NR 328Exam#1QuestionswithCompleteSolutions.
Which topics should the nurse discuss with the parents of a young child to promote health
in their child?
a. Dental care needs to be started by age 7.
b. Immunization schedule and the importance of immunizations.
c. Human milk or iron fortified formu...
Which topics should the nurse discuss with the parents of a young child to promote health
in their child?
a. Dental care needs to be started by age 7.
b. Immunization schedule and the importance of immunizations.
c. Human milk or iron fortified formula for the first 4 months of life.
d. Positioning the car seat in the front passenger seat. - Correct Answer Answer: B
Rationale: Immunizations have made a major impact in the prevention of disease in
children. The nurse should review individual immunization records at every clinic visit,
avoid missing opportunities to vaccinate, and encourage parents to keep immunizations
current. Dental caries is the single most common chronic disease of childhood and may
begin before the first birthday. Human milk or iron fortified formula for should be given for
the first year of life to prevent Iron Deficiency anemia. Children younger than 1 year of age
have the highest rate of death from motor vehicle accidents, primarily from a failure to
properly use car restraints.
What is the leading cause of death in children older than the age of 1 year?
a. Drowning
b. Burns
c. Motor vehicle accidents
d. Cancer - Correct Answer Answer(s): C
Rationale: a. Drowning is the second leading cause of death in children older than the age
of 1 year. b. Burns cause fewer deaths than motor vehicle accidents in children older than
the age of 1 year. c. Motor vehicle accidents are the leading cause of death in children
older than the age of 1 year. d. Cancer causes fewer deaths than motor vehicle accidents
in children older than the age of 1 year.
The nurse makes sure that a toddler has a teddy bear and that a nightlight is on in the
hospital room at bedtime. What concept would these nursing actions demonstrate?
a. Atraumatic care
b. Nonmaleficence
c. Justice
d. Advocacy - Correct Answer Answer(s): A
,Rationale: A. Atraumatic care is the provision of therapeutic care in settings, by personnel,
and through the use of interventions that eliminate or minimize the psychological and
physical distress experienced by children and their families in the health care system. In
this case, it is making sure that the toddler has a teddy bear and that a night light is on to
prevent a dark environment. B. Nonmaleficence is the obligation to minimize or prevent
harm; there is no situation present that would require this. C. Justice is the concept of
fairness and is not applicable to this situation. D. Advocacy involves ensuring that families
are aware of all available health services, adequately informed of treatments and
procedures, involved in the child's care, and encouraged to change or support existing
health care practices.
True or False: Open ended questions are most likely to encourage parents to talk about
their feelings r/t their child's illness. - Correct Answer True
When the nurse interviews an adolescent, what is important to help establish a
relationship?
a. Use the same type of language as the adolescent.
b. Emphasize that confidentiality will always be maintained.
c. Focus the discussion on the peer group.
d. Display a genuine interest in the adolescent. - Correct Answer Answer: D.
Rationale: Display a genuine interest in the adolescent.Adolescents accept anyone who
shows a genuine interest in them. Although peers are important to this age-group, the
focus of the interview should be on the adolescent. The nurse should clarify which
information will be shared with other members of the health care team and any limits to
confidentiality. The nurse should maintain a professional relationship with adolescents. To
avoid misinterpretation of words and phrases that the adolescent may use, the nurse
should clarify terms frequently.
What approach is the most appropriate when performing a physical assessment on a
toddler?
a. Demonstrate use of equipment.
b. Perform traumatic procedures first.
c. Use minimum physical contact initially.
d. Always proceed in a head-to-toe direction. - Correct Answer Answer: C.
Rationale: Parents can remove clothing, and the child can remain on the parent's lap. The
nurse should use minimum physical contact initially to gain the cooperation of the child.
,The nurse should introduce the equipment slowly. The child can inspect the equipment,
but demonstrations are usually too complex for this age-group. Traumatic procedures
should always be performed last. These will most likely upset the child and inhibit
cooperation. The head-to-toe assessment can be done in older children but usually must
be adapted in younger children.
What is the most consistent and commonly used indicator of pain in infants?
a. Thrashing of arms and legs.
b. Increased heart rate.
c. Increased respirations.
d. Facial expression of discomfort. - Correct Answer Answer: D.
Rationale: Facial expression of discomfort. Facial expression has consistently been
validated as an indicator of pain in infants. Behavioral pain measures are most reliable for
sharp procedural pain in infants. Increased heart rate and respirations are indicative of a
generalized and complex response to stress. They are not specific for pain in infants.
Thrashing of arms and legs is a reliable indicator in young children, not infants.
True or False: At age 1 month is the normal age for binocularity-ability to fixate on one
visual field with both eyes simultaneously. - Correct Answer Answer: False.
Rationale: Binocularity is usually achieved by age 3 to 4 months. One month is too young
for binocularity. If binocularity is not achieved by 6 to 12 months, the child must be
observed for strabismus.
What self-report pain rating scales can be used in children as young as 3 years of age?
a. FACES Pain Rating Scale
b. Visual Analog Scale
c. Word-Graphic Rating Scale
d. Who Cares? - Correct Answer Answer: A.
Rationale: The FACES Pain Rating Scale is for children as young as 3 years of age. The
Visual Analog Scale can be used for children older than 4 years of age but is most
appropriate for ages 7 and older. The Word-Graphic Rating Scale uses descriptive words
and is recommended for children 4 to 17 years of age.
An intravenous line is needed in a school-age child. What medication is appropriate
analgesic for use with this patient?
, a. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.
b. EMLA (eutectic mixture of local anesthetics) immediately before.
c. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
d. TAC (tetracaine, epinephrine [Adrenalin], cocaine) 15 minutes before. - Correct Answer
Answer: A.
Rationale: LMX is an effective analgesic agent when applied to the skin 30 minutes before
a procedure. It eliminates or reduces the pain from most procedures involving skin
puncture. TAC provides skin anesthesia about 15 minutes after application to nonintact
skin. The gel can be placed on the wound for suturing. It is not useful for intact skin.
Transdermal fentanyl patches are useful for continuous pain control, not rapid pain
control. For maximum effectiveness, EMLA must be applied approximately 60 minutes in
advance. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
At what age does Erickson consider the infancy stage? - Correct Answer 0 - 18 months
What is the basic conflict and important events of Erickson's infancy stage? - Correct
Answer Trust vs. Mistrust
Feeding/Comfort
At what age does Erickson consider the Early Childhood stage? - Correct Answer 2 - 3
years
What is the basic comfort and important events of Erickson's early childhood stage? -
Correct Answer Autonomy vs. Shame and Doubt
Toilet training/Dressing
At what age does Erickson consider the preschool stage? - Correct Answer 3 - 5 years
What is the basic conflict and important events of Erickson's preschool stage? - Correct
Answer Initiative vs. Guilt
Exploration/Play
At what age does Erickson consider the school age? - Correct Answer 6 - 11 years
What is the basic conflict and important events of Erickson's school age? - Correct
Answer Industry vs. Inferiority
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