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FINAL COACHING EXAMINATION

INFANT CARE AND FEEDING
Prepared by: Prof.Archie Alviz
Philippine Midwifery Licensure Examination
NAME:

PART A c. The child has difficulty separating

GROWTH AND DEVELOPMENT
1. What is the process involved when the
child cannot learns to control his knees until
his buttocks are strong enough
a. Proximodistal
b. Cephalocaudal
c. Simple to complex
d. Interdependent
2. To meet the major developmental need of
a 4 month old infant in the immediate
postoperative period the RM should:
a. Give the infant a pacifier
b. Put a mobile over the infant’s crib
c. Provide the infant with a soft cuddly
toy
d. Warm the infant’s formula before
feeding
3. When the child is about 9 months of age,
he will be expected to be able to play peek-a-
boo. Which critical event of the sensorimotor
phase of cognitive development does this
demonstrate?
a. Egocentrism
b. Use of symbols
c. Object permanence
d. Separation of self from environment
4. The mother of a 5 year old child tells the
RM that the child scolds the floor or the table
if the child hurts herself on the object. This
behavior is identified as:
a. Object permanence
b. Egocentric speech
c. Animism
d. Global organization
5. A nursing instructor asks the students to
describe the formal operation stage. The
most appropriate response would be
a. The child has the ability to think
abstractly
b. The child develops logical thought
pattern
fantasy from reality
d. The child begins to understand the
environment
6. The mother of a 4 year old child calls the
clinic RM and expresses concern because the
child has been masturbating. The most
appropriate response by the RM is which of
the following?
a. The child is very young to begin this
behavior and should be brought to
the clinic
b. This is not normal behavior, and the
child should be seen by the physician
c. This is a normal behavior at this age
d. Children usually begin this behavior
at 8y.o.
7. A nursing instructor ask the nursing
students to present a clinical conference to
peer regarding Freud’s psychosexual stages
of development, specifically anal stage. The
student plans the conference, knowing that
which of the following most appropriately
relates to this stage of development.
a. This stage is associated with toilet
training
b. This stage is associated with
pleasurable and conflicting feelings
about the genital organ
c. This characterized by a tapering off of
conscious biological and sexual urges
d. The stage is characterized by
gratification of self.
8. A clinic RM is preparing to discuss the
concept of moral development with a mother.
The RM understands that according to
Kohlberg’s theory of moral development, in
the pre-conventional level. It is thought to be
motivated by which of the following:
a. The parent’s behavior
b. Peer pressure
c. Social pressure
d. Punishment and reward
9. If the school-age child has an unsuccessful
resolution of the psychosocial crisis according
to Erikson, which of the following may result?
a. Trust-fear conflict and general
difficulties relating to people
b. Independence-fear conflict and
severe feelings of self-doubt
c. Sense of inferiority and difficulty
learning and working
d. Aggression-fear conflict and feelings
of inadequacy or guilt
10. The mother of an 8 year old child tells
the clinic RM that she is concerned about the
child because the child seems to be more
attentive to friends than anything else. The
most appropriate nursing response would be
which of the following
a. You need to be concerned
b. You need to monitor the child’s
behavior closely
c. At this age, the child is developing
his own personality
d. You need to provide more praise to
the child to stop this behavior
11. Which intervention is most appropriate
in order to facilitate the development of trust
in an infant?
a. Place pictures of the child's family at
the bedside.
b. Play tapes of the mother's voice.
c. Encourage the parents to room in and
participate in care.
d. Offer the infant a pacifier.
12. Which action would show an infant has
developed object permanence?
a. He looks for a Cheerio that falls off his
highchair tray.
b. He cries when he is either hungry or
lonely.
c. He prefers a large yellow ball to a
small red one.
d. He smiles when the mobile on his crib
jingles.
13. Piaget identifies that the 2- to 7-year-
old child is in a preoperational stage. The RM
observes a toddler take a toy from another.
The RM recognizes the child unable to put
him- or herself in the place of another is
displaying:
a.Concentration.
b.Negativism.
a. c.Egocentrism.
b. d.Selfishness.
14. When teaching parents about the
child’s readiness for toilet training, which of
the following signs should the RM instruct
them to watch for in the toddler?
a. Demonstrates dryness for 4 hours
b. Demonstrates inability to sit and walk
c. Has a new sibling for stimulation
d. Verbalizes desire to go to the
bathroom
15. Ms. N. tells you that she found her 5-
yr old daughter and her male cousin of the
same age inspecting each other’s private
areas. What interpretation of this behavior
would give to Ms. N?
a. The child should be punished so this
behavior won’t happen again.
b. Your daugther need counseling.
c. Sexual curiousity is quite normal
during this stage.
d. Children are quite curious. Give them
lots of opportunities to explore
each other.
16. Which of the following would the RM
identify as the underlying rationale for a 4
year old who tells the RM that her doll is in
the hospital because it was bad.
a. egocentrism
b. past experience
c. magical thinking
d. decentering
17. The RM observes parents playing with
their 10 month old daughter. Which behavior
indicates that the infant is developing object
permanence?
a. She looks for the toy that her parents
hid under the blanket
b. She returns the play blocks to the
same spot on the table
c. She recognizes that a ball of clay is
the same object even when it’s
flattened out.
d. She bangs two cubes in her hands
and throws them to the floor
18. Piaget describes the main
characteristic of the 2 to 7-year-old child’s
intellectual development as egocentric. This
means
a. Stubbornness
b. Inability to see another’s point of view
c. Sharing toys
d. Preferring to play and assume
responsibilities by oneself
19. By the end of the preschool period, a c. Inferiority
6-year-old usually has mastered the d. Role confusion
developmental task of: 26. In terms of preventive teaching for the
a. Identity parents of a 1 year old, the RM should speak
b. Industry to them about:
c. Initiative a. Aspiration
d. Autonomy b. Toilet training
20. A 14-year-old child must have the c. Adequate nutrition
capacity for self-awareness to d. Sexual development
a. Develop identity 27. The RM is aware that an appropriate
b. Eliminate fear of the dark toy for a 3 month old infant during
c. Maintain self-control hospitalization would be:
d. Focus on more than one dimension of a. Rattles
an object b. Tricycle
21. Negativism demonstrated by toddlers c. Ten piece puzzle
is frequently an expression of d. Wagon
a. A quest for autonomy 28. A term neonate weighs 7 ½ pounds at
b. Hyperactivity birth. When he’s 1 year old, approximately
c. Separation anxiety how much should he weigh?
d. Sibling rivalry a. 36 lb
22. The RM explained to the mother that b. 22 lb
according to Erikson’s framework of c. 28 lb
psychosocial development, play as a vehicle d. 32 lb
of development can help the school-age 29. During physical assessment of a
develop a sense of newborn, which of the following comparative
a. Initiative measurements would necessitate additional
b. Industry investigation?
c. Identity a. Head circumference 34 cm; chest
d. Intimacy circumference 31 cm
23. The RM is aware that the play b. Head circumference 31 cm; chest
of a 5 month-old infant Is in the oral stage. circumference 33 cm
The RM knows that this behavior most likely c. Head circumference 34.5 cm; chest
to consist of: circumference 32 cm
a. picking up a rattle or toy and putting it d. Head circumference 32 cm; chest
into the mouth circumference 30 cm
b. Exploratory searching when a cuddly 30. A 6 month old infant is admitted with a
toy is hidden from view diagnosis of failure to thrive. The birth weight
c. simultaneously kicking the legs and was 7 pounds. Based on growth and
batting the hands in the air development chart, the RM should expect an
d. waving and clenching fits and dropping infant at 6 months to weigh approximately:
toys placed in the hands a. 10 pounds
24. The RM is aware that the theorist b. 14 pounds
behind psychosocial theory is which of the c. 18 pounds
following? d. 21 pounds
a. Freud 31. Popcorn and nuts should not be given
b. Erikson to a toddler primarily because they
c. Piaget a. Will spoil the child’s appetite
d. Kohlberg b. Are easily aspirates
25. The adolescent’s inability to develop a c. Have very little food value
sense of who he is and what he can become d. Can cause tooth decay
results in a sense of which of the following? 32. Besides adolescents, children in which
a. Shame of the following age groups experience the
b. Guilt most rapid growth?
 a. Infancy
b. Toddler stage
c. Preschool age
d. School age
33. A mother tells the RM that each
morning she offers her 24 month old son
juice and he always shakes his head and
says, “No.” She asks the RM what to do,
because she knows the child needs fluids.
The RM suggests that the mother:
a. Distract him with some food
b. Be firm and hand him the glass
c. Let him see that he is making her
angry
d. Offer him a choice of two things to
drink
34. A 2 year old boy, is admitted to the
hospital for further evaluation, is standing in
his crib crying. The child refuses to be
comforted and calls for his mother. As the RM
approaches the crib to provide morning care
the child screams louder. The RM,
recognizing that the behavior is typical of the
stage of protest, decides to:
a. Pick him up and carry him around
the room
b. Fill the basin with water and
proceed to bathe him
c. Sit by his crib and bathe him later
when his anxiety decreases
d. Skip the bath because the child is
upset and does not really need a
bath
35. A mother asks when to take her 2 year
old to the dentist. For dental prophylaxis, the
RM encourages her to take the child:
a. Before starting school
b. Between 2 to 3 years old
c. When the child begins to lose
deciduous teeth
d. The next time another family
member goes to the dentist
36. When ordering a regular diet for a
young toddler the RM should choose foods
such as:
a. Spaghetti and bread
b. Corn dog and French fries
c. Hamburger with bun and grapes
d. Hot dog with bun and potato chips
37. The RM plans to talk to a mother
about toilet training a toddler, knowing that
the most important factor in the process of
toilet training is the:
a. Child’s desire to be dry
b. Ability of the child to sit still
c. Child’s willingness to work at it
d. Approach and attitude of the parent
38. A mother tells the RM that her 22 –
month old child says “no” to everything.
When scolded, the toddler becomes angry
and starts crying loudly but then immediately
wants to be held. What is the best
interpretation of this behavior?
a. The toddler isn’t effectively coping
with the stress
b. The toddler’s need for attention isn’t
being met
c. This is a normal behavior for a 2 –
year old child
d. This behavior suggests a need for
counseling
39. When asked about spanking as a
disciplinary technique, the RM’s best
response would be:
a. “It really depends on the child’s age.”
b. “It is strongly suggestive of negative
role modeling.”
c. “This may be the only option when no
other technique works.”
d. “Research studies have shown it to be
an effective disciplinary technique.”
40. Preschool children role play. This is an
important part of socialization because it:
a. Encourages expression
b. Help children think about careers
c. Teaches children about stereotypes
d. Provides guidelines for adult behavior
41. The RM is aware that Freud’s phallic
stage of psychosexual development, which
compares with Erikson’s psychosocial phase
of initiative vs. guilt, is best seen at:
a. Adolescent
b. 6 to 12 years
c. Birth to 1 year
d. 3 to 5 ½ years
42. During the oedipal stage of growth
and development, the child:
a. Loves and hates both parents
b. Loves the parent of the same sex
and the parent of the opposite sex
c. Loves the parent of the opposite
sex and hates the parent of the
same sex
d. Loves the parent of the same sex
and hates the parent of the
opposite sex
43. When teaching a parents’ class, the
RM explains that medication and household
cleaning products should be kept out of the
reach of the pre - school because:
a. They have high level of curiosity
b. Their sense of taste is developing
at this time
c. Their appetite is greater to
support rapid growth
d. They rebel against parental
authority during this phase
44. A 5-year-old boy believes that there
are “bogeymen and monsters” in his
bedroom at night. What advice can the RM
give to Eric’s parent to help Eric cope with his
fears?
a. Let Eric sleep with his parent
b. Tell Eric that bogeymen and monster
do not exist
c. Keep a night-light on in Eric’s room
d. Tell Eric that no one else sees any
monsters, so he must not see them
either
45. A 6 year old is brought to the pediatric
clinic for a routine visit. When assessing the
child’s relationship with other children, the
RM would expect to observe:
a. Solitary play
b. Parallel play
c. Initiative play
d. Cooperative play
46. The mother of a 5 year old asks,
“When do the deciduous teeth usually begin
to fall out?” Which of the following is the
RM’s most appropriate response?
a. Age 5 years
b. Age 6 years
c. Age 7 years
d. Age 8 years
47. Which of the following statements
about causes of accidents during the school-
age years is inaccurate?
a. School-age children are more active
and become more adventurous and
daring
b. School-age children are more
susceptible to hazards in the home
environment
c. School-age children are the age
group commonly aspirated
d. School-age children are less subject
to parental control over their
behavior
48. Practices common to school-age
children include all the following except:
a. Talking in code
b. Starting collections
c. Telling jokes
d. Participating mostly in activities with
both boys and girls
49. An adolescent client has just had
surgery and has a dressing on the abdomen.
Which of the following questions would the
RM expect the client to ask initially?
a. “Did the surgery go okay?”
b. “Will I have a large scar?”
c. “What complication can I expect?”
d. “When can I return to school?”
50. On average, the adolescent growth
spurt begins
a. Earlier for boys than for girls
b. Earlier for girls than for boys
c. At approximately the same time for
both sexes
d. Between the seventh and eighth years
PEDIATRIC DISORDERS
51. A child with leukemia complains of
fatigue. The RM assesses the skin color as
pallor. Considering the child’s diagnosis,
which of the following data explain these
findings?
a. Cerebrospinal fluid with elevated
white cells
b. Hemoglabin of 8 g/dl
c. Platelete count of 150,000/mm3
d. Sodium level of 130
52. A 7-year-old child complains of shakiness,
hunger, and headache. Based on these
findings, the school RM should suspect the
student has which of these conditions?
a. Diabetic ketoacidosis
b. Hyperglycemia
c. Hypoglycemia
d. Polyphagia
53. A mother of newly diagnosed diabetic is
receiving nutritional counseling. Which of
these statements by the mother indicates the
need for further teaching?
a. “Calories and nutrient proportions have
to be consistent on a daily basis.”
b. “Chocolate milk with meals is
accepted.”
 c. “Meals and snacks must be eaten at the
same time each day.”
b. “Cola may be exchanged for fruit juice.”
54. The mother of a newly diagnosed diabetic
asks why insulin needs to be injected. The
RM responds that the child cannot take oral
insulin because it
a. Is not tolerated well in oral form by
children
b. Is not available in pill form
c. Is destroyed by digestive enzymes
d. Will cause gastric ulcers
55. A 9-year-old girl has been brought to the
emergency department following an
automobile accident and is diagnosed with
femoral fracture. Which of these goals should
receive priority in the child’s care?
a. Adequate nutrition will be maintained
b. Infection will be prevented
c. Disturbance in body image will be
reduced
d. Pain will be reduced
56. Which of these assessments of a child
with a cast for correction of a clubfoot needs
to be reported?
a. Cast has not dried in 2 hours
b. Color change and cool skin proximal
c. Moves toes and capillary refill is <3
seconds
d. Rough edges on the cast
57. A child diagnosed with rheumatic fever is
prescribed aspirin. The purpose of this
medication is to
a. Decrease fever
b. Prevent headache
c. Promote relaxation
d. Reduce inflammation
58. Following surgical correction for Tetralogy
of Fallot, which of these goals should receive
priority in a child’s care?
a. Adequate sleep and rest periods
provided
b. Adequate nutrition
c. Pain management
d. Prevention of vascular complications
59. An infant is experiencing uncontrolled
vomiting. Based on this finding, the RM
would expect which acid-base imbalance?
a. Metabolic alkalosis
b. Metabolic acidosis
c. Respiratory alkalosis
d. Respiratory acidosis
60. When performing a postoperative
assessment on an infant with surgical
correction of a myelomeningocele, the RM
observes bulging anterior fontanel and
increased head size. Based on these findings
the RM knows the infant is at imminent risk
for developing.
a. Encephalitis
b. Hydrocephalus
c. Meningitis
d. Fluid overload
61. A child has diagnosed with a urinary tract
infection. Which statement about appropriate
dietary choices should be given to the
parents?
a. The child should drink adequate
amounts of water and juices
b. Carbonated and caffeinated
beverages are recommended
c. Citrus juices are highly effective in
eliminating urinary tract infection
b. No special recommendations should
be made
62. When performing a physical assessment
on an infant with hyospadias with chordee,
the RM should expect which of the following
findings?
a. Bladder exposed with visible
urethral opening
b. Bulge in the scrotal sac
c. Urethra opens on the dorsal aspect
of the penis
d. Urethra opens on the ventral side of
the penis
63. Before assessing an infant for
undescended testes, the RM should plan to
a. Allow the child to defecate
b. Assess vital signs
c. Palpate the inguinal canals
d. Warm her hands and the room
64. Following a tonsillectomy, a child grows
increasingly restless. The RM assesses the
child to find a pulse rate of 120 and frequent
swallowing. Based o n this findings, the RM
should suspect the client has which of these
conditions?
a. Airway obstruction
b. Hemorrhage
c. Infection
d. Usual signs following this surgery
65. Which of the following statements is
accurate regarding the mode of transmission
for autosomal recessive disorders such as
cystic fibrosis (CF)?
a. Both parents must have the disease to
have a child with CF
b. There is a 75% chance with each
pregnancy that the child will have CF
c. Both parents must be carriers of the
trait in order for the child to have the
disease
d. There is a 50% chance with each
pregnancy that the child will not have
CF
66. A preschooler is admitted to the hospital
with moderate burns sustained in a house
fire. He has sustained partial-thickness burns
over 20% of his body surface area, including
his hands and feet. Because of the client’s
condition, which of these nursing diagnoses
should receive priority on admission to the
hospital unit?
a. Altered parenting
b. Fluid volume deficit
c. Knowledge deficit
d. Self-esteem disturbance
67. A preschool who has been burned
exhibits a decreased interest in eating. Which
of the following measures should the RM take
to increase the child’s intake?
a. Ask the mother to feed the child
b. Eliminate the snacks
c. Offer smaller and more frequent
feedings
d. Withhold dessert until the meal is eaten
68. An intravenous infusion is started on a
child with severe burns. The RM should
assess for signs of fluid overload, which
include
a. Depressed anterior fontanel
b. Increased abdominal circumference
c. Moist rales in lung fields
d. Tea-colored urine
69. Which statement best describes the
problem of regulation of body temperature in
a 3-pound premature infant?
a. The surface area of the premature
infant is relatively smaller than that of
a healthy term infant.
b. There is a lack of subcutaneous fat,
which furnishes insulation.
c. There are frequent episodes of
diaphoresis causing loss of body heat.
d. There is limited ability to produce
body proteins.
70. The RM would identify which situation as
an indication for the administration of
RhoGAM?
a. A woman who has been Rh-
sensitized in the past two pregnancies.
b. An infant with increased hemolysis
of red blood cells because of ABO
incompatability
c. An infant with an increase in serum
bilirubin levels as a result of the
presence of Rh factor antibopdies.
d. A primigravida who is Rh negative is
pregnant with an infant who is Rh
positive.
71. While in the recovery room, the best
immediate postoperative position for an
infant who has had a cleft lip repair is:
a. Prone with the head turned to one
side.
b. Left Sims’ position
c. Supine with the head turned to the
side.
d. Trendelberg’s position to facilitate
drainage
72. An infant born at 28 weeks’ gestation
weighs 4 lb 3 oz. What does the initial
nursing care of this infant include?
a. Place the infant in protective
isolation because of the
underdeveloped immune system
b. Feed him a low phenylalanine
formula to increase digestion and
utilization of calories.
c. Provide gavage feedings every 2
hours because of an inadequate
sucking and swallow reflex.
d. Place the infant in a regulatory
heater to maintain regulation of body
temperature.
73. The clinical RM observes that a 3-day-old
baby girl is jaundiced. A bilirubin level is
determined, and it is 11.4 mg/dl. What cause
the bilirubin level?
a. Physiological jaundice
b. Hemolytic disease
c. Erythroblastosis fetalis.
d. Sepsis.
74. The RM assigned to the RMry
understands the importance of keeping the
newborn swaddled in a warm blanket to
prevent heat loss because:
a. Chilling leads to increased heat
production and greater oxygen needs.
b. The newborn’s metabolic rate is
decreased
c. Evaporation will affect the
newborn’s ability to feed
d. The newborn will sleep more
comfortably.
75. The newborn’s mother is concerned
about the shape of the baby’s head after
delivery. She states that it looks like a “cone
head.” The most appropriate response by the
RM is:
a. “You don’t need to worry about it. It
is perfectly normal after birth.”
b. “It is molding caused by the
pressure during birth and will
disappear in a few days.”
c. “I will report it to the physician, and
he will order a diagnostic scan.”
d. “It is a collection of blood related to
the trauma of delivery and will absorb
in a few weeks.”
76. The RM is responsible for documenting
the first meconium stool the newborn passes.
If the newborn does not have stool in the
first 24 to 48 hours of life, the RM should
first:
a. Insert a rectal thermometer to
facilitate the process
b. Inspect the anal area for an
opening
c. Monitor the vital signs for a rise in
temperature
d. Increase oral feeding to stimulate
passage of stool
77. A 10-pound newborn of a diabetic mother
is admitted to the intensive care unit because
of the hypoglycemia. His mother is concerned
that he will diabetes. The most appropriate
response by the RM is that the baby will:
a. Not have any long-term
consequences because of his mother’s
diabetes.
b. Not be at risk for diabetes until he
reaches puberty.
c. Have to follow a diabetic diet to
avoid complications
d. Need to be monitored closely during
his childhood years.
78. The RM is providing discharge teaching a
20-year-old who has had her first male child.
Which statement by the mother
demonstrates that she understands the
discharge teaching regarding his
circumcision?
a. “I will observe the whitish-yellow
drainage on his penis but I will not
remove it.”
b. “I will bring him back to the clinic in
3 days to have the drainage removed.”
c. “I will use antibiotic ointment on his
penis with every diaper change.”
d. “I will rub the area briskly with a
washcloth to remove the discharge.”
79. A 12-year-old hemophiliac client has been
admitted to the medical center for an acute
episode of hemarthrosis. Which of these
expected outcomes should receive priority in
the client’s care?
a. Family will receive genetic
counseling
b. Maximum function of the joint will
be restored
c. Child and family will seek support
from National Hemophilia Foundation
d. Child will participate in appropriate
activities for present condition
80. Sally, age 12 months, weighs 21 pounds.
The RM reviews the child’s record and finds
out that her birth weight was 7 pounds. In
planning care, the RM knows that the child:
A.Has not gained the expected weight
related to the birth weight.
B.Must not be eating enough.
C.Should be referred to Protective
Services immediately for being
severely underweight.
D.Falls within normal weight gain
related to the birth weight.
Rationale: D. An infant should triple
her birth weight by 12 months. This
child is on target for weight gain, and
does not need any further
intervention.
81. A preschool-age client needs a central
line dressing change. The most appropriate
technique to use to explain this procedure is
to:
A. show a picture of the procedure in a
book
 B. explain the procedure with few
words
C.let the child perform a dressing
change on a doll
D. explain the procedure to the child’s
mother as the child listens
82. A parent has understood the teaching for
introducing solid foods to her child if she
states:
A.“I can start to feed rice cereal at 2
months of age.”
B.“I will begin with cereal, then
introduce meats next.”
C.“I will introduce one new food at a
time.”
D.“I will begin to wean my baby from
the bottle after I start rice cereal, at 6
months of age.”
83. The RM is preparing to assess an infant
under the age of 6 months. The infant is
quiet and awake, sucking on a pacifier. The
RM should start with:
A.An otoscopic exam.
B.A lung, heart, and abdomen exam.
C.An oral exam.
D.An exam for hip dysplasia.
84. The RM palpates the anterior fontanel of a
12-month-old infant. Identify the area where
the RM is palpating.
A.Anterior fontanel
B.Posterior fontanel
C.Suture lines
D.Lambdoid Suture
85. The nursing assessment of a 4-year-old
child reveals a rounded chest, with the
anterior diameter approximately equal to the
lateral diameter. The most appropriate
interpretation of this finding is:
A.Abnormal, and could indicate a
chronic obstructive lung condition.
B.Abnormal, and pectus carinatum
might be present.
C.Normal, and no cause for concern.
D.Abnormal, and pectus excavatum
could be present.
86. The RM reviews the assessment of a 10-
year-old child and notes that the child has an
abnormal Romberg’s sign. What is the most
appropriate nursing action based on this
abnormal assessment finding?
A.Instruct the child to get help when
getting out of bed.
B.Speak when entering the room.
C.Explain the placement of food on the
child’s plate.
D.Place the child in restraints.
87. A RM is assessing a newborn. What is the
most accurate way for the RM to assess the
newborn’s respiratory rate?
A.Place a hand on the newborn’s chest
and count the rate for 30 seconds.
B.Use the stethoscope and count the
rate for 15 seconds.
C.Use the stethoscope or place a hand
on the newborn’s abdomen, and
count the rate for one minute.
D.Place a hand on the newborn’s back
and count for 30 seconds.
88. During a routine developmental screening,
the RM is concerned about the development
of a 5-year-old. Which of the following would
be recommended?
A.Refer the child to a social worker.
B.Tell the parent to take the child to a
physical therapist.
C.Refer the child to a trained specialist
to administer developmental testing.
D.Tell the mother that the child should
be retested in a year.
89. Which of the following assessment
questions and instructions used by the RM
would give information regarding relationship
issues of the child?
A.“Describe your infant’s temperament
to me.”
B.“What does your toddler like to do at
school?”
C.“Tell me about your child’s after
school activities.”
D.“How does your infant comfort
himself?”
90. The RM is assessing a newborn, and
notes all of the findings. Which of the
following nursing assessments would cause
the RM to be concerned?
A.Baby enjoys sucking on a pacifier
and sleeps 16 hours a day.
B.Baby is nursing every 2–2½ hours
and has 2 stools daily.
C.Birth weight is 6 pounds, 10 ounces.
Present weight is 5 pounds, 4 ounces.
D.Baby is sleeping in between feedings
and is not babbling.
91. A new mother asks the RM
whether breastfeeding is better than formula
for her newborn. Which response by the RM
is most appropriate?
A.“It often is easier to breastfeed,
because you do not have to prepare
bottles.”
B.“Breastfeeding is best for your baby;
of course you should choose this.”
C.“There are no advantages to
breastfeeding. You should do what is
best for you.”
D.There are many benefits to
breastfeeding; let me tell you more
about it.”
92. The father of a 9-month-old infant tells
the RM that his wife picks up the baby
immediately whenever she begins to cry. The
most appropriate response by the RM is:
A.“It is important for the child to learn
to comfort herself. Does the baby try
to calm herself by sucking her thumb?”
B.“It is OK to pick her up often;
eventually, she will stop crying.”
C.“Most infants do not know how to
calm themselves. It is important to be
responsive when they cry.”
D.“At 9 months, she is too young to
learn to calm herself. Wait until she is
2 years old before letting her cry
longer.”
93. The RM inquires about the activity level of
a 3-year-old. The mother states that the child
loves to play at the park, and that they go
there as much as possible. The RM
encourages the mother to continue to take
the child to the park for play. What important
principle is guiding the RM’s response?
A.Socialization with other toddlers
helps develop communication skills.
B.Allowing the toddler to walk, run,
and hop enhances the child’s
kinaesthesia.
C.Maternal bonding is enhanced
through play.
D.Only an emotionally happy child can
enjoy the park.
94. The father of a 2½ - year-old asks the RM
how to prevent early-childhood dental
cavities. The best response by the RM would
be:
A.“Your child has only baby teeth; they
will eventually fall out, and so there is
no need to worry.”
B.“Make sure your child’s diet is
nutritious, and limit snacks high in
sugar.”
C.“Take the child to the dentist to see
if he has any cavities.”
D.“Let the child watch you brush your
teeth so that he can learn how to do it
himself.”
95. The RM needs to obtain the height of a 3-
year-old as part of routine health screening.
To obtain an accurate measurement, the
child will:
A.Be measured in a recumbent
position.
B.Remove his shoes and stand upright,
with head level.
C.Stand with his feet wide apart.
D.Face the wall as he is measured.
96. Mother of a 3-year-old tells the RM that
her child has frequent nightmares. The
statement by the mother that indicates the
need for more teaching is:
A.“I usually talk quietly and rub her
back to reassure her.”
B.“I read her a story until she calms
down.”
C.“I take her to my bed so she will
calm down.”
D.“I stay with her awhile to reassure
her.”
97. Most schools include curricula regarding
human sexuality. What is the most
appropriate age group for the RM to include
in her instruction?
A.12-year-olds
B.9-year-olds
C.11-year-olds
D.15-year-olds
98. A 7-year-old sibling of a child with special
needs is acting out in school. This behavior
has been attributed to jealousy over the
attention the special needs child receives.
The school RM should suggest to the parents
that the sibling should:
A.Have a special time or activity with
each parent alone.
B.Be dealt with using behavior
modifications.
C.Be asked to participate in the care of
the special needs child to understand
why the child needs more attention.
D.Be evaluated by a psychologist to
rule out any mental illness.
99. A 2-year-old with epilepsy is showing
signs of developmental delay. The RM has
been working with the family to support
development. The response from the parents
that indicates the need for further teaching
is:
A.“He has a schedule by which we
abide at all times.”
B.“We make sure he is always in a
playpen or enclosed area when he
plays.”
C.“He has temper tantrums all the
time. We stay near, but don’t give in
to what he gets mad about.”
D.“He gets his Depakote every day at
the same time. He hasn’t shown
signsof a seizure since he was 6
months old.”
100. The mother of a trainable adolescent
with Down syndrome states to the school RM,
“I don’t know what’s going to happen to my
child when I die. How will he take care of
himself?” What is the RM’s best response?
A.“There will always be somebody to
take care of him. Don’t worry,
everything will be okay.”
B.“Is there a relative who can take
care of him if something happens? You
need to develop a plan for the future.”
C.“I am sure there is something we
can do. Let me look into alternative
care and see what kind of insurance
you have.”
D.“We do have a program that will
assist with vocational learning. I need
to get your consent first; then, we can
look at alternatives.”
.