Term
The nurse is preparing the immunizations for a 6-month-old baby. The mother says, “My baby is afraid of strangers, including my mother-in-law, and afraid of separating from me. My mother-in-law is upset and thinks I am causing it.” Which response by the nurse is most appropriate?
a. “Give your baby to strangers while you are present so your baby gets used to them.”
b. “Your mother-in-law is correct; you need to include her more in your baby’s needs.”
c. “Separation anxiety is normal due to development and parent-infant attachment.”
d. “Let your baby cry for a while; your baby will get used to being separated from you.” |
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Definition
| c. “Separation anxiety is normal due to development and parent-infant attachment.” |
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Term
The nurse is caring for the 10-month-old. Which nursing action is most appropriate for providing tactile stimulation for this child?
a. . Caress the child while diaper changing.
b. Give the child a soft squeeze toy.
c. Swaddle the child at nap time.
d. Let the child squash food while sitting in a high chair. |
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Definition
| d. Let the child squash food while sitting in a high chair. |
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Term
The nurse completed discharge education to the Native American parents of a 48-hour-old, full-term infant. The nurse concludes that the mother needs additional teaching about jaundice when she makes which statement?
a. “I know keeping my baby warm will help to decrease jaundice.”
b. “I know the jaundice should start to decrease after about 3 days.”
c. “The bilirubin causing the jaundice is eliminated in my baby’s stools.” d. “Feeding my baby frequently will help to decrease the jaundice.” |
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Definition
| b. “I know the jaundice should start to decrease after about 3 days.” |
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Term
The client with mastitis asks the nurse if she should stop breastfeeding because she has developed a breast infection. Which response by the nurse is best?
a. “Continuing to breastfeed will decrease the duration of your symptoms.”
b. “Breastfeeding should only be continued if your symptoms decrease.”
c. “Stop feeding for 24 hours until antibiotic therapy begins to take effect.”
d. “It is best to stop breastfeeding because the infant may become infected.” |
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Definition
| a. Continuing to breastfeed is recommended when the client has mastitis. If the breasts continue to be emptied by either breastfeeding or pumping, the duration of symptoms and the incidence of a breast abscess are decreased. |
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Term
The nurse is caring for the client who just gave birth. Which observation of the client should lead the nurse to be concerned about the client’s attachment to her male infant?
a. Asking the caregiver about how to change his diaper
b. Comparing her newborn’s nose to her brother’s nose
c. Calling the baby “Kelly,” which was the name selected
d. Repeatedly telling her husband that she wanted a girl |
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Definition
| d. Attachment is demonstrated by expressing satisfaction with a baby’s appearance and sex. Frequent expressions of dissatisfaction with the sex of the infant should be concerning and followed up. |
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Term
The home care nurse is visiting the mother and her 6-day-old son. The nurse observes that the infant is sleeping in a crib on his back and has a blanket draped over his body. The mother had been sleeping in a nearby room. Which statements are appropriate for the nurse to make in response to this situation?
a. “Having your baby sleep on his back will prevent SIDS.”
b. “It is best for you to sleep in the same room as your newborn.”
c. “Position your baby on his tummy and side when he is awake.”
d. “When using a blanket, always tuck its sides under the mattress.” |
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Definition
| c. This is an appropriate statement. While awake the infant should be positioned prone and side-lying to help build neck muscles and decrease the chance of deformation plagiocephaly. Deformation plagiocephaly is a malformation of the skull caused by consistently lying on the back. |
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Term
The nurse is calculating the pregnant client’s obstetrical history. The client reports having one miscarriage at 10 weeks and one child born at 39 weeks. What number should the nurse document on the client’s medical record for gravida?
a. 2
b. 3
c. 1
d. 4 |
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Definition
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Term
During which cycle day of a typical 28 day menstrual cycle does the follicular phase occur?
a. Cycle days 7-14
b. Cycle days 14-28
c. Cycle days 1-6
d. Cycle days 1-13 |
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Definition
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Term
The postpartum client, who is 24 hours post–vaginal birth and breastfeeding, asks the nurse when she can begin exercising to regain her prepregnancy body shape. Which response by the nurse is correct?
a. “Simple abdominal and pelvic exercises can begin right now.”
b. “You will need to wait until after your 6-week postpartum checkup.” c. “Once your lochia has stopped, you can begin exercising.”
d. “You should not exercise while you are breastfeeding.” |
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Definition
| a. On the first postpartum day, the client should be taught to start abdominal breathing and pelvic rocking. Kegel exercises, which should have been taught during pregnancy, should be continued. Simple exercises should be added daily until, by 2 to 3 weeks postpartum, the mother should be able to do sit-ups and leg raises. |
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Term
The postpartum client delivered a healthy newborn 36 hours previously. The nurse finds the client crying and asks what is wrong. The client replies, “Nothing, really. I’m not in pain or anything, but I just seem to cry a lot for no reason.” What should be the nurse’s first intervention?
a. Call the client’s support person to come and sit with her.
b. Remind her that she has a healthy baby and that she shouldn’t be crying.
c. Contact the HCP to have the counselor come see the client.
d. Ask the client to discuss her birth experience. |
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Definition
| d. A key feature of postpartum blues is episodic tearfulness without an identifiable reason. Interventions for postpartum blues include allowing the client to relive her birth experience. |
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Term
The nurse is preparing the parents of a full-term, 24-hour-old male newborn for discharge with their infant. Which are the expected discharge criteria that should be met before the infant leaves the hospital?
a. The infant has passed at least three meconium stools.
b. The infant has gained weight at the minimum 100 grams.
c. The infant has had six diaper changes in the last 24 hours.
d. The infant has completed 2 successful consecutive feedings. |
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Definition
| d. Completing two successful consecutive feedings is included in the discharge criteria. Successful feeding includes verification that the infant is able to coordinate sucking, swallowing, and breathing while feeding. |
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Term
What is not a complication of gestational hypertension?
a. macrosomia
b. Intrauterine fetal death
c. Placental insufficiency
d. HELLP syndrome |
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Definition
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Term
Which postpartum breast feeding nipple require the least amount of assistance?
a. Inverted Nipples
b. Flat Nipples
c. Averted Nipples
d. Everted Nipples |
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Definition
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Term
To prevent infant thrush, the appropriate teaching should include?
a. Clean thoroughly with a mild soap and rinse
b. Wipe with a moist Baby wipe
c. Clean thoroughly with warm water
d. Apply lanolin oil to the nipple |
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Definition
| c. Clean thoroughly with warm water |
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Term
A woman is trying to calm her fussy baby daughter in preparation for feeding. She exhibits a need for further instruction if she does which of the following?
a. Swaddles the baby
b. Dims lights in the room and turns off the television
c. Gently rocks the baby and talks to her in a low voice
d. Attempts to get the baby to latch on immediately |
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Definition
| d. mother should be encouraged to let her newborn begin to suck on her clean finger until the baby begins to calm down then switch to the breast; a, b, and c are all appropriate actions to calm a fussy baby. |
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Term
What best describes erythema?
a. Small distinct pinpoint hemorrhages of blood into skin
b. Large, diffuse bluish to black areas caused by hemorrhages
c. Bluish tone through skin
d. Redness possibly caused by increased blood flow |
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Definition
| d. Redness possibly caused by increased blood flow |
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Term
What condition might result is strabismus is not detected by age 4 to 6?
a. Permanent eye deviation
b. Blurred vision
c. Blindness
d. Anisometropia |
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Definition
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Term
What is the leading cause of vision loss amongst children?
a. Cataracts
b. Ambylopia
c. Pediatric Glaucoma
d. Myopia |
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Definition
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Term
What is the most common inherited cause of CI?
a. Attention Deficit Disorder
b. Missense mutation
c. Downs Syndrome
d. Fragile X Syndrome |
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Definition
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Term
If the toddler is diagnose as having trainable cognitive impairment, what kind of skills would be taught?
a. simple language skills with elementary health and safety habits.
b. language and arithmetic skills with practical skills
c. understanding of language with habit skill training
d. primitive speech with ambulation skills |
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Definition
| a. simple language skills with elementary health and safety habits. |
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Term
A mother is concerned about achieving a nutritious intake for her 14-month-old child. Which advice by the nurse would be best?
a. Feed the child before the rest of the family and then let the child play while the family eats.
b. Because the child’s stomach holds only 1 ⁄2 cup, select food from one food group for each meal.
c. Offer 11 ⁄2 tablespoons of food from each food group with every meal; offer nutritious snacks.
d. Avoid retrying foods that the child pushes away because these are foods the child dislikes. |
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Definition
| c. The 14-month-old child’s serving size should be about a tablespoonful for each year of age. Offering a variety of foods from the food groups will help ensure a nutritious diet and avoid consuming too much or too little food from any one food group. Offering three meals and three nutritious snacks a day increases the likelihood that the toddler will obtain sufficient nourishment. |
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Term
The nurse is caring for the 30-weeks-pregnant client who is having contractions every 11 /2 to 2 minutes with spontaneous rupture of membranes 2 hours ago. Her cervix is 8 cm dilated and 100% effaced. The nurse determines that delivery is imminent. What intervention is the most important at this time?
a. Administering a tocolytic agent
b. Providing teaching information on premature infant care
c. Notifying neonatology of the impending birth
d. Preparing for a cesarean section birth |
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Definition
| c. The most important intervention is to notify the neonatal team of the delivery because the team members will be needed for respiratory support and possible resuscitation. |
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Term
Why is avoiding seizure so important when treating a prenatal patient with preeclampsia?
a. risk of the mother choking from swallowing her tongue
b. seizures may result in permanent brain damage
c. seizure of abdominal muscles may result in cord constriction
d. the mother may harm herself during seizure activity |
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Definition
| c. seizure of abdominal muscles may result in cord constriction |
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Term
Which needle is used to access tunneled implanted central line?
a. Jelco
b. Butterfly
c. Huber
d. Portex |
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Definition
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Term
2 year old toddler presents to the emergency room with a positive diagnosis of mumps. Based on the CDC regulations, what type of precaution should be initiated?
a. Airborne Precautions
b. Droplet Precautions
c. Contact Precautions
d. Standard Precautions |
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Definition
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Term
A breast-feeding client is seen at home by the visiting nurse 10 days after a vaginal birth. The client has a warm, red, painful breast, a temperature of 100 ° F (37.7 ° C), and flu-like symptoms. What should the nurse do?
a. Encourage the client to breast-feed her infant using the unaffected breast.
b. Refer the woman to her healthcare provider (HCP).
c. Inform the client that she needs to discontinue breast-feeding.
d. Instruct the woman to apply warm compresses to the affected breast. |
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Definition
| b. The client is exhibiting signs and symptoms of a breast infection (mastitis). The nurse should instruct her to contact her HCP , who will likely prescribe a prescription for antibiotics. She should continue to breast-feed the infant from both breasts. Frequent breast-feeding is encouraged rather than discontinuing the process for anyone having a breast infection. Applying warm compresses may relieve pain. However, the underlying infection indicated by the elevated temperature indicates that additional treatment with antibiotics will be needed. |
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Term
What are the five factors or “P’s” affecting the process of labor and birth.
a. Passenger, passageway, powers, position, psychologic responses
b. Person, placenta, passenger, powers, position
c. Passenger, placenta, powers, position, psychologic responses
d. Position, pattern, powers, passenger, psychologic responses |
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Definition
| a. Passenger, passageway, powers, position, psychologic responses |
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Term
The age at which most infants can roll from back to abdomen is:
a. 1 to 3 months.
b. 4 to 6 months.
c. 7 to 9 months.
d. 10 to 12 months. |
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Definition
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Term
When placing a nasal gastric tube, how does one confirm initial placement?
a. Auscultation of the abdomen
b. Gastric ph is 5.5 or higher
c. Measurement
d. KUB Xray |
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Definition
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Term
Which long term central venous access is preferable for school child?
a. RIJ triple lumen central line
b. Tunneled Hickman
c. Groshong Dual Lumen Catheter
d. Implanted Port |
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Definition
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Term
What is the advantage of a PICC?
a. Difficult to discontinued by the patient
b. May be used for liquid medications
c. Not seen by the patient
d. May be inserted at bedside without general anesthesia |
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Definition
| d. May be inserted at bedside without general anesthesia |
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Term
What is a disadvantage of a Port-A-Cath?
a. Visible to the child’s peers
b. Higher infection rate than other venous access devices
c. Some pain to access through the skin
d. Easy to be dislodged |
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Definition
| c. Some pain to access through the skin |
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Term
6 month old infant with facial fractures is NPO. A small bore nasal gastric tube is inserted and placement is confirmed. What teaching is most important for the at home care givers to understand?
a. continuous feeding is preferred over bolus feeding
b. check frequently for skin breakdown around the nares
c. check the depth by confirming the centimeter mark at the nare
d. warm the feeding for gastric comfort |
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Definition
| c. check the depth by confirming the centimeter mark at the nare to assure proper placement to prevent aspiration. |
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Term
A 31-year-old pregnant patient and her husband arrive at the healthcare clinic for a prenatal visit. The nurse notes several areas of bruising on the patient’s legs and buttocks during the exam. Which response from the nurse is most appropriate in this situation?
a. Ask the patient if her husband is hurting her while she examines the bruises
b. Ask the patient’s husband to step out for a portion of the exam and then talk to the patient
c. Tell the patient that she has bruises and ask her if she knows where they came from
d. Tell the patient that the physician will need to assess the bruises further |
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Definition
| b. Ask the patient’s husband to step out for a portion of the exam and then talk to the patient |
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Term
If a mother is concerned about the fact that her 14-month-old infant is not walking, the nurse would particularly want to evaluate whether the infant
a. pulls up to the furniture.
b. uses a pincer grasp.
c. transfers objects.
d. has developed object permanence. |
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Definition
| a. pulls up to the furniture. |
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Term
While the nurse is caring for a primiparous client with cephalopelvic disproportion 4 hours after a cesarean birth, the client requests assistance in breast-feeding. To promote maximum maternal comfort, which position would be most appropriate for the nurse to suggest?
a. lateral or football hold
b. scissors hold
c. cross-cradle hold
d. cradle hold |
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Definition
| a. lateral or football hold |
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Term
A nurse observes several interactions between a mother and her neonate. Which maternal behaviors should the nurse identify as evidence of mother-infant attachment?
a. Talks and cuddles her son close to her
b. Doesn’t make eye contact with her son
c. Requests that the nurse take the baby to the nursery for feedings
d. Encourages the father to hold the baby |
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Definition
| a. Talks and cuddles her son close to her |
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Term
When assessing a 2-year-old child at the clinic for a routine checkup, which skill should the nurse expect the child to be able to perform?
a. ride a tricycle
b. tie his or her shoelaces
c. kick a ball forward
d. use blunt scissors |
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Definition
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Term
A 2-year-old child brought to the clinic by her parents is uncooperative when the nurse tries to look in her ears. What should the nurse try first?
a. Ask another nurse to assist.
b. Allow a parent to assist.
c. Wait until the child calms down.
d. Restrain the child’s arms. |
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Definition
| b. Allow a parent to assist. |
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Term
A nurse is assessing the growth and development of a 10-year-old. What is the expected behavior of this child?
a. enjoys physical demonstrations of affection
b. is selfish and insensitive to the welfare of others
c. is uncooperative in play and school
d. has a strong sense of justice and fair play |
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Definition
| d. has a strong sense of justice and fair play |
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Term
The parent tells the nurse that an 8-year-old child is continually telling jokes and riddles to the point of driving the other family members crazy. The nurse should explain this behavior is a sign of:
a. inadequate parental attention.
b. mastery of language ambiguities.
c. inappropriate peer influence.
d. excessive television watching. |
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Definition
| b. School-age children delight in riddles and jokes. Mastery of the ambiguities of language and of |
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Term
A nurse compares a child’s height and weight with standard growth charts and finds the child to be in the 50th percentile for height and in the 25th percentile for weight. The nurse interprets these findings as indicating that the child is:
a. typical height and weight.
b. overweight for height.
c. underweight for height.
d. abnormal in height. |
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Definition
| a. The values of height and weight percentiles are usually similar for an individual child. Measurements between the 5th and 95th percentiles are considered normal. Marked discrepancies identify overweight or underweight children. |
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Term
A parent brings a 4-month-old to the clinic for a regular well visit and expresses concern that the infant is not developing appropriately. Which finding in the infant would indicate the need for further developmental screening?
a. has no interest in peekaboo games
b. does not turn front to back
c. does not babble
d. sits unsupported |
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Definition
| c. By the end of 3 months, infants should babble. Lack of babbling suggests a language delay and warrants further investigation. Infants typically would begin playing peekaboo around 7 months. The ability to roll front to back typically occurs at 5 months. Sitting unsupported is expected at 6 months. |
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Term
An uncle is shopping for a toy to give his niece. He has no children of his own and asks his neighbor, a nurse, what would be the most appropriate toy to give a 15-month-old child. Which toy should the nurse recommend to facilitate learning and development?
a. a stuffed animal
b. a music box
c. a push-pull toy
d. a nursery mobile |
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Definition
| c. A push-pull toy will aid in development of gross motor skills and muscle development. A stuffed animal is age appropriate for a toddler but is not the toy to promote development. A music box and nursery mobile are most appropriate to stimulate development for an infant. |
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Term
Parents of a 15-year-old state that their child is moody and rude. The nurse should advise the parents to:
a. restrict their child’s activities.
b. discuss their feelings with their child.
c. obtain family counseling.
d. talk to other parents of adolescents. |
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Definition
| b. discuss their feelings with their child. |
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Term
A toddler who has been treated for a foreign body aspiration begins to fuss and cry when the parents attempt to leave the hospital for an hour. As the nurse tries to take the child out of the crib, the child pushes the nurse away. The nurse interprets this behavior as indicating which stage of separation anxiety?
a. protest
b. despair
c. regression
d. detachment |
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Definition
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Term
When preparing the teaching plan for the mother of a child with asthma, what information should the nurse include as a sign to alert the mother that her child is having an asthma attack?
a. secretion of thin, copious mucus
b. tight, productive cough
c. wheezing on expiration
d. temperature of 99.4 ° F (37.4 ° C) |
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Definition
| c. wheezing on expiration |
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Term
The nurse is providing medication instructions to a parent. Which statement by the parent indicates a need for further instruction?
a. “I should cuddle my child after giving the medication.”
b.“I can give my child a frozen juice bar after he swallows the medication.”
c. “I should mix the medication in the baby food and give it when I feed my child.”
d. “If my child does not like the taste of the medicine, I should encourage him to pinch his nose and drink the medication through a straw.” |
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Definition
| c. “I should mix the medication in the baby food and give it when I feed my child.” |
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