A client shоwing nо fаciаl expressiоn when engаging in a game with peers during an outing at a park. The nurse uses which term when documenting the client's affect?
Instructiоns Reаd eаch questiоn cаrefully. Answer each questiоn by bubbling your answer on the Scantron answer sheet. After you have finished answering all questions, select TRUE. Click Finish Attempt at the bottom of the page. On the next page, click Submit All and Finish. If a confirmation message appears, click Submit All and Finish again to complete your submission. Once your assessment has been submitted successfully, notify your proctor that you are finished. Please wait for the proctor's instructions before proceeding to the next step. Chapters 32-38 Key/Variation C ____ 1. What initial step must be completed during the diagnostic evaluation of a child suspected of having attention-deficit/hyperactivity disorder (ADHD)? a. Conducting psychological testing to identify visual-perceptual difficulties and problems with spatial organization c. Performing a complete physical examination including vision and hearing screening and neurologic evaluation b. Determining whether the child's behavior is age appropriate or truly problematic through multidisciplinary assessment d. Administering standardized behavioral checklists and adaptive scales to the child's caregivers and educators ____ 2. What nursing intervention addresses the hospitalization needs of a child with autism spectrum disorder who becomes agitated during medication administration? a. Increasing physical contact and maintaining direct eye contact throughout the procedure to provide reassurance and comfort c. Establishing a consistent daily routine with the same nurses administering medications at identical times each day b. Placing the child in a brightly lit room with multiple staff members present to ensure safety during administration d. Offering various food choices immediately before medication administration to encourage cooperation and reduce resistance behaviors ____ 3. What represents the most critical nursing assessment when caring for a school-age child diagnosed with depression a. Obtaining detailed family history and conducting interviews with parents and teachers about behavioral changes c. Assessing for suicidal ideation, specific self-harm plans, and history of suicide attempts or gestures b. Evaluating the child's academic performance and peer relationships to determine functional impairment levels d. Monitoring for therapeutic drug levels and side effects when antidepressant medications are prescribed ____ 4. What safety measure is most effective in preventing bicycle-related head injuries in school-age children? a. Restricting bicycle riding to designated bike paths and supervised recreational areas with adult oversight c. Ensuring children complete formal bicycle safety training courses before allowing independent riding privileges b. Limiting bicycle use to daylight hours when visibility conditions optimize driver awareness of cyclists d. Encouraging children to wear protective helmets consistently during all bicycle riding activities ____ 5. What primary function do schools serve in the socialization process of school-age children? a. Providing individualized academic instruction tailored to each child's unique learning style and pace c. Serving as centers of cultural diffusion that transmit societal standards from one generation to the next b. Offering therapeutic interventions to address behavioral and emotional challenges in childhood development d. Creating opportunities for physical activity and recreational programs that promote health and wellness ____ 6. What represents the single greatest source of unintentional injury and death in adolescents a. Motor vehicle crashes involving adolescent drivers or passengers in automobiles c. Drowning incidents occurring in unsupervised recreational water activities and natural aquatic environments b. Poisoning events associated with accidental overdose or exposure to toxic substances d. Firearm-related accidents resulting from improper storage and handling of weapons in residential settings ____ 7. What information prepares parents for their child's appearance immediately following enucleation for retinoblastoma? a. The exposed socket will resemble an open wound with significant drainage requiring frequent dressing changes daily c. The eyelids will remain closed over an implanted sphere, with the face appearing edematous and ecchymotic initially b. The prosthetic eye will be placed immediately during surgery, resulting in normal facial appearance upon awakening d. The surgical site will appear as a sunken cavity requiring specialized dressing techniques until prosthesis fitting occurs ____ 8. What developmental characteristic of toddlers places them at highest risk for drowning injuries? a. Poorly developed fine motor skills that prevent effective grasping of pool edges or safety equipment c. Decreased supervision needs due to emerging independence and improved gross motor coordination skills b. Intense drive for exploration combined with unawareness of danger and helplessness in water d. Limited ability to assess water depth combined with top-heavy body proportions that affect balance ____ 9. At what age is the time-out discipline strategy most effective for managing temper tantrums in toddlers a. Implementing at 30 months when the child shows readiness for more complex behavioral interventions c. Beginning at 12 months when the child first demonstrates autonomous behavior and independence b. Initiating at 24 months after the child has developed sufficient language skills for verbal reasoning d. Starting at 18 months when the child can understand the connection between behavior and consequences ____ 10. What nursing response demonstrates appropriate support for parents experiencing guilt during the adjustment phase following their child's diagnosis of a chronic condition? a. Providing factual information about the condition's etiology while acknowledging that guilt is a normal adaptation response c. Redirecting parents to focus on treatment plans and future outcomes rather than dwelling on past events b. Reassuring parents that guilt will resolve quickly once they accept the reality of their child's diagnosis d. Encouraging parents to suppress guilty feelings to maintain emotional stability for effective caregiving responsibilities ____ 11. What amount of fluoridated toothpaste is appropriate for brushing the teeth of a 2-year-old toddler? a. A thin layer covering all bristles to maximize the beneficial effects of fluoride c. A strip covering half the length of the toothbrush to ensure adequate fluoride exposure b. A smear or rice-size amount applied across the narrow width of the toothbrus d. A pea-size amount applied along the length of the toothbrush bristles ____ 12. What nursing intervention demonstrates appropriate support for parents immediately following their child's death in the hospital? a. Limiting the time parents spend with the body to prevent prolonged emotional distress and complicated grief c. Removing all medical equipment from the body and offering parents the option to assist with bathing and dressing b. Arranging for immediate transfer of the body to the morgue to help parents begin the acceptance process d. Encouraging parents to leave the room promptly after death to allow staff to prepare the body efficiently ____ 13. What nursing action best facilitates normalization for families caring for a child with a chronic condition at home? a. Scheduling all medical appointments on the same day each week to minimize disruption to family routines c. Advising parents to limit the child's participation in age-appropriate activities until the condition stabilizes b. Recommending that families designate one room in the home exclusively for medical equipment and treatments d. Identifying ways to incorporate complex care procedures into the family's existing daily routines and activities ____ 14. What daily vitamin D intake is recommended for toddlers to prevent rickets? a. At least 800 IU of vitamin D through fortified foods or supplementation c. At least 600 IU of vitamin D through fortified foods or supplementation b. At least 200 IU of vitamin D through fortified foods or supplementationV d. At least 400 IU of vitamin D through fortified foods or supplementation ____ 15. What nursing action ensures effective communication when awakening a hospitalized child with hearing impairment during the night? a. Waiting until morning rounds to perform necessary assessments to avoid startling the child during sleep c. Verbally calling the child's name in a progressively louder voice while standing at the doorway entrance b. Turning on the overhead room lights suddenly to provide maximum visual stimulation for immediate awareness d. Gently shaking the child or activating the hearing aid before attempting to arouse the child from sleep ____ 16. What approach should the nurse take when initiating a sexual history assessment with an adolescent patient? a. Requesting that parents remain present during questioning to ensure accurate reporting of sexual behaviors c. Using gender-specific terminology such as boyfriend or girlfriend to facilitate comfortable discussion of relationships b. Directly asking whether the adolescent is sexually active to establish baseline information for screening needs d. Beginning with questions about pubertal development and dating behaviors before progressing to sexual activity topics ____ 17. What parental behavior most effectively promotes healthy eating habits in preschool-aged children? a. Demonstrating positive dietary habits through their own food choices and eating behaviors c. Establishing strict meal schedules with consistent portion sizes to ensure adequate daily nutrient intake b. Offering multiple food alternatives at each meal to accommodate the child's changing daily preferences d. Monitoring and documenting the variety and quantity of foods consumed at each meal throughout the day ____ 18. What term describes the process of integrating children with disabilities into regular classroom settings with their peers? a. Transition planning, which involves preparing children with disabilities for movement between different care settings c. Early intervention, which involves systematic efforts to assist developmentally vulnerable children from birth to age three b. Mainstreaming, which involves integrating children with disabilities into regular classrooms for learning and socialization d. Normalization, which involves establishing life patterns and conditions consistent with everyday living for all children ____ 19. What helminthic infection represents the most common parasitic worm infestation in the United States among preschool-aged children? a. Giardiasis caused by the protozoan Giardia intestinalis transmitted through contaminated water sources c. Enterobiasis caused by the nematode Enterobius vermicularis transmitted through ingestion or inhalation of eggs b. Ascariasis caused by the roundworm Ascaris lumbricoides transmitted through contaminated soil ingestion d. Toxocariasis caused by the roundworm Toxocara species transmitted through contact with infected animal feces ____ 20. What nursing response appropriately addresses a bereaved parent who reports hearing their deceased child's voice several weeks after the child's death? a. Advising the parent to avoid discussing these experiences to prevent reinforcement of maladaptive grief responses c. Normalizing the experience as an expected grief reaction while assessing the parent's overall coping patterns b. Referring the parent immediately to psychiatric services for evaluation of auditory hallucinations and mental status d. Encouraging the parent to increase social activities to distract from intrusive thoughts about the deceased child ____ 21. What stage of moral development characterizes preschoolers aged 4 to 7 years according to Kohlberg's theory? a. Autonomous morality where actions are evaluated based on intentions rather than consequences alone c. Conventional morality where actions are guided by maintaining social order and following established rules b. Punishment and obedience orientation where actions are judged based on resulting rewards or punishments d. Naive instrumental orientation where actions are directed toward satisfying personal needs and occasionally others' needs ____ 22. What nursing intervention supports self-care and minimizes loss of control for a hospitalized school-age child requiring intravenous antibiotic therapy? a. Limiting visitor access to parents only to reduce overstimulation and maintain a calm therapeutic environment c. Restricting the child to wearing hospital gowns to prevent damage to personal clothing during medical procedures b. Allowing the child to choose preferred times for non-urgent care activities and participate in treatment decisions d. Scheduling all care activities according to unit routines to maintain consistency with other hospitalized children's schedules ____ 23. What behavioral indicator in a preschool-aged child most strongly suggests possible emotional maltreatment? a. Persistent and unexplained changes in behavior ranging from withdrawal to aggressive acting-out patterns c. Occasional episodes of separation anxiety when the primary caregiver leaves the childcare setting b. Consistent demonstration of age-appropriate social interactions with peers during supervised play activities d. Temporary regression in toileting skills following the recent birth of a younger sibling ____ 24. What nursing intervention best supports developmental autonomy for an adolescent with a chronic physical disability? a. Facilitating the adolescent's participation in care planning decisions and identifying personal assistance needs c. Establishing consistent routines with parental supervision to ensure adherence to the prescribed medical regimen b. Encouraging the adolescent to focus on academic achievement rather than social activities with peers d. Arranging frequent healthcare appointments to monitor the adolescent's physical condition and treatment progress ____ 25. What behavior most commonly indicates sibling rivalry in a toddler after the birth of a new baby? a. Showing heightened interest in caring for the newborn through gentle touching and offering toys c. Demonstrating increased independence by refusing parental assistance with self-care activities and routines b. Maintaining usual behavior patterns at home while seeking additional attention from extended family members d. Expressing verbal wishes for the infant to return inside the mother or reverting to infantile behaviors ____ 26. What physical characteristic differentiates males with fragile X syndrome from females with the same condition? a. Males typically demonstrate milder intellectual disability with more consistent cognitive functioning across developmental domains c. Males usually show better language development with fewer delays in expressive and receptive communication skills b. Males generally exhibit less severe behavioral problems including reduced hyperactivity and improved impulse control d. Males commonly present with macroorchidism as part of the characteristic physical features of the syndrome ____ 27. What factor increases the risk of negative psychosocial effects for siblings of children with chronic illnesses? a. Participation in support groups with other siblings experiencing similar family situations and challenges c. Assuming responsibility for caregiving tasks while receiving less attention and recognition from parents b. Receiving accurate information and knowledge regarding the brother's or sister's illness or complex condition d. Engaging in open family discussions about feelings and concerns related to the sibling's condition ____ 28. What essential component must the pediatric nurse assess before implementing health teaching for school-age children and their families? a. The family's health literacy level and cultural background to ensure appropriate information transmission c. The availability of community resources and referral agencies within the family's geographic service area b. The child's academic performance records and standardized test scores to determine cognitive development level d. The family's previous experiences with healthcare providers and their satisfaction with past medical interventions ____ 29. What nursing intervention addresses the respiratory complications associated with decreased muscle tone in infants with Down syndrome? a. Positioning the infant in an extended supine position to maximize chest expansion and lung capacity c. Administering prophylactic antibiotics routinely to prevent the development of upper respiratory tract infections b. Restricting oral fluid intake between feedings to minimize the risk of aspiration and respiratory distress d. Clearing nasal passages with a bulb syringe and increasing fluid intake to maintain mucous membrane moisture ____ 30. What nursing action maintains a sense of control for a child during emergency department treatment for a non-life-threatening injury? a. Restricting parent-child contact during procedures to prevent parental anxiety from affecting the child's cooperation c. Allowing the child to participate in care decisions and explaining events before or as they occur b. Completing all procedures rapidly to minimize the child's time in the unfamiliar emergency department environment d. Postponing explanations until after procedures are completed to avoid increasing the child's anticipatory fear ____ 31. What nursing action minimizes fear of bodily injury in a preschool-age child following a venipuncture procedure? a. Applying a bandage over the puncture site to provide visible reassurance that the body remains intact c. Explaining that the bleeding will stop soon after needle removal to reassure the child about the healing process b. Removing the bandage immediately after bleeding stops to demonstrate that the injury is minor and healing quickly d. Encouraging the child to draw pictures of internal organs to clarify misconceptions about body damage ____ 32. What represents the primary goal of nutrition therapy in the treatment of anorexia nervosa? a. Establishing individualized target weights based on age, height, pubertal stage, and premorbid weight patterns c. Achieving rapid weight restoration through aggressive nutritional replacement to reverse malnutrition quickly b. Treating life-threatening malnutrition and restoring dietary stability with appropriate weight gain d. Monitoring resumption of menses as the sole indicator of successful nutritional rehabilitation ____ 33. What developmental characteristic of adolescents provides the greatest opportunity for effective health promotion interventions? a. Their heightened concern about physical appearance and peer acceptance during social interactions c. Their increasing ability to understand abstract concepts and long-term consequences of health behaviors b. Their natural sense of curiosity and movement toward autonomy in decision-making processes d. Their growing capacity for self-reflection and identification of personal strengths and weaknesses ____ 34. What refractive error occurs when light rays entering the eye fall in front of the retina rather than directly on it? a. Hyperopia, resulting in difficulty focusing on distant objects while maintaining clear vision for near tasks c. Amblyopia, resulting in suppressed vision in one eye due to the brain ignoring images from the weaker eye b. Astigmatism, resulting in blurred vision at all distances due to irregular corneal curvature affecting light refraction d. Myopia, resulting in difficulty focusing on distant objects while maintaining clear vision for near tasks ____ 35. What anticipatory guidance strategy best addresses pedestrian motor vehicle injury prevention for preschool-aged children? a. Emphasizing verbal instruction about vehicle dangers while gradually reducing direct supervision during outdoor activities c. Teaching children traffic safety rules while ensuring parents consistently model safe pedestrian behaviors during street crossings b. Allowing independent neighborhood exploration to develop spatial awareness and traffic pattern recognition skills d. Restricting outdoor play activities to fenced yards until children demonstrate mastery of all traffic safety concepts ____ 36. What speech characteristic distinguishes a child with conductive hearing loss from a child with sensorineural hearing loss? a. Producing whispered speech with reduced volume control compared to loud speech with exaggerated vocal inflections c. Speaking in a loud, monotone voice with fairly clear articulation compared to distorted speech with articulation difficulties b. Demonstrating complete absence of verbal communication compared to age-appropriate speech development with normal volume d. Exhibiting high-pitched vocal quality with excessive nasality compared to low-pitched speech with reduced vocal intensity ____ 37. What percentage of adolescent boys experience transient gynecomastia during puberty? a. Approximately 25% of adolescent boys develop bilateral or unilateral breast enlargement during pubertal development c. Approximately 75% of adolescent boys develop bilateral or unilateral breast enlargement during pubertal development b. Approximately 50% of adolescent boys develop bilateral or unilateral breast enlargement during pubertal development d. Approximately 65% of adolescent boys develop bilateral or unilateral breast enlargement during pubertal development ____ 38. What nursing action promotes safety for a hospitalized child experiencing temporary visual impairment following an eye procedure? a. Restricting the child's movement to bed rest with side rails elevated to prevent falls and injury risks c. Placing the child in a private room away from other patients to minimize environmental distractions and stimulation b. Maintaining consistent nursing assignments to ensure the same nurse provides care throughout the hospitalization period d. Encouraging family members to remain at bedside continuously to provide all direct care and supervision needs ____ 39. What foundational approach should nurses use when presenting sexual information to school-age children? a. Separating boys and girls into different groups for all sex education content to minimize embarrassment c. Limiting discussions to anatomical terminology until children reach preadolescence and demonstrate readiness b. Treating sex as a normal part of growth and development while answering questions honestly d. Deferring detailed explanations about reproduction until parents provide written consent for instruction ____ 40. What nursing intervention supports siblings during a child's hospitalization for acute illness? a. Suggesting that parents delay explanations about the illness until after discharge to prevent unnecessary sibling anxiety c. Arranging for sibling visitation after providing developmentally appropriate preparation about the illness and hospital environment b. Encouraging parents to focus exclusively on the hospitalized child to ensure optimal recovery and family stability d. Recommending that siblings remain at home with extended family to maintain their normal routines and activities