Free Nursing Test Bank Questions – Pediatrics

MULTIPLE CHOICE

 

  1. In terms of fine motor development, what could the 3-year-old child be expected to do?
a. Tie shoelaces.
b. Copy (draw) a circle.
c. Use scissors or a pencil very well.
d. Draw a person with seven to nine parts.

 

 

ANS:  B

Three-year-olds are able to accomplish this fine motor skill of copying (drawing) a circle. The ability to tie shoelaces, to use scissors or a pencil very well, and to draw a person with seven to nine parts are fine motor skills of 5-year-olds.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 586

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. According to Piaget, magical thinking is the belief that:
a. thoughts are all-powerful.
b. God is an imaginary friend.
c. events have cause and effect.
d. if the skin is broken, the insides will come out.

 

 

ANS:  A

Because of their egocentrism and transductive reasoning, preschoolers believe that thoughts are all-powerful. Believing God is an imaginary friend is an example of concrete thinking in a preschooler’s spiritual development. Cause-and-effect implies logical thought, not magical thinking. Believing that, if the skin is broken, the insides will come out is an example of concrete thinking in development of body image.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 588

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. In terms of cognitive development, the 5-year-old child would be expected to do which of the following?
a. Think abstractly.
b. Use magical thinking.
c. Understand conservation of matter.
d. Understand another person’s perspective.

 

 

ANS:  B

Magical thinking is believing that thoughts can cause events. An example would be that thinking of the death of a parent might cause it to happen. Abstract thought does not develop until school-age years. The concept of conservation is the cognitive task of school-age children, ages 5 to 7 years. A five-year-old child cannot understand another’s perspective.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 588

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. The nurse is caring for a hospitalized 4-year-old boy. His parents tell the nurse they will be back to visit at 6 PM. When he asks the nurse when his parents are coming, the nurse’s best response would be which of the following?
a. “They will be here soon.”
b. “They will come after dinner.”
c. “Let me show you on the clock when 6 PM is.”
d. “I will tell you every time I see you how much longer it will be.”

 

 

ANS:  B

A 4-year-old understands time in relation to events such as meals. Children perceive “soon” as a very short time. The nurse may lose the child’s trust if his parents do not return in the time he perceives as “soon.” Children cannot read or use a clock for practical purposes until age 7 years. “I will tell you every time I see you how much longer it will be” assumes the child understands the concepts of hours and minutes, which does not occur until age 5 or 6 years.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 594

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. A 4-year-old boy is hospitalized with a serious bacterial infection. He tells the nurse that he is sick because he was “bad.” Which of the following is the nurse’s best interpretation of this comment?
a. Sign of stress
b. Common at this age
c. Suggestive of maladaptation
d. Suggestive of excessive discipline at home

 

 

ANS:  B

Preschoolers cannot understand the cause and effect of illness. Their egocentrism makes them think they are directly responsible for events, making them feel guilt for things outside of their control. Children of this age react to stress by regressing developmentally or acting out. Maladaptation is unlikely. This comment does not imply excessive discipline at home.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 588

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. A 4-year-old child tells the nurse that she doesn’t want another blood sample drawn because “I need all of my insides and I don’t want anyone taking them out.” Which of the following is the nurse’s best interpretation of this?
a. Child is being overly dramatic.
b. Child has a disturbed body image.
c. Preschoolers have poorly defined body boundaries.
d. Preschoolers normally have a good understanding of their bodies.

 

 

ANS:  C

Preschoolers have little understanding of body boundaries, which leads to fears of mutilation. The child is not capable of being dramatic at this age. She truly has fear. Body image is just developing in the school-age child. Preschoolers do not have good understanding of their bodies.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 589

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. Which of the following types of play is most typical of the preschool period?
a. Team
b. Parallel
c. Solitary
d. Associative

 

 

ANS:  D

Associative play is group play in similar or identical activities but without rigid organization or rules. School-age children play in teams. Parallel play is that of toddlers. Solitary play is that of infants.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 590

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. Which of the following characteristics best describes the language skills of a 3-year-old child?
a. Asks meanings of words
b. Follows directional commands
c. Can describe an object according to its composition
d. Talks incessantly regardless of whether anyone is listening

 

 

ANS:  D

Because of the dramatic vocabulary increase at this age, 3-year-olds are known to talk incessantly regardless of whether anyone is listening. A 4- to 5-year-old asks lots of questions and can follow simple directional commands. A 6-year-old can describe an object according to its composition.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 590

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. During a well-child visit the father of a 4-year-old boy tells the nurse that he is not sure if his son is ready for kindergarten. The boy’s birthday is close to the cut-off date, and he has not attended preschool. Which of the following is the nurse’s best recommendation?
a. Start kindergarten.
b. Observe a kindergarten class.
c. Perform developmental screening.
d. Postpone kindergarten and go to preschool.

 

 

ANS:  C

A developmental assessment with a screening tool that addresses cognitive, social, and physical milestones can help identify children who may need further assessment. A readiness assessment involves an evaluation of skill acquisition. Stating the child should start kindergarten or go to preschool and postpone kindergarten does not address the father’s concerns about readiness for school. Observation of a class will provide information about what happens during the day. The father can use this to help determine if his son is ready.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 592

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. Parents tell the nurse they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom. Which of the following is the most appropriate recommendation for the nurse to make?
a. Punish children so this behavior stops.
b. Neither condone nor condemn the curiosity.
c. Get counseling for this unusual and dangerous behavior.
d. Allow children unrestricted permission to satisfy this curiosity.

 

 

ANS:  B

Three-year-olds become aware of anatomic differences and are concerned about how the other sex “works.” Such exploration should not be condoned or condemned. Children should not be punished for this normal exploration. This is age appropriate and not dangerous behavior. Encouraging the children to ask their parents questions and redirecting their activity is more appropriate than giving permission.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 597

TOP:   Integrated Process: Teaching/Learning

MSC:  Client Needs: Health Promotion and Maintenance

 

  1. A boy age 4 1/2 years has been having increasingly frequent angry outbursts in preschool. He is aggressive toward the other children and the teachers. This behavior has been a problem for approximately 8 to 10 weeks. His parent asks the nurse for advice. Which of the following is the most appropriate intervention?
a. Refer the child for a professional psychosocial assessment.
b. Explain that this is normal in preschoolers, especially boys.
c. Encourage the parent to try more consistent and firm discipline.
d. Talk to the preschool teacher to obtain validation for behavior parent reports.

 

 

ANS:  A

The preschool years are a time when children learn socially acceptable behavior. The difference between normal and problematic behavior is not the behavior, but the severity, frequency, and duration. This child’s behavior meets the definition requiring professional evaluation. Some aggressive behavior is within normal limits, but at 8 to 10 weeks this behavior has persisted too long. There is no indication that the parents are using inconsistent discipline. A part of the evaluation is to obtain validation for behavior the parent reports.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 599             TOP:   Nursing Process: Planning

MSC:  Client Needs: Health Promotion and Maintenance

 

  1. Which one of the following dysfunctional speech patterns is a normal characteristic of the language development of a preschool child?
a. Lisp
b. Echolalia
c. Stammering
d. Repetition without meaning

 

 

ANS:  C

Stammering and stuttering are normal dysfluency in preschool-age children. Lisps are not a normal characteristic of language development. Echolalia and repetition are traits of toddlers’ language.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 599

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. The parent of a 4-year-old boy tells the nurse that the child believes “monsters and bogeymen” are in his bedroom at night. The nurse’s best suggestion for coping with this problem is which of the following?
a. Let the child sleep with his parents.
b. Keep a night light on in the child’s bedroom.
c. Help the child understand that these fears are illogical.
d. Tell the child that monsters and bogeymen do not exist.

 

 

ANS:  B

Involve the child in problem solving. A night light shows a child that imaginary creatures do not lurk in the darkness. Letting the child sleep with parents will not get rid of the fears. A 4-year-old is in the preconceptual stage and cannot understand logical thought.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 600

TOP:   Integrated Process: Teaching/Learning

MSC:  Client Needs: Health Promotion and Maintenance

 

  1. Which of the following is descriptive of the nutritional requirements of preschool children?
a. Quality of the food consumed is more important than the quantity.
b. Average daily intake of preschoolers should be about 3000 calories.
c. Nutritional requirements for preschoolers are very different from requirements for toddlers.
d. Requirements for calories per unit of body weight increase slightly during the preschool period.

 

 

ANS:  A

Parents need to be reassured that the quality of food eaten is more important than the quantity. Children are able to self-regulate their intake when offered foods high in nutritional value. The average daily caloric intake should be approximately 1800 calories. Toddlers and preschoolers have similar nutritional requirements. There is an overall slight decrease in needed calories and fluids during the preschool period.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 601

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. A child age 4 1/2 years sometimes wakes her parents up at night screaming, thrashing, sweating, and apparently frightened. Yet she is not aware of her parents’ presence when they check on her. She lies down and sleeps without any parental intervention. This is most likely which of the following?
a. Nightmare
b. Sleep terror
c. Sleep apnea
d. Seizure activity

 

 

ANS:  B

This is a description of a sleep terror. The child is observed during the episode and not disturbed unless there is a possibility of injury. A child who awakes from a nightmare is distressed. She is aware of and reassured by the parent’s presence. This is not the case with sleep apnea. This behavior is not indicative of seizure activity.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 603

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. During the preschool period the emphasis of injury prevention should be placed on which of the following?
a. Limitation of physical activities
b. Punishment for unsafe behaviors
c. Constant vigilance and protection
d. Teaching about safety and potential hazards

 

 

ANS:  D

Education about safety and potential hazards is appropriate for preschoolers because they can begin to understand dangers. Limitation of physical activities is not appropriate. Punishment may make children scared of trying new things. Constant vigilance and protection is not practical at this age, since preschoolers are becoming more independent.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 604

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. The nurse is talking to the parent of a 5-year-old child who refuses to go to sleep at night. Which of the following interventions should the nurse suggest in helping the parent to cope with this sleep disturbance?
a. Establish a consistent punishment if the child does not go to bed when told.
b. Allow child to fall asleep in a different room, then gently move the child to his or her bed.
c. Establish limited rituals that signal readiness for bedtime.
d. Allow the child to watch television until almost asleep.

 

 

ANS:  C

An appropriate intervention for a child who resists going to bed is to establish limited rituals such as a bath or story that signal readiness for bed and consistently follow through with the ritual. Punishing the child will not alleviate the resistance problem and may only add to the frustration. Allowing the child to fall asleep in a different room or to watch television to fall asleep is not a recommended approach to sleep resistance.

 

DIF:    Cognitive Level: Application           REF:   p. 602             TOP:   Nursing Process: Planning

MSC:  Client Needs: Health Promotion and Maintenance

 

  1. At a seminar for parents with preschool-age children the nurse has discussed anticipatory tasks during the preschool years. Which of the following statements by a parent would indicate a correct understanding of the teaching?
a. “I should be worried if my 4-year-old child has an increase in sexual curiosity, since this is a sign of sexual abuse.”
b. “I should expect my 5-year-old to change from a tranquil child to an aggressive child when school starts.”
c. “I should be concerned if my 4-year-old child starts telling exaggerated stories and has an imaginary playmate, since these could be signs of stress.”
d. “I should expect my 3-year-old child to have a more stable appetite and an increase in food selections.”

 

 

ANS:  D

A 3-year-old exhibits a more stable appetite than during the toddler years and is more willing to try different foods. A 4-year-old child is imaginative and indulges in telling “tall tales” and may have an imaginary playmate; these are normal findings, not signs of stress. Also a 4-year-old has an increasing curiosity in sexuality, which is not a sign of child abuse. A 5-year-old child is usually tranquil, not aggressive like the 4-year-old child.

 

DIF:    Cognitive Level: Analysis                REF:   p. 604             TOP:   Nursing Process: Planning

MSC:  Client Needs: Health Promotion and Maintenance

 

MULTIPLE RESPONSE

 

  1. Which if the following developmental achievements are demonstrated by a 4-year-old child? Select all that apply.
a. Cares for self totally
b. Throws a ball overhead
c. Has a vocabulary of 1500 words
d. Can skip and hop on alternate feet
e. Tends to be selfish and impatient
f. Commonly has an imaginary playmate

 

 

ANS:  B, C, E, F

Developmental achievements for a 4-year-old include throwing a ball overhead, having a vocabulary of 1500 words, tending to be selfish and impatient, and perhaps having an imaginary playmate. Caring for self totally and skipping and hopping on alternate feet are achievements normally seen in the 5-year-old age-group.

 

DIF:    Cognitive Level: Application           REF:   p. 594

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance