quiz #2 Flashcards
Which is the first sign of puberty in females?
a. Pubic hair growth
b. Menarche
c. Breast development
d. Growth spurt
Answer: c. Breast development
Rationale: Breast development (thelarche) is the first sign of puberty in females, followed by pubic hair growth, growth spurt, and menarche.
What is the correct sequence of puberty in males?
a. Penile growth → Voice deepening → Facial hair development
b. Testicular enlargement → Penile growth → Growth spurt
c. Pubic hair growth → Testicular enlargement → Penile growth
d. Testicular enlargement → Voice deepening → Growth spurt
Answer: b. Testicular enlargement → Penile growth → Growth spurt
Rationale: Testicular enlargement is the first sign of puberty in males, followed by pubic hair growth, penile growth, growth spurt, voice deepening, and facial hair development.
Which event marks the completion of puberty in females?
a. Growth spurt
b. Menarche
c. Breast development
d. Pubic hair growth
Answer: b. Menarche
Rationale: Menarche (the onset of menstruation) is typically the final event in the sequence of puberty in females.
An adolescent struggling to form a sense of identity is in which of Erikson’s stages?
a. Trust vs. Mistrust
b. Autonomy vs. Shame/Doubt
c. Identity vs. Role Confusion
d. Industry vs. Inferiority
Answer: c. Identity vs. Role Confusion
Rationale: Adolescents (12-18 years) are in Erikson’s stage of Identity vs. Role Confusion, focusing on developing a sense of self and personal identity.
Which asthma patient should be treated first?
a. A child with occasional wheezing and no retractions
b. A child with retractions, oxygen saturation of 92%, and wheezing
c. A child who is cyanotic, cannot speak, and has an oxygen saturation of 88%
d. A child with mild wheezing controlled by an inhaler
Answer: c. A child who is cyanotic, cannot speak, and has an oxygen saturation of 88%
Rationale: Severe symptoms such as cyanosis, inability to speak, and oxygen saturation <90% indicate respiratory distress and require immediate intervention.
A patient with mild asthma symptoms should receive which of the following interventions?
a. Immediate oxygen and bronchodilators
b. Short-acting beta-agonists (SABA) and monitoring
c. Routine inhaler use and education
d. Intubation and ICU care
Answer: c. Routine inhaler use and education
Rationale: Patients with mild symptoms need routine use of their inhaler and education on asthma management.
What is the primary psychosocial task of toddlers according to Erikson?
a. Trust vs. Mistrust
b. Autonomy vs. Shame/Doubt
c. Initiative vs. Guilt
d. Industry vs. Inferiority
Answer: b. Autonomy vs. Shame/Doubt
Rationale: Toddlers (1-3 years) strive to achieve autonomy while avoiding feelings of shame and doubt.
What safety measure is most critical for toddlers?
a. Supervise swimming and ensure pool safety
b. Teach proper use of helmets
c. Use age-appropriate car seats
d. Educate on safe biking practices
Answer: c. Use age-appropriate car seats
Rationale: Proper car seat use is essential for toddlers to ensure their safety during travel.
What is the most common choking hazard for infants?
a. Toys with small parts
b. Grapes and hot dogs
c. Coins and small batteries
d. All of the above
Answer: d. All of the above
Rationale: Infants are at high risk for choking on small objects like toys, food, and household items.
What is the leading cause of death among adolescents?
a. Congenital abnormalities
b. Suicide and homicide
c. Accidents
d. SIDS
Answer: c. Accidents
Rationale: Accidents (e.g., motor vehicle crashes) are the leading cause of death among adolescents, followed by homicide and suicide.
What is the primary cause of death in infants?
a. Drowning
b. SIDS and congenital abnormalities
c. Suicide
d. Motor vehicle accidents
Answer: b. SIDS and congenital abnormalities
Rationale: Sudden Infant Death Syndrome (SIDS) and congenital abnormalities are the most common causes of death in infants.
What is the priority intervention for a child with RSV and severe retractions?
a. Administer antibiotics
b. Administer oxygen and provide airway clearance
c. Start IV hydration
d. Monitor and wait for improvement
Answer: b. Administer oxygen and provide airway clearance
Rationale: Severe retractions indicate respiratory distress, requiring oxygen and airway management.
Which symptom is most commonly associated with bacterial pneumonia?
a. Wheezing
b. Fever and crackles
c. Nasal congestion
d. Apnea
Answer: b. Fever and crackles
Rationale: Fever, crackles, and tachypnea are hallmark symptoms of bacterial pneumonia.
Which factor is most critical in assessing burn severity?
a. Pain level
b. Total body surface area affected
c. Age of the patient
d. Time since the burn occurred
Answer: b. Total body surface area affected
Rationale: The extent of the burn (TBSA) is one of the primary factors in determining burn severity and management.
What is a common concern for adolescent females during the early stages of puberty?
a. Delayed menarche
b. Uneven breast development
c. Growth spurt occurring too early
d. Sudden facial hair growth
Answer: b. Uneven breast development
Rationale: During thelarche, uneven breast development is common and normal, which can be a concern for adolescents adjusting to changes.
Which of the following indicates that puberty is progressing normally in males?
a. Growth spurt before testicular enlargement
b. Voice deepening before penile growth
c. Testicular enlargement followed by pubic hair growth
d. Facial hair development before pubic hair growth
Answer: c. Testicular enlargement followed by pubic hair growth
Rationale: Testicular enlargement is the first sign of puberty in males, followed by pubic hair growth, penile growth, and other changes.
A child with asthma is wheezing and has an oxygen saturation of 91%. What is the nurse’s priority intervention?
a. Administer oxygen and prepare for intubation
b. Administer a short-acting beta-agonist (SABA) inhaler and monitor
c. Monitor without intervention and reassess in 15 minutes
d. Administer corticosteroids immediately
Answer: b. Administer a short-acting beta-agonist (SABA) inhaler and monitor
Rationale: An oxygen saturation of 91% with wheezing indicates moderate asthma symptoms, which should be treated with a SABA.
Which symptom indicates a mild asthma attack?
a. Cyanosis
b. Occasional wheezing without retractions
c. Retractions and SpO2 of 90%
d. Inability to speak full sentences
Answer: b. Occasional wheezing without retractions
Rationale: Mild asthma symptoms include occasional wheezing and minimal respiratory distress without retractions or hypoxia.
Which nursing intervention is most appropriate for a 7-year-old child according to Erikson’s stages?
a. Allow the child to choose their own clothes to promote independence
b. Encourage participation in school projects to build a sense of industry
c. Provide consistent caregivers to build trust
d. Focus on helping the child explore their identity
Answer: b. Encourage participation in school projects to build a sense of industry
Rationale: School-age children (6-12 years) are in the stage of Industry vs. Inferiority, where they develop confidence through accomplishments.
What is the nurse’s priority when working with an infant in Erikson’s Trust vs. Mistrust stage?
a. Provide opportunities for the infant to explore independently
b. Offer consistent care and respond to the infant’s needs promptly
c. Set firm boundaries to foster a sense of discipline
d. Encourage play with other infants to build social skills
Answer: b. Offer consistent care and respond to the infant’s needs promptly
Rationale: During the Trust vs. Mistrust stage, consistent and responsive care helps the infant develop a sense of trust in their environment.
What is the most appropriate safety recommendation for a school-age child?
a. Ensure all medications are kept out of reach
b. Provide helmet education for biking and sports activities
c. Use a rear-facing car seat during travel
d. Monitor for choking hazards during meals
Answer: b. Provide helmet education for biking and sports activities
Rationale: School-age children are often active and need proper safety measures, such as wearing helmets during sports and biking.
What is the nurse’s priority teaching for parents of a toddler?
a. Educate on proper use of booster seats
b. Monitor closely for choking hazards and toxic substances
c. Encourage participation in team sports
d. Begin discussions on safe sex practices
Answer: b. Monitor closely for choking hazards and toxic substances
Rationale: Toddlers are at high risk for accidental poisoning and choking due to their developmental curiosity and motor skills.
Which symptom is most commonly associated with an atrial septal defect (ASD)?
a. Harsh holosystolic murmur at the left sternal border
b. Poor feeding and failure to thrive
c. Fixed, split second heart sound (S2)
d. Retractions and nasal flaring
Answer: c. Fixed, split-second heart sound (S2)
Rationale: A fixed, split S2 is a hallmark finding in atrial septal defects and helps differentiate it from other cardiac conditions.
What is a key difference in clinical presentation between ventricular septal defect (VSD) and atrial septal defect (ASD)?
a. VSD is always asymptomatic, while ASD presents with symptoms of heart failure
b. VSD presents with a harsh holosystolic murmur, while ASD presents with a fixed, split S2
c. Both VSD and ASD always present with severe cyanosis
d. ASD presents with respiratory distress, while VSD presents with a systolic murmur
Answer: b. VSD presents with a harsh holosystolic murmur, while ASD presents with a fixed, split S2
Rationale: VSD often produces a harsh holosystolic murmur, while ASD is characterized by a fixed, split second heart sound.
A child with RSV is experiencing nasal flaring and tachypnea. What is the nurse’s priority intervention?
a. Administer antibiotics and bronchodilators
b. Provide oxygen therapy and ensure airway clearance
c. Restrict fluids to reduce pulmonary congestion
d. Encourage the child to blow their nose frequently
Answer: b. Provide oxygen therapy and ensure airway clearance
Rationale: RSV can lead to respiratory distress. The priority is to maintain airway patency and provide adequate oxygenation.
Order of Erikson’s Stages of Development by Age…
Infant (0-1 year): Trust vs. Mistrust, Toddler (1-3 years): Autonomy vs. Shame/Doubt, Preschool (3-6 years): Initiative vs. Guilt, School Age (6-12 years): Industry vs. Inferiority, Adolescence (12-18 years): Identity vs. Role Confusion.
Case Study: A 10-year-old girl presents to the pediatric clinic with concerns from her parents about her recent physical changes, including breast budding and pubic hair growth. They are unsure if these changes are normal for her age.
Question: What is the first step the nurse should take to address the parents’ concerns?
Intervention: Educate the parents that breast development (thelarche) is typically the first sign of puberty in females and often begins around ages 8-13. Pubic hair growth follows, along with a growth spurt and menarche. Reassure the family that these changes are within the normal range.
Case Study: A 6-year-old child with a history of asthma arrives at the emergency department. The child is wheezing, has severe intercostal retractions, and an oxygen saturation of 88%. The child can only speak one or two words at a time.
Question: What is the nurse’s priority intervention for this patient?
Intervention: Administer high-flow oxygen and a bronchodilator (short-acting beta-agonist). Prepare for possible intubation if the child’s condition does not improve. This patient is experiencing a severe asthma exacerbation and requires immediate intervention.
Case Study: A 15-year-old adolescent expresses feelings of confusion and frustration about “not knowing who I am or what I want to do.” The parents are concerned about their child’s behavior, which includes spending more time alone and changes in clothing style.
Question: According to Erikson’s stages of development, what is the primary focus for this adolescent?
Intervention: The nurse should explain to the parents that the adolescent is in the Identity vs. Role Confusion stage, where exploring and establishing a personal identity is normal. Encourage open communication and provide resources, such as counseling, if needed.
Case Study: A 2-year-old child is brought to the clinic for a wellness visit. During the visit, the nurse notices that the parents use an old car seat that is not rear-facing.
Question: What is the appropriate intervention to ensure the child’s safety?
Intervention: Educate the parents about the importance of using a rear-facing car seat for toddlers until they exceed the height and weight limits set by the manufacturer. Provide guidance on selecting an age-appropriate car seat and offer resources if they need financial assistance to purchase one.
Case Study: A 10-month-old infant is brought to the clinic with nasal congestion, wheezing, and retractions. The child’s oxygen saturation is 92%, and the parents report difficulty feeding due to congestion.
Question: What is the nurse’s priority intervention for this patient?
Intervention: Provide oxygen therapy to maintain oxygen saturation >92%, and use saline drops with suctioning to clear nasal congestion. Educate the parents on supportive care, including maintaining hydration and recognizing signs of worsening respiratory distress.
A parent brings their 6-month-old infant to the clinic with a red rash in the diaper area. Which of the following is the most likely cause of diaper dermatitis?
1. Prolonged exposure to moisture and irritants such as urine or feces.
2. Bacterial infection with Streptococcus pyogenes.
3. Vitamin deficiency.
4. Insufficient diaper changes.
Correct Answer: 1
Rationale: Prolonged exposure to moisture and irritants, such as urine and feces, is the most common cause of diaper dermatitis. Insufficient diaper changes (option 4) can exacerbate this, but the key cause is moisture and irritants. Bacterial infections and vitamin deficiencies are less likely.
Which of the following is a characteristic finding in diaper dermatitis caused by Candida albicans?
1. Generalized redness in the diaper area.
2. Small red lesions outside the primary area of the rash.
3. Yellow, crusty lesions around the diaper.
4. Thick scales and plaques over the diaper area.
Correct Answer: 2
Rationale: Diaper dermatitis caused by Candida albicans often presents with satellite lesions (small, red bumps) outside the primary area of redness. This distinguishes it from other forms of diaper rash. Thick scales or crusts are not typical of Candida-related diaper dermatitis.
A nurse is teaching a parent about preventing diaper dermatitis. Which of the following statements indicates the parent needs further teaching?
1. “I will change my baby’s diaper frequently to keep the area dry.”
2. “I can use mild, unscented wipes to clean the area.”
3. “I will use a talcum powder to keep the diaper area dry.”
4. “I will apply a barrier cream like zinc oxide after each diaper change.”
Correct Answer: 3
Rationale: Talcum powder is not recommended because it can irritate the infant’s respiratory system if inhaled. The other options reflect appropriate measures to prevent diaper dermatitis.
A pediatric patient is diagnosed with a urinary tract infection (UTI). The nurse knows the most likely causative organism is:
1. Klebsiella species.
2. Proteus species.
3. Enterococcus species.
4. Escherichia coli.
Correct Answer: 4
Rationale: Escherichia coli is the most common pathogen causing UTIs, particularly in pediatric patients. The other options are less common but are potential causes.
The nurse is assessing a child with gastroenteritis. Which of the following findings should be the priority for the nurse to address?
1. Fever of 101°F (38.3°C).
2. Abdominal cramping.
3. Dry mucous membranes and decreased urine output.
4. Watery diarrhea.
Correct Answer: 3
Rationale: Dehydration, indicated by dry mucous membranes and decreased urine output, is the most critical concern in gastroenteritis and requires prompt intervention. The other symptoms, while significant, are not life-threatening unless they contribute to severe dehydration or electrolyte imbalance.
A nurse is teaching a parent how to manage their child’s gastroenteritis at home. Which statement by the parent indicates an understanding of the teaching?
1. “I will offer my child plenty of water and juice to keep them hydrated.”
2. “I’ll continue to give my child their regular meals to maintain nutrition.”
3. “I’ll provide oral rehydration solutions like Pedialyte to prevent dehydration.”
4. “I should give my child an over-the-counter anti-diarrheal medication.”
Correct Answer: 3
Rationale: Oral rehydration solutions like Pedialyte are the most appropriate choice for maintaining hydration in children with gastroenteritis. Water and juice alone may not replace lost electrolytes. Anti-diarrheal medications are not typically recommended for children, as they can worsen the illness.
