Peds Exam 1 NCLEX style questions

Peds Exam 1 NCLEX style questions To establish a good interview relationship with an adolescent, which strategy is most appropriate? 1. Asking personal questions unrelated to the situation 2. Writing down everything the teen says 3. Asking open-ended questions 4. Discussing the nurse's own thoughts and feelings about the situation - ANSWER3. Asking open-ended questions RATIONALE: Open-ended questions allow the adolescent to share information and feelings. Asking personal questions not related to the situation jeopardizes the trust that must be established because the adolescent may feel as though he's being interrogated with unnecessary questions. Writing everything down during the interview can be a distraction and doesn't allow the nurse to observe how the adolescent behaves. Discussing the nurse's thoughts and feelings may bias the assessment and is inappropriate when interviewing any client A chronically ill school-age child is most vulnerable to which stressor? 1. Mutilation anxiety 2. Anticipatory grief 3. Anxiety over school absences 4. Fear of hospital procedures - ANSWER3. Anxiety over school absences RATIONALE: The school-age child is becoming industrious and attempts to master school-related activities. Therefore, school absences are likely to cause extreme anxiety for a school-age child who's chronically ill. Mutilation anxiety is more common in adolescents. Anticipatory grief is rare in a school-age child. Fear of hospital procedures is most pronounced in preschool-age children. When developing a care plan for an adolescent, the nurse considers the child's psychosocial needs. During adolescence, psychosocial development focuses on: 1. becoming industrious. 2. establishing an identity. 3. achieving intimacy. 4. developing initiative. - ANSWER2. establishing an identity. RATIONALE: According to Erikson, the primary psychosocial task during adolescence is to establish a personal identity while overcoming role or identity confusion. The adolescent attempts to establish a group identity by seeking acceptance and approval from peers, and strives to attain a personal identity by becoming more independent from his family. Becoming industrious is the developmental task of the school-age child; achieving intimacy is the task of the young adult; and developing initiative is the task of the preschooler. A nurse notes that an infant develops arm movement before fine-motor finger skills and interprets this as an example of which pattern of development? 1. Cephalocaudal 2. Proximodistal 3. Differentiation 4. Mass-to-specific - ANSWER2. Proximodistal RATIONALE: Proximodistal development progresses from the center of the body to the extremities, such as from the arm to the fingers. Cephalocaudal development occurs along the body's long axis; for example, the infant develops control over the head, mouth, and eye movements before the upper body, torso, and legs. Mass-to-specific development, sometimes called differentiation, occurs as the child masters’ simple operations before complex functions and moves from broad, general patterns of behavior to more refined ones. A teenage mother brings her 1-year-old child to the pediatrician's office for a well-baby checkup. She says that her infant can't sit alone or roll over. An appropriate response by the nurse would be: 1. "This is very abnormal. Your child must be sick." 2. "Let's see about further developmental testing." 3. "Don't worry, this is normal for her age." 4. "Maybe you just haven't seen her do it." - ANSWER. "Let's see about further developmental testing." RATIONALE: Stating that further developmental testing is necessary is appropriate because at age 12 months a child should be sitting up and rolling over. Therefore, this child may have developmental problems. Saying the infant's behavior is abnormal or suggesting that the mother hasn't seen her infant do these milestones isn't therapeutic and can cut off communication with the mother. Telling the mother that the infant's behavior is normal misleads the mother with false reassurance. The mother of an 11-month-old infant reports to the nurse that her infant sleeps much less than other children. The mother asks the nurse whether her infant is getting sufficient sleep. What should be the nurse's initial response? 1. Reassure the mother that each infant's sleep needs are individual. 2. Ask the mother for more information about the infant's sleep patterns. 3. Instruct the mother to decrease the infant's daytime sleep to increase his nighttime sleep. 4. Inform the mother that her infant's growth and development are appropriate for his age, so sleep isn't a concern. - ANSWER2. Ask the mother for more information about the infant's sleep patterns. RATIONALE: The nurse needs more information about the infant's sleep patterns to rule out potential problems before determining whether the infant is getting enough sleep. The nurse shouldn't offer advice or reassurance without knowing more about the infant's specific sleep habits. A nurse observes a 2½-year-old child playing with another child of the same age in the playroom on the pediatric unit. What type of play should the nurse expect the children to engage in? 1. Associative play 2. Parallel play 3. Cooperative play 4. Therapeutic play - ANSWER2. Parallel play RATIONALE: Two-year-olds engage in parallel play, in which they play side by side but rarely interact. Associative play is characteristic of preschoolers, in which they are all engaged in a similar activity but there is little organization. School-age children engage in cooperative play, which is organized and goal-directed. Therapeutic play is a technique that can be used to help understand a child's feelings; it consists of energy release, dramatic play, and creative play. An infant who weighs 7.5 kg is to receive ampicillin (Omnipen) 25 mg/kg I.V. every 6 hours. How many milligrams should the nurse administer per dose? Record your answer using one decimal place. Answer: milligrams - ANSWER187.5 milligrams RATIONALE: The nurse should calculate the correct dose using the following equation: 25 mg/kg × 7.5 kg = 187.5 mg When making ethical decisions about caring for preschoolers, a nurse should remember to: 1. provide beneficial care and avoid harming the child. 2. make decisions that will prevent legal trouble. 3. do what she would do for her own child or loved ones. 4. be sure to do what the physician says. - ANSWER1. provide beneficial care and avoid harming the child. RATIONALE: Nurses must provide beneficial care and avoid harming all clients. A nurse shouldn't base any decision solely on the desire to prevent legal trouble, on her own feelings for her loved ones, or what the physician says. An emergency department nurse suspects neglect in a 3-year-old boy admitted for failure to thrive. Signs of neglect in the child would include: 1. slapping, kicking, and punching others. 2. poor hygiene and weight loss. 3. loud crying and screaming. 4. pulling hair and hitting - ANSWER2. poor hygiene and weight loss. RATIONALE: Signs of neglect include poor hygiene and weight loss because neglect can involve failure to provide food, bed, shelter, health care, or hygiene. Slapping, kicking, pulling hair, hitting, and punching are examples of forms of physical abuse, not neglect. Loud crying and screaming are normal findings in a 3-year-old boy. When developing a care plan for a child, the nurse identifies which Eriksonian stage as corresponding to Freud's oral stage of psychosexual development? 1. Initiative versus guilt 2. Autonomy versus shame and doubt 3. Trust versus mistrust 4. Industry versus inferiority - ANSWER3. Trust versus mistrust RATIONALE: Freud defined the first 2 years of life as the oral stage and suggested that the mouth is the primary source of satisfaction for the developing child. Erikson posited that infancy (from birth to age 12 months) is the stage of trust versus mistrust, during which the infant learns to deal with the environment through the emergence of trustfulness or mistrust. Initiative versus guilt corresponds to Freud's phallic stage. Autonomy versus shame and doubt corresponds to Freud's anal/sensory stage. Industry versus inferiority corresponds to Freud's latency period An infant, age 10 months, is brought to the well-baby clinic for a follow-up visit. The mother tells the nurse that she has been having trouble feeding her infant solid foods. To help correct this problem, the nurse should: 1. point out that tongue thrusting is the infant's way of rejecting food. 2. instruct the mother to place the food at the back and toward the side of the infant's mouth. 3. advise the mother to puree foods if the child resists them in solid form. 4. suggest that the mother force-feed the ch