Which of the following is appropriate language development for an 8-month old?

The child
should be:
1) saying "dada" and "mama" specifically ("dada" to father and "mama" to mother).
2) saying three other words besides "mama" and "dada."
3) saying "dada" and "mama" nonspecifically.
4) saying "ball" when parents point to a ball.

The nurse should refer the parents of an 8-month-old child to a health care provider if the
child is unable to:
1) stand momentarily without holding onto furniture.
2) Stand alone well for long periods of time
3) Stoop to recover an object.
4) Sit without support for long periods of time.

The nurse is teaching the parents of an 8-month-old about what the child should eat. The
nurse should include which of the following points in the teaching plan?
1) Items from all four food groups should be introduced to the infant by the time the child
is 10 months old.
2) Solid foods should not be introduced until the infant is 10 months old.
3) Iron deficiency rarely develops before 12 months of age, so iron- fortified cereals should
not be introduced until the infant is 12 months old.
4) The infant's diet can be changed from formula to whole milk when the infant is 12
months old.

a 10-month old looks for objects that have been removed from his view. The nurse should
instruct the parents that:
1) Neuromuscular development enables the child to reach out and grasp objects.
2) The child's curiosity has increased.
3) The child understands the permanence of objects even though the child cannot see
them. 4) The child is now able to transfer objects from hand to hand.

Which of the following structures should be closed by the time the child is 2 months old?
1) Anterior fontanel
2) sagittal suture
3) Posterior fontanel
4) Frontal suture

The nurse is discharging from the hospital an 8-month-old who weighs 15 lb. The parents
have put the child in the back seat of the car with the car seat facing the front seat. The
nurse should:
1) Ask the parents to wait while the nurse obtains the correct car seat.
2) Complete the discharge with the child facing the front seat.
3) Give the parents a manual on proper car seat placement.
4) Show the parents proper placement of the car seat facing the back seat.
A mother who brings her 4-month- old infant to the clinic for a regular checkup is concerned
that her infant is not developing appropriately. When assessing the infant, which of the
following should the nurse expect to find?
1) Sitting up with support.
2) Finger-to-thumb grasping.
3) Reaching for a toy.
4) Saying "mama" or "dada."

In addition to immunizing for diphtheria, tetanus, and acellular pertussis (DTaP) during the
first 6 months of life, the nurse should administer which of the following immunizations?
1) Mumps.
2) Measles.
3) Tuberculosis.
4) Hepatitis B.

The parents of a 9-month-old bring the infant to the clinic for a regular checkup. The infant
has received no immunizations. Which of the following would be appropriate for the nurse
to administer at this visit?
1) Diphtheria, tetanus, and acellular pertussis (DTaP); Haemophilus influenzae type B
(Hib); inactivated poliomyelitis vaccine (IPV); and purified protein derivitive (PPD).
2) DTaP, Hib, oral polio vaccine (OPV), and measles, mumps, and rubella (MMR).
3) PPD, MMR, hepatitis B (hepB), and OPV
4) HepB, IPV, Hib, and varicella.

The mother of a 1-month-old infant states that she is curious as to whether her infant is
developing normally. Which of the following developmental milestones should the nurse
expect the infant to perform?
1) Smiling and laughing out loud.
2) Rolling from front to side.
3) Holding a rattle briefly.
4) Turning the head from side to side.

The mother of a 6-month-old states that she has started her infant on 2% milk. which of the
following should be the nurse's best response?
1) Your baby will probably be fine with this milk.
2) The baby should be switched to whole milk.
3) You need to keep the infant on formula.
4) You need to switch to formula right now.

The nurse notes that an infant stares at an object placed in her hand and takes it to her
mouth, coos and gurgles when talked to, and sustains part of her own weight when held in a
standing position. The nurse correctly interprets these findings as characteristics of an infant
at which of the following stages?
1) 2months 2) 4 months 3) 7 months 4) 9 months
An 8 month-old infant is seen in the well-child clinic for a routine checkup. The nurse should
expect the infant to be able to do which of the following. Select all that apply. 1) Say
"mama" and "dada" with specific meaning.
2) Feed self with spoon.
3) Play peek-a-boo.
4) Walk independently.
5) Stack two blocks.
6) Transfer object from hand to hand.

A parent seems concerned about the fact that the infant's soft spot is still open. Which of
the following should the nurse include when explaining about the usual age for closure of
the soft spot near the front of the infant's head.
1) 2-4 months 2) 5-8 months 3) 9-11 months 4) 12-18 months

A mother states that she thinks her 9-month-old "is developing slowly." When assessing the
infant's development, the nurse is also concerned because the infant should be
demonstrating which of the following characteristics?
1) Vocalizing single syllables.
2) Standing alone.
3) Building a tower of two cubes.
4) Drinking from a cup with little spilling

A 2-year-old tells his mother he is afraid to go to sleep because "the monsters will get him."
The nurse should tell his mother to:
1) Allow him to sleep with his parents in their bed whenever he is afraid.
2) Increase his activity before he goes to bed, so he eventually falls asleep from being tired.
3) Read a story to him before bedtime and allow him to have a cuddly animal or a blanket.
4) Allow him to stay up an hour later with the family until he falls asleep.

A 2-year-old always puts his teddy bear at the head of his bed before he goes to sleep. The
parents ask the nurse if this behavior is normal. The nurse should explain to the parents that
toddlers use ritualistic patterns to:
1) Establish a sense of identity.
2) Establish control over adults in their environment.
3) Establish sequenced patterns of learning behavior.
4)Establish a sense of security.

Which development is necessary for toilet training readiness for a 2- year-old? Select all that
apply.
1) Adequate neuromuscular development for sphincter control.
2) Appropriate chronological age.
3) Ability to communicate the need to use the toilet.
4) Desire to please the parent.
5) Ability to play with other 2-year- olds.

A mother of a toilet-trained 3-year- old expresses concern over her child's bedwetting while
hospitalized. The most appropriate response for the nurse to make is to tell the mother:
1) He was too immature to be toilet trained. In a few months he should be old enough.
2) Children are afraid in the hospital and frequently wet their bed.
3) It's very common for children to regress when they're in the hospital.
4) This is normal. He probably received too much fluid the night before.

A nurse working in the nursery identifies a goal for a mother of a newborn to demonstrate
positive attachment behaviors upon discharge. Which intervention would be least effective
in accomplishing this goal?
1) Provide opportunities for the mother to hold and examine the newborn.
2) Engage the mother in the newborn's care.
3) Create an environment that fosters privacy for the mother and newborn.
4) Identify strategies to prevent difficulties in parenting.

A mother brings her 18-month-old to the clinic because the child "eats ashes, crayons, and
paper." Which of the following information about the toddler should nurse assess first?
1) Evidence of eruption of large teeth.
2) Amount of attention from the mother.
3) Any changes in the home environment.
4) Intake of a soft, low-roughage diet.

When assessing a 2-year-old child brought by his mother to the clinic for a routine
checkup, which of the following should the nurse expect the child to be able to do?
1) Ride a tricycle.
2) Tie his shoelaces.
3) Kick a ball forward.
4) Use blunt scissors.

A 2-year-old child brought to the clinic by her parents is uncooperative when the nurse
tries to look in her ears. Which of the following should the nurse try first?
1) Ask another nurse to assist.
2) Allow a parent to assist.
3) Wait until the child calms down.
4) Restrain the child's arms.

When observing the parent instilling prescribed ear drops ordered twice a day for a
toddler, the nurse decides that the teaching about positioning of the pinna for instillation of
the drops is effective when the parent pulls the toddler's pinna in which of the following
directions?
1) Up and forward.
2) Up and backward.
3) Down and forward.
4) Down and backward.

The mother asks the nurse for advice about discipline for her 18- month-old. Which of
the following should the nurse suggest that the mother use first?
1) Structured interactions.
2) Spanking.
3) Reasoning.
4) Time-out.

When assessing for pain in a toddler, which of the following methods should be the most
appropriate?
1) Ask the child about the pain.
2) Observe the child for restlessness.
3) Use a numeric pain scale.
4) Assess for changes in vital signs.

When planning a 15-month-old toddler's daily diet with the parents, which of the
following amounts of milk should the nurse include?
1) 1/2 to 1 cup. 2) 2 to 3 cups. 3) 3 to 4 cups. 4) 4 to 5 cups.

To encourage autonomy in a 4 year-old, the nurse should instruct the mother to:
1) Discourage the child's choice of clothing.
2) Button the child's coat and blouse.
3) Praise the child's attempts to dress herself.
4) Tell the child when the combination of clothes is not appropriate.

The mother of a 4-year-old expresses concern that her child may be hyperactive. She
describes the child as always in motion, constantly dropping and spilling things. Which of
the following actions would be most appropriate at this time?
1) Determine whether there have been any changes at home.
2) Explain that this is not unusual behavior.
3) Explore the possibility that the child is being abused.
4) Suggest that the child be seen by a pediatric neurologist.

The mother of a preschooler reports that her child creates a scene every night at
bedtime. The nurse and the mother decide that the best course of action would be to do
which of the following?
1) Allow the child to stay up later one or two nights a week.
2) Establish a set bedtime and follow a routine.
3) Encourage active play before bedtime.
4) Give the child a cookie if bedtime is pleasant.

The parents of a preschooler ask the nurse how to handle their child's temper tantrums.
Which of the following should the nurse include in the teaching plan? Select all that apply.
1) Putting the child in "time-out."
2) Telling the child to go to his bedroom.
3) Ignoring the child.
4) Putting the child to bed.
5) Spanking the child.
6) Trying to reason with the child.
 After teaching a group of parents of preschoolers attending a well- child clinic about oral
hygiene and tooth brushing, the nurse determines that the teaching has been successful
when the parents state that children can begin to brush their teeth without help at which of
the following ages?
1) 3 years. 2) 5 years. 3) 7 years. 4) 9 years.

After having a blood sample drawn, a 5-year-old child insists that the site be covered
with an adhesive bandage strip. When the mother tries to remove the bandage before
leaving the office, the child screams that all the blood will come out. The nurse interprets
this behavior as indicating a fear of which of the following?
1) Injury.
2) Compromised body integrity.
3) Pain.
4) Loss of control.

A mother is concerned because her 5-year-old son seems prone to minor accidents such
as skinning his elbows and knees and falling off his scooter. The nurse explains to the
mother that childhood accidents are more likely to occur in which of the following
situations?
1) The child is the sole child in the family.
2) The family has limited formal education.
3) The family is experiencing changes.
4) The child and family live in the suburbs.

When developing the teaching plan about illness for the mother of a preschooler, which
of the following should the nurse include about how a preschooler perceives illness?
1) A necessary part of life.
2) A test of self-worth.
3) A punishment for wrong-doing.
4) The will of God.

A nurse is assessing the growth and development of a 10-year old. What is the expected
behavior of this child?
1) Enjoys physical demonstrations of affection.
2) Is selfish and insensitive to the welfare of others.
3) Is uncooperative in play and school.
4) Has a strong sense of justice and fair play.

The nurse asks a 9-year-old child and her mother about the child's best friend to assess
which of the following about the child?
1) Language development.
2) Motor development.
3) Neurologic development.
4) Social development.
 A 10-year-old child proudly tells the nurse that brushing and flossing her teeth is her
responsibility. The nurse interprets this statement as indicating which of the following about
the child?
1) She is too young to be given this responsibility.
2) She is most likely capable of this responsibility.
3) She should have assumed this responsibility much sooner.
4) She is probably just exaggerating the responsibility.

The mother tells the nurse that her 8--year-old child is continually telling jokes and
riddles to the point of driving the other family members crazy. The nurse should explain this
behavior is a sign of what?
1) Inadequate parental attention.
2) Mastery of language ambiguities.
3) Inappropriate peer influence.
4) Excessive television watching.

The mother asks the nurse about her 9-year-old child's apparent need for between-meal
snacks, especially after school. When developing a sound nutritional plan for the child with
the mother, which of the following should the nurse need to keep in mind?
1) The child does not need to eat between-meal snacks.
2) The child should eat the snacks the mother thinks are appropriate.
3) The child should help with preparing his or her own snacks.
4) The child will instinctively select nutritional snacks.

A nurse compares a child's height and weight with standard growth charts and finds the
child to be in the 50th percentile for height and in the 45th percentile for weight. The nurse
interprets these findings as indicating that the child is:
1) Average height and weight.
2) Overweight for height.
3) Underweight for height.
4) Abnormal in height.

The nurse is teaching an adolescent with asthma how to use an inhaler. In which order
should the nurse instruct the client to follow the steps?
1) Inhale through an open mouth.
2) Breathe out through the mouth.
3) Hold the breath for 5 to 10 seconds.
4) Press the canister to release the medication.

4132

Initiation of which of the following immunizations is recommended prior to the

adolescent entering college?
1) Diphtheria, tetanus, and acellular pertussis (DTaP).
2) Varicella.
3) Meningococcal.
4) Pneumococcal conjugate vaccine (PCV).
 The school nurse develops a plan with an adolescent to provide relief of dysmenorrhea
to aid in her development of which of the following?
1) Positive peer relations.
2) Positive self-identity.
3) A sense of autonomy.
4) A sense of independence.

An adolescent tells the school nurse that she would like to use tampons during her
period. Which of the following would be most appropriate for the nurse to do?
1) Assess her usual menstrual flow pattern.
2) Determine whether she is sexually active.
3) Provide information about preventing toxic shock syndrome.
4) Refer her to a specialist in adolescent gynecology.

The school nurse is invited to attend a meeting with several parents who express
frustration with the amount of time their adolescents spend in front of the mirror and the
length of time it takes them to get dressed. The nurse explains that this behavior indicates:
1) An abnormal narcissism.
2) A method of procrastination.
3) A way of testing the parents' limit-setting.
4) A result of developing self- concept.

Several high-school seniors are referred to the school nurse because of suspected
alcohol misuse. When the nurse assesses the situation, what would be most important to
determine?
1) What they know about the legal implications of drinking.
2) The type of alcohol they usually drink.
3) The reasons they choose to use alcohol.
4) When and with whom they use alcohol.

Which of the following actions initiated by the parents of an 8 month-old indicates they
need further teaching about preventing childhood accidents?
1) Placing a fire screen in front of the fireplace.
2) Placing a car seat in a front-seat, front-facing position.
3) Inspecting toys for loose parts.
4) Placing toxic substances out of reach or in a locked cabinet.

The mother of a 2-year-old is concerned because the child's right eye seems to turn in
toward his nose when he is tired. The nurse should:
1) Assure the mother that this is a normal event when the child is tired.
2) Advise the mother to continue to watch his eyes closely and if the problem persists to call
the clinic.
3) Test the child with the cover- uncover test and refer the mother and child to an
ophthalmologist if the test is abnormal.
4) Explain to the mother that the child will probably outgrow the weakness and she need
not be concerned.
 A nurse is assessing the growth and development of a 14-year-old boy. He reports that
his 13-year-old sister is 2 inches taller than he is. The nurse should advise the boy that the
growth spurt in adolescent boys, compared with the growth spurt of adolescent girls:
1) Occurs at the same time.
2) Occurs 2 years earlier.
3) Occurs 2 years later.
4) Occurs 1 year earlier.

Parents of a 15-year-old state that he is moody and rude. The nurse should advise his
parents to:
1) Restrict his activities.
2) Discuss their feelings with their child.
3) Obtain family counseling.
4) Talk to other parents of adolescents.

A parent asks the nurse about head lice (pediculosis capitis) infestation during a visit to
the clinic. Which of the following symptoms should the nurse tell the parent is most
common in a child infected with head lice?
1) Itching of the scalp.
2) Scaling of the scalp.
3) Serous weeping on the scalp surface.
4) Pinpoint hemorrhagic spots on the scalp surface.

A parents asks, "Can I get head lice too?" The nurse indicates that adults can also be
infested with head lice but that pediculosis is more common among school children,
primarily for which of the following reasons?
1) An immunity to pediculosis usually is established by adulthood.
2) School-age children tend to be more neglectful of frequent handwashing.
3) Pediculosis usually is spread by close contact with infested children.
4) The skin of adults is more capable of resisting the invasion of lice.

After teaching the parents about the cause of ringworm of the scalp (tinea capitis),
which of the following, if stated by the father, indicates successful teaching?
1) It results from overexposure to the sun.
2) It's caused by infestation with a mite.
3) It's a fungal infection of the scalp.
4) It's an allergic reaction.

Griseofulvin (Grisactin) was ordered to treat a child's ringworm of the scalp. The nurse
instructs the parents to use the medication for several weeks for which of the following
reasons?
1) A sensitivity to the drug is less likely if it is used over a period of time.
2) Fewer side effects occur as the body slowly adjusts to a new substance over time.
3) Fewer allergic reactions occur if the drug is maintained at the same level long-term.
4) The growth of the causative organism into new cells is prevented with long-term use.
 A mother asks the nurse, "How did my children get pinworms?" The nurse explains that
pinworms are most commonly spread by which of the following when contaminated?
1) Food.
2) Hands.
3) Animals.
4) Toilet seats.

A mother tells the nurse that one of her children has chickenpox and asks what she
should do to care for that child. When teaching the mother, which of the following would be
most important to prevent?
1) Acid-base imbalance.
2) Malnutrition.
3) Skin infection.
4) Respiratory infection.

A mother calls the clinic to talk to the nurse. The mother states that a physician
described her daughter as having 20/60 vision and she asks the nurse what this means. The
nurse responds based on the interpretation that the child is experiencing which of the
following?
1) A loss of approximately one-third of her visual acuity.
2) Ability to see at 60 feet what she should see at 20 feet.
3) Ability to see at 20 feet what she should see at 60 feet.
4) Visual acuity three times better than average.

After teaching a group of parents about temper tantrums, the nurse knows the teaching
has been effective when one of the parents states which of the following?
1) I will ignore the temper tantrum.
2) I should pick up the child during a tantrum.
3) I'll talk to my daughter during the tantrum.
4) I should put my child in time out.

The nurse discusses the eating habits of school-age children with their parents,
explaining that these habits are most influenced by which of the following?
1) Food preferences of their peers.
2) Smell and appearance of foods offered.
3) Examples provided by parents at mealtimes.
4) Parental encouragement to eat nutritious foods.

When discussing the onset of adolescence with parents, the nurse explains that it occurs
at which of the following times?
1) Same age for both boys and girls.
2) 1 to 2 years earlier in boys than in girls.
3) 1 to 2 years earlier in girls than in boys.
4) 3 to 4 years later in boys than in girls.
 A mother has heard that several children have been diagnosed with mononucleosis. She
asks the nurse what precautions should be taken to prevent this from occurring in her child.
Which of the following should the nurse advise the mother to do?
1) Take no particular precautionary measures.
2) Sterilize the child's eating utensils before they are reused.
3) Wash the child's linens separately in hot, soapy water.
4) Wear masks when providing direct personal care.

A father asks the nurse how he would know if his child had developed mononucleosis.
The nurse explains that in addition to fatigue, which of the following would be most
common?
1) Liver tenderness.
2) Enlarged lymph glands.
3) Persistent nonproductive cough.
4) A blush-like generalized skin rash.

A parent asks why it is recommended that the second dose of the measles, mumps, and
rubella (MMR) vaccine be given at 4 to 6 years of age? The nurse should explain to the
parent that the second dose is given at this age for what reason?
1) If the child reaches puberty and becomes pregnant when receiving the vaccine, the risks
to the fetus are high.
2) The change of contracting the disease is much lower at this age.
3) The dangers associated with a strong reaction to the vaccine are increased at this age.
4) A serious complication from the vaccine is swelling of the joints.