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1 MATERNAL AND CHILD NURSING

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MATERNAL AND CHILD NURSING

1. Which drug category may be safely administered during pregnancy?


A. Category A
B. Category B
C. Category C
D. Category D

2. Which of the following is a positive indication of pregnancy?


A. Quickening
B. Chadwick’s sign
C. Auscultation of fetal heart sounds
D. Ballottement

3. During the last months of pregnancy, the nurse should instruct the client to:
A. rest on her left side for at least 1 hour in the morning and afternoon
B. sleep on her back during the night and during naps
C. start nipple exercises and stimulation twice a day
D. start to cut back on water intake, especially at night

4. When teaching a pregnant woman about traveling during the pregnancy, it is important to focus on which of the
following?
A. If traveling by car, stop every 2 hours for 10 minutes
B. Get plenty of rest before long trips made in automobiles
C. Travel in any type of aircraft is acceptable
D. Travel can be completed anytime throughout the pregnancy

5. Which of the following is recommended for all women during the childbearing age?
A. Additional B vitamins
B. Additional vitamin A
C. Folic acid supplement
D. Vitamin C supplement

6. An 18-year old girl visits to obtain a contraceptive. She elected to use the intrauterine device (IUD) as a method of birth
control. The major concern with the use of the IUD is:
A. thrombophlebitis.
B. pain on intercourse.
C. infection.
D. abnormal bleeding and hemorrhage.

7. The client begins to question the nurse about sexuality and becoming sexually active. During sexual counseling, the nurse
should place a major point of emphasis on:
A. douching after sexual intercourse.
B. sex during menstruation.
C. performing Kegsl exercises.
D. safe and responsible sex.

8. Using Naegle’s Rule, calculate the estimate date of delivery if the woman’s LMP was October 1.
A. June 23
B. July 8
C. December 23
D. January 8

9. Which of the following would be appropriate to teach the pregnant woman regarding exercise?

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A. Avoid any physical activity during the second trimester


B. Contact sports are allowed during the first trimester
C. Extremely active women should reduce the level of exertion
D. Relaxation and stretching exercises should be discontinued.

10. One of the functions of the amniotic fluid is to:


A. exchange nutrients from mother to fetus
B. immobilize the fetus
C. protect the woman’s uterus
D. regulate temperature

11. A feeling of ambivalence about the pregnancy is:


A. a sign of unwanted pregnancy
B. normal in early pregnancy
C. rare at any stage of pregnancy
D. typical in late pregnancy

12. Which assessment relates most directly to rupture membranes and release of amniotic fluid?
A. Bloody show
B. Fluid with a pH of 7.0 to 7.5 with nitrazine test
C. Fluid with a pH of 5.0 with nitrazine test
D. Woman complains of urge to push

13. When the placenta is delivered with the dull side out (Duncan presentation), the woman is at risk for:
A. excessive bleeding
B. hemorrhoids
C. increased lacerations of the perineum
D. sterility

14. To assess the uterine contraction during labor, the nurse:


A. asks the woman if she is having a contraction.
B. palpates above the symphysis pubis.
C. palpates just below the xyphoid process of the sternum.
D. performs a sterile vaginal examination.

15. The nurse knows that a postpartum client’s susceptibility to hemorrhage is most likely related to a:
A. boggy uterus
B. firm fundus
C. long labor
D. negative Homan’s sign

16. Between 24 and 28 weeks, all pregnant women should be screened for:
A. Anemia
B. Bladder infections
C. Diabetes
D. Neural tube defects

17. Which of these measures would be helpful for the pregnant client complaining of sleeplessness?
A. Eat evening meal close to bedtime
B. Sit in a sitz bath before bedtime
C. Try to remain in one position when sleeping
D. Use pillows to help find a comfortable position

18. Why is the first 8 weeks of pregnancy known as the critical period of human development?

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A. By the time this period ends, the embryo is completely safe from any damage
B. Many embryos die during this period
C. The infant’s sex is determined at the end of the eight week
D. The major structures of the embryo are forming, and damage can result in major birth defects

19. Which of these statements is most accurate about the placenta?


A. The blood of the baby mixes with the mother’s blood to permit exchange of nutrients and oxygen.
B. The blood of the baby and the mother do not mix; exchange occurs across blood vessels and the walls of the villi.
C. The placenta lets the blood from the fetus cross to the mother, but the mother’s blood does not cross to the fetus.
D. The placenta serves as a complete barrier between the baby and mother so that any drugs the mother takes do not cross
the baby.

20. Which of the following is the best recommendation about taking medicines during pregnancy?
A. All over-the-counter (OTC) drugs are safe during pregnancy
B. All herbal preparations are safe during pregnancy
C. Don’t take anything during pregnancy without asking your health care provider
D. Take an OTC diuretic if you have swelling during the pregnancy

21. When providing postpartum teaching about self-care, one of the danger signs that a lactating woman should know to
report to the birth attendant is:
A. breast engorgement to a degree that the baby can’t latch on.
B. breast fullness just before feeding .
C. nipple soreness after feedings.
D. nipple dryness before feedings.

22. “Show” is usually present in:


A. Braxton Hicks contraction.
B. false labor.
C. true labor.
D. Second stage of labor only.

23. APGAR score assessments are completed at:


A. birth and 10 minutes.
B. 1 and 5 minutes.
C. 5 minutes and upon arrival to the nursery.
D. the time of birth.

24. A newborn of 4 hours displays grunting respirations and a respiratory rate of 70 breaths/minute. The priority nursing
intervention would be to:
A. begin resuscitative measures and call for help.
B. continue to monitor respiratory status variations are normal.
C. obtain vital signs every 15 minutes.
D. transfer the newborn to the mother’s room for feeding.

25. Which measure would be used to prevent loss of heat in the newborn?
A. Immediately give the baby a bath
B. Place the baby on the mother’s bare stomach
C. Offer the baby warm glucose water
D. Wrap the baby in room-temperature blankets

26. Which of the following indicates that the new mother understands how to handle breast milk safely?
A. “I can store fresh milk in the refrigerator for only 24 hours.”
B. “I can store frozen breast milk for up to 1 month.”
C. “I need to express my breast milk into a clear glass.”

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D. “I should never store my breast milk in a frozen-food locker.”

27. To prevent infection of the perineal area after delivery, the nurse should instruct the client to:
A. Begin sitz bath at the first sign of infection
B. Pull panties straight down
C. Use hot water to cleanse the area after bowel movement
D. Wipe with sweeping motion, from front to back

28. Analgesics given too late in labor can result in which of the following?
A. Contractions that increase in intensity
B. Early deceleration
C. FHR dropping to 100 beat per minute
D. Pain during contractions

29. In evaluating the effects if oxytocin after delivery, the nurse should monitor for:
A. effective breastfeeding.
B. engorged breasts.
C. relief of pain.
D. the uterus remaining firm.

30. During active labor, the mother usually exhibits which of the following behaviors?
A. Difficulty following directions
B. Excitedness and talkativeness
C. Frustration and irritability
D. Serious expression and apprehension

31. When evaluating the effectiveness of instruction regarding breastfeeding, which of the following responses by the
mother indicate that she understands the teaching?
A. “I need to rub my nipples to toughen them up.”
B. “I should apply lotion to my nipples to prevent cracking.”
C. “I should nurse at least 10 minutes on one breast before offering the next breast.”
D. “I should use soap and water to gently cleanse my breast gently.”

32. Which of the following should the nurse recommend to the breastfeeding mother to limit in her diet?
A. Cheese
B. Fruit
C. Strongly flavored foods
D. Vegetables

33. The fontanels are soft spots formed by the:


A. blood accumulated between the bone and periosteum.
B. edema of the scalp from birth pressure.
C. junction of individual skull bones.
D. pressure of a vacuum extractor.

34. Signs of respiratory distress in a neonate include:


A. grunting with expiration.
B. respiratory rate of 50 breaths per minute.
C. synchronized movement of the baby’s chest and abdomen.
D. the baby’s chest expanding as a whole.

35. The most efficient way for a baby to regulate temperature is to:
A. burn body fat.
B. move arms and legs.

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C. shiver.
D. use brown fat.

36. Which measure would be most effective in preventing the transfer of gonorrhea or Chlamydia to the infant’s eyes from
the mother?
A. Administering Vitamin K
B. Bathing the newborn
C. Cleaning the infant’s eyes with warm saline
D. Applying erythromycin ointment

37. A newborn will respond to sudden noises or jarring movement by throwing out the arms and drawing up the legs. This is
called a:
A. Moro reflex
B. Babinski reflex
C. Rooting reflex
D. Tonic neck reflex

38. The nurse is caring for a newborn at 12 hours of life. The newborn has just voided. The most appropriate response by the
nurse would be:
A. immediately check vital signs.
B. notify the physician.
C. continue to monitor voiding patterns.
D. obtain an order for a straight catheter.

39. Which position should newborns be placed when sleeping?


A. Back
B. Head of bed elevated
C. Prone
D. Side lying with pillow

40. Most babies should be fed:


A. Every 1 to 2 hours
B. Every 2 to 4 hours
C. Every 4 to 6 hours
D. On demand

41. Which of the following drugs can be given to the mother before a preterm birth to help reduce the severity of respiratory
distress syndrome?
A. Betamethasone
B. Diazepam
C. Phenobarbital
D. RhoGAM

42. Which intervention is the priority immediately after the delivery of a newborn who does not breathe?
A. Clear air passages of obstructive substances
B. Keep the mother calm
C. Place bulb suction at head of the bed
D. Rub the baby’s back

43. In which position should the newborn with intracranial hemorrhage be placed?
A. Prone
B. Side-lying
C. Slightly elevated head of bed
D. Supine

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44. Which of the following contraceptive methods also offers protection against sexually transmitted infections?
A. Abstinence
B. Coitus interruptus
C. Fertility awareness methods
D. Oral contraceptives

45. In teaching the postoperative client who has just had a vasectomy, it is important to focus on:
A. asking how his partner feels about the surgery.
B. alternate methods of expressing sexual needs and desires
C. discussing that a vasectomy does not make client less of a man
D. using birth control until sperm counts are zero for 6 weeks.

46. Which assessment most closely relates to a diagnosis of ectopic pregnancy?


A. Brownish red, tapioca-like vesicles
B. Elevated temperature
C. Spotting or bleeding 2 to 3 weeks after a missed menstrual period
D. Sudden absence of fetal movement

47. The drug of choice to treat pregnancy-induced hypertension is:


A. iron and vitamins
B. diazepam (valium)
C. furosemide (Lasix)
D. magnesium sulfate

48. Which nursing intervention would be appropriate for a client who has a diastolic blood pressure of more than 20 mmHg
on the “roll-over” test?
A. Increase intake of oral fluids
B. Rest on left side as much as possible
C. Schedule follow-up care every 2 weeks
D. Use the stairs to increase activity level

49. A mother receiving medications for pregnancy-induced hypertension should have her diastolic blood pressure
maintained in the range of 90 to 100 mmHg to:
A. avoid causing fetal anoxia.
B. ensure progression of labor.
C. prevent premature contractions.
D. present sudden elevations in pulse.

50. Which of the following would be a priority intervention for a client with the prolapsed cord?
A. Cover the cord with a dry sterile tower
B. Monitor the mother’s vital signs
C. Place the woman in the Trendelenburg position
D. Start medication as ordered

51. Juday has been experiencing regular, coordinated contractions with cervical dilation moving from 4 cm to 6 cm in the last
half, and her membranes are still intact. Juday is in which of the following stages of labor?
A. Latent phase of the second stage of labor
B. Active phase of the first stage of labor
C. Placental stage or the third stage of labor
D. Predelivery stage or the prelabor stage of labor

52. Lhia is admitted in active labor. The nurse locates fetal heart sounds in the upper left quadrant of her abdomen. The
nurse recognizes which of the following?

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A. Lhia will probably deliver very quickly and without problems.


B. This indicates Lhia will probably have a breech delivery.
C. The fetus is in the most common anterior fetal position.
D. This position is referred to as being left anteropelvic.

53. After the third stage of labor, the nurse may have which of the following responsibilities?
A. Administration of intramuscular oxytocin to facilitate uterine contractility.
B. Monitoring for blood loss greater than 60 cc, which would indicate gross hemorrhage.
C. Noting if the placenta makes a Schultze presentation, which is a sign of gross complication.
D. Pushing down on the relaxed uterus to aid in the removal of the placenta

54. Which action of the following instructions to a child would be most appropriate before a painful procedure?
A. “Do not tell the child anything, just proceed with the procedure.
B. “This won’t hurt at all.”
C. “This is going to hurt.”
D. “Would you like t help me?”

55. Which method would be helpful when administering liquid medication to a preschool-aged child?
A. Ask the child if he/she would like to take the medication from a cup or spoon.
B. Give the child a drop or two of liquid over an hour top help prevent spitting it out.
C. Tell the child the medicine is sweet candy syrup that he/she will like.
D. Tell the child firmly to take the medicine.

56. After a tubal ligation, it is not uncommon for the woman to complain of:
A. shoulder pain.
B. hemorrhoids.
C. leg pain.
D. breast tenderness.

57. When examining a postpartal woman, the nurse should immediately report:
A. a fundus that is palpated 2 cm below the umbilicus on the second postpartal day.
B. a fundus that cannot be located by palpation on the ninth postpartal day.
C. a soft, spongy uterine fundus noted during the first four hour postpartum.
D. red, bloody vaginal discharge on the perineal pad on the first day postpartum.

58. Which of the following clinical practices is appropriate to solicit initial respiration of the high-risk newborn?
A. Rubbing the back
B. Spanking the buttocks
C. Slapping the face
D. Squeezing the thorax

59. On the third hospital day in the nursery, Mr. and Mrs. Smith’s newborn baby girl Rhian is diagnosed with Rh
incompatibility. Mrs. Smith is a gravida 2, para 1, abortion 1. This disease causes blood cell hemolysis that is probably directly
due to
A. the exchange of fetal and maternal blood in the utero
B. Rh positive fetus and Rh positive father
C. Rh negative mother, Rh positive father
D. the sin of the abortion of the first child

60. Baby girl Luisa was born large for gestational age. After being delivered vaginally, this infant should be carefully assessed
for:
A. increased intracranial pressure
B. hypothermia
C. decreased red blood levels (anemia)

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D. hyperglycemia

61. Which of the following should the examiner do to assess for scoliosis?
A. Assist the child to look in a mirror for characteristic curing.
B. Have the child place the chin on the chest, place hands together, bend over, and let the hands hang freely.
C. Have the child turn sideways, and look for bulging in the thoracic region.
D. Palpate the spine for indentation in the lower back.

62. During an episode of somnambulism, it would be appropriate for the nurse to:
A. ask the child what he/she is doing
B. immediately wake the child.
C. pull the child back to bed.
D. observe for safety measures to avoid injury.

63. Which instruction should the nurse provide the adolescent who is experiencing acne?
A. Avoid chocolate in the diet.
B. Inspect skin for adverse reactions to treatment.
C. Pop pimples only when they are white with pus.
D. Scrub skin twice a day with prescribed medication.

64. Which of the following is an inappropriate technique to use when giving a back rub?
A. Long, even upward strokes
B. Tapping lightly with the edge of the hand
C. Firm scratching motion
D. Application of lotion

65. You are giving a parenting class. You will discuss which of the following with the parents of Dora, a 2-year old child?
A. Dora can be expected to be cooperative and easily cooperative and easily controlled at this stage of development.
B. Dora may prefer finger foods and clothing she can put on without assistance at this age.
C. Expect Dora to want to be held and cuddled a great deal at this stage of her development.
D. At this age, Dora will take the initiative in activities and will question everything.

66. When obtaining vital signs, which of the following is appropriate?


A. Oral temperature in children younger that 6 years
B. Radial pulse in children older than 2 years
C. Rectal temperature in child with hematology disorder
D. Tympanic temperature in child with ventilating tubes

67. When discharging a child from the hospital, it is most important for the nurse to document:
A. that child’s belongings were sent with caregivers.
B. reaction of child to staff.
C. teaching follow-up care to family caregivers.
D. weight of the child on discharge.

68. Which assessment findings most closely correlate with the diagnosis of Tetralogy of Fallot?
A. Cyanosis
B. Elevated blood pressure
C. Normal weight
D. Weak pulse in lower extremities

69. Which action would be most appropriate when caring for a child with idiopathic thrombocytopenic purpura?
A. Administer enemas to promote bowel movements.
B. Do not give intramuscular injections.
C. Place child with head of bed elevated.

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D. Weigh daily at the same time.

70. The most common chronic childhood illness is:


A. common cold.
B. diabetes mellitus.
C. mumps.
D. asthma.

71. Which of the following considerations is appropriate regarding children undergoing diagnostic procedures?
A. Parents should be asked to restrain infants when indicated.
B. Toddlers should be given procedures quickly and without warning to decrease resistance.
C. Adolescents should be expected to tolerate procedures maturely and without fear.
D. School-age children should be given thorough explanations for procedures.

72. After an endoscopy study, which of the following interventions would be most important?
A. Pushing oral fluids immediately to promote elimination of dye.
B. Monitoring airway and respiratory function for the first 4 hours.
C. Applying a warm compress to the neck to reduce spasm.
D. Administering atropine to reduce pulmonary secretions.

73. The nurse is aware that of the following food supplies, the better source of iron for the infant is which of the following?
A. Human breast milk
B. Iron-fortified cereals
C. Vegetables
D. Fruit

74. Which of the following interventions might be most effective in preventing glomerulonephritis?
A. Daily administration of children’s multivitamins and iron.
B. Increasing all children’s fluid intake to 3 liters daily.
C. Prompt evaluation of childhood complaints of sore throat.
D. Teaching children to avoid promptly when the urge is felt.

75. Which of the following would most likely be noted in a child with acute glomerulonephritis?
A. Blood pressure of 90/40 mmHg
B. Hypovolemia and signs of dehydration
C. Hematuria and pulmonary edema
D. Severe, foul-smelling diarrhea

76. A key developmental task of parenting is learning to determine if their child is crying from hunger, discomfort, or some
other reason.
A. Preschooler
B. Infant
C. Toddler
D. School-age child

77. Alice is 4 months of age. Her mother is singing to her. What type of response should be expected of Alice?
A. Imitating the sounds
B. Smiling, cooing, and gurgling
C. Saying “da-da”
D. Watching her mother’s face without making a sound

78. At what age should an infant begin to locate an object hidden under a blanket?
A. 6 months
B. 8 months

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C. 10 months
D. 12 months

79. Which of the following would be most effective in reducing the workload of the heart of a child with heart failure?
A. Bed rest in a semi-Fowler’s position
B. Digoxin administration daily, IV or orally
C. Oxygen therapy by mask, cannula or tent
D. Intravenous infusion of 2 to 3 liters daily

80. Crying is to avoided in a child who has had a cleft lip repair because it
A. sustains a traumatic experience.
B. places tension on the suture line.
C. threatens maternal-infant bonding.
D. predisposes to respiratory difficulties.

81. To visualize the inner surface of a child’s lower eyelid and most of the bottom globe, the nurse would
A. press on the lower lid with a finger tip.
B. pull the top eyelid outward and up.
C. invert the top eyelid with a special apparatus.
D. use a cotton tip to flip the lower lid.

82. When teaching Carlo, 14 years old, to walk with crutches, the nurse should instruct his to
A. move one crutch forward at a time when using a three-point swing through gait.
B. carry books and other items in a backpack to keep his hands free.
C. Rest the crutch pad on the upper arm to bear his weight on the axilla crutch pad.
D. use a two-point gait when no weight is allowed.

83. Which of the following would be a serious danger sign if noted in a child after head trauma?
A. Memory deficit with inability to recall time or date.
B. Complaint of headache along the area of trauma.
C. Blood pressure moving from 120/80 mmHg to 130/50 mmHg.
D. Pupils are equally and briskly reactive to light.

84. Jan, aged 13, is admitted with third degree burns over 25% of her body. Which of the following is an immediate concern
in Jan’s plan of care?
A. Liberal medication to control Jan’s severe pain
B. Arranging age-appropriate diversional activities
C. Preventing hypovolemia and circulatory collapse
D. Increasing oral intake of proteins to build tissue

85. Care of the child in coma would include


A. Encouraging parents to be positive since coma is often short term in children.
B. Performing passive range of motion exercises to maintain muscle tone.
C. Feeding the child with a spoon and fork to stimulate memories of normal activities.
D. Maintaining the child, in a flat, supine position to simulate normal sleeping position.

86. Hypoglycemia in children may be caused by


A. missing an insulin injection.
B. missing a meal or a snack.
C. too small an insulin dose.
D. too large a meal or snack.

87. Mara, aged 6, is admitted to your unit after an automobile accident. You would suspect increased intracranial pressure if
your assessment revealed which of the following?

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A. Bradycardia rhythm
B. Decreased pulse pressure
C. Hypotensive blood pressure
D. Tachypnea

88. Which of the following are signs of autonomic dysreflexia?


A. Bradycardia and flushed face
B. Headache and hypertension
C. Hypertension and pallor
D. Pale skin and dizziness

89. Bimby, 2 years old, has been diagnosed with cerebral palsy. The nurse should explain which of the following to Bimby’s
parents?
A. Cerebral palsy involves a progressive nerve generation.
B. Contractures are unavoidable since ambulation is impossible.
C. The brain damage that occurred at birth can be repaired with surgery when the child is older.
D. Two children with cerebral palsy may exhibit totally different symptoms and abilities.

90. The nurse should expect which of the following findings when assessing a child with acute otitis media?
A. Excessive cerumen in the outer ear
B. Recent respiratory infection
C. Increase mobility on the pneumatic examination
D. Copious amount of tenacious fluid

91. Because abuse involves and affects all the members of a family, the nurse should have which of the following as part of
the care plan goals?
A. Disrupting the dysfunctional family
B. Improving overall family functioning
C. Punishing the abusive family member
D. Removing the abuse victim from the family

92. Surgery is stressful for all children, and emotional support should be included in the nurse’s plan of care. Which of the
following is a useful intervention to prepare the child before eye surgery?
A. Showing the child a doll with patched over both eyes.
B. Restraining the child at the wrist bilaterally for 24 hours
C. Avoiding discussion of the impending surgery
D. Introducing the child to other children on the unit

93. While observing a two-year old girl recently admitted to the hospital, the nurse becomes concerned by which of the
following characteristics?
A. The child is not yet potty trained.
B. The child replies “no” to every position.
C. The child cannot share toys.
D. The child recognizes 4-6 words.

94. Nurse Olive who works in an adolescent clinic knows that obesity
A. in teenagers, is commonly due to hypothyroidism, hypopituitarism, or other endocrine problem.
B. is no more likely to be associated with emotional conflicts in teenagers who are not obese, than in teenagers who are
obsess.
C. during adolescence, is highly correlated with significant psychopathology.
D. is often associated with poor recognition of either hunger of satiation.

95. An 18-month old is being admitted with a diagnosis of Wilm’s tumor. Which nursing intervention takes priority?

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A. Checking vital signs every 8 hours for incidence of hypertension.


B. Placing a sign over the bed which says, “Do not palpate the abdomen”.
C. Raising the head of the bed to ease breathing.
D. Monitoring the urinary output every 2 hours.

96. Children who have brain tumor will have which of the following symptoms?
A. Abdominal pain
B. Vomiting
C. Hypotension
D. Diarrhea

97. Clara is 15 years old ad is admitted to the hospital with anorexia nervosa. She is a model and often spoken as an
overachiever. As the nurse interviews Clara and her family, she may discover other characteristics such as
A. early development of secondary sex characteristics.
B. amenorrhea.
C. permissive parenting.
D. hyperglycemia.

98. Mateo, a child with an IQ of 44, would be categorized as having which type of mental retardation?
A. Mild
B. Moderate
C. Severe
D. Profound

99. When providing anticipatory guidance to parents of a hyperactive child, the nurse would encourage them to
A. assign chores appropriate to the child’s age.
B. be flexible and lenient regarding limits.
C. give instructions to this child in the group setting with the other siblings.
D. delay punishing the child to allow the child to think about mistakes.

100. Which of the following is commonly seen in children with anorexia nervosa?
A. Morbid obesity
B. Ingesting copious amounts of water
C. Body mass index above 85% of expected
D. Binge eating and purging

Prepared by: Archie D. Alviz, R.N., R.M., N.C. II | manofsteel_archie@yahoo.com| facebook fan page: Sir Archie D. Alviz

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