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Question 1

The ability to know right from wrong and its application to real life situations is studied by which theorist?

Jean Piaget Erik Erikson Sigmund Freud Lawrence Kohlberg


Question 1 Explanation: Lawrence Kohlberg studied the ability to know right from wrong and its application to real life situations which denotes moral development.

Question 2
An 8 year old child is under what development task of the psychosocial development?

Sense of Industry vs inferiority Sense of identity vs role confusion Sense of initiative vs. guilt Latent stage
Question 2 Explanation: Schoolagers (6-12 years old) belong to the stage of industry vs inferiority.

Question 3
Mrs. Laos second child is persistently asking questions about the difference between male and female (sexual differences) and how birth is made possible. Knowing the stages of growth and development the nurse knows that Mrs. Laos child is about:

2 years old 8 years old 6 years old 4 years old


Question 3 Explanation: During the phallic stage the child learns sexual identity through awareness of the genital area. The childs sexual interest leads him/her to ask questions related to birth and sexual differences. Phallic stage occurs during the preschool period at about 3-5 years old, thus, the correct answer is D.

Question 4 WRONG
A mother brought her 6 month old child in the clinic. Which of the following is quite delay for this child?

Vocalizing the syllables oh and ah Holding rattle briefly Inability to clap both hands Inability to sit alone
Question 4 Explanation: A 6 month old child should be able to bottles well and verbalize oh and ah. A 5 month old infant should be able to handle a rattle well, thus is by 6 months the rattle is just held briefly is a negative observation. You expect a child to clap the hands by 10 months. Sitting alone is noted at 8 months.

Question 5 WRONG
An infant was brought to the clinic. The pediatrician was out so the mother and the baby were left waiting in the waiting area. The nurse is planning to obtain the infants vital signs and weight. As the infant is quietly sitting on the mothers lap which of the following would the nurse obtain first?

Weight Heart Rate Respiration rate Papillary reflex


Question 5 Explanation: No touch policy is done when obtaining V/S for infants. Thus, respiration should be taken first, since the nurse needs not to come closer or hold the infant in counting the breaths.

Question 6 WRONG
The following areas are measured by the Denver Developmental Screening Test except:

Language Social interaction Emotional development

Gross motor skills


Question 6 Explanation: DDST rates language, persona-social interaction, gross and the fine motor skills.

Question 7 WRONG
The ability to learn and understand the experiences in life to acquire knowledge, responses to various situations and solving problems pertains to whose theory?

Jean Piaget Erik Erikson Sigmund Freud Lawrence Kohlberg


Question 7 Explanation: The ability to learn and understand the experiences in life to acquire knowledge, responses to various situations and solving problems pertains to cognitive development that is introduced by Jean Piaget.

Question 8 WRONG
An 8-month old infant begins crying and trashing arms, when checked by his mother the diapers are wet. The child is showing what reaction pattern?

Approach Adaptability Rhythmicity Intensity of reaction


Question 8 Explanation: Intensity of reaction pertains to the strength of a childs reaction to situations (e.g. crying loudly or thrashing arms). A child who has rhythmicity manifests a regular rhythm in physiologic functions such as waking up at the same time in the morning. Approach refers to a childs response on initial contact with a new stimulus. Adaptability is the ability to change ones reaction to stimuli over time.

Question 9 WRONG
A child is expected to stand alone by what age?

10 months 11 months 1 year 15 months


Question 9 Explanation: By 1 year an infant can walk alone. At 15 months he/she can walk alone. 10 months = pulling oneself to stand; 11 months- stand with support.

Question 10 WRONG
Physical growth and some aspects of development occur in a process. In a 6-year old child, what body system reached its peak point?

Reproductive Musculoskeletal Neurological Lymphatic


Question 10 Explanation: Lymphoid tissues grow rapidly during infancy and childhood to protect a child from infection. In 5-year old children the tonsillar tissue has reached its peak size (about twice the size of that an adult).

Question 11 WRONG
Nurses should be knowledgeable about growth and development to understand changes in a pediatric patient and promote proper care. What is the main difference between growth and development?

The parameter of growth is weight while the parameter of development is height. Growth is an increase in physical size and fine motor skills while development is an increase in a childs ability. Growth denotes a quantitative change and development a qualitative change. Growth is generally used to denote a qualitative change while development a quantitative change.

Question 11 Explanation: Growth is an increase in physical size (quantitative) while development is an increase of ones ability qualitative. Parameters of growth are the weight and height while development is through observation and Denver developmental screening test.

Question 12 WRONG
The stage where the childs personality development appears to be dormant is noted during:

Genital Phallic Latent Anal


Question 12 Explanation: The school-age period is under the latent phase where according to Freud the libido of the children appears to be diverted into concrete thinking and no development is obvious (dormant).

Question 13 WRONG
The nurse observes that the infant is babbling. Most likely the infant is of what age?

8 months 2-6 months 2 months 1 year


Question 13 Explanation: An infant babbles when he or she is about 8-9 months. By 2-6 months the infant laughs. At 1-2 months an infant coos. By 10-12 months the infants specifically calls mama and dada for mother and father.

Question 14 WRONG
By the 3rd day Baby Vinas weight drop to 3.23 kg. What is the primary nursing action?

Notify the physician immediately. Observe the mother carefully during feeding and promote health teaching on the proper way of feeding the baby. Document the data. Perform further assessment to determine other problems.
Question 14 Explanation: Newborns normally loss 5-10% of birth weight in the first seven days (Physiologic weight loss) and regains the weight by 10 days.

Question 15 WRONG
A drop of a newborns temperature is expected by Nurse Joanne. What is the main reason for this?

Due to a smaller chest circumference Due to the immaturity of the body systems Due to the presence of brown fats in newborns Due to the inappropriate caregiver attention
Question 15 Explanation: A newborns temperature is expected to drop due to the immature body systems.

Question 16 WRONG
Based on Freuds psychosexual theory, this is a stage where a childs pleasure zone appears to shift from the anal to the genital area. The child also earns sexual identity in this stage which is known as:

Genital Phallic Latent Anal


Question 16 Explanation: During the phallic stage the child learns sexual identity through awareness of the genital area. In the genital stage, the child develops sexual maturity and learns to establish satisfactory relationships with the opposite sex.

Question 17 WRONG
Baby Girl Vina has a birth length of 16 inches. You interpret this as:

Above normal birth length

Normal birth length Below normal birth length None of the above
Question 17 Explanation: Normal birth length is 46-54 cm (18-21.25 inches) 1 inch = 2.54 cm

Question 18 WRONG
Mrs. Laos friend, Lane has a 2 year old boy. She is asking Mrs. Lao about the ways to promote a positive environment for the child. Which of the following correctly demonstrate a positive and stimulating environment for a toddler?

Providing visual stimulation for the child. Allowing the child to assemble and complete projects to feel rewarded for the accomplishment. Offering choices of clothes to wear or toys to play with. Providing opportunities for exploring new places or activities.
Question 18 Explanation: To form a sense of autonomy during the toddler period provide situations for the child to decide on his/her own. Providing visual stimulation for the child is for infants. Allowing the child to assemble and complete projects to feel rewarded for the accomplishment is for schoolagers. Providing opportunities for exploring new places or activities is applicable for preschooler.

Question 19 WRONG
There are varieties of factors affecting growth and development processes. The following correctly denotes a genetic influence in growth and development apart from:

Children with higher intelligence do not generally grow faster physically. On average girls are born lighter and shorter than boys. All children who inherited a disease will be left physically challenged. Temperament affects growth and development and is an inborn characteristic set at birth.
Question 19 Explanation: Children who inherited a disease will thrive and grow with good health supervision and early detection and treatment.

Question 20 WRONG
By 5 months what will be Baby Vinas normal weight, if her birth weight is 3.4 kg?

15 lbs 22 lbs 25 lbs 18 lbs


Question 20 Explanation: The birth weight doubles by 5-6 months. 3.4 kg x 2 = 6.8 kg x 2.2 = 14.9 lbs or 15 lbs (1 kg = 2.2 lbs)

Question 21 WRONG
By 4 months what reflex do you expect to diminish?

Extrusion reflex Tonic-neck reflex Palmar grasp reflex All of the above
Question 21 Explanation: By 4 months you expect extrusion, tonic-neck and palmar grasp reflex to fade.

Question 22 WRONG
At 1 year, if Baby Girl Vinas birth height is 16 inches you expect it to increase to:

61 cm 51 cm 63 cm 53 cm
Question 22 Explanation: The birth Length increases by about 50% in 1 year. Thus, 16 inches / 2 = 8 inches. 16+8 = 24 inches at 1 year, to convert to cm (1 inch = 2.54 cm) 24 x 2.54 = 60.96 cm or 61 cm at 1 year

Question 23

WRONG
Baby Girl Vina weighs 3.4 kilograms. This is interpreted to be:

Above normal birth weight Normal birth weight Below normal birth weight None of the above
Question 23 Explanation: Normal birthweight is 2.5-3.4 kg (5.5-7.5 lbs)

Question 24 WRONG
An infant is waking up at the same time each morning, hungry at regular 4-hour periods and naps at the same time each day. This is a manifestation of what reaction pattern in children?

Approach Adaptability Rhythmicity Intensity of reaction


Question 24 Explanation: A child who has rhythmicity manifests a regular rhythm in physiologic functions such as waking up at the same time in the morning. Approach refers to a childs response on initial contact with a new stimulus. Adaptability is the ability to change ones reaction to stimuli over time. Intensity of reaction pertains to the strength of a childs reaction (e.g. crying loudly or thrashing arms).

Question 25 WRONG
According to the psychosocial theory, the developmental task where a child learns to love and to be loved is under what age group?

Infancy Toddler School age Adolescent


Question 25 Explanation: Learning trust vs. mistrust (other terms are learning confidence or learning to love) is the developmental task during the infancy period

Question 1 WRONG
Presence of what hormone causes the ductus arteriosus to open?

Estrogen Progesterone Human Chorionic Gonadrotopin Prostaglandin


Question 1 Explanation: High levels of prostaglandin in the uterus cause the opening in the pulmonary artery and aorta which is the ductus arteriosus.

Question 2 WRONG
The statements are true about communicating hydrocephalus apart from:

It is also known as non-obstructive hydrocephalus. It is due to the functional impairment of arachnoid granulations.

It is caused by a CSF-flow obstruction ultimately preventing the CSF from flowing into the subarachnoid spaces. It can be caused by diffuse ventricular dilatation from scarring and fibrosis of subarachnoid space following infectious, inflammatory and hemorrhagic events preventing the flow of CSF.
Question 2 Explanation: Communicating hydrocephalus, also called non-obstructive hydrocephalus, is the functional impairment of arachnoid granulations. It can be caused by diffuse ventricular dilatation from scarring and fibrosis of subarachnoid space following infectious, inflammatory and hemorrhagic events preventing the flow of CSF. Non-communicating hydrocephalus, also called obstructive hydrocephalus, is caused by a CSF-flow obstruction ultimately preventing the CSF from flowing into the subarachnoid spaces (e.g. atresia, tumor).

Question 3 WRONG
A diagnosis of hydrocephalus is confirmed. The mother of a 2 year old patient is asking about the types of hydrocephalus. Which of the following correctly defines non-communicating hydrocephalus?

It is also known as non-obstructive hydrocephalus. It is characterized by enlarged cerebral ventricles, with only intermittently elevated cerebrospinal fluid pressure. It is due to the functional impairment of arachnoid granulations. It is caused by a CSF-flow obstruction ultimately preventing the CSF from flowing into the subarachnoid spaces.
Question 3 Explanation: Non-communicating hydrocephalus, also called obstructive hydrocephalus, is caused by a CSF-flow obstruction ultimately preventing the CSF from flowing into the subarachnoid spaces (e.g. atresia, tumor). Communicating hydrocephalus, also called nonobstructive hydrocephalus, is the functional impairment of arachnoid granulations. Normal Pressure Hydrocephalus (a form of communicating hydrocephalus) is caused by enlarged cerebral ventricles, with only intermittently elevated cerebrospinal fluid pressure.

Question 4 WRONG
The following observations are noted in a child under the acute phase of Kawasaki disease except:

Fever Increase platelet count Conjunctivitis Increase WBC count


Question 4 Explanation: Acute Phase: fever of 5 days or more, conjunctivitis, strawberry tongue, red cracked lips, enlarged cervical lymph nodes, abdominal pain, anorexia, joint swelling, diarrhea, polymorphous rash, increase WBC and ESR. Sub acute Phase (after 10 days): desquamation of palms and soles, increase platelet, vascular aneurysm.

Question 5 WRONG

A preschool child has been admitted for rheumatic fever. In the diagnosis of the disease which of the following meets the Jones criteria?

Increase ESR, arthralgia, fever Leukocytosis, carditis, fever Arthralgia, fever, leukocytosis Leukocytosis, increase ESR, history of Rheumatic fever
Question 5 Explanation: Jones criteria are used in the diagnosis is rheumatic fever. There should be 1 major or 2 major symptom plus 2 minor manifestations. Major S/S: carditis, erythema marginatum, polyarthritis, subcutaneous nodules, chorea Minor S/S: fever, history of RF, prolonged PR interval, arthralgia, Increase ESR, leukocytosis

Question 6 WRONG
Angelo, 1 year old has been tested for lead levels in the blood. Result shows that his blood lead level is 28 microgram pre deciliter. Which of the following management would be appropriate for Angelo?

Rescreen the child to confirm level every year for 6 years Administer oral Succimer Hospitalization and administer Edetate Calcium Disodium (EDTA) intramuscularly Assess kidney function
Question 6 Explanation: Blood lead level: 10-14 microgram/dl rescreen to confirm level every year for 6 years 15-19 microgram/dl retest every 3-4 months for children age 6-35 years old. Remove the child from the environment with lead; cover walls with paneling or MASONITE. 20-44 microgram/dl retest every 3-4 months; chelating agent SUCCIMER (Chemet) orally for 19 days 45-69 microgram/dl admit the child; chelation therapy with Dimercaprol (BAL) or Edetate Calcium Disodium (EDTA); EDTA is administered intramuscularly and add 0.5 ml procaine because administration of this drug is painful. >70 microgram/dl immediate treatment with chelating agent, Dimercaprol (BAL); after BAL, oral Penicillamine (Cuprimine) is given for 3-6 months

Question 7 WRONG
The surgical management for atrial septal defect (ASD) and ventricular septal defect (VSD) is which of the following?

Dacron or Silastic patch placement Ductal ligation Fontan procedure Brock Procedure
Question 7 Explanation: In ASD and VSD an opening or hole is present. To treat the disorder, a patch (Dacron or Silastic) is placed in between the atria (in ASD) and ventricles (in VSD). Ductal ligation is for PDA. Fontan procedure is for tricuspid atresia and Brock procedure is indicated for patients with Tetralogy of Fallot.

Question 8 WRONG
Health teaching is important in successful management of a certain disease. In Kawasaki disease, what is the main reason why steroids are not administered to clients with Kawasaki disease?

It can cause aneurysms. It can cause increase body temperature. It decreases WBC count and increases ESR. It causes more rashes in children.
Question 8 Explanation: Steroids are not given to children with K.Disease as this causes aneurysm that poses danger to the child.

Question 9 WRONG
A mother comes in a clinic asking about the normal development of her child. The nurse, told her that DDST (Denver Developmental Screening Test) is done for children to assess their developmental processes. When is DDST first done?

3 months 10 months 3-4 years 5 years


Question 9 Explanation: DDST is first done at 3 months, repeated at 10 months and again repeated at 3-4 years.

Question 10 WRONG
The platelet receptor inhibitor specific for Kawasaki Disease is prescribed by the physician. Which of the following drugs will you expect in the doctors order?

Ibuprofen Abciximab Succimer Dimercaprol


Question 10 Explanation: Abciximab is a platelet receptor inhibitor specific for Kawasaki Disease. Ibuprofen is used to decrease the inflammation in Kawasaki Disease. Succimer and Dimercaprol are chelating agents used for the management of lead poisoning.

Question 11 WRONG
The fetal accessory that is located in between the two atria is called:

Foramen ovale Ductus venosus Ductus arteriosus Pulmonary arteries


Question 11 Explanation: In the fetal structure, the opening between the two atria is called the foramen ovale.

Question 12 WRONG

Understanding a clubfoot disorder means knowing the normal anatomy and physiology of a skeletal foot. The weight of the body is carried by the largest tarsal bones of the foot which are: A. Cuneiform B. Talus C. Navicular D. Calcaneus E. Cuboid

A and D B and D A and E C and E


Question 12 Explanation: The weight of the body is carried by the largest tarsal bones, calcaneus (heelbone) and talus (ankle bone). Tarsus, the posterior half of the foot composed of seven tarsal bones: Medial cuneiform, Intermediate cuneiform, Lateral cuneiform, Cuboid, Navicular, Talus and Calcaneus.

Question 13 WRONG
A child diagnosed with PKU should be managed by giving which soy-based milk formula?

Nutraminogen Similac Lofenalac Sustagen


Question 13 Explanation: Lofenalac is the soy-based formula given to children with PKU. Nutraminogen is given for infants with galactosemia. Similac is given for those who have failure to thrive.

Question 14 WRONG
To manage the chorea in rheumatic fever which of the following is administered?

Ampicillin Erythromycin Diazepam Mannitol


Question 14 Explanation: Chorea is a jerky movement seen in rheumatic fever diazepam should be given.

Question 15 WRONG
A child is diagnosed with Kawasaki Disease. Which of the following manifestations is seen during the subacute phase of the disease?

Fever Conjunctivitis Strawberry tongue Desquamation of palms and soles


Question 15 Explanation:

Acute Phase: fever of 5 days or more, conjunctivitis, strawberry tongue, red cracked lips, enlarged cervical lymph nodes, abdominal pain, anorexia, joint swelling, diarrhea, polymorphous rash, increase WBC and ESR. Subacute Phase (after 10 days): desquamation of palms and soles, increase platelet, vascular aneurysm

Question 16 WRONG
Phalanges form the toes and are composed of 14 bones. The big toe is made up of how many phalanges?

2 3 1 5
Question 16 Explanation: Each toe has 3 phalanges with the exception of the great toe having only 2. Therefore, B,C and D are incorrect.

Question 17 WRONG
The fetal accessory ductus venosus closes due to which of the following?

Increase pressure of the right side of the heart Clamping of the cord Increase pressure of left side of the heart Increase prostaglandin levels
Question 17 Explanation: Clamping of the cord causes the closure of the ductus venosus of a newborn. Increase pressure of the left side of a neonates heart as well as increase PO2 level help the foramen ovale to close. Decrease prostaglandin level and increase PO2 contribute to the closure of the ductus arteriosus.

Question 18 WRONG
Which of the following accurately describes the treatment of a Pseudo talipes?

Pseudo-talipes does not need a surgical procedure, however ilizarov frames can be used at nighttime Pseudo-talipes only requires tendon replacement No procedures are done with pseudo-talipes, however passive foot exercises would be fine A cast above the knee is required for alignment; if the procedure poses no effect surgical procedures can be done
Question 18 Explanation: Some newborns have developed a twisted foot appearance due to intrauterine position. However, with manipulation the foot can be brought into a straight position. This temporary abnormality is called a pseudo-talipes disorder. A true clubfoot cannot be aligned properly without further intervention. (Letter a) P.Talipes does not need a surgery and traction with ilizarov frame. (Letter b) Tendon replacement is the last corrective treatment for a true talipes. (Letter d) the management is for T.Talipes.

Question 19 WRONG
An infant with phenylketonuria (PKU) has a mousy odor of urine. Which of the following causes this indifferent odor?

Phenylpyruvic acid Lactic Acid Galactic acid Insulin


Question 19 Explanation: Phenylpyruvic acid is the breakdown product when phenylalanine is metabolized. This ketoacid goes to the urine giving its musty/mousy odor.

Question 20 WRONG
Clamping of the cord causes the closure of what fetal accessory structure?

Ductus arteriosus Foramen ovale Pulmonary blood vessels Ductus Venosus


Question 20 Explanation: Clamping of the cord that causes decrease blood flow causes the closure of ductus venosus (shunts blood to the fetal liver).

Question 21 WRONG
As the nurse is assessing a 3-year old child, the toddler appears good. However the childs mother told the nurse that her child usually appears ill at nighttime. The cough is barking and inspiratory stridor is noted. The nurse interprets this as:

Laryngotracheobronchitis Epiglotitis Pneumonia Bronchitis


Question 21 Explanation: Croup or Laryngotracheobronchitis is characterized by the inflammation and infection due of the larynx, trachea and bronchi. The symptoms are marked retractions, inspiratory stridor, and a barking cough.

Question 22 WRONG
A 3 year old child is admitted in the hospital. The mother asks what developmental milestone is expected for this child to accomplish. The nurse correctly responds by pinpointing which of the following?

Bowel control achieved Riding a tricycle Sitting without support Tying shoelaces
Question 22 Explanation: At three years of age you expect the child to be able to ride a tricycle. Bowel control is achieved at about 18 months (bowel before bladder). Sitting unsupported is noted when the child is 8 months old. Tying shoelaces is possible at 4 years old.

Question 23

WRONG
The child was admitted in the ER with the presenting symptoms of sitting in a leaning position, with the tongue protruding, drooling and muffled cough. The nurse should prepare what equipment at the bedside?

Tongue depressor Intubation set Sterile gauze Clamp


Question 23 Explanation: Intubation set is used prepared at the bedside for children presenting the signs and symptoms of Epiglotitis. Never used a tongue depressor, manipulation of the throat can cause pulmonary arrest in a child with epiglotitis.

Question 24 WRONG
Inborn errors of metabolism are discussed in a nursing lecture. Absence of liver enzyme phenylalanine hydroxylase directly causes the absence of which of the following?

Thyroxine Melanin Epinephrine Tyrosine


Question 24 Explanation: P. Hydroxylase converts phenylalanine (an amino acid) to tyrosine. Thus, the direct effect of its absence is the lack of tyrosine. Tyrosine is the precursor of thyroxine, epinephrine and melanin.

Question 25 WRONG
A 2 year old child is diagnosed with Plumbism. Edetate Calcium Disodium (EDTA) is ordered to be administered intramuscularly. In the preparation of the medication, what should the nurse do?

Hold the syringe by the plunger Prepare calcium to be administered after EDTA is given Add 0.5 ml of procaine in the medication Add 10 ml of procaine
Question 25 Explanation: Procaine (0.5 ml) is added in the solution before administering the IM injection to the client because EDTA is very painful. The syringe should be held by the barrel not the plunger to prevent the escape of prepared medication.