POST TEST - MCN: PEDIATRICS

1.  A 6-month-old male is at his well-child checkup. The nurse weighs him, and his mother asks if his (1 point)
weight is normal for his age. The nurse’s best response is:
      ⚪ “At 6 months his weight should be approximately three times his birth weight.”
      ⚪ “Each child gains weight at his or her own pace.”
      ⚫ “At 6 months his weight should be approximately twice his birth weight.”
      ⚪ “At 6 months a child should weigh about 10 lb more than his or her birth weight.”

6 mos doubles; 12 mos triples, 18 mos quadruples

2.  How can the nurse best facilitate the trust relationship between infant and parents while the infant is (1 point)
hospitalized? The nurse should:
      ⚪ Encourage the parents to remain at their child’s bedside as much as possible.
      ⚪ Keep parents informed about all aspects of their child’s condition.
      ⚫ Encourage the parents to hold their child as much as possible.
      ⚪ Advise the parents to participate actively in their child’s care.

3.  Which statement by an infant’s mother leads the nurse to believe that she needs further education (1 point)
about the nutritional needs of a 6-month-old?
      ⚫ “I will continue to breastfeed my son and will give him rice cereal three times a day.”
      ⚪ “I will start my son on fruits and gradually introduce vegetables.”
      ⚪ “I will start my son on carrots and will introduce one new vegetable every few days.”
      ⚪ “I will not give my son any more than 8 ounces of baby juice per day.”

4.  Which statement accurately describes the best method for assessing a 12-month-old? (1 point)
      ⚪ The nurse should assess the child on the examining table.
      ⚪ The nurse should assess the child in a head-to-toe sequence.
      ⚫ The nurse should have the child’s mother assist in holding her down.
      ⚪ The nurse should assess the child while she is in her mother’s lap.

5.  The parents of a newborn are asking the nurse how to use the infant car seat and where it should be (1 point)
placed in their vehicle. Which is the next most appropriate action by the nurse?
      ⚪ Give the parents a pamphlet explaining how to install the car seat.
      ⚪ Accompany the parents to the car, and show them how to install the car seat.
      ⚫ Contact the hospital’s car-seat safety officer, and ask the officer to accompany the parents to the car for car-
seat installation.
      ⚪ Show the parents a video on car-seat installation and safety, and ask if they are comfortable with the
information.

6.  The mother of a newborn asks the nurse when the infant will receive the first hepatitis B immunization. (1 point)
Which is the nurse’s best response?
      ⚪ “Babies receive the hepatitis B vaccine only if their mother is hepatitis B–positive.”
      ⚫ “The first dose of the hepatitis B vaccine will be given prior to discharge today.”
      ⚪ “The first dose of hepatitis B vaccine is given at 1 year of age.”
      ⚪ “Babies receive their first hepatitis B vaccine at 6 months of age.”

7.  Which finding would the nurse consider abnormal when performing a physical assessment on a 6- (1 point)
month-old?
      ⚫ Posterior fontanel is open.
      ⚪ Anterior fontanel is open.
      ⚪ Beginning signs of tooth eruption.
      ⚪ Able to track and follow objects.

Posterior = closes 2-3 mos; Anterior = closes 12-18 mos

8.  A mother requests that her child receive the varicella vaccine at the 9-month well-child checkup. The (1 point)
nurse tells the mother that:
      ⚪ Children who are vaccinated will likely develop a mild case of the disease.
      ⚫ The vaccine cannot be given at that visit.
      ⚪ The vaccine will be administered after the physician examines the child.
      ⚪ A booster vaccination will be needed at 18 months of age.

12-15 mos; 4 yrs (2nd dose)

9.  An 8-day-old was admitted to the hospital with vomiting and dehydration. The newborn’s heart rate is (1 point)
170, respiratory rate is 44, blood pressure is 85/52, and temperature is 99°F (37.2°C). What is the
nurse’s best response to the parents who ask if the vital signs are normal?
      ⚪ “The blood pressure is elevated, but the other vital signs are within normal limits.”
      ⚪ “The temperature is elevated, but the other vital signs are within normal limits.”
      ⚪ “The respiratory rate is elevated, but the other vital signs are within normal limits.”
      ⚫ “The heart rate is elevated, but the other vital signs are within normal limits.”

10.  Which statement by the mother of an 18-month-old would lead the nurse to believe that the child (1 point)
should be referred for further evaluation for developmental delay?
      ⚫ “My child is able to stand but is not yet taking steps independently.”
      ⚪ “My child has a vocabulary of approximately 15 words.”
      ⚪ “My child is still sucking his thumb.”
      ⚪ “My child seems to be quite wary of strangers.”

Walking = 12 mos; Stand on 1 foot = 4 years old; Walks down stairs = 5 yrs old; Tandem walk = 6

11.  The mother of a child 2 years 6 months has arranged a play date with the neighbor and her child 2 (1 point)
years 9 months. During the play date the two mothers should expect that the children will do which of
the following?
      ⚪ Share and trade their toys while playing.
      ⚪ Play with one another with little or no conflict.
      ⚫ Play alongside one another but not actively with one another.
      ⚪ Only play with one or two items, ignoring most of the other toys.

PLAY:

Infant – Solitary; Toddler - Parallel; Preschool – associative; School age – Cooperative; Adolescence - competitive

12.  A 2-year-old admitted to the hospital 2 days ago has been crying and is inconsolable much of the (1 point)
time. The nurse’s best response to the child’s parents who are concerned about this behavior is that
the child is in the:
      ⚪ Detachment phase of separation anxiety, which is normal for children during hospitalization.
      ⚪ Despair stage of separation anxiety, which is normal for children during hospitalization.
      ⚪ Bargaining stage of separation anxiety, which is normal for children during hospitalization.
      ⚫ Protest stage of separation anxiety, which is normal for children during hospitalization.

13.  Which comment should the parent of a 2-year-old expect from the toddler about a new baby brother? (1 point)
      ⚪ “When the baby takes a nap, will you play with me?”
      ⚪ “Can I play with the baby?”
      ⚪ “The baby is so cute. I love him.”
      ⚫ “It is time to put him away so we can play.”

14.  Which stressor is common in hospitalized toddlers? Select all that apply. (1 point)
      ⬛ Social isolation.
      ⬛ Interrupted routine.
      ⬛ Sleep disturbances.
      ⬜ Self-concept disturbances.
      ⬛ Fear of being hurt.

15.  The best method to explain a procedure to a hospitalized preschool-age child is to: (1 point)
      ⚪ Show the child a pamphlet with pictures showing the procedure.
      ⚪ Have the 5-year-old next door tell the 4-year-old about the experience.
      ⚫ Demonstrate the procedure on a doll.
      ⚪ Show the child a video of the procedure

16.  A 3-year-old is hospitalized for an ASD repair. The parents have decided to go home for a few hours (1 point)
to spend time with her siblings. The child asks when her mommy and daddy will be back. The nurse’s
best response is:
      ⚫ “Your mommy and daddy will be back after your nap.”
      ⚪ “Your mommy and daddy will be back at 6:00 p.m.”
      ⚪ ''Your mommy and daddy will be back later this evening.”
      ⚪ “Your mommy and daddy will be back in 3 hours.”
17.  Which approach should the nurse use to gather information from a child brought to the ED for (1 point)
suspected child abuse?
      ⚪ Promise the child that her parents will not know what she tells the nurse.
      ⚪ Promise the child that she will not have to see the suspected abuser again.
      ⚪ Use correct anatomical terms to discuss body parts.
      ⚫ Tell the child that the abuse is not her fault and that she is a good person.

18.  What can a nurse do to reinforce a 5-year-old’s intellectual initiative when he asks about his upcoming (1 point)
surgery?
      ⚫ Answer the child’s questions about his upcoming surgery in simple terms.
      ⚪ Provide the child with a book that has vivid illustrations about his surgery.
      ⚪ Tell the child he should wait and ask the doctor his questions.
      ⚪ Tell the child that she will answer his questions at a later time.

19.  The nurse realizes that a 5-year-old’s mother needs further education about the Denver (1 point)
Developmental Screening Test when she states:
      ⚪ “It screens for gross motor skills.”
      ⚪ “It screens for fine motor skills.”
      ⚫ “It screens for intelligence level.”
      ⚪ “It screens for language development.”