 35 to 40

4. 45 to 50

3. Which statement by the parent would indicate a need for further guidance?

1. I use a car seat for my toddler whenever we are in the car, and he is right beside me as I drive so I can keep an eye on him.

2. I use a car seat for my toddler whenever we are in the car and secure it onto the rear seat of the car

3. I use a car seat for my toddler that is designed to hold children up to 40 lb.

4. I use a car seat for my toddler that is designed to fasten with the seat belt.

4. A mother tells the nurse that her 2 year old toddler often has temper tantrums at the family dinner table and asks how to handle the behavior. The best response of the nurse would be:

1. Temper tantrums are normal for a 2 year old, and the child will outgrow it.

2. The toddler should be removed from the family dinner table until he or she is old enough to behave.

3. Strict discipline and corporal punishment are appropriate to help the child to gain self control

4. Parents should agree on a method of discipline, such as time-out, and use it when the child misbehaves.

5. One of the developmental hallmarks of the toddler that most gives rise to safety hazards is:

1. Brief attention span

2. Need for ritual

3. Fluctuating appetite

4. Need to explore

Chapter 18 – The Preschool Child

1. When selecting play activities for a healthy 4 year old, the parent should be guided to understand that the 4 year old enjoys:

1. Solitary play, sitting next to a friend

2. Cooperative play with friends

3. Competitive play with teams

4. Observing rather than participating

2. An example of a therapeutic play activity for a preschool child who is recovering from an appendectomy would be:

1. A Wii game of bowling

2. Blowing bubbles

3. Reading a storybook

4. Coloring with crayons

3. The nurse is guiding a parent concerning techniques of dealing with a child with enuresis. The most appropriate suggestion by the nurse would be to:

1. Wake the child often during the night and take him to the bathroom to void

2. Limit liquids after dinner and have the child void before going to bed.

3. Use a consistent technique of discipline whenever the bed is wet.

4. Keep the child in diapers until bed wetting is no longer a problem

4. The appropriate amount of time to use in a time-out period for a 3 year old child is:

1. 1 minute

2. 3 minutes

3. 5 minutes

4. 10 minutes

5. A 4 year old child is in Erickson’s stage of:

1. Autonomy

2. Industry

3. Initiative

4. Identity

Chapter 19 – The School-Age Child

1. The pulse of the school-age child is approximately:

1. 100 to 120 beats/min

2. 95 to 120 beats/min

3. 85 to 100 beats/min

4. 60 to 80 beats/min

2. A parent asks the nurse if it is healthy to allow her school-age child to play computer games after school every day. The best response of the nurse would be that computer and video games:

1. Interest the school-age child and it will keep him off the streets

2. Can challenge the intellect but should be balanced with active play activities

3. Should only be played on weekend and not on school days

4. Can teach new skills and are appropriate for school-age children

3. While playing in school, a 9 year old child suffers and injury that knocks his tooth out of his mouth. What should the teacher or school nurse do?

1. Place the tooth in a cup of clean water, and send the child home

2. Place the tooth in a cup of milk, and call the parent to take the child to the dentist.

3. Wrap the tooth in a clean cloth, and call the parent to take the child to the dentist.

4. Rinse the child’s mouth, and place the tooth in and envelope for the child to show his parent.

4. The parent of an 8 year old child seeks advice from the nurse because her child is overweight. What would the nurse advise the parent to do?

1. Provide a reward for the child when he avoids between-meal snacks for a full week

2. Limit privileges when the child eats sweets or junk food

3. Include the child in meal planning and preparation

4. Limit party going activities where sweets will be served

5. A 9 year old practicing the piano continues to have difficulty in playing the theme song from a popular movie. She starts to pound on the piano keys in frustration. The best response would be to enter the room and say:

1. “Just what do you think you’re doing? That piano cost money!”

2. “That’s not difficult. Pull yourself together or you’ll never amount to anything.”

3. “That piece sound hard. I can see how you could be discouraged.”

4. “Here, let me show you how to play that.”

Chapter 20 - Adolescent

1. One of the tasks of adolescence as defined by Erickson is:

1. Finding an identity

2. Sexual latency

3. Heterosexuality

4. Concrete operations

2. When communicating with an adolescent about safety concerns, which concept of adolescent behavior should be considered?

1. The typical adolescent understands teaching and respects and usually follows the advice of adults.

2. Growth and development are complete in the adolescent, and muscle coordination and skills less the risks for injury

3. Safety concerns at this age mostly focus on sport injuries

4. Adolescents are risk takers and tend to experiment with potentially dangerous outcomes

3. Puberty can most accurately be defined as the period of life characterized by the:

1. Occurrence of sexual maturity and appearance of secondary sex characteristics

2. Substitution of adult interests and value systems for child interests

3. Most rapid rate of physical and mental growth and development

4. Awakening of sexual feelings and initiation of sexual experience

4. A 16 year old female towers over her companions, which bothers her. She confides in the nurse and says, “I just hate school-everyone is always staring at me.” The nurse’s best response would be:

1. “Don’t pay any attention to it.”

2. “You just don’t know how lucky you are to be tall.”

3. “This will resolve itself in time. Don’t worry.”

4. “Tell me more about how this embarrasses you.”

5. Which action is most important when planning nutrition management for the adolescent?

1. Planning a low calorie diet

2. Incorporating favorite or fad food into the diet

3. Encouraging a positive attitude toward obesity

4. Skipping a meal to reduce caloric intake

Chapter 21

1. What are the stages of separation anxiety in the toddler?

1. Protest, Despair, and denial

2. Denial, Dependence, and submission

3. Protest, Sadness, and despair

4. Despair, Anxiety, and regression

1. Protest, Despair, and denial

2. Assessment of pain is considered a fifth vital sign o be documented by the nurse. The nurse understands that pain in infants: 

1. Cannot be reliably assessed.

2. Will not be remembered by the infant.

3. Can be assessed by observation and behavior.

4. Is usually caused by fear and anxiety.

3.The best way to minimize separation anxiety in a hospitalized infant is to: 

1. Explain routines carefully.

2. encourage parent to room-in.

3. Provide age-appropriate roommates.

4. Provide an age-appropriate toy. 

4. Which statement by the parent of a hospitalized 4-year-old child indicates an understanding of the child’s needs?

1. “I am going to buy him a box of new toys to keep him busy while in the hospital.”

2. “I am going to bring some of his favorite toys from home for him to play with while in the hospital.”

3. “I’m glad there is a television in the room for him to watch all day.”

4. “I will stay every day until he falls asleep and then I will go home.”

5. A 4-year-old hospitalized child wets his bed. The parents tell the nurse that the child was completely toilet trained.  What should the nurse understand?

1. The parents are denying a problem exists. 

2. The child may be developmentally delayed. 

3. The child may be experiencing regression.

4. The child is probably “punishing” the parents. 

Chapter 22.

1. Which approach is best when administering an oral medication to a young child? 

1. “Would you please take your medicine now, David?”

2.  “Look how good Johnny took his medication. Can you do that too, David?”

3. “You must take your medicine now if you want to get better”

4. “It’s time for your medication, David. Would you like water or juice after it?”

2.The preferred site for an intramuscular injection in infants is: 

1. Dorsogluteal.

2. Ventrogluteal

3. Vastus lateralis.

4. Deltoid

3. The physician orders 10 mg of Demerol for an infant after surgery.  If the label reads 50mg/mL, the nurse would administer:

1. 2.0 mL.

2. 0.8 mL.

3. 0.5 mL.

4. 0.2 mL. 

4. When preparing an enema for a young child, the nurse would select which solution?

1. Tap water

2. Saline

3. Oil retention

4. Fleet’s solution

5. The mother and grandmother of a child are at the bedside, rubbing the skin of the child.  When the nurse enters the room the visitors are startled and drop the item they were using to rub the child’s skin.  The nurse picks up the item and recognizes  it as a penny.  The best response of the nurse is to: 

1. Ask, “what on earth are you doing to that child with this penny?”

2. Give the penny back to the mother and leave the room to give hem their privacy.

3. Tell them they could hurt the child with the penny and there are many germs on coins. 

4. Return the penny to the mother and open a dialogue about the practice they are using. 

4. Return the penny to the mother and open a dialogue about the practice they are using. 

Chapter 23. 

1. Symptoms of an earache in an infant include: 

1. External drainage, pain, and decrease in temperature.

2. Tugging at the ear and rolling head from side to side. 

3. Crying and pointing to affected ear. 

4. Redness of the cheeks and cyanosis of the ear. 

2. A parent asks the nurse to tell her what cerebral palsy is.  The best response of the nurse would be that it is a: 

1. Motor disability caused by a nonprogressive disturbance in brain development.

2. Disorder of the brain that results in mental retardation.

3. Complication of the birth process that causes brain damage. 

4. Brain disorder that involves seizures. 

1. Motor disability caused by a nonprogressive disturbance in brain development.

3. Reye’s syndrome affects the: 

1. Stomach and the intestine.

2. Islet of Langerhans.

3. Liver and the brain.

4. Heart and the blood vessels.

4. A practice that has been helpful in preventing mental retardation is:

1. Administering the Stanford-Binet test.

2. A blood test at birth.

3. Careful preschool developmental screening. 

4. A urine 

5. Which term describes a seizure in which the child cries out, falls to the floor, becomes rigid, and then has a convulsion? 

1. Petit mal

2. Myoclonic

3. Grand mal

4. Atonic

Chapter 24

1. A disorder in which the blood supply to the epiphyses of the bone is disrupted is called: 

1. Muscular dystrophy

2. Cerebral palsy

3. Congenital hip dysplasia 

4. Legg-Calve-Perthes disease

2. A teenager who had a cast applied after a tibia fracture complains that his pain medication is not working and his pain is still a 9 or 10.  The nurse notices some edema of the toes and a capillary refill of 6 seconds.  The priority action of the nurse would be: 

1. Call the health care provider immediately.

2. Check if there is an order for a stronger pain medication

3. Try no pharmacological techniques of pain relief.

4. Explain to the teen that a new fracture is expected to be painful the first day. 

3. Buck’s extension is an example of: 

1. Skin traction.

2. Skeletal traction.

3. Balanced traction.

4. Bryant’s traction. 

4. An abnormal S-shaped curvature of the spine seen in school-age children in: 

1. Sclerosis.

2. Sciatica. 

3. Scabies.

4. Scoliosis. 

5. A yellow bruise is approximately: 

1. 2 days old. 

2. 5 to 7 days old. 

3. 7-10 days old.

4. 10 -14 days old. 

Chapter 25

1. Which is a priority nursing diagnosis in a child admitted with acute asthma?

1. Risk for infection

2. Imbalanced nutrition

3. Ineffective breathing pattern

4. Disturbed body image

2. Which sign or symptom observed in a sleeping 2-year-old child immediately after a tonsillectomy necessitates reporting and follow-up care?

1. A pulse of 110 beats/min

2. A blood pressure of 96/64 mm Hg

3. Nausea

4. Frequent swallowing

3. The nurse in reinforcing teaching concerning the use of a cromolyn sodium inhaler for a 10-year-old with asthma.  Which would be an accurate concept to emphasize?

1. You should use the inhaler whenever you feel some difficulty in breathing.

2. You should use the inhaler between meals.

3. You should use the inhaler regularly every day even if you are symptom free.

4. You can discontinue using the inhaler when you are feeling stronger. 

4. A health care provider is preparing to examine the throat of a child diagnosed with acute epiglottitis.  A priority nursing responsibility would be to: 

1. Have a tracheotomy set at the bedside.

2. Immobilize the child’s head.

3. Restrain the child’s arms.

4. Have oxygen available. 

5. An infant is admitted with a diagnosis of respiratory syncytial virus (RSV) infection.  The type of transmission-based isolation precaution the nurse would set up would be: 

1. Standard precautions.

2. Droplet precautions. 

3. Contact precautions. 

4. Airborne infection isolation precautions. 

3. Contact precautions. 

Chapter 26

1. When administering digoxin (Lanoxin) to an infant, the medication should be withheld and the physician notified if the: 

1. Pulse rate is below 60 beats/min.

2. Infant is dyspeic. 

3. Pulse rate is below 100 beats/min. 

4. Respiratory rate is above 40 breaths/min. 

2. An infant with tetra logy of Fallot is experiencing a tet attack involving cyanosis and dyspnea.  Which position should the infant be placed in?

1. Fowler’s 

2. Knee-chest

3. Trendelenburg’s 

4. Prone 

3. Prevention of rheumatic fever can best be accomplished by: 

1. Keeping children with fever home. 

2. Sending children with sore throats home from school. 

3. Having sore throats cultured as soon as possible. 

4. Treating all colds with antibiotics

4. The nurse is assessing a child admitted with possible Kawasaki’s disease.  A characteristic sign or symptom that the nurse should observe and document would be: 

1. Cardiac dysrhythmia.

2. Decreased urine output. 

3. Peeling skin on fingers. 

4.decreased level of consciousness. 

5. A child who has had heart surgery returns to the pediatric unit with a chest tube and drainage bottles in place.  What is a priority nursing responsibility when caring for a child with chest tubes?

1. Empty the chest tube drainage bottles each shift.

2. Clamp the chest tubes when turning the patient. 

3. Place the drainage bottles on the bed when moving the bed. 

4. Keep the drainage bottles below the chest level at all times. 

Chapter 27

When the patient experiences apprehension and urticaria while receiving a blood transfusion, the nurse:

1. Slows the transfusion and take s the patient’s vital signs. 

2. Observes the child for further transfusion reactions. 

3. Stops the transfusion, allows normal saline solution to run slowly, and notifies the charge nurse. 

4. Stops what he or she is doing and obtains the patient’s history. 

2. A child who is in a vasoocclusive crisis caused by a sickle cell anemia is experiencing acute pain.  The nurse understands that Demerol (meperidine) is not an appropriate pain medication to administer to this child because it: 

1. Is very addictive. 

2. Is not strong enough. 

3. May induce seizures. 

4. Cannot be given by mouth. 

3.  Which principle should the nurse teach the parent concerning administering liquid iron preparations to the child with iron-deficiency anemia?

1. Allow the preparation to mix with saliva and bathe the teeth before swallowing. 

2. Warm the medication before administering. 

3. Administer between meals.

4. Administer in the bottle of formula. 

4. Thalassemia major (Cooley’s anemia) is treated primarily with: 

1. A diet high in iron.

2. Multiple blood transfusions. 

3. Bed rest until the sedimentation rate is normal. 

4. Oxygen therapy. 

5. What is a characteristic manifestation of Hodgkin’s disease? 

1. Petechiae

2. Erythematous rash

3. Enlarged lymph nodes

4. Pallor

Chapter 28. 

1. The pathologic disturbance of pyloric stenosis results from: 

1. Edema of the pyloric muscle. 

2. Ischemia of the pyloric muscle. 

3. Hypertrophy of the pyloric muscle. 

4. Neoplastic obstruction

2. Which menu selections are best for a child diagnosed with celiac disease? 

1. Pizza and chocolate cake

2. Spaghetti and blueberry muffin

3. Chicken sandwich on whole-wheat bread

4.  Corn tortilla and fresh fruit

3. After surgery for pyloric stenosis, the nurse could anticipate what the infant will:

1. Have nasogastric suction for 24 hours. 

2. Be fed clear liquids within 6 hours. 

3. Remain NPO for 24 to 48 hours. 

4. Be fed formula within 4 hours. 

4. How are pinworms diagnosed?

1.  Seeing the worm in the stool. 

2. A blood antigen level

3. A “scotch tape test” in the early morning

4. A stool laboratory examination obtained at the hour of sleep

5. Priority teaching for a parent of a child who ingested a foreign body includes: 

1. Encouraging the use of mild laxatives every night. 

2. Slicing each stool passed to observe the foreign body. 

3. Encouraging a daily enema until the foreign body is passed

4. Keeping the child NPO until the foreign body is passed. 

Chapter 29. 

1. The nurse understand that genitourinary surgery affects growth and development.  When caring for a 4-year-old postoperatively, a priority nursing responsibility would include: 

1. Strategies to preserve the child’s body image.

2. Assurances that appearance and sexual function will not be affected. 

3. Providing age appropriate toys such as tricycles. 

4. Preventing embarrassment by limiting visitation of family and friends. 

2. The administration of prednisone to children with nephritis creates the problem of : 

1. Intolerance of foods. 

2. Increased risk of infection. 

3. Increased periorbital edema.

4.  Weight loss. 

3.  Daily weights are obtained in children with nephritis to monitor: 

1. Weight loss from a low-protein diet. 

2. Accuracy of fluid balance sheets. 

3. Changes in the amount of edema. 

4. Percentile on the growth grid. 

4. A priority nursing responsibility in the care of a child with Wilm’s tumor is to: 

1. Maintain accurate intake and output records. 

2. Omit abdominal palpation during daily assessments. 

3. Maintain strict bed rest. 

4. Assess neurological function. 

5. The nurse is caring for a child diagnosed with nephrosis.  Symptoms that are characteristic of nephrosis include (select all that apply): 

1. Massive proteinuria

2. edema

3. A positive antistreptolysin titer 

4. Bacteriuria 

1. Massive proteinuria

2. edema

Chapter 30

1. Why is pain relief important in the burn patient? 

1. It prevents discomfort. 

2. The child must be kept from crying. 

3. Parents become upset. 

4. Pain contributes to shock. 

2. What would be contraindicated in a patient with infantile eczema?

1.  Wrapping the infant in a wool blanket

2. Covering hands with cotton mittens

3. Using elbow restraints to prevent scratching

4. Using open, wet dressings

3.  What is a characteristic sign of third-degree burns? 

1. Absence of pain

2. Blisters and warmth

3. Redness

4. Severe pain

4. What is contained in an emollient bath often prescribed for children with eczema? 

1. Bath oil

2. Glycerin soap

3. Oatmeal

4. Salt or saline solution

5. The cause of infantile eczema may be the basis of a teaching plan for the child’s parent. Infantile eczema is most  likely caused by: 

1. An infection with Staphylococcus aureus. 

2. A parasitic skin disease. 

3. Poor hygiene. 

4. An allergic response.