exam rationalization
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Exam RationalizationTRANSCRIPT
1. The mother of a 9 month old infant is concerned that the head circumference of her baby is greater than the chest circumference. The best response by the nurse is:
a.“These circumferences normally are the same, but in some babies this just differs.”
b.”perhaps your baby was small gestational age or premature.”
c.“This is normal until the age of 1 year, when the chest will be greater.”
d.“Let me ask you few questions, and perhaps we can figure.”
2. Preschoolers are able to see things from which of the following perspectives?
a.Their peers’b.Their own and their caregivers’c.Their own and their mother’sd.Only their own
3. A parent calls you and frantically reports that that her child has gotten into her ferrous sulfate pills and ingested number of these pills. Her child is now vomiting has bloody diarrhea and is complaining abdominal pain. You will tell the mother to:
a.Call emergency medical services (EMS) and get the child to the emergency room
b.Relax because these symptoms will pass and the child will be fine
c.Administer syrup of ipecacd.Call the poison control center
4. The nurse is working with an adolescent who complains of being lonely and having a lack of fulfillment in her life. This adolescent shies away from intimate relationships at times yet at other times she appears promiscuous. The nurse will likely work with this adolescent in which of the following areas?
a.Isolation
b.Loneliness
c.Lack of fulfillment
d.Identity
5. A child suffers a head injury in a tumbling accident in a gym class. The nurse’s best course of action is to:
a.Get the child up walking and make he she stays awake
b.Leave the child and go get helpc.Leave the child in the care of an older child
and go get help d.Stay with the child keep assessing and
someone call the caregivers
6. Which of the following arrangements is generally considered to the best for the parents of a hospitalized infant or young child?
a.Rooming- inb.Separate caregiver sleeping room on the unitc.Day visits and sleeping at homed.Staying at a nearby hotel or motel
Situation: Nurse Michelle works with the Family
Nursing Team in Calbayog Province specifically handling a UNICEF Project for children. The following conditions pertain to CARE OF THE FAMILIES WITH PRESCHOOLERS
7. Ronnie asks constant questions. How uestions does a typical 3- year old ask in day’s time?
a.300- 400b.100- 200c.1,200 or mored.Less than 50
8. Ronnie will need to change to a new bed because his baby sister will need Ronnie’s old crib. What measure would you suggest that his parents take to help decrease sibling rivalry between Ronnie and his new sister?
a.Tell him he will have to share with the new babyb.Ask him to get his crib ready for the new babyc.Move him to the new bed before the baby
arrivesd.Explain the new sisters grow up to become best
friends
9. How many words does a typical 12 months old infant use?
a.20 or moreb.2 plus “mama” and “dada”c.About 50 wordsd.About 12 words
10. Which of the following would watched on the baby?
a.APGAR scores and congenital defectsb.Birthmark and pigmentationc.Foot and hand markd.Measurement of length
SITUATION: Mark Foster a 10-month old infant with a
cleft lip and palate, is admitted to the pediatric unit for the first stage of surgical correction on his lip. Primarily breast-fed, he occasionally receives a supplemental bottle.
11. Feeding an infant with a cleft lip or palate offers a special challenge to the nurse because;a. Bottle-feeding disrupts the maternal-infant
bondb. The infant has difficulty maintaining suction
around a nipplec. The nurse must discourage the infant from
trying to suckd. The infant has no desire to suck
12. Immediate post-operative complications for Mark may include:a. Hemorrhage and respiratory distressb. Fever and coagulation difficultiesc. Infection and hemorrhaged. Irritability and difficulty swallowing
13. The physician orders elbow restraints postoperatively. the nurse should:a. Put the restraints on Mark’s dominant handb. Use the restraints only when Mark is awakec. Use the restraints only when Mark is asleepd. Release the restraints every 2-4 hours
14. Mrs. Foster is concerned about Mark’s dental development. The nurse knows that an infant’s first teeth, which usually erupt between ages 6 and 8 months are the:a. Upper lateral incisorsb. Lower central incisorsc. Lower lateral incisorsd. Upper central incisors
15. After cleft palate repair, Mark should be fed with:a. Soup spoonb. Dessert forkc. Plastic syringed. Infant spoon
SITUATION: Mrs. Smith reveals to the visiting nurse that
Nicholas, aged 2 weeks, has been vomiting 3 tablespoons of previously ingested food daily for the past 3 days. The vomitus contains neither blood nor bile. Mrs. Smith tells the nurse that she feeds Nicholas 4 oz. (120ml) of a soy-based, iron-fortified formula ( SIMILAC 20 with Iron) every 4 hours and that the vomiting occurs effortlessly regardless of the neonates position. Nicholas growth parameters have remained unchanged since birth. The physician suspects Gastro esophageal reflux.
16. To prevent Nicholas from aspirating during or after feeding, Mrs. Smith should,a. Keep Nicholas prone at a 15-degree angle
after feedingb. Thicken the morning and evening feedings
with cerealc. Administer large-volume feedings every 6
hours.d. Maintain Nicholas in an upright position, at a
60-degree angle with an infant seat.
v
17. To evaluate the effectiveness of Nicholas’ home care program, the nurse should consider which of the following as most important?a. Absence of spitting upb. Weight gainc. Ability to tolerate clear liquids between
feedingsd. Tolerance of feedings scheduled every 6
hours
SITUATION: Jenifer, a full-term neonate, is transferred to
the neonatal intensive care unit after x-ray reveal that her esophagus ends in a blind pouch. She has had problems with feeding and is now on NPO status. Her diagnosis is Esophageal Atresia: Surgery is schedule for the next morning.
18. Which physical findings are commonly associated with esophageal Atresia?a. Decrease bowel soundsb. Choking, coughing and cyanosisc. Visible gastric peristaltic wavesd. Jaundice and drooling
19. Which position is best for Jenifer preoperatively?a. Prone on her abdomenb. Right side-lyingc. Supine, with her head and chest elevated 30
degreesd. Left side-lying
20. To prevent aspiration of secretions, the nurse must suction Jennifer every 2 – 4 hours as needed. Prolonged and vigorous suctioning of a neonate can cause:a. Pallorb. Tachycardiac. Laryngospasmd. Pneumonia
SITUATION: Sonja Manthis, age 13 months, has a history
of repeated upper respiratory tract infections and poor weight gain. She was admitted to the hospital with pneumonia 3 days ago; today she is diagnosed with Cystic Fibrosis.
21. The nursing care for Sonja should involve all of the following except:a. Preventing infectionb. Maintaining nutritional needsc. Assisting with Oxygenationd. Preventing disease transmission
22. Which nursing intervention should the nurse include in Sonja’s care plana. Monitoring Sonja’s blood glucose level 4
times a dayb. Performing postural drainage with
percussion 3 times a dayc. Accompanying Sonja to physical therapy dailyd. Placing Sonja in protective ( reverse)
isolation
23. The Physician prescribes pancrelipase (Pancrease) for Sonja to:a. Soften stools and prevent constipationb. Prevent an allergic reaction to milkc. Supply needed enzymes to digest foodd. Prevent upper respiratory tract infection
SITUATION: Karen, age 18 months is admitted to the
pediatric unit with the diagnosis of Bronchiolitis. She has an elevated temperature, is pale, and looks tired. She also appears to be mildly dyspneic. The physician prescribe administration of 30 % oxygen with mist.
24. The admitting nurse should ensure that Karen’s room includes:a. Tracheotomy setb. Croup tentc. A sign indicating the need for respiratory
isolationd. A portable chest X-ray Machine
25. While Karen is receiving humidified oxygen the nurse must be concern with:a. Keeping the mist level low enough so that her
pajamas and bedding remain dry.b. Caring for the areas of skin under the nasal
cannulac. Preventing oxygen toxicity in the tentd. Frequent changes of linens/ bedding
26. At age 3, what level of personality will start to develop?a. Egob. Superegoc. IDd. Consciousness
27. In assessing a 5-month-old infant of the following assessment findings will cause you an alarm?a. (+) Moro reflexb. (+) Swimming reflexc. Absent Babinski reflexd. (+) Rooting reflex
28. Toilet training should start at what age:a. 1 ½b. 2c. 2 ½d. 5
29. In Piaget’s cognitive development, what stage does abstract thinking develop?
a.Sensorimotorb.Concrete thinkingc.Formal operationd.Pre operationale.sensorimotor
s
30. At what stage of growth and development does the boy compete with the father for mother attention?
a.Phallicb.Genitalc.Latencyd.Anal
31. According to Piaget’s theory of cognitive development, which of the following is true about school-age children?
a.They remain egocentricb.They are able to reason abstracted to predict
outcomesc.They are able to make judgments based only
on what they seed.They are able to classify or group objects
shared characteristics
32. Which of the following play activities would most likely be appropriate for a healthy 6-year-old girl?
a.Sitting quickly with books, crayons, and puzzles
b.Playing “house” with the 6-year-old boy who lives next door
c.Playing only with her imaginary friendd.Baking a cake from a mix with her parent’s
assistance
33. Play has been described as the work of children. Which preschool of the following best described the play behaviours of a prescribed child?
a.Preschooler generally prefer to sit alone quietly and play with blocks and crayons
b.The attraction span of preschoolers is long enough to watch full-length video movies without interruption
c.Preschooler’s play is associative. Group is common and rules are minimal
d.Preschooler children will always choose same-gender playmate
34. Elizabeth is 3 years old. Which of the following skills would you expect her to able to demonstrate proficiently?
a. Able to build a tower of 8 and 10 cubesb. Able to add 3 parts to – figurec. Able to tie her shoesd. Able to walk down stairs using alternate footing
35. Mrs. Lauro is worried that her 2 ½ -year-old child Irish is not getting enough to eat. She tells the nurse, “She’s such a picky eater.” The first nursing action is to:
a. Encourage the mother to feed the child’s smaller and more frequent meals
b. Provide teaching pamphlets on nutrition’s snacksc. Review the basic food group requirements with
the motherd. Assess the daily eating pattern of the child
36. 2-year-old Ron weighs 27 lbs and 34 inches tall; at birth, he weighed 7 lbs 2 oz.. And at 1-year-old, he weighed 22 lbs, the nurse graphing the child’s growth interpret this as:
a. Failure to thriveb. Below-normal growthc. Normal growthd. Above-normal growth
37. A mother voices frustration that her 2 ½ -year-old daughter takes her favorite blanket to day care every day. The best response for the nurse is:
a. “You need to discourage this because it is overly dependent behavior.”
b. “Don’t worry, all children do this.”c. “This is normal behavior and helps to prevent fear
and loneliness.”d. “You need to stop this because your daughter will
be teased by other children.”
Situation: Kikay, 16 years old is called in the guidance
because of failing grades. She spend more time playing computer games and surfing in the internet than studying her lessons. She is late referred to the school clinic for her health problems.
38. At age 16, which of the following is the following is the normal developmental task of Kikay?
a. Identity
b. Indus c. Intimacy d.Initiative
39. The first and most important need of the newborn is to:
a. Maintain adequate nutritionb. Maintain adequate oxygen supplyc. Prevent eye infectiond. Maintain normal temperature
40. The change from fetal to adult circulation is triggered by:
a. Obstruction of the umbilical vesselsb. Pressure on the baby’s head incurred during
birth processc. Higher oxygen content of the blood resulting
from pulmonary circulationd. Pressure changes associated with expansion
of the lungs and closure of foramen ovale
41. During the first few days following birth the neonate is expected to lose weight. It is estimated that the loss will be appropriately between:a. 1%-2% c. 8%-15%b.5%-10% d. 2%-6%
42. Which of the following would be signs of dehydration exhibited by an infant?
a. Pallor, periorbital edema, fever, rapid pulseb. Sunken fontanel, poor skin turgor, oliguriac. Fever, anuria, slow pulse, edemad. Poor skin turgor, weight loss, bulging
fontanel
43. The normal time of the closure of the anterior fontanels expected to bea. At the end of the second monthb. At the end of the sixth monthc. Six to ten of aged. Twelve to eighteen months of age
44. The stool of the breast fed five day old baby would be most likely
a. Meconiumb. Scambled eggc. Putty-liked. Black Tarry
45. The Normal time for the closure of the posterior fontanel is expected to be:
a. At the end of sixth monthb. Twelve to eighteen months of agec. At the end of the second monthd. At the beginning of the second year of life
46. The infant had an APGAR score of nine at birth. An APGAR score of nine indicate that the baby is:
a. In good condition and no special care is necessary
b. In fair condition and may require treatment for validity
c. In severe distress and immediate measures will have to be taken
d. Immature and need to be placed in an incubator
47. An infant was admitted to the nursery after a very difficult labor and a forceps delivery. His original APGAR score was five. After 5 minutes was seven. An APGAR score of five indicates that the baby is:
a. In excellent condition and no special care is necessary.
b. In fair condition and need to be watchc. In severe distress and drastic measures have
to be takend. Immature and need to be placed in an
incubator
48. According to APGAR scoring, which is the most valuable index concerning the condition if the newborn?a. Respirations
b. Reflex Irritability c. Heart Rate d. Muscle Tone e. Color
irregular
least
49. Which of the following reflex responses indicate brain damage?a. Positive retrusion of the tongue reflexb. Positive rooting reflexc. Negative moro reflexd. Positive grasp reflex
50. A six month old baby is attending the Well Baby Clinic. At sixth months the baby had all of the abilities, which developed last.
a. Sitting for a short period without supportb. Laughing aloud when hold and cuddledc. Following a rolling object with his eyesd. Recognizing his mother
3 mos.
Situation 10: Boy Rocco, two-month-old infant is brought
to the pediatrician for well-baby check-up.
51. Upon assessment, the nurse noticed that two reflexes of Baby Rocco have faded out which include?
a.Rooting and suckingb.Moro and tonic neckc.Mora and Babinskid.Rooting and landau
52. Which of the following situations would alert you are to a potentially development problem with a child?
a.Saying “mama” and “papa” for the first time at 13 months of age
b.Cooling at 3 monthsc.Using gestures to communicate at 18 months
oldd.Pointing to body parts at 15 months age
53. Which of the following is most important factor of successful toilet training?
a.Readiness of the child based on developmental stage
b.Age of the childc.Toilet-sitting at definite scheduled timesd.Mother’s willingness to be flexible
54. She asks why her baby’s hands and feet are bluish. Which of the following refers to this condition?
a.Port-win stainb.Acrocyanosisc.Tetralogy or fallotd.Mongolian spots
55. Angeli, a 6-month-old infant has a delayed development. Upon assessment, Abby expects her infant to:
a.sits upright for long periodb.reach out for her toyc.be able to hold a piece of cheese curls with
her finger and thumbd.hold her feeding bottle for a short while
56. Mrs. Simon asks Abby what attachment behaviors she will expect her 4-month-old son Gabby to demonstrate. Which of the following is NOT included by Abby in her teaching?
a.greets his mother when she returnsb.recognizes and responds to his mother’s
voicec.follows his mother as she movesd.friendly to strangers
57. She encourages Mrs. Perez to talk to her child, a 9-month-old girl, who at her age should be:
a.obeying simple commandsb.vocalizing single syllablesc.copying when talked tod.saying “Dada”
58. A neonate demonstrate the tonic neck reflex by:a. Extending the leg on the same side to which
his head is trunedb. Flexing the leg on the same side to which his
head is turnedc. Extending the leg on the opposite side to
which is head is turned d. Abducting the leg on the same side to which
his head is turned
59. The best way for the nurse to examine a small child is by proceeding:a. Cephallocuadally (head to toe)b. Proximally to distallyc. From the intrusive area to the least intrusive
aread. From the least intrusive area to the most
intrusive area
60. Blood pressure that varies among extremities is common finding in children with:a. Aortic stenosisb. Coarctation of the aortac. Patent ductus arteriosusd. Atrial septal defect
61. Which congenital cardiac anomaly is associated with tetralogy of Fallot (TOF)
a. Origination of the aorta from the right ventricle and origination of the pulmonary artery from the left ventricle
b. A hole in the ventricular septum allowing the communication between ventricles
c. Pulmonary stenosis, right ventricular hypertrophy, ventricular septal defect, and dextroposition of the aorta
d. Narrowing of the aorta, which restricts left ventricular outflow
a.
62. A neonate receiving double volume exchange transfusion is at increased risk of all of the following complications except:a. Academiab. Hypokalemiac. Hyperkalemiad. Hypoglycemia
63. A neonate with sickle cell anemia is protected from initial morbidity because of:a. Maternal antibodiesb. Persistent fetal circulationc. Fetal hemoglobind. Maternal hemoglobin
64. An enlarged scrotum in an infant younger than age 4 months indicates:a. Hypospadiasb. Phimosisc. Inguinal herniad. Hydrocele
65. A low grade fever, barky cough, inspiratory stridor and retractions in a child under age 3 may indicate:a. Allergiesb. Asthmac. Bronchitisd. Croup