NURS 629 PEDIATRICS ACTUAL EXAM 1

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NURS 629 PEDIATRICS ACTUAL EXAM 1

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Which of the following immunizations should the nurse plan to give to a 5 year old child?DTap PCV Hib Hep B DTap The mother of a 3-year-old is concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response?Hesitancy and dysfluency are normal during this period of development.Reading to the child will help model appropriate speech.Expressive language concerns warrant a developmental evaluation.The mother should ask her child's physician for a speech therapy evaluation.A.Which of the following statements by a parent should the nurse investigate further regarding the developmental needs of adolescents?

• My child has frequent mood swings
• My child has a very messy bedroom
• My child takes 1-2 showers a day
• My child spends 4 hours per day on internet chat rooms

D.The mother of a 3-month-old boy asks the nurse about starting solid foods. What is the most appropriate response by the nurse?

• "It's okay to start puréed solids at this age if fed via the bottle." 1 / 4

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• "Infants don't require solid food until 12 months of age."
• "Solid foods should be delayed until age 6 months, when the infant can handle a

spoon on his own."

• "The tongue extrusion reflex disappears at age 4 to 6 months, making it a good

time to start solid foods." D.The father of a 2-month-old girl is expressing concern that his infant may be getting spoiled. What is the nurse's best response?"She just needs love and attention. Don't worry; she's too young to spoil." "Consistently meeting the infant's needs helps promote a sense of trust." "Infants need to be fed and cleaned; if you are sure those needs are met, just let her cry." "Consistency in meeting needs is important, but you are right, holding her too much will spoil her." B.Parents of an 8-month-old girl express concern that she cries when left with the babysitter. How does the nurse best explain this behavior?Crying when left with the sitter may indicate difficulty with building trust.Stranger anxiety should not occur until toddlerhood; this concern should be investigated.Separation anxiety is normal at this age; the infant recognizes parents as separate beings.Perhaps the sitter doesn't meet the infant's needs; choose a different sitter.C.The nurse is providing anticipatory guidance to the mother of a 6-month-old infant.What is the best instruction by the nurse in relation to the infant's oral health?"Start brushing her teeth after all the baby teeth come in." "Use a washcloth with toothpaste to clean her mouth." "Clean your baby's gums, then new teeth, with a washcloth." "Rinse your baby's mouth with water after every feeding." C.A 9-month-old infant's mother is questioning why cow's milk is not recommended in the first year of life as it is much cheaper than formula. What rationale does the 2 / 4

pg. 3 nurse include in her response?It is permissible to substitute cow's milk for formula at this age as he is so close to

• year old.

Cow's milk is poor in iron and does not provide the proper balance of nutrients for the infant.As long as the mother provides whole milk, rather than skim, she can start cow's milk in infancy.If the mother cannot afford the infant formula, she should dilute it to make it last longer.B.Which of the following actions should the nurse take to prepare a school-age child for a tonsillectomy?

• Schedule the child for a preop visit to the facility
• Inform the child he will be put to sleep during the procedure
• Read the child a story about a cartoon character having a similar operation
• Tell the child the appointment is to have his throat checked

A.The nurse is caring for a hospitalized 30-month-old who is resistant to care, is angry, and yells "no" all the time. The nurse identifies this toddler's behavior as: problematic, as it interferes with needed nursing care.normal for this stage of growth and development.normal because the child is hospitalized and out of his routine.B.The mother of a 15-month-old is concerned about a speech delay. She describes her toddler as being able to understand what she says, sometimes following commands, but using only one or two words with any consistency. What is the nurse's best response to this information?The toddler should have a developmental evaluation as soon as possible.If the mother would read to the child, then speech would develop faster.Receptive language normally develops earlier than expressive language.The mother should ask her child's physician for a speech therapy evaluation.

C. 3 / 4

pg. 4 A 2-year-old is having a temper tantrum. What advice should the nurse give the mother?For safety reasons, the toddler should be restrained during the tantrum.Punishment should be initiated, as tantrums should be controlled.The mother should promise the toddler a reward if the tantrum stops.The tantrum should be ignored as long as the toddler is safe.D.What is the best advice about nutrition for the toddler?Encourage cup drinking and give water between meals and snacks.Encourage unlimited milk intake, because toddlers need the protein for growth.Avoid sugar-sweetened fruit drinks and allow as much natural fruit juice as desired.Allow the toddler unlimited access to the sippy cup to ensure adequate hydration.A.To gain cooperation from a toddler, what is the best approach by the nurse?Immediately pick the toddler up from the mother's lap.Kneel in front of the toddler while he or she is on the mother's lap.Do the nursing tasks quickly so the toddler can play.Ask the toddler if it is okay if you begin the needed task.B.The nurse is caring for a hospitalized 4-year-old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment or intervention done to herself. The nurse identifies

this preschooler's behavior as:

Problematic; the child is old enough to begin to have a basis in reality.Normal, because the child is hospitalized and out of her routine.Normal for this stage of growth and development.Problematic, as it interferes with needed nursing care.C.The mother of a 4-year-old asks for advice on using time-out for discipline with her child. What advice should the nurse give the mother?If spanking is not working, then time-out is not likely to be helpful either.Place the child in time-out for 4 minutes.

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