1.

The mother of a 9 month old infant is concerned that the head circumference of her baby is greater than the chest circumference. The best response by the nurse is: a. These circumferences normally are the same, but in some babies this just differs. b. perhaps your baby was small gestational age or premature. c. This is normal until the age of 1 year, when the chest will be greater. d. Let me ask you few questions, and perhaps we can figure.

2. Preschoolers are able to see things from which of the following perspectives? a. Their peers b. Their own and their caregivers c. Their own and their mothers d. Only their own

3. A parent calls you and frantically reports that that her child has gotten into her ferrous sulfate pills and ingested number of these pills. Her child is now vomiting has bloody diarrhea and is complaining abdominal pain. You will tell the mother to: a. Call emergency medical services (EMS) and get the child to the emergency room b. Relax because these symptoms will pass and the child will be fine c. Administer syrup of ipecac d. Call the poison control center

4. The nurse is working with an adolescent who complains of being lonely and having a lack of fulfillment in her life. This adolescent shies away from intimate relationships at times yet at other times she appears promiscuous. The nurse will likely work with this adolescent in which of the following areas? a. Isolation b. Loneliness c. Lack of fulfillment d. Identity

5. A child suffers a head injury in a tumbling accident in a gym class. The nurses best course of action is to: a. Get the child up walking and make he she stays awake b. Leave the child and go get help c. Leave the child in the care of an older child and go get help d. Stay with the child keep assessing and someone call the caregivers

6. Which of the following arrangements is generally considered to the best for the parents of a hospitalized infant or young child? a. Rooming- in b. Separate caregiver sleeping room on the unit c. Day visits and sleeping at home d. Staying at a nearby hotel or motel

 Situation:

Nurse Michelle works with the Family Nursing Team in Calbayog Province specifically handling a UNICEF Project for children. The following conditions pertain to CARE OF THE FAMILIES WITH PRESCHOOLERS

7. Ronnie asks constant questions. How uestions does a typical 3- year old ask in days time? a. 300- 400 b. 100- 200 c. 1,200 or more d. Less than 50

8. Ronnie will need to change to a new bed because his baby sister will need Ronnies old crib. What measure would you suggest that his parents take to help decrease sibling rivalry between Ronnie and his new sister? a. Tell him he will have to share with the new baby b. Ask him to get his crib ready for the new baby c. Move him to the new bed before the baby arrives d. Explain the new sisters grow up to become best friends

9. How many words does a typical 12 months old infant use? a. 20 or more b. 2 plus mama and dada c. About 50 words d. About 12 words

10. Which of the following would watched on the baby? a. APGAR scores and congenital defects b. Birthmark and pigmentation c. Foot and hand mark d. Measurement of length

 SITUATION:

Mark Foster a 10-month old infant with a cleft lip and palate, is admitted to the pediatric unit for the first stage of surgical correction on his lip. Primarily breastfed, he occasionally receives a supplemental bottle.

11. Feeding an infant with a cleft lip or palate offers a special challenge to the nurse because;
Bottle-feeding disrupts the maternal-infant bond b. The infant has difficulty maintaining suction around a nipple c. The nurse must discourage the infant from trying to suck d. The infant has no desire to suck
a.

12. Immediate post-operative complications for Mark may include:

Hemorrhage and respiratory distress b. Fever and coagulation difficulties c. Infection and hemorrhage d. Irritability and difficulty swallowing
a.

13. The physician orders elbow restraints postoperatively. the nurse should:
Put the restraints on Marks dominant hand b. Use the restraints only when Mark is awake c. Use the restraints only when Mark is asleep d. Release the restraints every 2-4 hours
a.

14. Mrs. Foster is concerned about Marks dental development. The nurse knows that an infants first teeth, which usually erupt between ages 6 and 8 months are the:
Upper lateral incisors b. Lower central incisors c. Lower lateral incisors d. Upper central incisors
a.

15. After cleft palate repair, Mark should be fed with:

Soup spoon b. Dessert fork c. Plastic syringe d. Infant spoon
a.

 SITUATION:

Mrs. Smith reveals to the visiting nurse that Nicholas, aged 2 weeks, has been vomiting 3 tablespoons of previously ingested food daily for the past 3 days. The vomitus contains neither blood nor bile. Mrs. Smith tells the nurse that she feeds Nicholas 4 oz. (120ml) of a soy-based, ironfortified formula ( SIMILAC 20 with Iron) every 4 hours and that the vomiting occurs effortlessly regardless of the neonates position. Nicholas growth parameters have remained unchanged since birth. The physician suspects Gastro esophageal reflux.

16. To prevent Nicholas from aspirating during or after feeding, Mrs. Smith should,
Keep Nicholas prone at a 15-degree angle after feeding b. Thicken the morning and evening feedings with cereal v c. Administer large-volume feedings every 6 hours. d. Maintain Nicholas in an upright position, at a 60degree angle with an infant seat.
a.

17. To evaluate the effectiveness of Nicholas home care program, the nurse should consider which of the following as most important?
Absence of spitting up b. Weight gain c. Ability to tolerate clear liquids between feedings d. Tolerance of feedings scheduled every 6 hours
a.

 SITUATION:

Jenifer, a full-term neonate, is transferred to the neonatal intensive care unit after x-ray reveal that her esophagus ends in a blind pouch. She has had problems with feeding and is now on NPO status. Her diagnosis is Esophageal Atresia: Surgery is schedule for the next morning.

18. Which physical findings are commonly associated with esophageal Atresia?
Decrease bowel sounds b. Choking, coughing and cyanosis c. Visible gastric peristaltic waves d. Jaundice and drooling
a.

19. Which position is best for Jenifer preoperatively?

Prone on her abdomen b. Right side-lying c. Supine, with her head and chest elevated 30 degrees d. Left side-lying
a.

20. To prevent aspiration of secretions, the nurse must suction Jennifer every 2 4 hours as needed. Prolonged and vigorous suctioning of a neonate can cause:
Pallor b. Tachycardia c. Laryngospasm d. Pneumonia
a.

 SITUATION:

Sonja Manthis, age 13 months, has a history of repeated upper respiratory tract infections and poor weight gain. She was admitted to the hospital with pneumonia 3 days ago; today she is diagnosed with Cystic Fibrosis.

21. The nursing care for Sonja should involve all of the following except:
Preventing infection b. Maintaining nutritional needs c. Assisting with Oxygenation d. Preventing disease transmission
a.

22. Which nursing intervention should the nurse include in Sonjas care plan
Monitoring Sonjas blood glucose level 4 times a day b. Performing postural drainage with percussion 3 times a day c. Accompanying Sonja to physical therapy daily d. Placing Sonja in protective ( reverse) isolation
a.

23. The Physician prescribes pancrelipase (Pancrease) for Sonja to:

Soften stools and prevent constipation b. Prevent an allergic reaction to milk c. Supply needed enzymes to digest food d. Prevent upper respiratory tract infection
a.

 SITUATION:

Karen, age 18 months is admitted to the pediatric unit with the diagnosis of Bronchiolitis. She has an elevated temperature, is pale, and looks tired. She also appears to be mildly dyspneic. The physician prescribe administration of 30 % oxygen with mist.

24. The admitting nurse should ensure that Karens room includes:
Tracheotomy set b. Croup tent c. A sign indicating the need for respiratory isolation d. A portable chest X-ray Machine
a.

25. While Karen is receiving humidified oxygen the nurse must be concern with:
Keeping the mist level low enough so that her pajamas and bedding remain dry. b. Caring for the areas of skin under the nasal cannula c. Preventing oxygen toxicity in the tent d. Frequent changes of linens/ bedding
a.

26. At age 3, what level of personality will start to develop?

Ego b. Superego c. ID d. Consciousness
a.

27. In assessing a 5-month-old infant of the following assessment findings will cause you an alarm?
(+) Moro reflex b. (+) Swimming reflex c. Absent Babinski reflex d. (+) Rooting reflex
a.

28. Toilet training should start at what age:

1 b. 2 c. 2 d. 5
a.

29. In Piagets cognitive development, what stage does abstract thinking develop? a. Sensorimotor b. Concrete thinking s c. Formal operation d. Pre operational
e.

sensorimotor

30. At what stage of growth and development does the boy compete with the father for mother attention? a. Phallic b. Genital c. Latency d. Anal

31. According to Piagets theory of cognitive development, which of the following is true about school-age children? a. They remain egocentric b. They are able to reason abstracted to predict outcomes c. They are able to make judgments based only on what they see d. They are able to classify or group objects shared characteristics

32. Which of the following play activities would most likely be appropriate for a healthy 6-year-old girl? a. Sitting quickly with books, crayons, and puzzles b. Playing house with the 6-year-old boy who lives next door c. Playing only with her imaginary friend d. Baking a cake from a mix with her parents assistance

33. Play has been described as the work of children. Which preschool of the following best described the play behaviours of a prescribed child? a. Preschooler generally prefer to sit alone quietly and play with blocks and crayons b. The attraction span of preschoolers is long enough to watch full-length video movies without interruption c. Preschoolers play is associative. Group is common and rules are minimal d. Preschooler children will always choose same-gender playmate

34. Elizabeth is 3 years old. Which of the following skills would you expect her to able to demonstrate proficiently?
a.

b.
c. d.

Able to build a tower of 8 and 10 cubes Able to add 3 parts to figure Able to tie her shoes Able to walk down stairs using alternate footing

35. Mrs. Lauro is worried that her 2 -year-old child Irish is not getting enough to eat. She tells the nurse, Shes such a picky eater. The first nursing action is to:
a.

b. c. d.

Encourage the mother to feed the childs smaller and more frequent meals Provide teaching pamphlets on nutritions snacks Review the basic food group requirements with the mother Assess the daily eating pattern of the child

36. 2-year-old Ron weighs 27 lbs and 34 inches tall; at birth, he weighed 7 lbs 2 oz.. And at 1-year-old, he weighed 22 lbs, the nurse graphing the childs growth interpret this as:
a.
b. c. d.

Failure to thrive Below-normal growth Normal growth Above-normal growth

37. A mother voices frustration that her 2 -year-old daughter takes her favorite blanket to day care every day. The best response for the nurse is:
a.

b. c.

d.

You need to discourage this because it is overly dependent behavior. Dont worry, all children do this. This is normal behavior and helps to prevent fear and loneliness. You need to stop this because your daughter will be teased by other children.

 Situation:

Kikay, 16 years old is called in the guidance because of failing grades. She spend more time playing computer games and surfing in the internet than studying her lessons. She is late referred to the school clinic for her health problems.

38. At age 16, which of the following is the following is the normal developmental task of Kikay? a. Identity b. Indus c. Intimacy d.Initiative

39. The first and most important need of the newborn is to: a. Maintain adequate nutrition b. Maintain adequate oxygen supply c. Prevent eye infection d. Maintain normal temperature

40. The change from fetal to adult circulation is triggered by: a. Obstruction of the umbilical vessels b. Pressure on the babys head incurred during birth process c. Higher oxygen content of the blood resulting from pulmonary circulation d. Pressure changes associated with expansion of the lungs and closure of foramen ovale

41. During the first few days following birth the neonate is expected to lose weight. It is estimated that the loss will be appropriately between: a. 1%-2% c. 8%-15% b.5%-10% d. 2%-6%

42. Which of the following would be signs of dehydration exhibited by an infant? a. Pallor, periorbital edema, fever, rapid pulse b. Sunken fontanel, poor skin turgor, oliguria c. Fever, anuria, slow pulse, edema d. Poor skin turgor, weight loss, bulging fontanel

43. The normal time of the closure of the anterior fontanels expected to be a. At the end of the second month b. At the end of the sixth month c. Six to ten of age d. Twelve to eighteen months of age

44. The stool of the breast fed five day old baby would be most likely a. Meconium b. Scambled egg c. Putty-like d. Black Tarry

45. The Normal time for the closure of the posterior fontanel is expected to be: a. At the end of sixth month b. Twelve to eighteen months of age c. At the end of the second month d. At the beginning of the second year of life

46. The infant had an APGAR score of nine at birth. An APGAR score of nine indicate that the baby is: a. In good condition and no special care is necessary b. In fair condition and may require treatment for validity c. In severe distress and immediate measures will have to be taken d. Immature and need to be placed in an incubator

47. An infant was admitted to the nursery after a very difficult labor and a forceps delivery. His original APGAR score was five. After 5 minutes was seven. An APGAR score of five indicates that the baby is: a. In excellent condition and no special care is necessary. b. In fair condition and need to be watch c. In severe distress and drastic measures have to be taken d. Immature and need to be placed in an incubator

48. According to APGAR scoring, which is the most valuable index concerning the condition if the newborn? a. Respirations irregular b. Reflex Irritability c. Heart Rate d. Muscle Tone e. Color

least

49. Which of the following reflex responses indicate brain damage? a. Positive retrusion of the tongue reflex b. Positive rooting reflex c. Negative moro reflex d. Positive grasp reflex

50. A six month old baby is attending the Well Baby Clinic. At sixth months the baby had all of the abilities, which developed last. a. Sitting for a short period without support b. Laughing aloud when hold and cuddled c. Following a rolling object with his eyes d. Recognizing his mother

3 mos.

 Situation 10:

Boy Rocco, two-month-old infant is brought to the pediatrician for well-baby check-up.

51. Upon assessment, the nurse noticed that two reflexes of Baby Rocco have faded out which include? a. Rooting and sucking b. Moro and tonic neck c. Mora and Babinski d. Rooting and landau

52. Which of the following situations would alert you are to a potentially development problem with a child? a. Saying mama and papa for the first time at 13 months of age b. Cooling at 3 months c. Using gestures to communicate at 18 months old d. Pointing to body parts at 15 months age

53. Which of the following is most important factor of successful toilet training? a. Readiness of the child based on developmental stage b. Age of the child c. Toilet-sitting at definite scheduled times d. Mothers willingness to be flexible

54. She asks why her babys hands and feet are bluish. Which of the following refers to this condition? a. Port-win stain b. Acrocyanosis c. Tetralogy or fallot d. Mongolian spots

55. Angeli, a 6-month-old infant has a delayed development. Upon assessment, Abby expects her infant to: a. sits upright for long period b. reach out for her toy c. be able to hold a piece of cheese curls with her finger and thumb d. hold her feeding bottle for a short while

56. Mrs. Simon asks Abby what attachment behaviors she will expect her 4-month-old son Gabby to demonstrate. Which of the following is NOT included by Abby in her teaching? a. greets his mother when she returns b. recognizes and responds to his mothers voice c. follows his mother as she moves d. friendly to strangers

57. She encourages Mrs. Perez to talk to her child, a 9month-old girl, who at her age should be: a. obeying simple commands b. vocalizing single syllables c. copying when talked to d. saying Dada

58. A neonate demonstrate the tonic neck reflex by:

Extending the leg on the same side to which his head is truned b. Flexing the leg on the same side to which his head is turned c. Extending the leg on the opposite side to which is head is turned d. Abducting the leg on the same side to which his head is turned
a.

59. The best way for the nurse to examine a small child is by proceeding:
Cephallocuadally (head to toe) b. Proximally to distally c. From the intrusive area to the least intrusive area d. From the least intrusive area to the most intrusive area
a.

60. Blood pressure that varies among extremities is common finding in children with:
Aortic stenosis b. Coarctation of the aorta c. Patent ductus arteriosus d. Atrial septal defect
a.

61. Which congenital cardiac anomaly is associated with tetralogy of Fallot (TOF)
a. b. c.

d.

Origination of the aorta from the right ventricle and origination of the pulmonary artery from the left ventricle A hole in the ventricular septum allowing the communication between ventricles Pulmonary stenosis, right ventricular hypertrophy, ventricular septal defect, and dextroposition of the aorta Narrowing of the aorta, which restricts left ventricular outflow

a.

62. A neonate receiving double volume exchange transfusion is at increased risk of all of the following complications except:
Academia b. Hypokalemia c. Hyperkalemia d. Hypoglycemia
a.

63. A neonate with sickle cell anemia is protected from initial morbidity because of:
Maternal antibodies b. Persistent fetal circulation c. Fetal hemoglobin d. Maternal hemoglobin
a.

64. An enlarged scrotum in an infant younger than age 4 months indicates:

Hypospadias b. Phimosis c. Inguinal hernia d. Hydrocele
a.

65. A low grade fever, barky cough, inspiratory stridor and retractions in a child under age 3 may indicate:
Allergies b. Asthma c. Bronchitis d. Croup
a.