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CPN practice 334 questions WITH
COMPLETE SOLUTIONS
what is an example of cephalocaudal development Correct Answer: - a child lifts his head before lifting his shoulders, sits with support before sitting without support (develops from head to toe) when assessing a school age child's development the nurse understands that a primary development task of this age group is Correct Answer: developing friends -eriksons developmental age milestones which nursing action would be most important in the psychosocial support of a 2 year old who is having invasive procedure preformed Correct Answer: -providing for parental presence separation anxiety is big at this age which of the following would be most helpful when assessing a child's bone age Correct Answer:
- x-ray which of the following assessments would be the most concerning in a 3 month old Correct Answer: -failure to track objects through visual fields -posterior fontanel should close 2-3 months -doesn't roll over until 4 months -laughing occurs at 4 months of age a healthy 6 month old infant brought to the well baby clinic for a check up when assessing the infants anterior fontanel the nurse expects it to be Correct Answer: -to be open should close between 12 and 18 months which of the following developmental milestones of the 5 month old best reflects the principle of proximodistal growth and development Correct Answer: -babbling -raking objects should occur at 4 months -pincer grasp should be occurring around 9 months the nurse notes that an infant develops arm movements before fine motor skills and interprets this as an example of which pattern of development Correct Answer: proximodistal you are the nurse at the community health clinic. the mother of a 2 y/o male expresses concern to you that her previously healthy child is non-verbal. which of the following responses is most
appropriate Correct Answer: -given your sons age, we should probably test his hearing to be sure that is not the source of his delayed language skills -a 2 y/o should be speaking 2-3 word sentences. a 5 year old should use how many words in a sentence Correct Answer: -5 to 6 worded sentences the nurse should expect a 4 month old to Correct Answer: -roll over -sit without support at 5 months -sit without support at 8 months
- 6 months should be able to rock on hands and knees what is the most important consideration when telling a 4 year old child about his upcoming procedure Correct Answer: -use simple terms when assessing the toddlers growth and development the nurse understands that a child in this age group displays behavior that fosters which developmental task Correct Answer: -autonomy (me do, no, mine) the nurse should expect a 3 year old child to be able to perform which action Correct Answer: - ride a tricycle when performing a physical assessment of a 10 year old girl the nurse keeps in mind that the first sign of sexual maturity in girls is Correct Answer: -breast development a 6 month old infant weighed 7 pounds at birth what should they weigh now Correct Answer: 14 pounds should double at 6 months and triple at a year a parent calls the clinic and expresses concern that hers child eats very little and consumes only a singly type of food for weeks on end, the nurse knows this behavior is characteristics of which age group Correct Answer: -preschool aged children when developing a plan of care for an adolescent, the nurse considers the psychosocial needs. the psychosocial development depends on Correct Answer: -establishing identity what is the best way to prepare a 4 y/o got their admission to the hospital for same day surgery Correct Answer: -allow them to play with medical equipment at the pre op visit while explaining they will be staying in the hospital for a few days, they are magical thinkers
-toilet training should start at three, cooperative play should start at the school age group level a baby's length is 20 inches at birth how told should she be at age 4 Correct Answer: -40 inches, birth height should nearly double at age 4 which of the following assessment findings are normal in a healthy 6 month old Correct Answer: -open anterior fontanel and closed posterior fontanel anterior closes at 2 months post closes between 12 and 18 months 18 month old admitted for surgery, what would you anticipate being their biggest fear Correct Answer: -separation anxiety -fear of death is in adolescence -body integrity and pain are in school aged children mom of a 2 y/o voices concern that child uses the word mine, you know that this is is typical of which developmental stage according to Erikson Correct Answer: -autonomy versus shame and doubt (toddlers are egocentric) caring for a 14 y/o who experience menarche one year ago, she is concerned she is short and wants to know if she grow more? Correct Answer: -in girls menarche occurs late in puberty after the height spurt average height velocity peaks at age 12, potential 2.5 cm after birth when assessing the development of a 6 month old which of the following would be most concerning? Correct Answer: the child does nit transfer objects from hand to hand (should be able to do by 5 months) according to erikson a 4 y/o is in which developmental stage? Correct Answer: initiative versus guilt in which of the following age groups does the child experience the fastest rate of growth in the limbs Correct Answer: -school aged children -head experiences the fastest rate of growth during infancy, trunk grows the fastest during toddler and preschool years. which of the following about growth and development are true Correct Answer: -development refers to the maturation of structures of the body and includes growth the mother of an infant states, molly used to put her hands in her mouth, now she is putting her feet in her mouth. The nurse knows this is an example of what concept of development Correct Answer: -cephaocaudal; development from head to toe
why is it important for a 9 month old height and weight to be recorded on the growth chart? Correct Answer: -the growth charts show how the 9 month old lenght and weight compare to other infants her age as well as show us a patten over time a 7 month old is kept clean and dry and is picked up and comforted when she cries, by consistently meeting this basic needs which psychological strength are his parents promoting? Correct Answer: -hope the nurse is teaching a parenting class when a mother asks when does a child develop a conscience. Based on Eriksons theory you know that this usually occurs Correct Answer: - during preschool years (thats when they found their inner voice) how old do you think an outgoing child who likes to talk about his friends, plays board games and is concerned with the rules of the game and throws the game when he loses the game is? Correct Answer: -7; school aged children are very competitive 3 year old is restricted to bedrest due to a broken femur, which toys should the nurse select for this child? Correct Answer: - a play hammer and pounding board (these will help with gross motor skills and also help relieve frustration) Ella is a 15 year old admitted with asthma. She admits that she is currently smoking. The nurse incorporates a long term goal of smoking cessation. Which of the following would be most effective in helping ella quit Correct Answer: -have ella attend a smoking cessation group led and attended by other teens -teens can easily identify with other teens 5 year old with leukemia which of the following erikson stages should you be aware of when planning care for this child Correct Answer: -initiative vs. guilt -trust vs mistrust is at infancy, industry vs inferiority occurs at school age, identity vs. role confusion happens in adolescence. according to piaget the child who is beginning to imitate behavior is in which of the following stages? Correct Answer: -sensorimotor when does head circumference usually get smaller than chest circum. Correct Answer: - months -head is usually bigger from birth to 6 months when a bmi is in the 90th percentile you correctly explain to her mother that Correct Answer: -a bmi in the 90th percentile indicates that jessica is overweight, would you like to see a dietician -85-95% means child is overweight
after selecting a toy mikey from a 2.5 y/o what is the next best toy option? Correct Answer: - large dump trunks and garbage trucks at what age should an infant be about to raise her chest when lying on stomach, babbles ad tracks object 180 degrees with eyes? Correct Answer: -3 months which of the following is a cause for concern in a 6 month old child Correct Answer: -the infant does not hold and grasp objects (this should realistically occur by 3 months) the mother of a 3 month old says she is concerned he does not move his head towards her when she talks to him which is the best response Correct Answer: -this can be of concern, tell me mire abut things regarding his hearing
- appropriate to gather more info bc they should be turning toward voices at this point what would be most concerning in a 4 month old in terms of development Correct Answer: -he doesn't hold objects in his hands (should happen at three months -begin raking at 4 & transferring, and clapping around 10 months at what age would a child most likely push up from stomach onto knees and rocks back and fourth Correct Answer: - 8 months at what age is it appropriate to give cheerios as a snack Correct Answer: - 9 months old due to pincer grasp development 20 inches at birth and now 30 inches, what age would you think this child is? Correct Answer: 12 months, grows 50 % of overall height in first year 2.5 inches in toddler years 2 y/o's mom has to leave ad she is worried about her reaction the nurse's best response should be Correct Answer: -tell her that you need to pick up christie from school and you will be back once lunch is over and dora the explorer comes on TV, 2 y/o understand the concept of time in terms of routin a parents of a 12 month old is concerned that his child lifts and throws toys, what is the best response Correct Answer: -try not to worry, this is normal behavior, Mark is learning about his world by feeling, hitting and throwing objects a nurse is caring for a child who can say his first and last name and can say 3-4 worded sentences, what age do you think this child is Correct Answer: -3 years old at what age would you anticipate a child first learning to run Correct Answer: -24 months
how many words should a 12 month old on average have in their vocabulary Correct Answer: - words -50 words develops around 18 months 22 inches at birth and is now 44 inches, how old do you think this child is Correct Answer: - 4 years old, doubles birth length at this age 4 y/o cannot tie shoes, what is the greatest cause for concern Correct Answer: - tying shoes does not usually happen until school age years, you should be concerned if she cannot throw a ball over head sammy enjoys copying shapes, and can identify most colors. He draws a picture of the nurse with just two body parts. How old most likely is sammy Correct Answer: - 4 years old based on these skills when a child is questioned about a fib and says "i think it is wrong to tell a lie to get out of trouble, but telling your mom you like her hair when you don't so you don't hurt her feelings" how old is this child Correct Answer: - 10 years old
- recognize the gray areas at this age when a girl asks when she should expect to start her period to start. Correct Answer: -13 years old, this is the average age when menses start which of the following is accurate regarding puberty in females? Correct Answer: -growth spurts occurs before menarche which of the following is the first sign of puberty in makes Correct Answer: testicular enlargement in comparing height spurt among males and females, which is accurate? Correct Answer: - girls have low potential for growth after the beginning of menarche what is an important intervention to reduce SIDS Correct Answer: -encourage use of pacifier what comment in terms of nutritional needs indicates effective teaching Correct Answer: - I will start my baby on cereal between 4 & 6 months
- 4 months is the earliest this should occur lead screening should start at what age Correct Answer: - 6 months a mother plans to provide her baby with breast milk post op, The RN instructs the mother in the use of breast pump because Correct Answer: -bottle feeding breast milk is more accurate way of monitoring intake and output for post op I/Os
when is the best time to administer pancreatic enzymes to a cf patient Correct Answer: - immediately before meals which of the following resp. conditions is a medical emergency Correct Answer: -epiglottis---> narrowing of the airway you know infants and children are more prone to otitis media because Correct Answer: -the eustachian tubes are short and in a horizontal position the nurse will do which of the following for the child with epiglottitis Correct Answer: -avoid using oropharyngeal suctioning due to possible airway obstruction have emergency equipment set up at the bedside for these kids, HIB vaccine is crucial here what indicated immediate post op tonsillectomy complications Correct Answer: -vomiting bright red blood also look for increased HR, and increased swallowing 2 year old with pneumonia, in addition to albuterol he pt is to receive chest physiotherapy, percussion, and postural drainage. in which order should these occur to be most effective? Correct Answer: -administer albuterol immediately before PPD, and do PPD 30 min before next meak 4 year old bronch patient also has a trach. what represents appropriate care of a child with a trach Correct Answer: -prior to suctioning the catheter should be measured against the extra trach tube and not insterted more than 0.5 cm beyond the length of the trach tube Ph 7. PaO2 88 PCO2 48 Correct Answer: Respiratory acidosis what should be a priority tx for a child with respiratory acidosis Correct Answer: -admin O2, monitor work of breathing, prepare for intubation of necessary inspiratory stridor indicates what Correct Answer: -there is edema in the upper airway a 12 year old with CF has has problems with chronic hypoxemia most of his life. what would be indicative of acute resp. distress? Correct Answer: -intercostal retractions -clubbing of toes, barrel chest, and having to take a breath after each sentence is baseline norm
10 month old with RR 45/min using accessory muscles with each breath, grunting, she is awake and alert, pale but not cyanotic, what is the most appropriate action Correct Answer: -administer O2, complete the assessment while she remains on moms lap -call for assistance, and allow on moms lap as it will decrease anxiety how to differentiate between allergies and a cold Correct Answer: -children with allergies tend to complain of itchiness in their throats instead of pain what is essential to do for a 3 month old with URI that is very congested with thick secretions Correct Answer: -before each feeding place saline drop in nostrils and bulb syringe them there is a 3 y/o sib around a 2 week old. the 3 y/o has a cold. parents are afraid baby will get the cold. what is the best recommendation Correct Answer: -have 3y/o wash hands frequently 2 year old post tonsillectomy, what is the best way to assess for pain Correct Answer: -assign rating based on FLACC scale (most effective for this age group) 6 y/o post tonsillectomy just had pain medication and lunch tray arrives, what food should the patient try first Correct Answer: -diluted apple juice -clear liquids, stay away from red -no milk products nurse follows up with post op day 1 tonsillectomy, what statements indicates patient needs to be seen emergently Correct Answer: -he is sleeping but appears to be swallowing a lot a 6 month old with OM, what is the right way to admin ear drops Correct Answer: -pull ear down and back to open the canal 10 month old with OM, which recommendation will help decrease ear infections? Correct Answer: -ensure patient receives pneumococcal vaccine what is commonly seen in children with epiglottitis Correct Answer: -they refuse to drink -its also a bacterial infection what should you never do when assessing epiglottitis unless the team is ready at the bedside Correct Answer: -examine the throat what is the most common organism that leads to croup Correct Answer: -flu a & B when doe LTB (also known as croup) usually occur Correct Answer: -on a winter evening
what would suspect to find in a CF patient plan of care that is presenting with congestion, coughing more, lungs that are coarse in sound Correct Answer: -admission for IV abx give more of what is a cf patient has more than 3 stools a day Correct Answer: -pancreatic enzymes... 2-3 stools are normal for them in a day more than that means food is not being broken down and absorbed as it should be males with CF are always almost Correct Answer: -infertile due to blockages in vas deferens what statement regarding SIDS means a parents needs more education Correct Answer: -their child is at risk because they were larger at birth---> this is not a r/f r/f: laying prone to sleep, co sleeping, having other items in the crib such as blankets and etc. what is something that should be avoided to help prevent sids Correct Answer: -exposure to passive smoke feed in upright positions, promote pacifier use for first 6 months what is a late symptom of CO2 poisoning? Correct Answer: -chest pain early s/s: include dizziness, weakness, headache ph 7. CO2 43 HCO3 19 Correct Answer: -metabolic acidosis ph 7. CO2 48 HCO3 23 Correct Answer: respiratory acidosis ph 7. CO2 30 HCO3 24 Correct Answer: -respiratory alkalosis ph 7. CO2 41 HCO3 28 Correct Answer: -metabolic alkalosis 48 hours after birth a neonate has not passed meconium. The nurse suspects which condition Correct Answer: -cystic fibrosis
when providing dietary instructions to a parent of a child with celiac's what should they avoid Correct Answer: -prepared puddings can have veggies, rice, fruits a toddler is brought to the ED with sudden onset of ABD pain, vomiting, stools that look like red currant jelly. To confirm intussusception, the nurse expects the doctor to order Correct Answer: -a barium enema (the bowel telescopes here) what is the most common assessment finding in a child with ulcerative colitis Correct Answer: - bloody diarrhea when caring for a 12 month old that is dehydrated and metabolic acidosis the nurse expects to see Correct Answer: -tachypnea (compensatory mechanism to blow off CO2) a 10 month old is admitted with dehydration and metabolic acidosis. What is the most common cause of dehydration and acidosis in infants? Correct Answer: -diarrhea what symptoms would suggest tracheo- esophageal fistula Correct Answer: -increased mucous production and oral secretions also look for resp. distress, keep NPO, assure suction and ventilation are set up at bedside to manage excessive oral secretions and resp. distress what are signs of hirschsprungs disease Correct Answer: -abd distention, constipation, foul smelling stools, vomiting, ribbon like stools there is decreased intestinal motility here what is the most important nursing intervention for imperforate anus Correct Answer: - maintaining NPO status *will need surgical intervention, thus NPO status what s/s would you expect to see with a 7 month old with intussusception? Correct Answer: - inconsolable crying, abd pain, sausage shaped mass in the RLQ *telescoping of a portion of the bowel what is the most important discharge teaching for a child with celiacs Correct Answer: - eliminating wheat, rye, barley and oats from the diet
see picture in a patient history what would you expect to see when they're being worked up for GER Correct Answer: -asthma (coughing increases tension on stomach ) a 6 week old has GER , what should be included in her teaching plan for parents Correct Answer: -she should eat smaller amounts in each feeding -small frequent feedings, held up right 30 min after feedings does it matter when you give you infant ranitidine Correct Answer: -give antacids 30 minutes before feedings a patient with chronic constipation what can you educate them on Correct Answer: -increase liquids and fiber, decrease protein and fat what is a symptom you would see with encopresis Correct Answer: -liquid stool stains in underwear cleft palate and lip children are more at risk for Correct Answer: -increased risk for aspiration---
pneumonia, otitis media, and ineffective parent coping mechanism due to physical look a mother of an infant who has a cleft palate states she is upset that she wont be able to breastfeed, as the RN you should say Correct Answer: -some mothers are still able to nurse their babies, have you tried yet why cant a cleft palate repair and cleft lip repair be done at the same time at 4 weeks of age Correct Answer: -the lip can be repaired but the palate needs time to grow between 6 and 12 months of age a 12 month old just had a cleft palate repair, what should be included in the plan of care Correct Answer: -encourage the mom to hold and rock frequently no pacifier, do not give anything that can harm suture line, no sucking what is the highest priority for the nurse when caring for a patient who is scheduled for a cleft lip repair Correct Answer: -restraining the childs arms at all times using elbow restraints you are recently caring for a 12 month old who has recently had surgery to repair his cleft palate. Which of the following would be the best toy to stimulate this infant Correct Answer: -a mobile (something they cannot grab and put into their mouth) how would you provide fluids to a kid who just had a cleft palate repair Correct Answer: -in a cup
how can an infant be fed after a cleft lip repair Correct Answer: -by bottle or being breast fed the greatest post op danger for cleft palate repair is Correct Answer: - rupture of the suture lines 8 week is admitted for surgery to repair cleft lip, what is the most important nursing intervention Correct Answer: -decrease stress on the suture line -sleep on back, hands away from the face what would you expect to find with someone who has TEF -- tracheoesophageal fistula Correct Answer: -they have a lot of secretions and become cyanotic when feeding -those with tef should be NPO and upright or bed elevated the nurse is caring for a newborn with suspected TEF when the mother offered the first feeding the newborn became cyanotic, coughed, and choked. as the nurse what would expect to be apart of the care Correct Answer: -begin IV fluids and IV abx iv fluids to prevent dehydration and abx to prevent/ treat aspiration pneumonia what should be done with a patient who has TEF and has a g tube getting feeds Correct Answer:
- always check for residual formula before beginning the next feeding by attaching a syringe and gently withdrawing a one day old is suspected to have TEF, what nursing intervention is important Correct Answer: -elevating the head of the bed/ crib and making the patient NPO what info reflects accurate info on pyloric stenosis Correct Answer: -surgical correction involves spreading open the muscle around the pyloric valve the nurse suspects the baby will be tested for pyloric stenosis when the mom states Correct Answer: - my baby still wants to eat right after her vomits what is common with someone who has hirschsprungs Correct Answer: -the tend to have long skinny stools what is true about hirschprungs disease Correct Answer: -there is secretion without peristalsis a child with hirschsprungs disease is a few days away from surgery, what diet would be best for them? Correct Answer: -low fiber, high calorie/ high protein the nurse is caring for a 6 y.o who has appendicitis, what would she expect to find on assessment Correct Answer: - the patient complains of increased pain when the nurse releases her hand from the RLQ
how long should a patient be monitored for tylenol poisoning Correct Answer: -24 to 36 hours post poisoning what is the antidote for tylenol poisoning Correct Answer: - n. acetylcysteine within 8 hours of admin infant undergoes surgery to repair myelomeningocele to detect ICP as early as possible, the nurse should stay alert for which post op finding? Correct Answer: -bulging fontanel a neonate born within the last 24 hours with a myelomeningocele is scheduled for corrective surgery. Post op what is the most important nursing goal? Correct Answer: -preventing infection due to the sac of CSF following the repair of a myelomeningocele the nurse watches for symptoms of hydrocephalus. What symptoms indicate ICP? Correct Answer: -bulging fontanel, decreased pulse, irritability, icrease in BP -sunset eyes are a late symptom -a positive ortolani's sign that is felt and heard when the neonate with congenital hip dysplasia's hip is flexed an abducted a child is born with a myelomeningocele in their lumbar area. What pre op nursing care should be provided? Correct Answer: -place in. prone position with a sterile dressing -surgery usually occurs within 48 hours of birth an 8 year old has epilepsy and is being d/c. They are on dilantin (phenytoin) What is an important component of the d/c teaching regarding the side effects of that med? Correct Answer: -gum hyperplasia -use a soft toothbrush a child is being treated with a lead chelating agent, what would be the most appropriate information to include in your patient family education regarding its mechanism of action Correct Answer: -it aids in eliminating the agent via urine what is the most important nursing intervention immediately following post op placement of a VP shunt? Correct Answer: - place the child on their non post op side flat for 24 hours (recumbent position) what would you expect to see as an early symptom of lead intoxication in a a toddler Correct Answer: -hyperactivity -distractibility, learning problems and mild behavioral changes
if a child had a repaired myeolomeningocele that was repaired during infancy what foods should the child avoid Correct Answer: -banana and kiwi due to the latex cross contamination -also avoid avocados and chestnuts lead poisoning is suspected in a 21 month old. what might be the source of her lead ingestion Correct Answer: -she lives near a paint factory -other possible sources include lead based paint chips, dust, contaminated drinking water, battery casings, collectible toys, some jewelry the first symptom in a toddler with lead intoxication might be Correct Answer: -poor coordination -lead binds to neurons hence behavioral and coordination issues the most detrimental long term effects of lead intoxication are caused by Correct Answer: - neurotoxicity what would expect the course of treatment for a toddler with a lead level of 70 Correct Answer: -hospitalize immediately for inpatient lead chelation therapy 70 or greater should be hospitalized which of the following describes a positive fencing reflex Correct Answer: - when the infant is lying on his back with his head turned to one side, the infant will flex the opposite arm and leg and extend the arm and leg on the side the infant is facing when the sole of a toddler is stroked upward from the heel to the ball of the foot and the toes hyperextend, what does this mean? Correct Answer: -postive babinski reflex the mother of an infant tells the nurse that her baby used to hold onto her finger whenever she touched her hand and that she stopped doing this a few weeks ago. Based on this information, the nurse knows that the baby is most likely how old? Correct Answer: - 5 months old (infant reflexes should disappear by 5 months old a patient has an amblyopia in his left eye what is the best option Correct Answer: -wear an eye patch on the right eye (the good eye) to help strengthen the weak eye a 5 y/o lost her vision one year ago from a bag deployment in a motor vehicle accident. What should the nurse do when obtaining her assessment Correct Answer: - explain everything that the nurse will be doing, what body parts she will be touching and how it will feel speak loudly, the hearing has not been affected. a 9 y/o is complaining of itching and burning behind both eyelids. The nurse notes that her eyes are red with yellow discharge. Pt. has been diagnosed with bacterial conjunctivitis to both eyes.
