A 9-month-old child is seen in the well clinic. Which of the following behaviors would the
nurse expect to see? SATA
(A) Plays peek-a-boo
(B) Walks independently
(C) Feeds self with a spoon
(D) Stacks 2 blocks together
(E) Transfers objects from hand to hand - Answer -A, E
-walks independently at 15 months
-feeds self with spoon at 18 months
-stacks 2 blocks together at 18 months
The mother of a six-year-old child arrives at the clinic because the child has been
experiencing red and swollen eyes. The nurse notes a discharge from the eyes and
sends a culture to the lab. Chlamydia conjunctivitis is diagnosed. On the basis of this
diagnosis, the nurse determines that which requires further investigation?
(A) Possible trauma to the eye
(B) Possible sexual abuse
(C) Presence of an allergy
(D) Presence of a respiratory infection - Answer -(B) Possible sexual abuse
-Chlamydia is sexual transmitted disease. The diagnosis of chlamydia in a child not
sexually active should signal the health care provider to assess the signs of possible
sexual abuse
The school nurse determines a group of young women are in early adolescents based
on the following observation. All of the women:
(A) Have decided on their career path
(B) Are dressed in the same-style clothes and have the same hair style
(C) Broke curfew by staying out late at a party they went to
(D) Brag about drinking beer when their parents were at work - Answer -(B) Peer
identity is important at this age
The nurse is watching two siblings, ages 7 and 9 years of age, verbally arguing over a
toy. The nurse has counseled the parents before about how to handle the situation. The
nurse should judge that the teaching has been effective when the parent takes which
action?
(A) Tell the siblings to stop arguing and shake hands
, (B) Ignores the arguing and continues what she is doing
(C) Tells the children they will be punished when they go home
(D) Says they will not go out to lunch now since they have argued - Answer -(B) The
best approach by the mother is not to interfere. The children need to learn how to solve
disagreements on their own. If the parents always intervenes, when the children do not
learn how to do this
The nurse is caring for a newborn with a suspected diagnosis of imperforated anus.
Which clinical manifestation is associated with this defect?
(A) Bile-stained fecal emesis
(B) The passage of current jelly stools
(C) Failure to pass meconium stool in the first 24 hours after birth
(D) Sausage-shaped mass in the upper right quadrant - Answer -(C) This is a defect
where incomplete development or absence of the anus
Which drug may be given to newborns to close the patent ductus arteriosus (PDA)? -
Answer -Indomethacin (prostaglandin inhibitor)
Which drug may be given to newborns to keep the ductus arteriosus (PDA) open until
surgery can be performed? - Answer -Prostaglandin E
After receiving change of shift report, which patient should you assess first?
(A) An 18-month-old with coarcation of the aorta who has decreased pedal pulses
(B) A 3-year-old with rheumatic fever who reports severe knee pain
(C) A 5-year-old with endocarditis who has crackles throughout both lungs
(D) An 8-year-old with Kawasaki's disease who has a fever of 102.2 - Answer -(C)
Crackles through the lungs indicate the child has left ventricular failure as a
complication of endocarditis. Hypoxemia is likely, so the child needs a rapid respiratory
assessment, possible administration of oxygen. The other children should be assessed
as quickly as possible, but are not experiencing life-threatening complications
An infant is born with ventricular septal defect (VSD) and surgery is planned to correct
the defect. The nurse recognizes that surgical correction is designed to achieve which
outcome?
(A) Stop the flow of deoxygenated blood into systemic circulation
(B) Increase the flow of deoxygenated blood to the lungs
(C) Prevent the return of oxygenated blood to the lungs
(D) Reduce peripheral tissue hypoxia and nail bed clubbing - Answer -(C)
The nurse would suggest genetic counseling for each of the following except:
(A) Sickle cell anemia
(B) B-thalassemia
(C) Hemophilia A
(D) Henoch-Schonlein purpura - Answer -(D) This is an inflammation of the small blood
vessels of the skin, joints, bowels, and kidneys and is common in children. However, it
is not genetic
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