Question 5441)
A 6-year-old child is admitted for a tonsillectomy. Considering the child’s age,
which of the following would be the most important to include in a preoperative physical
assessment?
A. Characteristics of tongue, gum, or lip sores
B. Any sign of tonsillar inflammation
C. The number and location of any loose teeth
D. The location and presence of tenderness in any swollen lymph nodes
Answer: C
Explanation: A 6-year-old is apt to be loosing baby teeth. This is an important consideration when anesthesia is to
be administered and the child will be intubated. The nurse should assess for loose teeth in any school-age child
who is admitted for surgery or other procedures requiring intubation of any kind.
Question 5442)
A 6-year-old child is in the terminal stage of leukemia. The child appears helpless
and afraid. How can the nurse best help the child?
A. Allow the child to make the major decisions for her care
B. Make all decisions for the child
C. Discuss with the child the fears that dying children usually have
D. Discuss with the child the reasons for her fears
Answer: D
Explanation: by discussing with child the reasons for the child’s fears, the child will feel less afraid and less
abnormal. Discussion of fears should be individualized. The child is not old enough to make care decisions. The
child should, however, be given some input into the care plan. The child might decide which site the nurse will use
for an injection but not whether or not the medication will be given. The parents will make those decisions.
Question 5443)
The nurse is preparing a 6-year-old child for cardiac surgery. Which preoperative
teaching technique is most appropriate?
A. Have the child practice procedures that will be performed postoperatively, such as coughing and deep breathing
B. Arrange for the child to tour the operating room and surgical intensive care unit
C. Encourage the child to draw pictures illustrating the operation.
D. Arrange for the child to discuss heart surgery and postoperative events with a group of children who have
undergone heart surgery.
Answer: A
Explanation: A 6-year-old learns best by doing. A 6-year-old cannot conceptualize what he or she cannot see.
Touring the operating room and surgical intensive care unit can be very frightening for a 6-yearold. Drawing
pictures of the procedure would be more appropriate postoperatively, when the nurse may want to help him in
understanding what happened to him. Drawing pictures is a good way to express feelings that a 6-year-old cannot
put into words. Group discussion is more appropriate for an adolescent. A 6-year-old does not have the verbal skills
to participate in and learn from a discussion group.
Question 5444)
A 10-year-old girl is being treated for rheumatic fever. Which would be an
appropriate activity while she is on bed rest?
A. Stringing large wooden beads
B. Engaging in a pillow fight
C. Making craft items from felt
D. Watching television
Answer: C
Explanation: Craft work allows her to accomplish something while meeting her needs for rest. Industry is the
developmental task for school-age children. The joint pains with rheumatic fever tend to be in the large joints, not
the small ones, so craft work using finger activity would probably not be painful. Stringing large wooden beads is
appropriate for younger children. Pillow fighting requires too much energy for a child on bed rest and is not
appropriate for a hospital environment. Watching television is a solitary activity with no sense of accomplishment.
Question 5445)
A 10-year-old boy who is immobilized in a cast following an accident has been
squirting other children and the staff with a syringe filled with water. The nurse wants to provide
other activities to help him express his aggression. Which activity would be most appropriate?
A. Cranking a wind-up toy
A. Cranking a wind-up toy
B. Pounding clay
C. Putting charts together
D. Writing a story
Answer: B
Explanation: Pounding movements allow for the expression of aggression. The other activities would not allow for
an expression of aggression. The scenario describes a child who is expressing aggression in a very physical manner.
This child is not likely to respond well to writing a story. Writing a story could be used to help a child express
aggression, but pounding clay is more appropriate given the child’s aggressive behavior.
Question 5446)
An 11-year-old boy is admitted to the pediatric unit in traction with a fractured
femur sustained in a motorcycle accident. His uncle, who was driving the cycle when the accident
occurred, received only minor injuries. The child tells the nurse that his uncle was not to blame
for the accident. He is “the best motorcycle rider in the world.” The nurse interprets this to mean
that the child is exhibiting which defense mechanism?
A. Denial
B. Repression
C. Hero worship
D. Fantasy
Answer: C
Explanation: Hero worship is very common among school age children. Denial would be manifested by saying that his
leg really is not broken. Repression is putting an upsetting or guilt-laden experience deep in the unconscious mind.
This behavior does not suggest repression. Fantasy is living in a make-believe world. This boy shows no evidence of
living in a make-believe world.
Question 5447)
The nurse is planning care for an 11-year-old child who has a fractured femur and
is in traction. Which activity would be most appropriate?
A. Dramatizing with puppets
B. Building with popsicle sticks
C. Watching television
D. Coloring with crayons or colored pencils
Answer: B
Explanation: Building with popsicle sticks will foster his sense of industry and can be done while he is in bed in
traction. Puppets and coloring would be more appropriate for younger children. Watching television will not
promote his development, although it can be used as diversion occasionally.
Question 5448)
A 2-year-old child is hospitalized for a fractured femur. During his first two days in
the hospital, he lies quietly, sucks his thumb, and does not cry. Which is the best interpretation of
his behavior?
A. He has made a good adjustment to being in the hospital.
B. He is comfortable with the nurses caring for him.
C. He is experiencing anxiety
D. He does not have a good relationship with his parents.
Answer: C
Explanation: The child’s behavior is typical of the despair phase of toddler responses to anxiety. The child should
cry. Lying quietly, sucking his thumb, and saying nothing are suggestive of severe anxiety, a bad adjustment to the
hospital, and no comfort with the nurses. This anxiety response does not suggest a poor relationship with his
parents. In fact, his severe separation anxiety may be because he is so close to his parents.
Question 5449)
A hospitalized 2.5-year-old child has a temper tantrum while her mother is bathing
her. Her mother asks the nurse how she should handle this behavior. Which information should be
included in the nurse’s reply?
A. Temper tantrums in a hospitalized child indicate regression.
B. Tantrums suggest a poorly developed sense of trust.
C. Discipline is necessary when a child has a temper tantrum
D. This behavior is a normal response to limit setting in a child of this age.
Answer: D
Explanation: Temper tantrums are a normal response to limit setting in a 2-year-old child. Answer 1 might be
correct if the child were older. However, temper tantrums in a 2-year-old child do not indicate regression; rather,
they are normal for this age. Tantrums are not suggestive of a poorly developed sense of trust; they are normal.
Ignoring the tantrum is preferable to discipline when a 2-yearold has a tantrum.
Question 5450)
A 3-year-old child resists going to bed at night. Her mother asks the nurse what
she should say to her. Which response should the nurse suggest to the mother as most
appropriate?
A. “I don’t love you anymore because you don’t know how to listen.”
B. “All good children go to bed on time.”
C. “If you go to sleep now, I’ll take you to the zoo tomorrow.”
D. “Here is your blanket. It’s time to go to sleep.”
Answer: D
Explanation: The best response is to simply state that it is time for sleep and to give the child her security blanket
or toy. Answer 1, telling the child that she isn’t loved because she won’t listen, is not therapeutic. Answer 2
implies that if you don’t go to bed on time, you are not a good child. This is not a good suggestion to implant in a
child. Answer 3 is bribery and is not appropriate
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