NR 328: Unit 1 In-class Quiz

Mrs. Green has brought her daughter Karen to the clinic where you work as a nurse. Karen, age
12 years, is a new patient and needs a physical examination in order to play volleyball. Which of
the following techniques would NOT be helpful to establish effective communication during the
interview process?
a. You introduce yourself and ask the name of all family members present.
b. After the introduction, you are careful to direct questions about Karen to Mrs. Green,
since she is the best source of information.
c. After the introduction and explanation of your role, you begin to interview by saying
to Karen, “Tell me about your volleyball team.”
d. You choose to conduct the interview in a quiet area with few distractions.

Which of the following best describes the appropriate use of play as a communication technique
with children?
a. Small infants have little response to activities that focus on repetitive actions, such as
patting and stroking.
b. Few clues about intellectual or social developmental progression are obtained from the
observation of a child’s play behavior.
c. Therapeutic play has little value in reduction of trauma from illness or hospitalization.
d. Play sessions serve as assessment tools for determining children’s awareness and
perception of illness.

The nurse should obtain the vital signs of an infant in what order?
a. Measure temperature, count pulse, and count respirations.
b. Count the pulse, count respirations, and measure the temperature.
c. Count respirations, count the pulse, and measure the temperature.
d. Measure the temperature, count respirations, and count the pulse.

You are assessing 7-year-old Mary’s lymph nodes. Using the distal portion of your fingers, you
press gently but firmly in a circular motion along the occipital and post auricular node areas.
You record the findings as “tender, enlarged, and warm lymph nodes.” Which of the following
is TRUE?
a. Your findings are within normal limits for Mary’s age.
b. Your assessment technique was incorrect and should be repeated.
c. Your findings suggest infection or inflammation in the scalp area or external ear
canal.
d. Your recording of the information is complete because it includes temperature and
tenderness.

When assessing the ear of a 2-year-old child, the nurse should?

a. Expect cerumen in the external ear canal only.
b. Use the smallest speculum to prevent trauma to the ear.
c. Pull the pinna up and back to visualize the canal better.
d. Pull the pinna down and back to visualize the canal better.
When evaluating the respiratory status of a newborn that is 2 hours old, which finding should
promote additional observation?
a. Periodic pauses in breathing lasting up to 10 seconds.
b. Respiratory rate of 50 breaths per minute.
c. Asymmetrical chest expansion.
d. Increased respiratory rate while crying.

The nurse is caring for a newly delivered baby girl. The assessment reveals the infant’s
temperature is 97 degrees Fahrenheit. Which action is the MOST appropriate to begin first?
a. Remove the infant’s clothing.
b. Document the findings as normal.
c. Recheck using a rectal thermometer, inserting 1 inch into the infant’s rectum.
d. Initiate warming methods.

Which developmental characteristic is expected in a 4-month-old?

a. Holds on to items.
b. Smiles at self in mirror.
c. Sits unsupported.
d. Has mood changes.

Which physical assessment finding is ABNORMAL for a 4-month-old infant?

a. Bulging fontanel
b. Mouth breathing
c. Babinski reflex
d. Drooling

In treating a patient with an anaphylactic reaction, the first nursing intervention should be which
of the following?
a. Stop the trigger, such as a medication.
b. Ensure ABC’s are being met, placing the patient on oxygen.
c. Obtain a set of vital signs.
d. Call the physician.

Signs and symptoms of anaphylaxis include all of the following EXCEPT?

a. Difficult breathing
b. Swelling
c. Rash/hives
d. Hypertension/bradycardia

Upon discharge of a patient with a newly diagnosed antibiotic allergy, the nurse should ensure
the patient’s family understands which of the following?
a. The antibiotic should always be listed as an allergy in the future.
b. The patient will need to take Diphenhydramine daily for 1 month due to his/her
reaction.
c. The patient cannot take any antibiotics ever again.
d. The patient can take this antibiotic again in the future in smaller doses.
A successful outcome for a patient experiencing an anaphylactic reaction depends MOSTLY
upon:
a. Rapid recognition of symptoms and early interventions.
b. Early administration of an antihistamine.
c. Having personnel available to intubate the patient.
d. Having all pediatric staff certified in CPR.

The nurse is developing a plan of care for a child who is 7-years-old. Which developmental
period does the child fall under?
a. Trust vs. mistrust
b. Autonomy vs. shame/doubt
c. Initiative vs. guilt
d. Industry vs. inferiority

The nurse is caring for a child with a fever. When discussing the fever with the child’s parents,
what response by the parents warrants additional education by the nurse?
a. “Fever will increase my child’s metabolic rate.”
b. “The use of Ibuprofen is safe for managing a child’s fever.”
c. “High fevers are the body’s way of getting rid of infection and should not be treated.”
d. “My child will need additional fluid intake during periods of fever.”

On palpation of an 8-year-old patient’s apical pulse, where would the nurse expect to place
his/her fingers?
a. At the lower left midclavicular line and fifth intercostal space
b. Lateral to the left midclavicular line and fourth intercostal space
c. Over the pulmonic valve
d. Over the aortic valve

During your physical examination, which of the following physical findings could be consistent
with excess carbohydrate nutrition?
a. Caries
b. Skin elasticity and firmness
c. Hair stringy, friable, dull, and dry
d. Enlarged thyroid

While inspecting the abdomen, which one of the following is a NORMAL finding?
a. Concave upper quadrants.
b. Silvery, whitish lines when the skin is stretched out.
c. Bulging at the umbilicus.
d. Protruding abdomen with skin pulled tight.

The nurse is assessing a male adolescent client’s knowledge of contraception. The teen states, “I
have all the info I need.” What is the best response by the nurse?
a. “Tell me what you know about birth control.”
b. “Do you know how to apply a condom?”
 c. “Teen pregnancy should not be taken lightly.”
d. “You need to visit your guidance counselor.”

The nurse expects a 2 year-old child to exhibit which behavior?

a. Build a house with blocks.
b. Ride a small tricycle 6 feet.
c. Display possessiveness with toys.
d. Look at a picture book for 15 minutes.

The nurse is preparing a health teaching program for parents of toddlers and preschoolers. The
nurse plans to include information about the prevention of accidental poisonings. It is most
important for the nurse to include which instruction?
a. Tell children that they should not taste anything but food.
b. Store all toxic agents and medicines in locked cabinets.
c. Provide special play areas in the house and restrict play in other areas.
d. Punish children if they open cabinets that contain household chemicals.

The nurse observes a 4 year-old boy in a day care setting. Which behavior should the nurse
expect this child to exhibit?
a. Throws a temper tantrum when told he must share the toys.
b. Plays by himself for most of the day.
c. Boasts aggressively when telling a story.
d. Cries and is fearful when separated from his parents.

Following the administration of immunizations to a 6 month-old girl, the nurse provides the
family with home care instructions. Which statement by the mother indicates that further
teaching is needed?
a. “I will give her a baby aspirin every 4 hours as needed for fever.”
b. “I will call the clinic if her cry becomes high-pitched or unusual.”
c. “I know I can expect her to be irritable over the next 2 days.”
d. “I will exercise her legs regularly to decrease the soreness.”

A child breaks out with the varicella infection (chickenpox) while hospitalized for a minor
surgical procedure. Which interventions should the nurse implement? (Select all that apply).
a. Place a mask on the child before transporting the child outside the room.
b. Immunize exposed family members with the varicella vaccine.
c. Place the child in strict isolation to prevent an outbreak on the unit.
d. Determine which staff have had varicella before making assignments.

Which nursing interventions are therapeutic when caring for a hospitalized toddler?
(Select all that apply).
a. Require parents to leave the room when performing invasive procedures.
b. Allow the toddler to choose the color of the Band-Aid after an injection.
c. Give brief, but simple explanations to the child before procedures.
d. Insert a urinary catheter if bedwetting occurs during hospitalization.
e. Do not all any toys to be brought in from the child’s home.