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PILLITERI QUESTIONS 1. Suppose Melissa Chung asks you whether maternal child health nursing is a profession.

What qualifies an activity as a profession? a. Members supervise other people. b. Members use a distinct body of knowledge c. Members enjoy good working condition. d. Members receive relatively high pay. 2. Nursing is changing because social change affects care. Which of the following is a trend that is occuring in nursing because of social change? a. So many are treated in ambulatory units that nurses are hardly needed. b. Immunization are no longer needed for infectious diseases c. The use of skilled technology has made nursing care more complex d. Pregnant women are so healthy today that they rarely need prenatal care 3. The best description of FNP role is a. To give bedside care to critically ill family members b. To supervise the health of children up to age 18 years c. To provide health supervision for families d. To supervise women during pregnancy 4. The hanovan family was a single parent one before mrs. Hanovan re married. What is a common concern of single parent families? a. Too many people give advice b. Finances are inadequate c. Children miss many days of school d. Children dont know any other family like theirs 5. Mrs. Hanovan serves many roles in her family. If, when you talk to Carey, she interrupts to say, Don t tell our family secrets, she is fulfilling what family role? a. Decision maker b. Gate keeper c. Problem solve d. Bread-earner 6. The Hanovan family consist of two parents; Carey 12; and Brian 2. Mrs. Hanovan is a 5 months pregnant. Which of Duvall s family life stages is the family currently experiencing? a. Pregnancy stage b. Pre school stage c. School age stage d. Launching stage 7. Maria Rodriguez is the 12 year old student you met at the beginning of the chapter. Which statement by her is the best example of ethnocentrism? a. My school, Steven park, is the best in the city b. Many schools in the city have good soccer teams c. Children from many cultures attend my school d. I want to go to a public, not a private college 8. While she is in the hospital, Maria Rodriguez makes the following statements. Which is the best example of stereotyping? a. My doctor is funny; he tells jokes and makes me laugh b. I m glad I m Mexican because all mexicans are smart c. I m sure my leg will heal quickly; im overall healthy d. I like mexican food; although not if it tastes too spicy 9. Suzzane matthews tells you she used to worry because she developed breast later than most of her friends. Breast development is termed: a. Adrenarche b. Mamarche c. Thelarche d. Menarche 10. Suppose Kevin matthews tells you that he is considering vasectomy after the birth of his new child. Vasectomy is the incision of which organ? a. The testes b. The vas deferens c. The epididymis d. The scrotum 11. On physical examination, Suzanne Matthews is found to have a cystocele. A cystocele is: a. A sebaceous cyst arising froma vulvar fold b. Protrusion of the intestine into the vagina c. Prolapse of the uterus and cervix into the vagina

d. Herniation of the bladder into the vaginal wall 12. Suzanne Mattthews typically has a menstrual cycle of 34 days. She tells you she had coitus on days 8,10,15, and 20 of her last cycle. Which is the day on which she most like conceived? a. The 8th day b. The 10th day c. Day 15 d. Day 20 13. The Matthews neighbor Cindy is a woman who has sex with women. Another term for this sexual orientation is a. Lesbian b. Celibate c. Gay d. Voyeur 14. Suppose Dana, 17 years old, tells you she wants to use a fertility awareness method of contraception. How will she determine her fertile days? a. She will notice that she feels hot, as if she has an elevated temperature b. She should asess whether her cervical mucus is thin and watery c. She should monitor her emotions for sudden anger or crying d. She should asess whether her breast feels sensitive to cool air 15. Suppose Dana, 17 years old, chooses to use a combination oral contraceptive (COC) as her family planning method? What is a danger signs of COCs you would ask her to report? a. A stuffy or runny nose b. Arthritis like symptoms c. Slight weight gain d. Migraine headache 16. Suppose dana, 17 year old, chooses subcutaneous implant (Norplant) as her method of reproductive life planning. How long will these implants be effective? a. One month b. Twelve months c. Five years d. Ten years 17. Dana 17 years old, wants to try female condoms as her reproductive planning method. Which instruction would you give her? a. The hormone the condom releases may cause mild weight gain b. She should insert the condom before any penile penetration c. She should coat a condom with a spermicide before use d. Female condoms, unlike male condoms, can be reused. 18. Dana, 17 year old, asks you how a tubal ligation prevents rpegnancy, which would be the best answer? a. Sperm can nolonger reach the ova, because fallopian tubes are blocked b. S[erm cannot enter the uterus, because the cervical entrance is blocked c. Prostaglandins released from the cut fallopian tubes can kill sperm d. The ovary no longer release ova, as there is no where for them to go 19. The Carls are a couple undergoing testing for infertility. Infertility is said to exist when: a. A couple has been trying to conceive for 1 year b. A woman has no children c. A woman has no uterus d. A couple has wanted a child for 6 months 20. Cherry carl is diagnosed of having endometriosis. This condition interfers with infertility because: a. Because the ovaries stop producing adequate estrogen b. The uterine cervix become inflammed and swollen c. Pressure on the pituitary leads to decreased FSH level d. Endometrial implants can block fallopian tube 21. Cherry carl is scheduled to have a hysterosalpingogram. Which of the following instruction would you give her regarding this procedure? a. She may feel some mild cramping when the dye is inserted b. The sonogram of the uterus will reveal any tumors present c. She will not able to conceive 3 months after the procedure d. Many women experience mild bleeding as an after effect 22. Bob Carl asks you what artificial insemination by donor entails. Which would be best answer?

a. Artificial sperm are injected vaginallyt to testtubal patency b. Donor sperm are introduced vaginally into the uterus or cervix c. The husband s sperm is administered intravenously weekly d. Donor sperm are injected intraabdominally into each ovary 23. Cheryl Carl is having a GIFT procedure. What makes her a good candidate for this procedure? a. She has patent fallopian tubes, so fertilizes ova can be implanted into them b. She is Rh negative, a necessary stipulation to rule out Rh incompatibility c. She is a normal uterus, so spem can be injected through the cervix into it d. Her husband is taking sildenafil (Viagra), so all his sperm will be motile 24. Amy Alvarez is pregnant with her first child. Her phenotype refers to. a. Her concept of herself as male or female b. Whether she has 46 chromosomes or not c. Her actual genetic composition d. Her outward appearance 25. Amy Alvarez is a balanced translocation carrier for Down syndrome. This term means that: a. All of the children will be born with some aspects of Down syndrome b. All of her female and none of her male children will have Down syndrome c. She has a greater than average chance a child will have Down syndrome d. Its impossible for any of her children to be born with Down syndrome 26. Amy Alvarez has told a genetic councelling session that she is a balanced translocation carrier for Down syndrome. What would be your best action regarding this information? a. Be certain all her family members understand that this means b. Discuss the costs of various abortion techniques with Amy c. Be sure Amy knows she hsould not have any more children d. Ask Amy if she has any questions that you could answer for her 27. Amy Alvarez child is born with Down syndrome. What is a common physical feature of newborns eith this disorder? a. Spastic and stiff muscles b. Loose skin at back of neck c. S white lock of forehead hair d. Wrinkles on the sole of the feet 28. Liz Calhorn asks how much longer her doctor will refer to the baby inside her as an embryo. What would be your best explanation? a. The tern is used during the time before fertilization. b. Her baby will be a fetus as soon as the placenta forms c. After the 20th week of pregnancy, the baby is called a zygote d. From the time of implantation until 5 to 8 weeks, the bay is an embryo 29. Liz Calhorn is worried that her baby will be born with a congenital heart disease. What assessment of a fetus at birth is important to help detect congenital heart defects? a. Assessing whether the Whartons jelly of the cord has a pH higher than 7.2 b. Asessing whether the umbilical cord has 2 arteries and 1 vein c. Measuring the length of the cord to be certain that it is longer than 3 feet d. Determining that the color of the umbilical cord is not green. 30. Liz calhorn asks you why her doctor is so concerned about whether her fetus is producing surfactant or not. Your best answer would be: a. Surfactant keeps lungs from collapsing on expiration, and thus newborn breathing b. Surfactant is produced by the fetal liver, so its presence reveals liver maturity c. Surfactant is the precursor to IGM antibody production, so it prevents infection d. Surfactant reaveals amture kidney function,as it is produced by kidney glomeruli.

31. Liz Calhorn is scheduled to have an ultrasound examination. What instruction would you give her before her examination? a. Void immediately before the procedure to reduce bladder size b. The intravenous fluid infused to dilate your uterus does not hurt the fetus c. You will need to drink at least 3 glasses of fluid before the procedure d. You can have medicine for pain for any contractions caused by the test. 32. Liz Calhorn is scheduled to have an amniocentesis to test for fetal maturity. What instruction would you give her before this procedure? a. void immediately before the procedure to reduce your bladder size b. The x-ray used to reveal your fetus position has no longterm effects c. The intravenous fluid infused to dilate your uterus does not hurt the fetus d. No more amniotic fluid forms afterward, which is why only a small amount is removed. 33. Lauren sometimes feels ambivalent about being pregnant. What is the psychological task you d like to see her complete during the first trimester of pregnancy? a. View morning sickness as tolerable b. accept the fact that she is pregnant c. Accept the fact the baby is growing inside her d. Choose a name for the baby 34. Lauren Maxwell is aware that shes been showing some narcissism since becoming pregnant. Which of her actions best describe narcissism? a. Her skin feels pulled thin across her abdomen. b. Her thoughts tend to be mainly about herself c. She feels a need to sleep a lot more than usual d. She often feels numb or as if shes taken a narcotic 35. Lauren Maxwell did a urine pregnancytest but was surprised to learn that a positive result is not a sure sign of pregnancy. She asks you what would be a positive sign. You tell her a positive sign would be if: a. she is having a consistent uterine growth b. She can feel the fetus move inside her c. hCG can be found on her bloodstream d. The fetal heart can be seen on ultrasound 36. lauren Maxwell s doctor told her she has a positive Chadwick s sign. She asks you what this means, and you tell her that: a. Her abdomen is soft and tender b. Her uterus has tipped forward c. Cervical mucus is clear and sticky d. Her vagina is darkened in color 37. Lauren Maxwell overheard her doctor say that the insulin is not as effective during pregnancy as usual. That made her worry that she is developing diabetes, like her aunt. How would you explain how decreased insulin effectiveness safeguards the fetus? a. Decreased effectiveness prevents the fetus from being hypoglycemic b. If insulin is ineffective, it cannot cross the placenta and harm the fetus c. The lessened action prevents the fetus from gaining too much weight d. The mother not the fetus, is guarded by this decreased insulin action 38. Sandra Czerinski feels well. She asks you why needs to come for prenatal care. The best reason for her to receive regular care is: a. Discovering allergies can help eliminate early birth b. It helps document howmany pregnancies occur each year c. It provides time for education about pregnancy and birth d. It determines whether the pregnancy today are planned or not 39. Why is it important to ask Sandra about past surgery on a pregnancy health history? a. To test her recent and long term memory b. Adhesion from the surgery could limit uterine growth

c. To assess whether she could be allergic to any medication d. To determine if she has effective health insurance 40. Sandra reports that the palms of her hands are always itchy. You notice scratches on them when you do a physical exam. What is most likely cause of this finding during pregnancy? a. She must have become allergic to dishwashing soap b. She has an allergy on her fetus and will probably abort c. Her weight gain has stretched the skin aver her hands d. This is a common reaction to increasing estrogen levels 41. Sandra has not had a pelvic exam since she was in highschool. What advice would you give her to help her relax during her first prenatal pelvic exam? a. have her take a deep breath and hold it during the exam b. Tell her to bear down slightly as the speculum is inserted c. Singing outlouds helps, because it pushes down the diaphragm d. She should breathe slowly and evenly during the exam 42. Sandra has pelvic measurement taken. What size should the ischial tuberosity siameter to be to considered adequate? a. 6cm b. Twice the width of the conjugate diameter c. 11cm d. Half the width of the symphysis pubis 43. Which ststement by Juliberry Adams would alert you that she needs more teaching about safe practices during pregnancy? a. I take either a shower or tub bath, because I know both are safe. b. I wash my breast with clear water, not with soap daily. c. Im glad I don t have to ask my boyfriend to use condom anymore d. Im wearing low heeled shoes to try and avoid back ache 44. Juliberry Adams describes her typical day to you. What would alert you that she may need further pregnancy advice? a. I jog rather than walk every time I can for exercise b. I always go to sleep on my side, not on my back c. Ipack my lunch in the morning when I m not so tired d. I walk arould my desk every hour to prevent varicosities 45. Juliberry adams tells you she is developing oainful hemorrhoids. Advice you would give her would be; a. Take a tablespoon of mineral oil with each of your meal b. Omit fiber from your diet. This will prevent constipation c. Lie on your stomach daily to drain blood from rectal veins d. Witch hazel pads feel cool against swollen hemorrhoids. 46. juliberry Adams has ankle edema by the end of each day. Which statement by her would reveal that she undertand what causes this? a. Iknow this is a beginning complication; I ll call my doctor tonight b. I understand this is from eating too much salt; ill restrict that more c. I ll rest in a simss position to take pressure off lower extremity veins d. I walk for half an hour everyday to relieve this; I ll try walking more 47. Julliberry Adams makes the following statements. Which one is the safest practice? a. My brother takes medicine for heartburn; if I get that ill just borrow his b. Im going to get a measles shot; I don t want measles while I am pregnant c. there are so many medicines for headache, I have to ask my doctor what to take d. I know all-over-the-counter medicine is safe; it s why it s over all counter. 48. Suppose Toni Alarino has a normal BMI. What would be the recommend weight gain for her during pregnancy? a. 10lbs b. 20lbs c. 30lbs d. 60lbs 49. Which statement by Toni lets you know she understand how iron is best absorbed? a. I always take my iron pills with milk b. I take iron pills mixed with mashed potatoes c. I take the pills with ice cream to disguise the taste

d. I swallow my iron pills with orange juice 50. You need to obtain a nutrition history from Toni. What is the best way to do this? a. Ask her to tell you how much protein she eats daily b. Asess if Toni feels satisfied or not with her nutrition c. Ask Toni to describe what she ate in the last 24 hours d. tell Toni to describe her concept of ideal nutrition 51. Which statement by Toni would best suggest she has pica? a. I love snacking on ice cubes; no food just ice cubes b. I can t eat a thing before 11 every morning c. I notice I ve been eating more sweet stuff than usual d. I crave oranges; cant get enough of them everyday 52. Suppose Tori is a vegetarian. What is apt to be her greatest nutritional risk? a. Lack of iron b. Lack of Vitamin C c. Lack of Folic acid d. lack of vitamin b12 53. Julia Marco asks you which type of exercise is best to strengthen perineal muscles. Your best answer would be; a. Walk 20 minutes daily at a fairly rapid pace. b. Alternately tighten and relax perineal muscle as if stopping voiding c. Periodically push as if you moving your bowels d. Lift both legs into the air while you lie supine 54. Julia wants to learn Lamaze breathing techniques. What is a principle of Lamaze birth? a. Pain can be interrupted before it registers in the brain as pain b. Labor contractions are not pain; the are muscle inflammation c. Brown Pain like labor contractions can be lessened d. labor contractions are intensified by abdominal massage 55. What is a goal of all birth settings? a. To allow women to eat during labor b. To keep childbirth pain free c. To have a safe birth for mother and baby d. To limit the cost of medical procedures 56. Angelina Gomez is 22 y/o woman who met at the beginning of the chapter. Which condition would make her more prone than other to developing a Candida infection during pregnancy? a. She usually drinks tomato juice for breakfast b. She was over 35 when she became pregnant c. Her husband play golf 6 days a week d. She has developed gestational diabetes 57. Angelina develops a deep vein thrombosis following an auto accident and is prescribed heparin subq. What should you educate her about in regard to this? a. Her infant would be born with scattered petechiae on his trunk b. Heparin can cause darkened skin in newborns c. Heparin does not cross the placenta and so does not affect a fetus d. Some infants will be born with allergic symptoms to heparin 58. Whick statement by woman with sickle cell anemia would alert you she may need further instruction on prenatal care? a. I understand why folic acid is important to red cell formation b. Im careful to drink atleast 8 glasses of fluid everyday c. I take an iron pill everyday to help grow new red blood cells d. I ve stopped jogging so I don t risk becoming dehydrated 59. Angelina had tuberculosis as a teenager. What is a danger of this during pregnancy? a. Calcium deposits that wall off old tuberculosis lesions can break down b. Tuberculosis can turn to pneumonia if a woman has a folic acid deficit c. PPD tests are negative during pregnancy so TB goes undetected d. If tuberculosis spreads to the stomach, it can cause stomach ulcers 60. Angelina routinely takes acetylsalicylic acid (aspirin) for arthritis. Why she should limit or discontinue this toward end of pregnancy? a. salicylates can lead to increase maternal bleeding at childbirth

b. Newborns develop withdrawal headache from salicylates c. Aspirin can lead to deep vein thrombosis following birth d. Newborns develop a red rash from salicylate toxicity 61. Angelina uses an insulin pump to administer insulin for gestational diabetes. Why is night time a particularly hazardous time for her fetus with pump therapy? a. The fetus can develop hyperglycemia from excessive insulin administration b. Continous insulin administration with no food can lead to hypoglycemia c. the mothers lack of exercise at night tends to lead to hyperglycemia d. The pump s needle can migrate inward and possibly pierce the fetus 62. Angelina received laceration on her leg from her automobile accident. Why are laceration of lower extremities potentially more serious in pregnant woman than others? a. A woman is less able to keep laceration clean because of her fatigue b. Increased bleeding can occur from uterine pressure on leg veins c. Lacerations can provoke allergic responses because of gonadotropic hormone d. healing is limited during pregnancy, so these will not heal until after birth 63. Beverly Muzuki, the woman you met at the beginning of the chapter, had a miscarriage when she was younger. What would be the best advice to give a woman who tells you she is miscarrying? a. Lie down and don t move for 24 hours to stop the bleeding b. Don t do anything special; early miscarriage happen all the time c. Save any clots or material passed for your health care provider d. Use a tight tampon to put pressure on your cervix and stop the bleeding 64. Suppose Beverly was discovered to have an ectopic pregnancy. What advice would you give her; a. Most ectopic pregnancies go to completion, although the newborn is small b. If she must have a fallopian tube removed, she will be sterile afterward c. She will have a continous nagging pain through the rest of pregnancy d. Ectopic pregnancy can be either medically or surgically treated 65. Suppose Beverly develops a placenta previa. What would be an important assessment to make with her after her baby s birth? a. Whether she recognizes that this is inherited and will probably happen again b. Asessment of vaginal bleeding, as she is prone to have more than usual c. Whether she appears Jittery from the prebirth drugs she received d. Whether she understands that her uterus has a scar and so will always be weakened 66. Beverly is in preterm labor. When you see her in the emergency room, what should be your first action? a. keep her walking so the fetal heads puts harder pressure on the cervix b. Ask her to lie down on a side lying position and assess her contraction c. Obtain blood for Hcg hormone assessment. d. Caution her not to allow anyone to start IV fluid dehydration halts contractions. 67. If Beverly had developed severe pre eclampsia . what would be the drug you would expect to administer? a. magnesium sulfate b. RANITIDINE (Zantac) c. NSAID Agents d.A loop diuretic 68. if a patient developed a HELLP syndrome, what symptoms would be most important to assess for? a. rapid, anxious breathing b. Ecchymosis or petechiae c. Blink reflex d. Enlarged thyroid

69. Suppose Beverly was RH negative. Under what circumstance would she be eligible for Rh (D) immune globulin (RhiG) a. If she were having a multiple pregnancy b. If her fetus were found to be Rh negative c. If her fetus heartbeat became tachycardic d. If her fetus blood type was Rh positive 70. You need to schedule a first home visit for Lee Puente. When is a first home care visit typically made? a. Within 1 hour after discharge b. Within 24 hrs after discharge c. Within 4 days after discharge d. Within 1 week of discharge 71. What should you do if, in the middle of visiting Lee Puente at home, her former boyfriend arrives a. And threatens you and Lee? What would you do? b. Tell him threatening someone is not mature behavior and he should stop c. Suggest that Lee change all of her home locks so this man cant visit again d. Leave the home and notify your agency that you were in unsafe circumstances e. Telephone 911 and report that you and a client are being threatened 72. lee Puenteis developing constipation from being on bed rest. What measure would you suggest she take to help prevent this? a. drink more milk, as increased calcium intake prevents constipation b. Walk for at least half an hour daily to stimulate peristalsis c. Drink 8 full glasses of a fluid such as water daily d. Eat more frequent small meals instead of 3 large ones daily 73. Mindy carson is still an adolescent. What is a task of adolescence, according to Erikson, that she needs to complete to be ready to be a mother? a. establish a value system b. Grow to her final height c. prepare clothes for the baby d. Finish her education 74. Mindy was placed on an iron supplement because her hemoglobin level was below normal. What is a usual test to demonstrate an adherence to an iron supplement? a. Assessing if her skin appears darker b. Assessing her blood reticulocyte count c. Analyzing her urine for iron deposits d. Measuring if she has grown in height 75. Women over 40 are at increased risk for developing pregnancy induced hypertension. The reason for this is; a. Many are overweight before they enter pregnancy b. They drink more fluids daily than younger women c. They do not exercise much, so edema fluid accumulates d. Their blood vessels are not as elastic as those of younger women 76. Women with high thoracic spinal cord injury can develop autonomic dysreflexia during labor. The best action to take for this would be a. Ask her to lie flat and take deep breathes b. Elevate her legs to restore her blood pressure c. Give a prescribed hypotensive medicine d. Talk to her calmly to reduce her anxiety 77. mindy carson tells you she takes methamphetamine almost daily. A fetus of a drug addicted mother receives approximately what percentage of a mothers drug concentration? a. 20% b. 50% c. 70% d. 100% 78. Celeste Balley didn t recognize for over an hour that she was in labor. A sign of true labor is; a. Sudden increased energy from epinephrine release b. Nagging but constant pain in the lower back c. Urinary urgency from increased bladder pressure d. show or release of the cervical mucus plug 79. Celeste asks you which fetal position and presentation are ideal. Your best answer would be

a. Right occipitoanterior with full flexion b. Left transverse anterior in moderate flexion c. Right occipitoposterior with no flexion d. Left sacroanterior with full flexion 80. Celeste is having long and hard uterine contractions. What leghth of contraction would youreport as abnormal? a. Any length over 30 seconds b. A contraction over 70 seconds in length c. A contraction that peaks at 20 seconds d. A contraction shorter than 60 seconds 81. you assess Celeste s uterine contractions. In relation to the contraction, when does a late deceleration begin? a. Forty five seconds after the contraction is over b. Thirty seconds after the start of a contraction c. After every tenth or more contraction d. After a typical contraction ends 82 Celeste has an amniotomy (artificial rupture of the membranes). After this procedure, which of the following would be an important nursing assessment? a.Ask her pain level is tolerable post procedure b.Assess maternal heart rate to detect possible bleeding c.Assess fetal heart rate to detect possible cord prolapsed d.Document the amount of amniotic fluid that has been lost 83. Jonny asks you what is the purpose of a doula inlabor. Your best answer would be: a. She times contractions and keeps them from becoming too lengthy b. She can cook for a woman in labor to keep her from becoming dehydrated c. She can serve as a support person and coach during labor d. She replaces the husband as a womans support person 84. Jonny asks you if she could use warm water tub bathing during labor. Your best answer would be; a. No. no one is allowed to tub bathe during labor b. Yes, as long as her membranes are not ruptured c. No, because warm water can diminish labor contractions d. Yes, as long as the warm water doesn t raise her temperature 85. Johnny chooses to have epidural anesthesia. What are two risks associated with this? a. Hypotension and prolonged second stage of labor b. Severe headache and coldness of all extremities c. Continued back pain and short first stage of labor d. Hypertension and a reduced red blood cell count 86. There is n o reason to thing that Jonny will need a fgeneral anesthetic. If she did, what type of drug is usually prescribed to minimize the risk of aspiration of vomitus? a. An anticonvulsant such as diazepam (valium) b. A nerve relaxant such as Phenobarbital c. Metoclopramide (Reglan) to speed gastric emptying. d. Oxytocin to increase the effectiveness of labor 87. Jonny reports in early labor she isn t having much pain. You assess that her contractions are also not strong. What position usually promotes efficient uterine contractions in early labor? a. Sitting or standing b. Lying supine c. Lying prone d. Side lying 88. Moja Hamma is concerned she may lose an excessive amount of blood with caesarian surgery. What is the usual amount of blood lost with cesarean birth? a. 100-220ml b. 250-350ml c. 300-500ml d. 500-1000ml 89. What is an important measure to reduce the size of the bladder and keep it away from the surgical field during a cesarean birth? a. Restrict fluids in the woman for 4 hours before surgery b. Insert a urinary catheter to drain the bladder and decrease its size. c. Administer an oxytocic to contract the bladder d. Give a diuretic to reduce the bladder to its smallest size

90. Moja Hamma asks you how big her scar will be after cesarean birth. Your best answer would be: a. The incision is big and runs vertically across your abdomen b. The incision is made through the vagina so doesn t leave a scar c. Most cesarean birth incisions are so low they don t show over a bikini d. it is so large that it will always show, but think of it as a mark of pride 91. Roseann Bigalow has prolonged labor. What is the most common cause for arrest of descent during the second stage of labor? a. Cephalopelvic disproportion (CPD) b. Maternal Calcium deficiency c. The fetus is sleep during labor d. The maternal outlet is narrow 92. Suppose a woman experiences a uterine inversion and the placenta is still attached. What would be your best action? a. Remove the placenta manually so that the uterus contracts. b. Attempt to replace the uterus so that it becomes compressed c. Increase women s intravenous fluid to help restore blood loss d. Give an emergency bolus of an oxytocin such as Pitocin IV 93. Oxytocin is administered to Roseann to augment labor. What are the first symptoms of water intoxication to observe for during the procedure? a. A high, choking voice b. Headache and vomiting c. A swollen tender tongue d. Abdominal bloating and pain 94. Which of the following action would alert you that a new mother is entering a postpartal taking hold phase? a. She tells you she was in a lot of pain all during labor b. She sleeps as if exhausted from the effort of labor c. She urges the baby to stay awake so that she can breast feed him or her d. She say that she has not selected a name for the baby as yet 95. You observe Joan Cooper holding her newborn. Which position would best reassure you that she is relating well to her newborn? a. She looks directly at her infant s face and talks to him. b. She holds the infant over her shoulder to burp him. c. She sits in a rocking chair and rocks the new infant. d. She lies in bed and places the infant on her stomach. 96. You care for joan Cooper at a 6 week postpartum visit. What should her fundal height be at this time? a. 6 fingerbreadths below the umbilicus b. No longer palpable on her abdomen c. One centimeter above the symphysis pubis. d. Inverted and palpable at the cervix 97. Suppose Mary Blackhawk has a retained placental fragment that is causing extensive postpartal bleeding. What hormone test would you anticipate being ordered to detect whether placenta is still present? a. Placental and cord blood estrogen b. Progesterone from the placenta c. human chorionic gonadotropin hormone d. Systemic prolactin (a pituitary hormone) 98. Mary develops endometritis. What would be the best activity for her? a. Lying in bed with a cold cloth on her forehead. b. Walking around her room listening to music. c. Reading while resting in a Trendelenburg position. d. Sitting with her feet elevated while playing cards. 99. Which statement by Mary is most suggestive of a woman developing postpartal psychosis? a. I wish my baby had more hair b. My baby has the devil s eyes c. I feel exhausted since birth d. Breast-feeding is harder than I thought 100. Beth Ruiz, like all newborns, can lose body heat by conduction. Under which condition is this most apt to occur? a. If the nursery is cooled by air conditioning.

b. If the infant is wet from amniotic fluid. c. If there is a breeze from an open window. D . If Beth is placed in a cold bassinet. 101. A moro reflex is the single best assessment of neurologic ability in a newborn. What is the best way to test this reflex? a. Observe the infant while she is on her abdomen to see whether she can turn her head. b. Lift the infant s head while she is supine and allow it to fall back 1 inch. c. Shake the infants crib until the infant responds by flailing her arms. d. make a sharp noise, such as clapping your hands, to wake the infant. 102. Beth Ruiz has milia on her nose. What is the necessary therapy for this? a. Ice packs to reduce inflammation. b. Warm heat to increase circulation c. No therapy is necessary for milia. d. Lancing the lesions so they drain. 103. Beth had apgar scores of 6 and 8. The five areas assessed with Apgar scoring are: a. Heart rate, respiratory effort , muscle tone, reflex irritability, and color. b. Respiratory rate, abdominal tone, reflex irritability, color, head circumference. c. Color, breathing rate, cry, amount of brown fat, response to an adult voice. d. Abdominal tone, persistence, gastric acidity, arterial pressure, response to pain. 104. Ms. Ruiz is preparing to take her new daughter home. On about what day of life can she expect her baby s umbilical cord to fall off? a. day 1. b. Day 2 to 3. c. Day 6 to 10. d. Day 30. 105. Newborns need more fluid than adults, because their extracellular fluid component differs from that of adults. How much of a newborn s body weight is extracellular fluid? a. 20%, compared with 35% in an adult b. 35%, compared with 20% in an adult c. 50%, compared with 70% in an adult d. 70%, compared with 40% in an adult 106. How does breast milk help prevent infection in a newborn? a. it is rich in faftty acid, so bacteria are destroyed by it. b. It is always flowing forward in the breast, so it is not static. c. it contains maternal antibodies and viral binding factors. d. It is low in lactose, so it becomes a poor culture medium. 107. Palaka wants to lose the weight she gained in pregnancy, so she is reluctant to increase her caloric intake for breast feeding. By howmuch should a lactating mother increase her caloric intake during the first 6 months after birth? a. 200 kcal/day b. 350 kcal/day c. 500 kcal/day d. 1000 kcal/day 108. Baby Atkins was given a drug at birth to reverse the effects of a narcotic given to his mother in labor. What drug is commonly used for this? a. Sodium chloride b. Morphine sulfate c. Penicillin G d. Naloxone (narcan) 109. Why are small for gestational age newborns are at risk for difficulty maintaining body temperature? a. They are preterm so are born relatively in small size. b. They are more active than usual so throw off covers. c. They do not have as many fat stores as other infants. d. Their skin is more susceptible to conduction of cold. 110. Baby Atkins has surfactant administered at birth. The purpose of surfactant is to: a. Help raise lung secretions by relaxing the airway. b. Prevent alveoli from collapsing on expiration. c. paralyze respiratory muscles to synchronize breathing. d. reduce gastric secretions by action on the pancreas.

111. Baby Atkins develops hyperbilirubinemia. What is a method use to treat hyperbilirubinemia ina newborn? a. Keeping infants in a warm and dark environment. b. Early feeding to speed passage of meconium. c. gentle exercise to stop muscle breakdown. d. Administration of a cardiovascular stimulant. 112. Why are infants of diabetic mothers fed early: a. Their stomachs are empty at birth. b. To help prevent hypoglycemia. c. Their mothers could not eat during labor. d. To clear mucus from their intestinal tracts. 113. John is 6 years old. What body system is reaching its peak point of development at this time? a. Neurological system. b. Lymphatic system. c. Reproductive system. d. Musculoskeletal system. 114. John, 6 years old, is a school age child. What must he learn, according to Erikson, to complete the developmental task of this period? a. How to be creative b. How to think abstractly c. How to trust others d. How to do things well 115. Suppose john, 6 years old, tells you his broken leg wants to get better. What type of thinking is he using? a. Magical thinking b. Deductive reasoning c. Concrete operational thinking d. Sensorial thought 116. Bryan is 2 months old. At what age would you expect him to sit securely? a. 2.5 months b. 6 months c. 8 months d. 12 months 117. How many words does a typical12 month old infant use? a. two, plus mama and dada b. About 12 words c. Twenty or more words d. About 50 words 118. Which action would show an infant has developed object permanence? a. he looks for a cheerio that falls off his highchair tray. b. He cries when he is either hungry or lonely. c. He prefers a large yellow ball to a small red one. d. He smiles when the mobile on his crib jingles. 119. You review infant safety with bryan s mother. What are the two of the most common type of accidents in infants? a. Drowning and homicide b. Poisoning and burns c. Falls and auto accidents d. Aspiration and falls 120. Bryan s mother is concerned about him developing baby bottle syndrome. What would be her best action to prevent this? a. use plastic rather than glass bottle b. Boil the formula to reduce the curd c. Don t put bryan to bed with a bottle d. Check the expiration date on formula 120. What type of sentence should Jason, a 2 year old, have mastered? a. Red ripe tomatoes b. Daddy come c. Old MacDonald d. Please, please 121. Jason answers every request of his mother by saying, No! How can she minimizes this? a. Tell Jason she doesn t want him to say no anymore. b. Answer all Jason s question by saying No c. Reduce the number of questions she asks Jason d. Explain he is not using good communication skills. 122. Jason s mother uses timeout for punishment. What is a good rule for this? a. The child should sit still for as many minutes as his age. b. The child should sit still for as many minutes as he misbehaved. c. Timeout activities can include quiet play or reading books d. Children are not ready for timeout until school age.

123. Cathy asks constant questions. How many does a typical 3 year old ask in a day time? a. Less than 50 b.100-200 c.300-400 d.1200 or more 124. Cathy will need to change to a new bed because her baby sister will need Cathy s old crib. What measure would you suggest that her parents take to help decrease sibling rivalry between Cathy and her new sister? a. Ask her to get her crib ready for the new baby. b. Tell her she will have to share with the baby. c. Move her to the new bed before the baby arrives d. Explain the new sisters grow up to become best friends. 125. Cathy s parents want to know how to react to her when she begins to masturbate while watching television. What would you suggest? a. They give her time out when this begins. b. They refuse to allow her to watch television c. They remind her some activities are private d. they scheduled a health check up for vaginal disease. 126. Shelly has belonged to a series of clubs for 9 year olds. A usual characteristic of clubs for this age child is; a. The clubs has formal rules and regulations. b. it is designed to help shy children socialize. c. It is designed to spite or exclude another child d. Clubs include both boys and girls. 127. if Shelly eats candy, what is the best type in terms of preventing caries? a. Salt water taffy b. A chocolate bar c. Chewy caramels d. hard candy 128. School agers can begin drug abuse. What is a common household product frequently abused by school agers? a. grated orange peel b. Laundry bleach c. Aerosol cooking oil d. Shredded cabbage 129. Raul is concerned about developing body odor. What body glands are responsible for this? a. Adipose glands b. Apocrine glands c. Liver cystic glands d.Dermal pod glands 130. Raul is entering final stage of cognitive development. This stage is termed; a. Formal operational thought b. Cognitive attainment c. Concrete operational thought d. Scientific formulating 131. Raul admits he has experimented with cocaine. A typical change in facial appearance that occurs with cocaine use is; a. Frown lines in the forehead b. Thin fissured lips c. loss of eyebrow hair d. Absent nasal hair 132. You take a health history on Keoto from her father. What question should you ask at the end of every interview? a. Do you have a ride so you can get home? b. Is there anything else you d like to discuss? c. Am I a good interviewer? Im trying hard d. do you have another child who also needs care? 133. Keoto s sister is 2 y/o . at what age you should include blood pressure as a routine procedure? a. 1 y/o b. 2 y/o c. 3 y/o d. 6 y/o 134. You typically gag children to inspect the back of their throat. When is it important not to elicit a gag reflex? a. When children are under 5 years of age b. When a child has symptoms of epiglottitis c. When a boy has a possible inguinal hernia d. When a girl has a geographic tongue 135. Keoto has a sinus arrhythmia. This refers to: a. A wide spaced rib cage b.Faint, barely audible heart sounds c.increased heart rate on inspiration d.An abnormal heart rate in a child

136. Keoto s father wants to be sure keoto s immunization are up to date. When is the immunization for varicella usually given? a. At 12 to 18 months of age b.As a preschooler booster c. At 16 years of age d. it isnot recommended for children 137. Barry tells you he hate school. Which response would be the best example of paraphrasing? a. Tell me again what you said b. School? c. You re telling me you re unhappy with school? d. Hate is a strong emotion for a teenager to feel 138. You want Barry to increase his cognitive understanding of his condition. Which statement from him would be best show he has increased cognitive knowledge? a. Ifeel so much better now about the care I need b. I understand I have to take two types of medicines c. I ve finally learned how to swallow big capsules d. I hate having to take medicines but will take it 139. You want to use a board game to teach Barrymore about his hypercholesterolemia. At what age are children first ready for completion and so enjoy board games? a. 3 y/o b. 6 y/o c. 10 y/o d. 14 y/o 140. Young children are more at risk for dehydration with vomiting than adults are. This is because; a. They have a smaller stomach and intestines than adults b. They have proportionally more extracellular water than adults. c. Children metabolize fluid more slowly than do most adults d. They maintain more fluid inside body cells than do adults. 141. Suppose Becky shows signs of separation anxiety. The first stage of separation anxiety is marked by; a. Loud, demanding crying. b. silent, sullen protest. c. Quiet introspective thought d. inability to respond verbally 142. You want to encourage Becky to drink a lot of water, which action would do this best? a. Scold her for not cooperating to make herself well again. b. offer her small glasses of fluid so she can drink these frequently c. c. offer her large glasses of fluid so she doesn t have to drink so often. d. Alert her if she doesn t drink fluid, she will have to receive an IV. 143. You worry about Becky aspirating a toy you give her. Which of the following items is most apt to be aspirated? a. pages in a coloring book b. Clothing from a baby doll c. Pieces of colored chalk d. Blocks 2 inches square 144. Becky will have a large bandage on her foot after surgery. Which type of therapeutic play would be best for her? a. letting her hold and handle a medicine syringe b. Giving her a doll and a bandage to change c. helping her insert an NG tube into a puppet d. teaching her a rhyme about good girls 145. You are going to restrain T.J to draw a blood sample from his hand. What type of restraint would be best? a. ask his mother to hold him tightly on her lap. b. Apply a jacket restraint to confine his body. c. Ask a fellow nurse to hold his hand firmly. d. Use a mummy restraint so he can t be hurt. 146. T.J will have a 24 hour urine specimen collected. You would time this from: a. the time of discard specimen. b. The first urine voided in the morning. c. A set time, such as 8am d. the first voiding after the discard urine. 147. T.J is younger brother receives total parenteral nutrition. Why does dehydration tend to occur with this? a.The glucose solution leads to dieresis b.infection occurs easily and causes fever c.Only 100ml of fluid can be infuse daily

d.Children tend to develop diarrhea 148. You are going to give acetaminophen (Tylenol) to terry in the emergency room. She has no ID band inplace as yet. What would be the best way to identify her? a.Ask her what is her name. b.tell her you need to know her name. c.Ask a parent to identify her for you. d.Ask her to see her school bus pass I.D 149. Suppose terry needed to have eardrops. What is the best technique for giving them? a. have her place them herself to give a sense of control. b. Refrigerate the drug first so it numbs the ear canal c.Pull the pinna of her ear down to straighten the canal d.keep her head turned to the side to help retain the drops 150. Terry is going to have an intravenous antibiotic infused by piggyback inserted into her dominant hand. What would be the best activity for her while her medicine infuses? a.listening to a story you read. b.Coloring a hospital brochure c.Completing a jigsaw puzzle d.Fingerpainting or drawing 151. You teach Robin imaging to help reduce pain from blood drawing. Why does a technique such as imagery work well for children? a.Children pain is not as acute as an adults. b.Intravenous pain relief in not effective in children c.Children imagination are at their peak d.childrens muscle are less tense than adults muscle 152.Robin was given analgesia intravenously. Why is the I.M route infrequently used to administer analgesia to children? a. The average child has a tremendous fear of injection. b. IM doses must be larger in children than in adults c. IM medications must be administered cold or chilled. d. IM solution are readily confused with IV solutions. 153. Suppose Robin are scheduled for conscious sedation to have her repeat bone marrow aspiration. Which would be the best explanation to prepare her for this? a. you ll be given a special medicine to put you to sleep for surgery b. I ll give you some medicine, but you ll still be awake and feel pain c. Conscious sedation is an analgesic, not anesthetic, method of pain relief d. I ll give you medicine so you re very sleepy but can still talk to me 154. What is the most important consideration in the care of the child with an omphalocele at birth? a. Position the infant on his stomach to contain the intestine. b. Wrap the omphalocele in cold icy gauze to prevent fever. c. Keep the infant seated upright under a radiant warmer. d. Contain the intestine in a sterile saline-lined bowel bag. 155.Which is an important nursing measure for a newborn with diaphragmatic hernia? a. Feed the infant immediately to decrease air in the intestine. b. Keep the infant positioned head down so the intestine can expand. c. Wrap the infant s abdomen tightly to better contain intestine. d. Position the infant in an infant chair to contain intestine in abdomen. 156. Baby Sparrow may be developing increased intracranial pressure. What vital sign changes occur with this? a. Decreased temperature; increased blood pressure b. Increased respirations; decreased pulse rates c. Increased temperature; decreased pulse rate d. Decreased blood pressure; increased temperature 157. Which is an important care measure to teach parents of a child with torticollis? a. Encourage the infant to turn his head to stretch the neck. b. Wrap the infant s neck in a warm towel twice daily

c. Massage the infants shoulders and torso at bed time d. Administer 1 grain of aspirin with each bottle feeding 158. What is a typical description of an infant with Down syndrome? a. Holds arms stiff and pronated. b. Muscle are hypotonic or flaccid c. Head is larger than other infants d. Skin is ruddy and vein streaked. 159. Michael was born with choanal atresia. What is the best way to assess if this is present? a. Observe if a newborn can breathe while lying on his stomach. b. Close the infants mouth to see if he can breathe through his nose. c. Assess if the infant s palatine tonsils are blocking his airway. d. Listen for the sound of either stridor or wheezing on inhalation. 160. Suppose Michael is diagnosed as having a streptococcal pharyngitis. The chief danger of such an infection is; a. Lymph nodes will swell and obstruct the airway. b. Infection may spread and cause a tooth abscess. c. A small number of children develop kidney disease. d. Four out of five children will develop lung abscess. 161. Suppose Michael s 4 year old roommate spits up dark red blood following her tonsillectomy. Your best action in relation to this would be; a. Suction the back of her throat. b. Encourage her to cough vigorously. c. Perform a Heimlich maneuver d. Continue to observe her for bleeding. 162. Michael has a barking cough, sore throat, and high fever. You want to see if his throat looks sore. Your best procedure to do this would be; a. Gag him with a tongue blade to inspect his tonsils. b. Ask him to press down on his tongue with a finger. c. Elicit a gagreflex using only one gloved finger d. Inspect his throat visually only 163. Children with cystic fibrosis take the pancreatic enzyme pancrelipase before each meal. You would prepare this by; a. Opening the capsule and adding it to warm tea. b. Adding it to atleast 8 ounces of milk to drink. c. Sprinkling it into small amount of applesauce. d. Teaching the child how to swallow large capsule 164. Megan has a heart murmur from a tetralogy of Fallot, a congenital heart disorder. This type of murmur is termed: a. Innocent b. Functional c. Organic d. Symmetrical 165. Megan is scheduled for a cardiac catheterization. Why might a child develop cardiac arrhythmias after this procedure? a. The dye inserted can create inflamed heart chambers. b. The many x-rays taken lead to a weakened heart muscle c. The catheter can irritate nerves in the heart septum d. Latex allergy can cause symptoms of unusual heart rate. 166. Megan will be scheduled for open heart surgery. What type of fluid imbalance is apt to occur after surgery? a. Hypervolemia from aldosterone production b. Hypercalcemia from calcium release from bones c. Hypernatremia from excess sodium retention d. Hypokalemia from excess urine dieresis 167. Suppose Megan has a simple ventricular septal defect. With this condition, in which direction would blood shunt? a. From the left to right ventricle. b. From the right ventricle to aorta. c. From the right to left ventricle d. From the left ventricle to the left atria 168.You need to teach CPR to Megan s parents before hospital discharge. What is the ratio of ventilation to compression used for resuscitating the infant? a. One to five b. One to ten c. Two to fifteen d. Three to fifteen

d. Antibody production against red cells 169. When Dexter s mother learned he had an immunologic disease, she was concerned that he had developed AIDS. What is the transmission method by which most children acquire HIV infection? a. Blood transfusion b. Shared bath towels c. Placental transfer d. Sneezing and coughing 170. Any child can have an anaphylactic reaction to a food or drug. What is the drug of choice you would want to have available to treat anaphylactic reaction? a. Prednisone b. Epinephrine c. Penicillin d. Ibuprofen 171. Dexter is atopic or prone to allergies. In the hospital he has no toys. What would be a poor choice of a toy to make for him? a. A paper deck of cards b. A cloth bean bag c. A latex glove balloon d. A tounge blade puppet. 172. If a smallpox epidemic should occur, it will be important to be able to distinguish chickenpox (varicela) from smallpox. What are the stages of chickenpox lesions? a. Macular, papular, vesicular, and crusting b. Macular,crusting, and extensive peeling c. Papular,vesicular, and pruritic crusting d. Maculopapular lesion with fine flaking 173. Which is the best description of mumps (infectious parotitis)? a. Cervical lymph nodes become swollen. b. Swelling behind the child s ear occur. c. Swelling above the jaw line occur. d. The adenoid tonsils are red and swollen. 174. For a child with infectious mononucleosis, why must abdominal palpation be performed gently? a. Regional lymphnodes are painful b. The enlarged spleen can rupture c. red cells pocket just under skin d. Petechiae form easily from bruising 175. Marty has developed scarlet fever. What is the mark of scarlet fever lesions? a. They appear on skin and mucous membrane b. The crusts that form are mildly contagious c. The lesions weep a clear, sticky fluid d. Lesions are dark brown and black 176. Marty had a pinworm infection last year. A typical symptoms of this infection to assess for would be; a. Nausea and vomiting b. Anal itching on awakening c. Loose, bloody stools d. Mild jaundice and itching 177. Lana, who has thalassemia major, is scheduled for a bone marrow transplant. Which is the best instruction for her regarding this? a. She must not move while the bone marrow is infused into her b. She will not be allowed to eat raw fruit following the transplant. c. Her hip bones will feel tender from the marrow transplantation. d. She will not need any further bone marrow aspiration after this 178. Lana has received iron chelation therapy in the past iron chelation therapy is: a. A procedure to remove excess iron from the childs body b. A procedure to help iron move effectively into hemoglobin c. A therapy to increase the iron level in bone and muscle cells d. A therapy to convert iron into calcium to increase heart action. 179. Joey, who has a sickle cell anemia, has had two vasoocclusive crises in the past year. a vaso occlusive crisis occurs because; a. An enlarged spleen causes blood to pool there b. Dehydration leads to thrombosed sickle cells c. Hemorrhage reduces a child s total blood volume d. Decreased platelet number leads to poor coagulation 180. Auto immune acquired hemolytic anemia can occur in any child. The usual cause of this disorder is; a. Allergy to the protein found in fish b. A mutant gene similar to sickle-cell c. An elevated eosinophil cell count 181. Disseminated intravascular coagulation can occur in any child with a critical illness. The drug of choice you would expect to administer to this condition is; a. Erythroprotein, to stimulate red cells b. Methotrexate, to decrease red cell number c. Heparin, to halt abnormal coagulation d. Prednisone, to decrease immune reaction 182. Barry has frequent bouts of vomiting. What secondary electrolyte problem often occurs when metabolic alkalosis results from vomiting? a. acidosis b. Hyponatremia c. Hypokalemia d. Hyperchlorosis 183. Barry s mother tells you she often makes milkshakes with raw eggs. What infectious organism is easily spread this way? a. Pneumococcus b. Salmonella c. Streptococcus A. d. H. pylori 184. Barry s older sister had pyloric stenosis as an infant. Vomiting with pyloric stenosis typically occurs; a. Immediately after feeding b. An hour after feeding c. On arising in the morning d. When the infant cries 185. Barrry s family likes to eat shellfish. What form of hepatitis is most apt to be contracted by eating contaminated shellfish? a. Hepatitis B b. Hepatitis A c. Hepatitis E d. Hepatitis D 186. Kwashiorkor is a disorder common in developing countries. This disorder occurs because of lack of what nutrient? a. Water soluble vitamins b. Fats and triglycerides c. Quality protein d. Vitamin K 187. Carol has voiding cystourethrogram last year to help diagnose her urinary tract infection. Why is a voiding cystourethrogram a difficult test for preschool children? a. Reading the instruction for the test is difficult b. Lying in an MRI machine is dark and scary c. They feel uncomfortable voiding in public d. The dye capsules may be too large to swallow 188. The appearance of a child with hypospadias is; a. The urethra opens on the underside of the penis b. The bladder opens on the surface of the abdomen c. Urine drains into the rectum and is excreted with stool d. The child is unable to void, as there is no urethral meatus 189. What is typically the first symptom of acute glomerulonephritis? a. Low blood pressure from excessive aldosterone b. Old blood in urine from kidney bleeding c. dependent edema from protein accumulation d. pain on urination from urethra inflammation 190. What is an important nursing intervention for children with nephritic syndrome? a. Caution them not to eat salt, as salt irritates the bladder b. Encourage them to walk a mile daily for exercise c. Teach them to test their urine for proteinuria d. teach them to take their temperature daily 191. How would you best explain kidney transplantation to a child? a. A new kidney will be placed in your abdomen b. The new kidney will be placed in your bladder c. You must never eat eggs after a kidney transplant d. Your uterine will be brown for the rest of your life. 192. Suppose a girl develops precocious puberty. What advice would you give her parents? a. Excess estrogen causes children to be intersexed or hermaphrodites b. Although her sexual appearance is advanced, the girl cannot conceive c. To remember to treat the child appropriately for her chronologic age, not the age she appears to be

d. To not allow the child to eat processed meats, which contain hormones 193. Navi wants to have breast augmentation as soon as she s 18. What advice would you give her regarding this? a. She will not be able to breast feed after augmentation. b. Breast implant cause a high degree of fibrocystic disease c. She cannot do breast self examination with implants d. Implants do not increase the risk of breast cancer 194. Candidal vaginal infections can occur as an opportunistic infection when adolescents are prescribed antibiotics. What are the typical symptoms of a candidal vaginal infection? a. yellow pinpoint vaginal lesions b. Pruritc reddened vaginal walls c. White, cheese-like vaginal discharge d. vaginal atrophy with final scarring 195. Rob s sister developed hyperthyroidism (Grave s disease) at puberty. Which is a typical appearance she would have shown? a. Slow, lethargic movements. b. Swollen protuberant abdomen c. Jittery, nervous mannerism d. reduced intellectual processing 196. Rob has his adrenal gland function assessed. What is the effect on a child when sufficient aldosterone cannot be produced? a. Substantially fewer red blood cells are produced. b. There is an overall decreased urine output c. An excessive amount of sodium is lost in urine d. The child s growth rate increases abnormally 197. When Rob was first diagnosed with diabetes mellitus he experienced a honeymoon period. This means; a. He developed an unnatural craving for sweets b. puberty occurred because of glucose stimulation c. His need for injectable insulin was drastically reduced d. he became light headed or giddy every afternoon 198. Tasha has a full neurologic examination after a seizure. What cranial nerve is assessed when you asked a child to raise her shoulders as you push against them? a. Nerve VII or facial b. Nerve VIII or auditory c. Nerve XI or accessory d. Nerve XII or hypoglossal 199. What information would you want parents to know about their child with cerebral; palsy? a. Symptoms of cerebral palsy usually fade by puberty b. All children with cerebral palsy are cognitively challenged c. Cerebral palsy may be associated with a vaccine reaction d. Symptoms may seem to grow worse as fine motor skill is needed 200. Tasha is diagnosed as having bacterial meningitis. How long should she placed on respiratory precautions for this condition? a. 4 hours b. 24 hours c. Ten days d. 30 days 201. Tasha had a generalized or tonic clonic seizure. What is the usual description of this type seizure? a. A momentary halt of about ten seconds in respiration. b. Stiffening pf the extremities, then shaking of the body c. Extreme pain and twitching of one of the extremities d. Rapid blinking, then foaming of the mouth 202. Spinal cord injuries occur from accidents. Which is the most common type of injury in adolescents? a. Cervical fracture from a diving accident b. Sacral fracture from a bicycle accident c. Thoracic fracture from a bullet injury d. Thoracic sacral injury from lifting weights 203. What if Carla had amblyopia? What is a common assessment for amblyopia? a. Doing a cover test b. Asessing for a red reflex c. Preschool E chart testing d. Pressing for tenseness 204. After cataract surgery, why should vomiting be prevented if at all possible?

a. Vomitus could be splashed into the eye b. Loss of sodium discolors the new lens c. Vomiting increases intraocular pressure d. loss of fluid causes the globe to shrink 205. Carla has an acute otitis media. How does this differ from otitis externa? a. Otitis media manifests as a sudden disease externa tends to be a chronic disease. b. Otitis media is infection of middle ear; externa is infection of outer canal c. Otitis media occurs on the inner surface of the eardrum; externa occurs on the cochlear nerve. d. otitis media is treated with antibiotics; externa is treated with antifungal agents 206. You are teaching a child to walk with crutches. Which is the best instruction? a. he should bear weight on his armpits to keep stress off his arms b. he should lean forward at a 45 degree angle while walking c. he should bear weight on his arms to avoid pressure on his axilla d. it is unsafe to walk downstairs with crutches; upstairs is alright 207. When caring for Jeffrey s osteomyelitis, which of the following os the most important intervention? a. Maintain an I.V antibiotic therapy solution b. Tell his parents the infection was caused by food poisoning c. Restrict fluid to encourage red blood cell production d. Assist the child with moderate weight bearing activity 208. Jeffrey s sister has juvenile arthritis. What is a common method used to reduce pain with this disorder? a. Apply ice to painful joint to reduce inflammation b. have the joints scraped during an arthroscopy c. Apply hydrocortisone ointment to affected joints d. take a non-steroidal anti-inflammatory drug daily 209. What is an important nursing intervention with children with muscular dystrophy? a. Urge them to rest most of the day to avoid fatigue b. Guide them to avoid weight gain so they can be mobile longer c. Caution them not to eat meat and legumes at the same meal d. Encourage a diet rich in calcium to prevent osteoporosis 210. Why is casting an elbow a potentially dangerous type of cast application? a. it prevents the ulna and radius from continuing to grow b. Edema at the elbow can cause permanent nerve damage c. Holding the arm bent at the elbow causes low grade pain d. These casts get dirty and so lead to humeral osteomyelitis 211. You see Jason s sister in the emergency department after acetaminophen poisoning. Which of the following would be an appropriate action to take? a. Advise the parents that their child must never receive acetaminophen again b. Counsel the parents about not taking the medication in front of children c. Question an order to give an activated charcoal to neutralize the drug d. Symphatize with parents, but reassure them this poisoning is not serious. 212. Suppose Jason s older brother had lead poisoning. What is the common source of lead poisoning in young children? a. Smelling lead fumes from cooking utensils b. Chewing on batteries that fall out of toys c. Drinking lead contaminated drinking water d. Chewing on chips of lead based outdoor paint 213. If Jason spilled scalding hot water on his hand, which of the following would be the best emergency action? a. Apply an ice compress on his hand b. Pour vegetable oil over his hand c. Cover his hand with a gauze dressing d. Apply hand lotion to keep the area moist

214. Parents are often unaware that their child is developing leukemia. What are the first signs commonly seen in a child with acute lymphocytic leukemia (ALL)? a. Nodules and pink rash b. Headache and sleepiness c. Fatigue and purpura d. Join pain and coughing 215. Geri is going to have a surgery for a brain tumor. Why may children be prescribed a stool softener before this type of surgery? a. Constipation stimulates the release of hypopituitary hormones b. Straining with bowel movements increase intracranial pressure c. Constipation can lead to anal fissure and a source of infection d. Children in Trendelenburg positions cannot evacuate bowels well 216. What is an important intervention to take for a child with nephroblastoma (Wilms tumor) a. Post a sign over a crib: No abdominal palpation b. Alert the mother that her child will be infertile after the surgery c. Be certain the child eats no red vegetables before surgery d. record a head circumference in the nursing care plan 217. Suppose Todd had symptoms of autism. Which of these symptoms is common in autism? a. Lack of short term memory b. hallucinations of voices talking c. Whirling and whirling around in a circle d. Severe depression or feeling of sadness 218. Children like Todd, with ADHD, have difficulty with concepts such as before and after. This difficulty reflects which underlying problem? a. Not being able to sequence b. Not hearing equally on both ears c. Feeling chronically depressed d. Being too hyperactive to care 219. Which child is most apt to have anorexia nervosa? a. Jake, a 7 year old boy whose parents are divorced b. Mary, a 15 year old girl who has a poor self image c. Odom, a 14 year old boy who plays varsity sports d. Jenny, a 13 year old girl who is overweight 220. Which finding in Hillary s background is atypical finding of child abuse/ a. Hillary s mother describe her as not pretty b. Hillary s birthday is in the fall of the year c. Hillary s mother works part time for low pay d. Hillary s father smokes a pack of cigarettes a day 221 If Hillary had been abused as an infant she might have experienced shaken baby syndrome. Which of the following is a usual finding with this syndrome? a. A baby is fearful of strangers B. Retinal hemorrhages develops c. A baby develops crohns disease d. A major bone, such as a femur, is broken. 222. Which description most accurately describe rape? a. It is a crime of deep passion b. It is associated with poverty c. It occurs in mentally adults d. It is a crime of violence 223. What factor is most apt to help parents accept long-term illness in their child? a. The parents are isolated so cannot compare their child to others b. The parents have good relationships with their own parents c. The parents are wealthy so have few worries other than the child d. Parents believe in alternative therapies so have many options 223. Charlie s parents are starting to grieve because they fear he will not survive this reoccurrence of his illness. During which stage of grief do parents usually feel saddest? a. The first stage because everything is such a shock b. The last stage because they fully accept the death c. the fourth stage, as they realize death is coming d. The stage at which the child talks about death

224. Suppose parents are told that their child will die, but then the child doesn t die. What is an unexpected consequence of anticipatory grieving? a. it has no effect, because the child doesn t die b. it can disrupt the parent-child relationship c. it teaches the child that parents can be wrong d. It breaks parents confidence in their religion

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