Scenario #1 Questions 1-9 relate to the

Scenario #1 Questions 1-9 relate to the scenario below A newborn infant, or neonate, is a child under 28 days of age. During these first 28 days of life, the child is at highest risk of dying. The vast majority of newborn deaths take place in developing countries where access to health care is low. 1. The COMMONEST cause of hyperbilirubinemia in the newborn is: a. Breastfeeding b. Enzyme deficiency c. Mother with diabetes d. Physiologic jaundice 2. Which of the following is a factor in the pathophysiology of respiratory distress in the newborn? a. Respiratory Alkalosis b. Increase pulmonary blood flow c. Deficient production of surfactant d. Decreased pulmonary vascular resistance 3. The most serious cardiovascular disorders of the newborn are _______________ defects. a. Anaemia b. Seizures c. Congenital heart d. Respiratory distress 4. Which of the following are the most advantageous positions for maintaining an infant’s on airway? a. On the side with the head supported in alignment by a small, folded blanket, or prone positioned to keep the neck slighted extended b. Prone with the head supported in alignment by a small folded, or, when on the back, positioned to keep the neck slightly extended c. Supine with the head supported in alignment by a small, folded blanket, or, when on the back, positioned to keep the neck slightly extended d. On the side with the head supported in alignment by a small, folded blanket, or, when on the back, positioned to keep the neck slightly extended 5. Seizures in the neonatal period are usually the clinical manifestation of a: a. infection b. severe allergy c. neurologic injury d. serious underlying disease 6. Which of the following are central nervous system signs of neonatal sepsis? a. Mottling b. Dyspnoea c. Hypothermia d. Full fontanel 7. ____________________ is the first act of communication parents and child. a. Seeing b. Hearing c. Longing d. Touching 8. The commonest treatment of hyperbilirubinemia is: a. Hydration b. Phototherapy c. Scheduled feedings d. Cessation of breastfeeding 9. During the first 4 hours after a male circumcision, assessing for which of the following is the priority? a. Infection b. Discomfort c. Hemorrhage d. Dehydration Scenario #2: Questions 10-16relate to the scenario below Infancy includes ages 1 month to 1 year. In these important months, an infant undergoes such rapid development that parents sometimes believe their baby looks different and demonstrates new abilities every day. 10. During a 6-month well-child checkup, an infant should have mastered all of the following developmental tasks EXCEPT: a. Imitates sounds b. Sits in highchair c. Pulls up to stand d. Holds head at 90 degrees without any head lag 11. A mother of a 12-month-old infant asks what new gross motor skills her baby should be demonstrating when he returns for his next scheduled immuniza- tions. The nurse’s best response is: “At the next scheduled appointment for immunizations, your son is expected to”: a. Catch a big ball b. Walk on his own c. Jump with both feet d. Walk up and down stairs, one step at a time 12. The nurse hears a mother telling a friend on the telephone about umbilical cord care. Which of the following statements by the mother indicates effective teaching? a. “He can have a tub bath each day” b. “Alcohol helps it dry and kills germs” c. “Daily soap and water cleansing is best” d. “An antibiotic ointment applied daily prevents infection” 13. A newborn weighing 3000 grams and feeding every 4 hours needs 120 calories/kg of body weight every 24 hours for proper growth and development. How many ounces of 20 cal/oz formula should this newborn receive at each feeding to meet nutritional needs? a. 2 ounces b. 3 ounces c. 4 ounces d. 6 ounces 14. While performing physical assessment of a 12 month-old, the nurse notes that the infant’s anterior fontanelle is still slightly open. Which of the following is the nurse’s most appropriate action? a. Perform an intensive neurologic examination b. Perform an intensive developmental examination c. Do nothing because this is a normal finding for the age d. Notify the physician immediately because there is a problem 15. Which of the following toys should the nurse recommend for a 5-month-old? a. A big red balloon b. A colorful busy box c. A push-pull wooden truck d. A teddy bear with button eyes 16. When discussing normal infant growth and development with parents, which of the following toys would the nurse suggest as most appropriate for an 8-month-old? a. Rattler b. Mobile c. Large blocks d. Push-pull toys Scenario #3 Questions 17- 21 relate to the scenario below During the toddler period, the age span from 1 to 3 years, enormous changes take place in a child and, consequently, in a family. During this period, children accomplish a wide array of developmental tasks and change from largely immobile and preverbal infants who are dependent on caregivers for the fulfillment of most needs to walking, talking young children. Sibert-Flagg, 2023 17. To assess language development of a 3-year-old child at a well-child visit, the nurse would ask the parent: a. Does your child imitate animal sounds? b. Does your child speak in complete sentences? c. Does your child ask who, what, and where questions? d. Does your child seem to comprehend explanations that provide the “what” and “why” of things? 18. A nursing strategy that will not threaten a 2-year-old child’s developmental level and will provide atraumatic care when administering an immunization would be to: a. Apply a local anaesthetic cream before the procedure b. Tell the child the shot will hurt but will be done with quickly c. Encourage the parent to wait outside while the injection is administered d. Tell the child that “big boys” are brave and hold still when getting a shot 19. If a parent keeps a toddler dependent in areas where they are capable of using skills, the toddle will develop a sense of: a. mistrust b. shame c. guilt d. inferiority 20. Which of the following is an appropriate toy for an 18-month-old? a. Comic book b. Finger paints c. Miniature cars d. Multiple-piece puzzle 21. When teaching parents about typical toddler eating patterns, which of the following should the nurse include? a. Picky eaters b. Increase in appetite c. Preference to eat alone d. Consistent table manners Scenario #4 Questions 22- 31 relate to the scenario below The preschool period traditionally includes the years 3, 4, and 5. Although physical growth slows considerably during this period, personality and cognitive growth continue at a rapid rate. Caregivers may be unsure how much independence and responsibility for self-care they should allow their rapidly maturing child. Silbert-Flagg, 2023 22. Which of the following aspects of psychosocial development is necessary for the nurse to keep in mind when providing care for the preschool child? a. The child engages in competitive types of play b. Fear of body mutilation is a common preschool fear c. Immediate gratification is necessary to develop initiative d. The child can use complex reasoning to think out situations 23. Which of the following advice should the nurse offer the parents of a 4-year-old boy who resists going to bed at night? a. “Allow him to fall asleep in your room, then move him to his own bed.” b. “Encourage active play at bedtime to tire him out so he will fall asleep faster.” c. “Tell him that you will lock him in his room if he gets out of bed one more time.” d. “Read him a story and allow him to play quietly in his bed until he falls asleep.” 24. When providing therapeutic play, which of the following toys BEST promote imaginative play in a 4-year-old? a. Big wheels b. Large blocks c. Dress-up clothes d. Wooden puzzle 25. Which of the following should the nurse suspect when noting a 3-year-old engaging in explicit sexual behaviour during doll play? a. The child is acting out personal experiences b. The child is probably developmentally delayed c. The child does not know how to play with dolls d. The child is exhibiting normal pre-school curiosity 26. The most important safety precaution for parents to teach preschoolers is: a. to chew bites of food three times b. not to ride in a car with strangers c. not to begin formal dance classes d. not to watch their father mow the lawn 27. During the preschool years, female children may develop a strong attachment to their fathers. This attachment is called: a. Electra complex b. Oedipus complex c. Freudian complex d. Sexual identification complex 28. When planning how to respond to a 3-year-old child about telling stories (“tall tales”), the nurse would base the statement on the fact that: a. a preschooler is in an insecure period b. preschoolers have a limited vocabulary c. imagination in a 3-year-old is at its peak d. a 3-year-old knows the word two but not the concept of two 29. What suggestions regarding the evaluation of a childcare center would the nurse share with a preschooler’s mother? a. A ratio of 10 children to 1 teacher is adequate b. The longer the center has been in operation, the better it is c. Specific program goals to be accomplished should be available d. Research local newspapers to see if there are any complaints against the center 30. A preschooler’s mother asks the nurse an appropriate time to tell her son that she is pregnant. The nurse’s best answer would be: a. probably at the point she begins to look pregnant b. about 1 week before her due date, to reduce anxiety about waiting c. not until the baby is born, so that she can say whether it is a girl or a boy d. about 1 month before her due date, when she moves the preschooler out of his crib 31. The nurse is helping parents enhance the developmental task of initiative in their preschool-age child. Which activity would the nurse suggest the parents implement? a. Help the child learn how to follow rules b. Teach the child how to cross the street safely c. Allow the child to experiment with molding clay d. Provide the child with clothes that snap rather than button Scenario #5: Questions 32 to 43 relate to the scenario The term “school-age” refers to children between the ages of 6 to 12 years. Although these years represent a time of slow physical growth, the school-age child’s cognitive growth and development continue to proceed at a rapid pace. There are many differences among children in each year of this group. (Pilliteri, 2018) 32. A 12-year-old has a BMI in the 60th percentile. Anticipatory guidance that the nurse would provide to this child and his parent would involve: a. Discussing weight-reduction strategies b. Implementing a plan for increased physical activity c. Referring the child and parent to a nutritionist for weight-management strategies d. Encouraging the child to continue to maintain his current diet and level of activity 33. The parent of a 6-year-old child is concerned that her son is small for his age. The child’s weight is 42 pounds and he is 42 inches tall. The nurse’s BEST response to this parent’s concern is a. “Actually, your child is somewhat overweight and tall for his age.” b. “Your son’s weight and height are in the average range for a boy his age.” c. “All children vary in their weight and height, so I would not be concerned.” d. “I am concerned too. I will request a nutritional consult for you and your child.” 34. Which of the following activities, when voiced by the parents following a teaching session about the characteristics of school-age cognitive development would indicate the need for additional teaching? a. Developing plans for the future b. Ordering dolls according to size c. Collecting baseball cards and marbles d. Considering simple problem-solving options 35. After teaching a group of parents about accident prevention for schoolagers, which of the following statements by the group would indicate the need for more teaching? a. “Schoolagers are unable to understand potential dangers around them.” b. “Schoolagers are more active and adventurous than are younger children.” c. “Schoolargers are less subject to parental control than are younger children.” d. “Schoolagers are more susceptible to home hazards than are younger children.” 36. Which of the following skills is the most significant one learned during the schoolage period? a. Sorting b. Reading c. Ordering d. Collecting 37. According to Freud, the school- age child is in the stage of: a. Oral b. Anal c. Oedipal d. Latency 38. The developmental task of the school-aged period, according to Erikson, is gaining a sense of: a. identity versus failure b. autonomy versus shame c. industry versus inferiority d. independence versus dependence 39. According to Erikson, the developmental task of middle childhood is acquiring a sense of: a. Trust b. Industry c. Initiative d. Autonomy 40. According to Piaget, the school-age child is in the stage of: a. Sensorimotor b. Preoperational c. Formal operational d. Concrete operational 41. Which of the following BEST describes the younger (6 to 7 year-old) school- age Child’s perception of rules and judgement of actions? a. Understands the reasoning behind rules b. Believes that rules and judgements are not absolute c. Interprets accidents and misfortunes as punishment for misdeeds d. Judges an act by its intentions rather than by the consequences alone 42. Typical development for the school-aged child includes playing games with friends. At what age are children typically ready for games that include playing on a team that has a winner or loser? a. 5 years b. 7 years c. 10 years d. 13 years 43. A 7-year-old child has taken money from a sibling’s dresser on two occasions. When counseling the parent about this behavior, what would the nurse advise? a. “Stealing is unusual for a 7-year-old child.” b. “You may need to remind your child about property rights.” c. “You should buy your other child a bank that cannot be opened.” d. “You should talk to the child’s teacher about putting less pressure on your child.” Scenario #6: Questions 44 to 51 relate to the scenario Adolescence is defined as the period between ages 13 and 20 years, a time that serves as a transition between childhood and becoming a late adolescent. It can be divided into an early period (13 to 14 years), a middle period (15 to 16 years), and a late period (17 to 20 years). Silbert-Flagg, 2023 44. A 15-year-old adolescent is seen at a health care facility for facial acne. When counseling the teen, the nurse would teach that the basic cause of acne is: a. activation of androgen hormones b. vitamin deficiency from an inadequate diet c. lack of showering adequately after gym class d. thyroid-gland secretions increasing with adolescence 45. An adolescent is concerned that he is going to be unusually short. The nurse advises him that the epiphyseal lines of long bones in boys that govern growth usually close between ages: a. 13 and 14 years b. 14 and 15 years c. 17 and 18 years d. 20 and 22 years 46. Which nursing action would BEST assist a 15-year-old client accomplish the developmental task according to Erikson? a. Praise the client for correctly performing self-care b. Permit the client to make decision regarding one’s care c. Allow the client’s friends to visit while the client is hospitalized d. Provide the client with crafts and puzzles to complete independently 47. Which activity would BEST foster the developmental task of an adolescent who uses a wheelchair to ambulate? a. Allowing the adolescent to decide when to bathe b. Having a teacher bring school work to the adolescent c. Watching television on the set in the adolescent’s room d. Talking to another adolescent who has a similar situation 48. A 16-year-old girl who has been confined to a wheelchair since early childhood has been acting rebellious and rude. Her parents ask the nurse, “Are all adolescents like this?” What is the nurse’s best response? a. “No. Your daughter must need some help in dealing with her feelings.” b. “Your daughter’s behavior results from feelings about her disability; ignore them.” c. “Yes. Although your daughter’s behaviours are more like those of an adolescent boy.” d. “Your daughter’s behaviour seems to be typical adolescent behaviour. Let’s talk more about it.” 49. An adolescent asks the nurse what the term “puberty” means. Which of the following is the nurse’s BEST response? a. “It is the time span between 12 and 18 years.” b. “It is the time span that denotes the onset of maturity.” c. “It denotes the beginning of secondary sex characteristics.” d. “It is the age at which one first becomes capable of sexual reproduction.” 50. The school nurse prepares an educational session for adolescents to address the 2030 National Health Goals for healthy habits. Which should the nurse EXCLUDE in this presentation? a. Abstaining from alcohol b. Avoidance of tobacco products c. Providing support in times of crisis d. Attending college preparation programs 51. The nurse prepares a discussion on the most frequent causes of death in adolescents with a group of high school students. Which area should the nurse focus on during this discussion? a. burglary b. water safety c. home safety d. motor vehicle safety Scenario #6: Questions 52 to 60 relate to the scenario Communication is fundamental to health literacy as well as social interaction and is one of the first and most important skills children learn. It can be either a formal or an informal exchange. Silbert-Flagg 52. Following a principle of learning, the nurse can anticipate that school-age children will best learn a skill such as bandaging if they: a. are allowed to practice it b. are criticized for not learning it well c. have it demonstrated to them by a teacher d. are shown a photo of someone important doing it 53. Based on the school-aged cognitive development, which teaching technique is BEST received by the child? a. Explaining elevated and decreased blood pressure as a concept b. Asking children to conceptualize the effect of falling blood pressure c. Asking children to think through “what if” situations and blood pressure d. Using containers of water to demonstrate how hemorrhage leads to decreased body fluid 54. The nurse prepares to teach a 9-year-old child how to do active range-of-motion exercises. Which technique is MOST appropriate to use? a. Demonstrate the technique by performing it the same way each time b. Allow the child to review instructional pamphlets as the nurse is teaching c. Tell the child different ways to perform the technique so the child can choose d. Suggest the child tell the nurse how he or she wants the range-of-motion exercises to be done 55. Preschool children tend to “center” on information. The nurse understands the child may: a. learn only the middle part of a procedure b. not retain information longer than a week c. concentrate on one part of a procedure and appear not to hear another d. have to have printed material directly in front of him or her to understand it 56. A 6-year-old child who does not speak the dominant language is in the hospital for an appendectomy. It is late at night when the nurse needs to catheterize the child for a distended bladder. Which action by the nurse would be most helpful in relaying this information? a. Tell the parents to tell the child what will be happening b. Draw a picture of the procedure using an anatomically correct figure c. A child of this age does not require a detailed explanation; just perform the procedure d. Call the interpreter on the phone and have the interpreter explain the procedure to the child 57. A school-age child is newly diagnosed with type 1 diabetes. Which behavior indicates to the nurse that the child might be interested in learning how to self-administer insulin injections? a. The child cries and calls for the mother with every insulin injection. b. The child watches the nurse fill the insulin syringe and asks to hold it. c. The child asks how many “shots” are needed before the illness is “all better.” d. The child tells the nurse that a parent will give the injection so the parent needs the teaching. 58. The nurse plans to incorporate teaching while caring for a preschool-age child. Which statement is appropriate for the nurse to use when caring and teaching this child? a. “I need to put a needle in your arm so please hold still.” b. “I can hear your heart beat and your pulse is 88 beats/minute.” c. “You have to try to eat all of your dinner and then you may have a treat” d. “It is important to put a pillow under your leg so the swelling will go down.” 59. The parent of an infant does not speak the dominant language. The parent’s 8-year-old child speaks the dominant language, and the parent wants to communicate with the nurse through the child. How should the nurse best handle teaching the parent? a. Obtain an interpreter b. Use a translation app on a phone c. Teach through the 8-year-old child d. Provide a nurse who speaks the parent’s language 60. The nurse educator is providing a class to the nurses on how to communicate with children who have hearing impairments. Which communication techniques should be EXCLUDED from the class? a. Use dolls to communicate b. Face the child when speaking c. Provide a sign language interpreter d. Write out instructions for the older child Match each type of play with the defining characteristic by writing the letter in the spaces provided on the left. Solitary Play Cooperative Play Onlooker Play Associative Play Parallel Play ____________ __ A. Child watches what other children are doing but makes no attempt to enter the play activity. An example is watching an older sibling colour a picture. ____________ B. Child plays alone and independently with toys different from other children within the same area. The child’s interest is centred on his or her activity. ____________ C. Child plays independently among other children with toys that are like those that the child around him or her are using, neither influencing nor being influenced by them. There is no group association _____________ D. Child plays with other children, engaging in a similar or identical activity in which there is no organization, division of labour, or mutual goal. An example is two children playing with dolls. ______________ E. Child plays with other children with discussion and planning of activities for accomplishing an end. Sydney, a 5 year old girl, and her parents are in for a well- child checkup. The nurse interviews the parents and discovered that Sydney is attending a preschool program. 2 Identify five (5) approaches parents can promote readiness for day care or preschool for this age group. SECTION C GROWTH CHART Scenario Two-year-old Greg is brought to the paediatric clinic for a well- child checkup. His present height is 89 cm and his weight is 13.6 kg. His previous weight and height measurement were: Age Height Weight 6 months 5 kg 58 cm 9 months 8.5 kg 63 cm 1 year 10 kg 70 cm 15months 12kg 75 cm Questions 1. Plot Greg’s height & weight on the growth chart provided using a pencil. 2. How do Greg’s measurements compare with the norm for his age? 3. Greg’s parents are concerned that he is not gaining enough weight or inches since his last visit 9 months ago. State the information the nurse would provide to the parents regarding a healthy toddle’s development. 4. Identify three (3) developmental milestones that Greg should accomplish for his present age in the following areas: a. Gross motor development b. Fine motor development c. Language development

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