Baby / Children

Question 1

All of the following are periods of prenatal development except:
a. germinal
b. embryonic
c. fetal
d. postpartum

Answer 1

D

Question 2

Lack of prenatal care increases the risk of all of the following except:
a. infants with low birth weight.
b. child abuse
c. increased infant mortality
d. preterm births

Question 3

All of the following have been found to endanger the unborn child except:
a. saunas and hot tubs
b. PCB - polluted fish
c. carbon monoxide
d. computer monitors

Question 4

What frequently happens between adolescents and parents?
a. they compete for family resources.
b. they violate one another’s expectations.
c. they reject one another’s personal space.
d. they get along well because they share similar levels of cognitive development.

Question 5

Nurse Julia plans to instruct the postpartum client about methods to prevent breast engorgement. Which of the following measures would the nurse include in the teaching plan?
a. decreasing fluid intake for the first 24-48hrs.
b. breast-feeding the bay at frequent intervals.
c. wearing a supportive bra with nipple shields.
d. feeding the baby a maximum of 5mins per side on the first day.

Answer 5

Breast-feeding the baby at frequent intervals.

Question 6

A new mother calls the clinic crying because her 2 day old infant now weighs 7pounds, 2 ounces and when he weighed 7 pounds, 8 ounces at birth. She says, “i must be doing something wrong.” The nurse should respond?
a. The infant should be taken to the nearest emergency room immediately.
b. You are right to be concerned. I will schedule an apt for tomorrow.
c. This is normal weight loss. The infant should be back to birth weight in 5-7days.
d. The infant is obviously not feeding enough. Try to feed every 2 hours.

Answer 6

This is normal weight loss. The infant should be back to birth weight in 5-7days.

Question 7

A nurse advises a female client to learn pubococcygeal exercises. What is the purpose of these exercises?
a. contracting and relaxing the gluteus maximus muscle.
b. preventing constipation.
c. contracting and relaxing the muscles of the pelvic floor.
d. helping prevent pregnancy.

Answer 7

Contracting and relaxing the muscles of the pelvic floor.

Question 8

A client tells the nurse, “i think my baby likes to hear me talk to him.” When discussing neonates and stimulation with sound, which of the following would the nurse include as a means to elicit the best response?
a. high-pitched speech with tonal variations.
b. low-pitched speech with a sameness of tone.
c. cooing sounds rather than words.
d. repeated stimulation with loud sounds.

Answer 8

High pitched speech with tonal variations.

Question 9

When the nurse on duty accidentally bumps the bassinet, the neonate throws out it arms, hands opened, and begins to cry. The nurse interprets this reaction as indication of which of the following reflexes?
a. startle reflex
b. babinski reflex
c. grapsing reflex
d. tonic neck reflex

Answer 9

Startle reflex

Question 10

When caring for a 3day old neonate who is recieving photopherapy to treat jaundice, the nurse in charge would expect to do which of the following?
a. notify the physician if the skin becomes bronze in colour.
b. turn the neonate every 6 hours.
c. check the vital signs every 2 to 4 hrs.
d. encourage the mother to discontinue breast-feeding.

Answer 10

Check the vital signs every 2-4hours.

Question 11

A female adult client is taking a progestin-only oral contraceptive, or minipill. Progestin use may increase the patient’s risk for:
a. endometriosis
b. premenstrual syndrome.
c. female hypogonadism
d. tubal or ectopic pregnancy.

Answer 11

Tubal or ectopic pregnancy.

Question 12

A primigravida client at 25weeks gestation visits the clinic and tells the nurse that her lower back aches when she arrives home from work. The nurse should suggest that the client preforms:
a. leg lifting
b. squatting exercises
c. should circling
d. tailor sitting.

Answer 12

Tailor sitting

Question 13

A pregnant patient asks the nurse if she can take castor oil for her constipation. How should the nurse respond?
a. no, it can initiate premature uterine contractions.
b. yes, it produces no adverse effect.
c. no, it can promote sodium retention.
d. no, it can lead to increased absorption of fat-soluable vitamins.

Answer 13

No, it can initiate premature uterine contractions.

Question 14

A pregnant women with pregnanc-induced hypertension probably exhibits which of the following symptoms?
a. Proteinuriea, headaches, vaginal bleeding
b. headaches, double vision, vaginal bleeding
c. proteinuria, headaches, double vision
d. proteinuria, double vision, uterine contractions.

Answer 14

Proteinuria, headaches and double vision.
Proteinuria is elevation protein in the urine.

Question 15

The nurse is seeing several pregnant women at a general practice surgery. Which woman is at highest risk of having a low-birth weight infant or one with birth defects, and is in need of prenatal education?
a. an 18yr old woman who is in her 8th month and has gained 22pounds.
b. a 32 year old woman, unmarried middle class executive secretary.
c. a 25yr old woman who smokes and drinks two beers a day.
d. a 30yr old woman who was 10pounds overweight before becoming pregnant.

Answer 15

A 25yr old woman who smokes and drinks two beers a day.

Question 16

A client asks the nurse why Vit C intake is so important during pregnancy. Which of the following would be the nurse’s best response?
a. Studies have shown that Vit C helps the growth of fetal bones.
b. Supplemental Vit C in large doses can help prevent neural tube defects.
c. Eating moderate amounts of food high in Vit C helps metabolize fats and carbs.
d. Vit C is required to promote blood clot and collagen formation.

Answer 16

Vit C is required to promote blood clot and collagen formation.

Question 17

A young woman who is contemplating pregnancy and has a diet consisting mainly of ‘junk food’ tells the nurse. “I will begin eating right and taking multivitamins after i become pregnant.” The best nursing response is:
a. As long as you consume enough calories, there will not be problems if you become pregnant.
b. You must eat well and take multiple vitamins both before and during pregnancy.
c. Eating well and taking multiple vitamins are not important until the second trimester of pregnancy.
d. You must being eating well and may take multiple vitamins as soon as you suspect that you are pregnant.

Answer 17

You must eat well and may take multiple vitamins both before and during pregnancy.

Question 18

The nurse is caring for a primigravida at about 2mths and 1 week gestation. After explaining self-care measures for common discomforts of pregnancy, the nurse determines that the client understands the instructions when she says:
a. leg cramps can be alleviated if i put an ice pack on the area.
b. nausea and vomitting can be decreased if i eat a few crackers before arising.
c. if i start to leak colostrum, I should cleanse my nipples with soap and water.
d. If i have a vaginal discharge, I should wear nylon underwear.

Answer 18

Nausea and vomiting can be decreased if i eat a few crackers before arising.

Question 19

A bilingual nurse practitioner working in a rural clinic is working with a pregnant mother of four childre. The women does not speak english and has been in the country for several years with her children attending the local school. In an attempt to teach the expectant mother the value of good nutrition on the neonate’s health, the nurse could incoporate which tactic for health promotion activities?
a. Write the information on an information sheet in english for the children to read.
b. Ask the mother to bring an older friend into the clinic for health promotion activities since the children are too young.
c. Give the client a poster with pictures of nutritionally balanced meals and move on.
d. Include the bilingual children in the discussion of good nutrition.

Answer 19

Include the bilingual children in the discussion of good nutrition.

Question 20

A home health nurse has been assigned to an elderly woman who is cohabitating with her daughter and her son in a one bedroom apartment on the edge of town. The grandson is the primary caregiver at the age of 14 since his mother is an alcoholic and often absent from caring for her mother. The home health nurse completes a health history of the client but realizes:
a. the focus of the client teaching should be the grandson.
b. the nurse should report the daughter to child welfare agency as an abusive mother.
c. the nurse should create a plan of care that includes all members of the family.
d. the nurse should congratulate the grandson on his impeccable care of his grandmother.

Answer 20

The nurse should create a plan of care that includes all members of the family.

Question 21

A nurse approaches a family who is living in a shelter for abused women. The mother has bruises around her mouth and on her arms. The nurse asks if she can perform a physical examination to assess the extent of her injuries. As the nurse begins the examination, the woman recoils from the nurse’s touch and screams, “don’t touch me!” The nurse’s best response would be:
a. i know that you have been hurt and i will try not to hurt you with my touch.
b. would you prefer to have another nurse examine you?
c. relax, I have to check how badly you were beaten.
d. i am not going to hurt you.

Answer 21

I know that you have been hurt and i will try not to hurt you with my touch.

Question 22

Which of the following should a nurse consider when evaluating a family’s coping resources?
a. preventative health practices within the family.
b. family structure.
c. roles of family members.
d. availability of support persons.

Question 23

What instruction is most important for the nurse discharging a client home who has had a 14 week amniocentesis?
a. bedrest in the side lying position for 24hrs.
b. report round ligament pain.
c. drink plenty for 24hrs.
d. report contractions or abdominal pain.

Answer 23

Report contractions or abdominal pain.
Amminocentesis is a procedure used to take out small sample of the amniotic fluid for testing.

Question 24

You are questioning a client about how she is enjoying her pregnancy. She replies that she is terrified of labour but hasn’t attended a childbirth class. You assess her need for:
a. informational support
b. advocacy support
c. physical support
d. family support

Answer 24

Informational support.

Question 25

In order to prepare new parents for their first visit to the their baby in the NICU, which statement by the nurse would be the least helpful?
a. i will explain the equipment.
b. your baby is lucky, it could have been much worse.
c. your baby’s primary nurse will talk to you when you arrive at the NICU.
d. saying your baby is small, but has a good cry.

Answer 25

Your baby is lucky, it could have been much worse.

Question 26

After 3 days of breast-feeding, a postpartal patient reports nipple soreness. To reliever her discomfort, the nurse suggest that she should:
a. apply soap directly to her nipples, and then rinse.
b. lubricate her nipples with expressed milk before feeding.
c. apply warm compresses to her nipples just before feedings.
d. dry her nipples with a soft towel after feedings.

Answer 26

lubricate her nipples with expressed milk before feeding.

Question 27

The nurse is developing a teaching plan for a patient who is 8 weeks pregnant. The nurse should tell the patient that she can expect to feel the fetus move at which time?
a. between 21-23 weeks.
b. between 10-12 weeks.
c. between 24-26weeks.
d. between 16-20 weeks.

Answer 27

Between 16-20 weeks.

Question 28

Four female clients at the clinic where you work want information about contraception. What person is the best candidate for an intrauterine device (IUD)?
a. a 16yr old client is nulliparous.
b. a 40yr old woman who is a smoker.
c. 22yr old client with multiple sexual partners.
d. 32yr old client with untreated chlamydia.

Answer 28

a 40yr old women who is a smoker.

Question 29

A client who has recently initiated use of IUD for contraception reports to you that she has not had a period in 3mths. How should you repsond to this?
a. amenorrhea is associated with anorexia nervosa. Are you eating normally?
b. Amenorrhea can be a normal side effect of IUD use.
c. maybe early menopause is occurring.
d. you are probably pregnant.

Answer 29

Amenorrhea can be a normal side effect of the IUD use.

Question 30

Sally calls to report that she is having pain with intercourse following insertion of an IUD. Which nursing intervention is appropriate?
a. inquire about nausea and vomiting.
b. encourage the client to take a herbal supplement prior to intercourse.
c. refer her to a sexual counselor.
d. ask the client to come to the clinic for an apt.

Answer 30

Ask the client to come to the clinic for an apt.

Question 31

The nurse asks a client taking combined oral contraceptives to describe her menstrual cycle. The client reports frequent episodes of break-through bleeding. What information will the nurse ask for next?
a. type of menstrual protection used.
b. number of sex partners.
c. regularity of taking the pill.
d symptoms of sexually transmitted diseases.

Answer 31

Regularity of taking the pill.

Question 32

A client is having difficulty with her combined oral contraceptive pill. In order to ascertain whether or not the side effects are due to progesterone ingestion, the nurse asks about which of the following symptoms?
a. breast tenderness, chloasma, and fluid retention.
b. nausea, nervousness and irritability.
c. weight gain, headache and hypertension.
d. decreased libido, acne and fatigue.

Question 33

You see four pregnant clients in one day at the outpatient department where you work. Which client is most at risk for spontaneous preterm birth?
a. 40yr old with anemia.
b. 17yr old with twins.
c. 26yr old with history of DM.
d. 18yr old with a hyperthyroid disorder.

Question 34

A pregnant client at 27weeks gestation telephones you to check that her LMC is correct in saying she does not need to be seen more often than 4 weekly for checkups at this stage of her pregnancy. You tell her that she needs to be seen by her LMC:
a. in 4 weeks
b. in 1 week.
c. only when symptoms change or worsen.
d. in 2 weeks.

Answer 34

in four weeks.

Question 35

A client at 18weeks gestation has requested you measure her BP. Her ‘booking’ BP pressure with her midwife was 122/82. Which of the following BP recordings would be considered normal at this visit?
a. 126/82
b. 130/90
c. 118/76
d. 110/70

Question 36

You are measuring BP on a client who at 32 weeks gestation. She begins to feel dizzy while lyping supine. What nursing intervention would be most appropriate?
a. administer O2 at 4L via hudson mask.
b. notify the GP.
c. Start IV fluids.
d. place client on her left side.

Answer 36

Place client on her left side.

Question 37

A client at 8 weeks gestation asks why she is experiencing nausea and vomiting so early in her pregnancy. Which of the following statements best explains the nurse’s understanding of pregnancy hormones which contribute to nausea and vomiting?
a. increased levels of prostaglandin contribute to N/V during pregnancy.
b. increased levels of human chorionic gonadotrophin (hCG) contribute to N/V during pregnancy.
c. increased levels of progesterone contribute to N/V during pregnancy.
d. increased levels of oestrogen contribute to N/V during pregnancy.

Question 38

When a 4yr old child refuses to take a medication in pill form because it is “too big and it hurts when i swallow”, the nurse demostrates critical thinking by:
a. checking with the pharmacy to see if the medication can be dispensed in liquid form.
b. allowing the child to skip a dose this one time documentate the reason why.
c. ask the mother how she gets him to cooperate.
d. ask the nurse manager what to do?

Answer 38

Check with the pharmacy to see if the medication can be dispensed in liquid form.

Question 39

What statement by a nurse to a new nurse, orientating to the unit, is correct regarding seizure precautions?
a. do not force a tongue depressor between the teeth.
b. apply o2 if the client turns cyanotic.
c. any seizure can lead to status epilepticus.
d. administering an anticonvulsant drug is not beneficial.

Answer 39

Do not force a tongue depressor between the teeth.

Question 40

Parents of a 2 1/2 yr old child report that the child has began to have temper tantrums and ask the nurse what they should do. Strategies that the nurse could suggest include:
a. attempting to reason with the child during the tantrum.
b. giving the child what is wanted to avoid the tantrums.
c. determining the child’s safety and then leaving the room when the child has a tantrum.
d. throwing cold water on the child during the tantrum to help the child ‘snap out of it.’

Answer 40

Determining the child’s safety and then leaving the room when the child has a tantrum.

Question 41

The nurse is developing a teaching plan for a 9yr old female client who is a diabetic. Which actions would be appropriate?
a. discussing future hazards of pregnancy for diabetic mothers.
b. using hypothetical problem situations to teach potential problem solving.
c. using hand puppets to teach proper nutrition.
d. teaching size of food portions and importance of timing snacks and meals.

Question 42

The nurse discusses the eating habits of school-aged children with their parents, explaining that these habits are most influenced by which of the following?
a. smell and appearance of foods offered.
b. examples provided by parents at mealtimes.
c. food preferences of their peers.
d. parental encouragement to eat nutritious foods.

Answer 42

Examples provided by parents at mealtimes.

Question 43

A mother calls the clinic to talk to the nurse. The mother states that physician described her daughter has have 20/60 vision and ask the nurse what this means? The nurse responds based on the interpretation that the child is experiencing which of the following?
a. visual acuity 3times better than average.
b. ability to see at 60ft what she should see at 20ft.
c. a loss of approx 1/3 of her visual acuity.
d. ability to see at 20ft what she should see at 60ft.

Answer 43

Ability to see at 20ft what she should see at 60ft.

Question 44

A family with 5 children experiences a stillbirth. While intervening with the family, one member expresses a view that causes special concern for the nurse. This person is:
a. a 3yr old who wonders if the baby will come home after it gets better.
b. a 5yr old who cries, believing the death occured because the child drew with magic markers on one of the baby blankets.
c. a 13yr old who assumes blame as punishment for shoplifting.
d. a 15yr old who says ‘ i still can’t believe it.”

Answer 44

A 13yr old who assumes blame as punishment for shoplifting.

Question 45

A mother is frustrated because her 2 1/2 year old daughter is not toilet trained and will not use the pottery when placed on it. What suggestion by the nurse is most appropraite?
a. make up a game to encourage the child to want to use the potty.
b. Do not let the child off the potty until stool or urine is evacuated.
c. do not try to toilet train the child, as it is too early.
d. give the child a laxative and place on the potty in 30mins.

Answer 45

Make up a game to encourage the child to want to use the potty.

Question 46

A parent asks, “can i get head lice too?” The nurse indicates that adults can also be infested with head lice but that pediculosis is more common among school children, primarily for which of the following reasons?
a. an immunity to pediculosis usually is established by adulthood.
b. school aged children tend to be more neglectful of frequent handwashing.
c. the skin of adults is more capable of resisting the invasion of lice.
d. Pediculosis is usually spread by close contact with infested children.

Answer 46

Pediculosis is usually spread by close contact with infested children.

Question 47

A 6mth infant is brought to the clinic by an aunt who says the infant’s parents are out of the country on business. The nurse notes that the infant seems healthy but withdrawn, and is below the 5th percentile for weight and height on the standard growth chart. The aunt states the infant has had a succession of undependable babysitters since she was born, and that the parents work extremely long hours. Based on the assessment data, the nurse forms a preliminary diagnosis of:
a. child abuse - shaken baby syndrome.
b. weight loss related to infant colic.
c. failure to thrive related to organic causes.
d. Failure to thrive related to inorganic causes.

Answer 47

Failure to thrive related to inorganic causes.

Question 48

Which technique is best for assessing the respiration of a 3yr old?
a. place one hand against the chest when counting.
b. use a stethoscope and auscultate the lungs.
c. tell the child you will check his breathing.
d. obverse the rise and fall of the abdomen.

Question 49

What is the preferred site for measuring body temperature in very young children?
a. rectal
b. axillary
c. temporal
d. oral

Answer 49

Axillary

Question 50

A nurse feels vulnerable after a child dies following a lengthy reuscitation effort. A positive coping strategy for the nurse is to:
a. take a sedative when getting home.
b. review the resuscitation until mistakes are found to explain the child’s death.
c. accept it as part of the days work with vulnerable children.
d. meet with others who participated in the resuscitation to grieve together.

Answer 50

Meet with others who participated in the resuscitation to grieve together.

Question 51

When discussing the onset of adolescence with parents, the nurse explains that it occurs at which of the following times:
a. same age for both boys and girls.
b. 1 - 2 years earlier in boys than girls.
c. 3-4 years later in boys than in girls.
d. 1-2 yrs earlier in girls than in boys.

Answer 51

1-2 year earlier in girls than in boys.

Question 52

Parents report that they think their 15yr son is moody and rude. The nurse develops a plan with the parents that includes which of the following initially?
a. obtaining family counseling.
b. discussing their feelings with him.
c. limiting involvement in non-school activities.
d. talking with other parents of adolescents.

Answer 52

Discussing their feelings with him.

Question 53

An 18yr old adolescent client expresses fear over a complex, painful, sterile procedure, and asks that the chaplain be allowed in the room and close by while it is being performed. The best nursing action would be to:
a. place the chaplain by a window where the client can see him or her during the procedure.
b. explain that procedure is sterile, and that the chaplain cannot stay, but can return as soon as its completed.
c. let the chaplain stand way back in a far corner of the room during the procedure.
d. place the chaplain in sterile apparel and allow them to be close to the client during the procedure.

Answer 53

place the chaplain in sterile apparel and allow them to be close to the client during the procedure.

Question 54

A 15yr old client with cancer, together with her parents, has decided against further treatment. Which nursing action would be most helpful?
a. informing the clients physician, and asking her/him to the client and intervene, if necessary.
b. Accepting hte decision and making no comments to the family.
c. talking to the parents and trying to persuade the client to think about reversing the decision.
d. making sure the client has accurate information and understands the consequences of the decision.

Answer 54

making sure the client has accurate information and understands the consequences of the decision.

Question 55

A 15yr old girl has been admitted to the obstetrics unit after delivering her second baby in 2yrs. The focus of health promotion activities should be:
a. obtaining income support to feed the childre.
b. methods of birth control.
c. a lecture on the perils of unprotected sexual intercourse.
d. a discussion on the morality of having children out of wedlock.

Answer 55

Methods of birth control.

Question 56

A mother states that her 14yr old daughter has abdominal cramps during menstruation. What should the nurse advise?
a. use an ice pack to the abdomen.
b. take your daughter to ED.
c. have your daughter rest and apply warmth to the abdomen.
d. it sounds as though your daughter wants to stay home from school.

Answer 56

have your daughter rest and apply warmth to the abdomen.

Question 57

The school nurse is invited to attend a meeting with several parents who express their frustration with the amount of time their adolescents spend in front of the mirror and the length of time it takes them to get dressed. The nurse explains that this behaviour is indicative of which of the following:
a. a way of testing the parents limit-setting.
b. an abnormal narcissism.
c. a result of developing self-concept.
d. a method of procrastination.

Answer 57

A result of developing self-concept.

Question 58

An 18yr old woman reports the following health history: sexual activity beginning age 14, multiple sex partners and previous Trichomonas vaginitis. Based on this history, the nurse knows that an essential screening exam to prepare the client for will be:
a. chest x-ray
b. Papanicolau test (pap)
c. drug screen
d. breast exam and mammography

Answer 58

Pap test.

Question 59

A client is non compliant about adhering to dietary restrictions designed to manage his DM. Which statement by the nurse would be most likely to motivate the client to comply with treatment?
a. I don’t understand why you don’t follow your diet.
b. let me review your diet with you again, because you don’t seem to understand it.
c. i understand that following this diet is hard for you. Can you share with me why this has been difficult?
d. not following your diet may shorten your life?

Answer 59

i understand that following this diet is hard for you. Can you share with me why this has been difficult?

Question 60

Several high school seniors are referred to the school nurse because of suspected alcohol misuse. When the nurse assesses the situation, which of the following would be most important to determine?
a. the reasons they choose to use alcohol?
b. when and with who they use alcohol.
c. the type of alcohol they usually drink.
d. what they know about the legal implications of drinking.

Answer 60

The reasons they choose to use alcohol.

Question 61

A 19yr old student has had a breast biopsy and is nervous about the results. The resident physician peeks into her room and says “the biopsy is negative”. The nurse finds the student in her room sobbing. What is the nurse’s best response to the this situation?
a. why are you crying with such good news?
b. the term negative in this case is good.
c. you seem upset. Do you want to talk to me about the results?
d. what did the physician tell you?

Answer 61

you seem upset. Do you want to talk to me about the results?

Question 62

The school nurse develops a plan with an adolescent to provide relief of dysmenorrhea to aid in her development of which of the following?
a. a sense of autonomy.
b. positive peer relations.
c. a sense of independence.
d. positive self-identity.

Answer 62

Positive self identity.

Question 63

An adolescent tells the school nurse that she would like to use tampons during her period. Which of the following would be most appropriate for the nurse to do?
a. provide information about preventing toxic shock syndrome.
b. determine whether she is sexually active.
c. assess her usual menstrual flow pattern.
d. refer to her specialist in adolescent gynecology.

Answer 63

Provide information about preventing toxic shock syndrome.