Free Sample NCLEX-RN Questions

 

301) A baby has just been delivered, and you are examining its posture.  The baby has tremors, twitches, startles easily, arms and hands are flexed,legs extended.  What is this called?

            a) hypotonia

            b) hypertonia

            c) opisthotonic posturing

            d) expected

 

Answer:  b) hypertonia:  baby has tremors, twitches, startles easily, arms and hands are flexed,legs extended

 

302) A preterm baby has been delivered.  You are inspecting her posture.  Which of the following would be expected?

            a) slight flexion of extremities; holds head erect momentarily, turns head from side to side when prone; may have brief tremors

            b) limp extended limbs, legs abducted

            c) limp extended extremities, marked head lag

            d) tremors, twitches, startles easily, arms and hands are flexed,legs extended

 

Answer: b) expected preterm baby posture: limp extended limbs, legs abducted

 

303) A  baby has been delivered.  You are inspecting her posture and find that she has hypotonia.  Which of the following would be matches the description of hypotonia?

            a) slight flexion of extremities; holds head erect momentarily, turns head from side to side when prone; may have brief tremors

            b) limp extended limbs, legs abducted

            c) limp extended extremities, marked head lag

            d) tremors, twitches, startles easily, arms and hands are flexed,legs extended

 

Answer: c) hypotonia: limp extended extremities, marked head lag

 

304)  You are examining the head shape of a newborn.  The doctor mentioned he has caput succedaneum.  Which of the following should you observe in the baby?

            a) Diffuse edema of soft scalp tissue that crosses suture line

            b)Hematoma between periosteum and skull bone; unilateral and does not cross suture line

            c) Muscle twitching, seizures, cyanosis, breathing abnormal, shrill cry

            d) Head large compared to chest; small fontanels; hair like matted wool

 

Answer: a) caput succedaneum: Diffuse edema of soft scalp tissue that crosses suture line

 

305)  You are examining the head shape of a newborn.  There is a family history of cephalhematoma.  Which of the following matches the description of cephalhematoma?

            a) Diffuse edema of soft scalp tissue that crosses suture line

            b) Hematoma between periosteum and skull bone; unilateral and does not cross suture line

            c) Muscle twitching, seizures, cyanosis, breathing abnormal, shrill cry

            d) Head large compared to chest; small fontanels; hair like matted wool

 

Answer: b) cephalhematoma : Hematoma between periosteum and skull bone; unilateral and does not cross suture line

 

306)   You are examining the head shape of a newborn.  Looking at the signs, you fear there may be intracranial hemmorhage.  Which of the following are indications of intracranial hemorrhage?

            a) Diffuse edema of soft scalp tissue that crosses suture line

            b) Hematoma between periosteum and skull bone; unilateral and does not cross suture line

            c) Muscle twitching, seizures, cyanosis, breathing abnormal, shrill cry

            d) Head large compared to chest; small fontanels; hair like matted wool

 

Answer: c) indications of intracranial hemorrhage: Muscle twitching, seizures, cyanosis, breathing abnormal, shrill cry

 

307)  You are completing measurements of a newborn and after noted that she may have hydrocephalus.  Which of the following may indicate hydrocephalus?

            a) bulging or depressed fontanels when quiet

            b) widened sutures or fontanels

            c) head circumference < 10th percentile

            d) head circumference > 90th percentile

 

Answer: d) hydrocephalus: head circumference > 90th percentile

 

308)    You are completing measurements of a newborn and after noted that she may have microcephaly.  Which of the following may indicate microcephaly?

            a) bulging or depressed fontanels when quiet

            b) widened sutures or fontanels

            c) head circumference < 10th percentile

            d) head circumference > 90th percentile

 

Answer: c) microcephaly: head circumference < 10th percentile

 

309)  A preterm baby has just been delivered.  What would you expect its head shape to be like?

            a) Diffuse edema of soft scalp tissue that crosses suture line

            b) Widened sutures or fontanels

            c) Muscle twitching, seizures, cyanosis, breathing abnormal, shrill cry

            d) Head large compared to chest; small fontanels; hair like matted wool

 

 

Answer: d) expected characteristics of preterm baby: Head large compared to chest; small fontanels; hair like matted wool

 

310)  You are examining a newborn's eyes.  You notice he has epicanthal folds.  When would this be expected?

            a) If he is of African descent

            b) If he is of European descent

            c) If he is of Native American descent

            d) If he is of Asian descent

 

Answer: d) Epicanthal folds are expected if he is of Asian descent

 

311)  You are checking the eye reflexes of a neonate.  Which of the following is not expected?

            a) blink

            b) corneal

            c) papillary

            d) green

 

Answer: d) green reflex is not expected

 

312)  You are examining a newborn and believe he has facial palsy. Facial palsy is due to trauma to the 7th cranial nerve during birth.  Which of the following fits the description of facial palsy?

            a) unable to close both eyes with drawing of mouth to 1 side and inability to smooth forehead

            b) unable to close 1 eye with drawing of mouth to 1 side and inability to wrinkle forehead

            c) unable to close 1 eyes with drawing of mouth to the opposite side and inability to smooth forehead

            d) unable to close 1 eyes with drawing of mouth to the same side and inability to wrinkle forehead and twitch nose

 

Answer: b) description of facial palsy: unable to close 1 eye with drawing of mouth to 1 side and inability to wrinkle forehead

 

313)  You are examining the eyes of a neonate, paying special attention to the expected characteristics.  Which of the following is expected?

            a) absence of reflexes

            b) absence of tears

            c) unable to follow bright light

            d) purulent discharge

 

Answer: b) absence of tears is expected in neonates

 

314)  You are examining the ears of a preterm baby.  Which of the following would be expected of a preterm baby?

            a) ear cartilages formed, pinna flexible; top of pinna on horizontal line with outer canthus of eye

            b) ear cartilages formed, pinna rigid

            c) ear cartilages undeveloped, ear may fold easily

            d) ear cartilages undeveloped, pinna rigid; top of pinna does not the horizontal plane with outer canthus of eye

 

Answer: c) expected ears of preterm baby: ear cartilages undeveloped, ear may fold easily

 

315)  A baby was developed on term.  You are examining her ears.  Which of the following is expected?

            a) low placement

            b) absence of startle reflex in response to noise

            c) ear may fold easily

            d) ear cartilages developed; top of pinna on horizontal line with outer canthus of eye

 

Answer:d) expected ear characteristics: ear cartilages developed; top of pinna on horizontal line with outer canthus of eye

 

316)  You are examining a newborn baby and notice she has a cleft lip.  Which of the following matches the description of a cleft lip?

            a) incomplete closure of lip

            b) incomplete closure of plate or roof of mouth

            c) white patches on oral membranes and tongue

            d) frenulum of tongue and upper lip

 

Answer:a) cleft lip: incomplete closure of lip

 

317)    You are examining a newborn baby and notice she has a cleft palate.  Which of the following matches the description of a cleft palate?

            a) incomplete closure of lip

            b) incomplete closure of plate or roof of mouth

            c) white patches on oral membranes and tongue

            d) frenulum of tongue and upper lip

 

Answer:b) cleft palate: incomplete closure of lip

 

318)     You are examining a newborn baby and notice she has candidiasis/thrush.  Which of the following matches the description of candidiasis/thrush?

            a) incomplete closure of lip

            b) incomplete closure of plate or roof of mouth

            c) white patches on oral membranes and tongue

            d) frenulum of tongue and upper lip

 

Answer: c) candidasis/thrush - white patches on oral membranes and tongue

 

319)  You are examining the nose of a newborn baby.  Which of the following traits is expected?

            a) compressed and bruised

            b) flaring of nares

            c) nonpatent nostrils

            d) purulent or copious nasal discharge

 

Answer: a) compressed and bruised nose is expected of neonates

 

320)  You are examining a newborn baby.  The doctor has noted that the baby has pectus carinatum.  Which of the following matches the description of pectus carinatum?

            a) milky discharge from breast

            b) wide-spaced nipples, extra nipples

            c) pigeon chest

            d) depressed sternum, funnel chest

 

Answer: c) pectus carinatum: pigeon chest

 

321)   You are examining a newborn baby.  The doctor has noted that the baby has supernumerary nipples.  Which of the following matches the description of supernumerary nipples?

            a) milky discharge from breast

            b) wide-spaced nipples, extra nipples

            c) pigeon chest

            d) depressed sternum, funnel chest

 

Answer: b) supernumerary nipples: wide-spaced nipples, extra nipples

 

322)   You are examining a newborn baby.  The senior nurser has noted that the baby has witch's milk.  Which of the following matches the description of witch's milk?

            a) milky discharge from breast

            b) wide-spaced nipples, extra nipples

            c) pigeon chest

            d) depressed sternum, funnel chest

 

Answer: a) witch's milk: milky discharge from breast

 

323)  You are examining the chest of a newborn baby, using a chart of expected characteristics.  Which of the following is not expected?

            a) xiphoid process evident

            b) marked retractions during inspiration

            c) bilateral areola and breast bud tissue 0.5-1.0 cm

            d) anteroposterior and lateral diameters equal

 

Answer: b) marked retractions during inspiration is abnomal

 

324)  You are examining the chest of a preterm baby.  Which of the following is expected?

            a) absent or decreased breast tissue

            b) marked retractions during inspiration

            c) assymetric chest expansion

            d) depressed sternum

 

Answer:a) absent or decreased breast tissue is expected in preterm babies

 

325)  You are examining the abdomen, back and rectum of a neonate.  You noticed he has diastasis recti.  What is diastasis recti?

            a) decreased bowel sounds

            b) gap between rectimuscles

            c) abdominal distention; absent bowel sounds

            d) anal constriction when touched

 

Answer: b) diastasis recti: gap between rectimuscles

 

326)   You are examining the abdomen, back and rectum of a neonate.  He is expected to have the anal wink.  What is the anal wink?

            a) decreased bowel sounds

            b) gap between rectimuscles

            c) abdominal distention; absent bowel sounds

            d) anal constriction when touched

 

Answer: d) anal wink: anal constriction when touched

 

327)   You are examining the abdomen, back and rectum of a preterm neonate.  Everything looks normal so far, but which of the following is expected of a preterm baby?

            a) decreased bowel sounds

            b) gap between rectimuscles

            c) abdominal distention; absent bowel sounds

            d) anal constriction when touched

 

Answer: a) preterm babies usually have decreased bowel sounds

 

328)  You are examining the abdomen of a child.  You note that there is an abnormality, which may require further examination.  Which of the following is abnormal?

            a) presence of bowel sounds

            b) liver is palpable 2-3 cm below right costal margin

            c) kidneys are palpable 1-2 cm above umbilicus

            d) visible peristaltic waves

 

Answer: d) visible peristaltic waves is abnormal in newborns

 

329)  You are examining the back and rectum of a child.  You note that there is an abnormality, which may require further examination.  Which of the following is abnormal?

            a) spine is intact

            b) trunk incurvation reflex present

            c) imperforate anus

            d) passage of meconium within 24 hr

 

Answer: c) imperforate anus is abnormal

 

330) You are examining the back of a neonate and noticed that she has spina bifida.  Which of the following matches the description of spina bifida?

            a) external saclike protrusion along spinal column

            b)  dimple with tuft of hair along spine

            c) no trunk incurvation

            d) extra vertebrae

 

Answer:  a)spina bifida: external saclike protrusion along spinal column

 

331) You are examining the back of a neonate and noticed that she has a pilonidal cyst.  Which of the following matches the description of pilonidal cyst?

            a) external saclike protrusion along spinal column

            b)  dimple with tuft of hair along spine

            c) no trunk incurvation

            d) extra vertebrae

 

Answer: b)  pilonidal cyst: dimple with tuft of hair along spine

 

332)  You are examining the extremities of a postterm neonate.  Which of the following is expected?

            a) fine wrinkles

            b) long fingernails

            c) audible click on flexion and abduction of hips

            d) fixed plantar flexion with medial deviation

 

Answer: b) postterm babies are expected to have long fingernails

 

333)   You are examining the extremities of a preterm neonate.  Which of the following is expected?

            a) fine wrinkles

            b) long fingernails

            c) audible click on flexion and abduction of hips

            d) fixed plantar flexion with medial deviation

 

Answer: a) preterm babies are expected to have fine wrinkles

 

334)  You are examining the extremities of a preterm neonate.  Which of the following signs are used as a sign of gestational age?

            a) square window sign

            b) Ortolani's sign

            c) Duchenne-Erb sign

            d) hat sign

 

Answer: a) square window sign (flexing of hand toward forearm creates angle that decreases with increase in gestational age)

 

335)  You are examining the extremities of a neonate.  There are a number of abnormalities.  Which of the following is expected normally.

            a) fixed plantar flexion with medial deviation

            b) unequal gluteal or leg folds

            c) feet flat, creases on anterior 2/3 of sole

            d) audible click on flexion and abduction of hips

 

Answer: c) feet flat, creases on anterior 2/3 of sole is an expected characteristic

 

336)  You are examining a newborn's extremities and noticed that he has Ortolani's sign.  Which of the following matches the description of Ortolani's sign?

            a) palmar simian crease

            b) unequal gluteal or leg folds

            c) audible click on flexion and abduction of hips

            d) fixed plantar felxion with medial deviation

 

Answer: c) Ortolani's sign : audible click on flexion and abduction ofhips

 

337)  You are examining a newborn's extremities and noticed that he has talipes equinovarus.  Which of the following matches the description of alipes equinovarus?

            a) palmar simian crease

            b) unequal gluteal or leg folds

            c) audible click on flexion and abduction of hips

            d) fixed plantar felxion with medial deviation

 

Answer: d) alipes equinovarus: fixed plantar felxion with medial deviation

 

338)  A newborn you helped deliver has Duchenne-Erb paralysis, where one of the arms is flaccid with elbow extended and hand internally rotated.  What is the cause of Duchenne-Erb paralysis?

            a) genetic mutation

            b) birth trauma

            c) preterm birth

            d) postterm birth

 

Answer: b) Duchenne-Erb paralysis caused by birth trauma

 

339)  You are checking a newborn's genitalia.  You noticed that the uretha opens on the ventral surface rather than the tip of the penis.  What is this called?

            a) chordee

            b) hydrocele

            c) hypospadias

            d) epispadias

 

Answer: c) hypospadias: urethal opening on ventral surface

 

340)  You are examining a newborn's genitalia and checking a list of expected characteristics.  Which of the following is expected for male babies?

            a) may be unable to retract foreskin

            b) testes not palpable

            c) fluid in scrotum

            d) ventral curvature of penis

 

Answer: a) may be unable to retract foreskin is expected

 

341)  You are examining a male newborn for health.  You noticed that he has fluid in the scrotum.  What is the medical name for that abnormality?

            a) hypospadias

            b) epispadias

            c) chordee

            d) hydrocele

 

Answer: d) hydrocele:  fluid in the scrotum

 

342)  You are examining a preterm male infant.  When checking his genitalia, which of the following is expected?

            a) undeveloped scrotum

            b) testes not palpable

            c) ventral curvature of penis

            d) urethral opening on dorsal surface

 

Answer: a) undeveloped scrotum is expected for preterm male babies

 

343)  You are examining the scrotum of a newborn baby.  Which of the following do you not expect?

            a)pendulous

            b)multiple rugae

            c)fluid in scrotum

            d)contains testes

 

Answer: c)fluid in scrotum is not an expected characteristic

 

344)  You are checking the genitals of a preterm female baby.  What would expect from the following?

            a) fused labia, no vaginal opening

            b) ambiguous genitalia

            c) enlarged clitoris with urethral opening at tip

            d) labia majora incompletely developed, clitoris prominent

 

Answer: d) preterm female neonates usually have their labia majora incompletely developed, clitoris prominent

 

345)  You notice that a baby has mucoid vaginal discharge while checking her genitalia.  What is this discharge called?

            a) pseudomenstruation

            b) vaginalition

            c) labianation

            d) ambiurination

 

Answer: a) blood-tinged or mucoid vaginal discharge of neonates: pseudomenstruation

 

346)  Using the Apgar Score, a baby has scored 2.  What category does that fall into?

            a) Normal

            b) Mild Depression

            c) Moderate Depression

            d) Aggressive Resuscitation

 

Answer: d) Aggressive Resuscitation: Scores 0 - 3

 

347)  Using the Apgar Score, a baby has scored 6 after assessing respiratory effort, heart rate, muscle tone, reflex irritability and appearance.  What category does that fall into?

            a) Normal

            b) Mild Depression

            c) Moderate Depression

            d) Aggressive Resuscitation

 

Answer: c) Moderate Depression: Scores 4-6

 

348)  Using the Apgar Score table, a child scored a 2 on color/appearance.  Which of the following descriptions matches the score?

            a) Pale, blue

            b) Pink torso, blue extremities

            c) Pink torso and extremities

            d) Black

 

Answer: b) Pink torso, blue extremities is a 2 on color/appearance according to the Apgar Score

 

349)  Using the Apgar Score table, what would a child score on muscle tone/activity if he has limited movement and some flexion of extremities?

            a) 0

            b) 1

            c) 2

            d) 3

 

Answer: b) 1 on muscle tone/activity  =  limited movement and some flexion of extremities

 

350)  A 3 month-old baby is in the clinic for a checkup.  You are testing the baby's reflexes.  Which of the following reflexes disappears after the fourth month?

            a) Corneal

            b) Extrusion

            c) Gag

            d) Babinski

 

Answer: b) The Extrusion Reflex (when tongue is touched, tongue moves forward out through the lips persists for 4 mo)

 

351)  A 3 week-old baby is in the clinic for a checkup.  You are testing the baby's reflexes.  Which of the following reflexes disappears after the first month?

            a) Moro

            b) Step

            c) Pupillary

            d) Rooting

 

Answer: b) Step – when supported under both arms with feet against firm surface, feet will make stepping movements; persists 3-4 wk

 

352)   A 3 week-old baby is in the clinic for a checkup.  You are testing the baby's reflexes.  Which of the following persists for life?

            a) Moro

            b) Step

            c) Pupillary

            d) Rooting

 

Answer: c) Pupillary – when retina stimulated by light, pupil constricts

 

353)  You are testing the reflexes of a neonate.  One of the reflexes you test is the Babinkski Reflex.  What is the physical response for the Babinkski Reflex?

            a) When stimulating outer sole of foot from heel upward and across ball of foot toward large toe, large toe dorsiflexes and toes flare

            b) When startled (noise, jarring), arms extend and abduct with fingers forming a C while knees and hips flex slightly, arms return to chest in an embracing motion

            c) When touching cheek or lips, head turns toward touch and mouth opens in attempt to suck

            d) When supine with head turned to one side, extremities on same side straighten and extremities on opposite side flex

 

Answer: a) Babinski Reflex: When stimulating outer sole of foot from heel upward and across ball of foot toward large toe, large toe dorsiflexes and toes flare

 

354)  You are testing the reflexes of a neonate.  One of the reflexes you test is the Tonic Neck Reflex.  What is the physical response for the Tonic Neck Reflex?

            a) When stimulating outer sole of foot from heel upward and across ball of foot toward large toe, large toe dorsiflexes and toes flare

            b) When startled (noise, jarring), arms extend and abduct with fingers forming a C while knees and hips flex slightly, arms return to chest in an embracing motion

            c) When touching cheek or lips, head turns toward touch and mouth opens in attempt to suck

            d) When supine with head turned to one side, extremities on same side straighten and extremities on opposite side flex

 

Answer: d) Tonic Neck Reflex: When supine with head turned to one side, extremities on same side straighten and extremities on opposite side flex

 

355)  You are testing the reflexes of a neonate.  One of the reflexes you test is the Rooting Reflex.  What is the physical response for the Rooting Reflex?

            a) When stimulating outer sole of foot from heel upward and across ball of foot toward large toe, large toe dorsiflexes and toes flare

            b) When startled (noise, jarring), arms extend and abduct with fingers forming a C while knees and hips flex slightly, arms return to chest in an embracing motion

            c) When touching cheek or lips, head turns toward touch and mouth opens in attempt to suck

            d) When supine with head turned to one side, extremities on same side straighten and extremities on opposite side flex

 

Answer: c) Rooting Reflex: When touching cheek or lips, head turns toward touch and mouth opens in attempt to suck

 

356)  A mother has just given birth to a new baby.  Before separating them, you give them ID bracelets.  What should be on the ID bracelets?

            a) name, sex, time of birth, blood type, ID number

            b) name, sex, date, time of birth, ID number

            c) ID number, sex, date, time of birth, blood type

            d) ID number, attending doctor, sex, date, time of birth, blood type

 

Answer: b) name, sex, date, time of birth, ID number should be on the matching bracelets

 

357)  Right after the mother has given birth, you have to complete the identification form for the baby.  What is on the form?

            a) newborn handprint, mother's fingerprints, name, date, time of birth

            b) newborn fingerprints, mother's fingerprints, name, date, time of birth

            c) newborn footprint, mother's fingerprints, name, date, time of birth

            d) newborn handprint, mother's handprints, name, date, time of birth

 

Answer: c) newborn footprint, mother's fingerprints, name, date, time of birth should be on form

 

358)  A baby has just been delivered and you immediately clamp the umbilical cord.  How long do you clamp the cord for?

            a) Clamp for 24 hours until cord is dry

            b) Clamp for 48 hours; remove before cord is dry

            c) Clamp for 48 hours until cord is dry

            d) Clamp for 2 weeks (when cord should fall off)

 

Answer a) Clamp umbilical cord for 24 hours until cord is dry

 

359)  You are administering vitamin K to a newborn.  The mother asks you why newborns need vitamin K to be administered externally.  What is your answer?

            a) The baby has not produced vitamin K yet because vitamin K is produced in the GI tract when

bacterial formation occurs after ingesting breast milk or formula, usually by 8th day.

            b) Vitamin K is not produced in the human body and only ingested (eg. bananas).  As the baby is not eating solid food yet, vitamin K must be administered externally.

            c) The baby is producing its own vitamin K, but is not producing enough, therefore you are giving the infant supplements.

            d) The amount of vitamin K the infant receives depends on the breast milk and how much vitamin K the mother has ingested.  Vitamin K is administered externally as a precaution in case the mother does not receive enough vitamins in her daily diet.

 

Answer: a) Vitamin K is administered externally because the baby has not produced vitamin K yet because vitamin K is produced in the GI tract when bacterial formation occurs after ingesting breast milk or formula, usually by 8th day.

 

360)  You are administering vitamin K to an infant and the father asks you what the vitamin K is used for.  Your response is that vitamin K is used to:

            a) promote nerve growth

            b) promote formation of antibodies

            c) promote bone growth

            d) promote normal clotting

 

Answer:d) Vitamin K promotes normal clotting

 

361)  A baby still has her umbilical cord attached.  What special care would the cord need?

            a) No special care is needed – the cord will fall off in 10 – 14 days

            b) Assess cord for bleeding or infection.  Clean cord with soap and water after each diaper change and apply topical antibiotic if ordered.  Place diaper below umbilical cord stump.

            c) Assess cord for bleeding or infection.  Clean cord with soap and water daily apply topical antibiotic if ordered.  Place diaper below umbilical cord stump.

            d) Assess cord for bleeding or infection.  Clean cord with soap and water daily and apply topical antibiotic if ordered.  Place diaper on top of umbilical cord stump.

 

Answer: b) Care for umbilical cord: assess cord for bleeding or infection.  Clean cord with soap and water after each diaper change and apply topical antibiotic if ordered.  Place diaper below umbilical cord stump.

 

362)  You are about to insert an ophthalmic antibiotic in the newborn's eye.  The parent asks you what the antibiotic is for.  What is your response?

            a) It prevents gonorrheal or chalamydial infection of eyes contracted during vaginal birth

            b) It prevents ophthalmia neonatorum contracted during caesarean birth

            c) It prevents eye infection caused by insufficient eye development due to preterm birth

            d) It is a precaution to prevent eye infection caused by contact with improperly sterilized surgical instruments

 

Answer: a) Ophthalmic antibiotic given to newborn to prevent gonorrheal or chalamydial infection of eyes contracted during vaginal birth

 

363)  A newborn has just been circumcised.  The doctor reminds you to monitor the circumcision for swelling, redness and bleeding.  How long should you monitor the baby for?

            a) Every 2 hours for 12 hours, then with each diaper change

            b) Every 2 hours for 24 hours, then with each diaper change

            c) Every 30 minutes for 24 hours, then with each diaper change

            d) Every 30 minutes for 2 hours, then every 2 hours for 24 hours, then with each diaper change

 

Answer: d) Should assess for swelling, redness, bleeding after circumcision every 30 minutes for 2 hours, then every 2 hours for 24 hours, then with each diaper change

 

364)   While changing the diaper of a baby who was circumcised the day before, you noticed some yellowish exudate.  What should you do?

            a)  Immediately inform the doctor

            b) Wipe the exudate away and apply antibiotic cream

            c) Avoid disrupting it as it is part of the healing process

            d) Check for signs of infection, before wiping away the exudate and administering oral antibiotics.

 

Answer: c) Avoid disrupting the yellowish exudate as it is part of the healing process after circumcision

 

365)  A baby is placed in the charge of a junior nurse after circumcision. She asks you if she should apply a diaper to the baby.  Your response is:

            a) avoid applying diapers to the baby for the next three days until the baby has healed

            b) apply diaper as normal

            c) apply diaper tightly to increase pressure

            d) apply diaper loosely to decrease pressure and friction

 

Answer: d) after circumcision, apply diaper loosely to decrease pressure and friction

 

366)  A baby has just been delivered and the doctor hands you the baby.  How should you clean the baby?

            a) Bathe with warm water and mild soap to remove amniotic fluid, blood, vaginal secretions, and skin residue.

            b) Sponge bathe to remove amniotic fluid, blood, vaginal secretions, and skin residue.

            c) Bathe with water (no soap) to remove amniotic fluid, blood, vaginal secretions and skin residue

            d) Sponge bathe to remove blood, vaginal secretions and skin residue, but leave the amniotic fluid until the doctor has examined it.

 

Answer: a) Bathe neonate with warm water and mild soap to remove amniotic fluid, blood, vaginal secretions, and skin residue.

 

367)  You are teaching a new mother how to take care of her new baby.  She asks you how to bathe it.  What is your response?

            a) Tub bathe with mild soap after returning from the hospital

            b) Sponge bathe daily until the cord falls off and circumcision is healed.  Tub bathe afterward.

            c) Sponge bathe daily until baby can sit up by him/herself.

            d) Do not bathe until the cord falls off and circumcision is healed.  Tub bathe afterward.

 

Answer: b) Sponge bathe newborn daily until the cord falls off and circumcision is healed.  Tub bathe afterward.

 

368)  An expectant mother wants to breastfeed and asks you about some of the benefits.  What are the maternal benefits of breastfeeding?

            a) Increases attachment.  Releases oxytocin promoting uterine contraction and involution.  Energy and calories increase weight reduction.  Extends anovultion beyond 4 – 6 weeks.  Convenient and economical.  Decreases risk of breast and ovarian cancer.

            b)Increases attachment.  Releases estrogen promoting uterine contraction and involution.  Energy and calories decrease, causing weight gain.  Reduces anovultion to 4 – 6 weeks.  Convenient and economical.  Decreases risk of breast, gastro-intestinal and ovarian cancer.

            c)Increases attachment.  Releases estrogen promoting uterine contraction and involution.  Energy and calories increase, causing weight loss.  Reduces anovultion to 4 – 6 weeks.  Convenient and economical.  Decreases risk of breast and  gastro-intestinal.

            d)Increases attachment.  Releases estrogen and progesterone promoting uterine contraction and involution.  Energy and calories decrease, causing weight gain.  Reduces anovultion to 4 – 6 weeks.  Decreases risk of breast, gastro-intestinal and ovarian cancer.

 

Answer: a) Maternal benefits of beastfeeding are: increases attachment.  Releases oxytocin promoting uterine contraction and involution.  Energy and calories increase weight reduction.  Extends anovultion beyond 4 – 6 weeks.  Convenient and economical.  Decreases risk of breast and ovarian cancer.

 

369)  An expectant mother is considering breastfeeding.  She wants to know how long her child can be on only breast milk for.  You tell her that:

            a) breast milk, while nutritious should never be given by itself; calcium and vitamin D supplements should be added from the start

            b) breast milk gives optimum nutritional value for first year, but potassium, calcium,  vitamin D and fluoride supplements should be given after first year

            c) breast milk gives optimum nutritional value for first 6 months, but vitamin D and fluoride supplements should be given after 6 months

            d) breast milk gives optimum nutritional value for first 3 months, but potassium, calcium,  vitamin D and fluoride supplements should be given after 3 months

 

Answer: c) breast milk gives optimum nutritional value for first 6 months, but vitamin D and fluoride supplements should be given after 6 months

 

370)  An expectant father is very interested in the benefits of breast milk and asks you how it can benefit his child's immune system.  You tell him:

            a) breast milk provides passive immunity  through carrier A, B, G immunoglobulins, , microphages, leukocytes, lymphocytes

            b) breast milk provides passive immunity via lgE, lgM, and lgA immunoglobulins, macrophages, leukocytes, lymphocytes, neurtrophils

            c) breast milk provides passive immunity via mmunoglobulins, macrophages, microphages, leukocytes, lymphocytes, tetrocytes, miterocytes

            d) breast milk provides passive immunity via carrier A, B, G immunoglobulins, macrophages, microphages, leukocytes, lymphocytes, blastocysts

 

Answer: b) breast milk provides passive immunity via lgE, lgM, and lgA immunoglobulins, macrophages, leukocytes, lymphocytes, neurtrophils

 

371)  An expectant mother who is HIV positive has been warned by her doctor not to breastfeed her baby.  The mother shouldn't breastfeed when she is/has:

            a) HIV positive, active TB, hepatitis, narcotic addiction, breast abnormalities. Chronic disease that interferes with lactation or maternal status. Taking drugs excreted in breast milk that are harmful to infant. Inadequate maternal fluid/nutrition intake

            b) HIV positive, active TB, alcoholic, hepatitis, Huntingdon's disease, narcotic addiction, breast abnormalities from trauma, burns, radiation. Chronic disease that interferes with lactation or maternal status.  Inadequate maternal fluid/nutrition intake

            c) HIV positive, active and passive TB, active and passive hepatitis, infected with encephalitis, narcotic addiction, breast abnormalities from trauma, burns, radiation. Chronic disease that interferes with lactation or maternal status. Taking drugs excreted in breast milk that are harmful to infant.

            d) HIV positive, active TB, narcotic addiction, breast abnormalities from trauma, burns, radiation. Chronic disease that interferes with lactation or maternal status. Taking drugs excreted in breast milk that are harmful to infant. Inadequate maternal fluid/nutrition intake

 

Answer: d) Mothers should not breastfeed when they are/have HIV positive, active TB, narcotic addiction, breast abnormalities from trauma, burns, radiation. Chronic disease that interferes with lactation or maternal status. Taking drugs excreted in breast milk that are harmful to infant. Inadequate maternal fluid/nutrition intake

 

372)  An new mother plans on breastfeeding her child.  You teach her how to care for her breasts.  Other than cleansing her breasts with water daily, what else should she do?

            a)  Wear a supportive brassiere during the day, but take it off at night; wear nursing pads to absorb leaking milk; dry nipples with a dryer several times a day.

            b) Wear a supportive brassiere day and night; wear nursing pads to absorb leaking milk; allow nipples to air-dry several times a day.

            c) Wear a supportive brassiere during the day, but take it off at night; wear nursing pads to absorb leaking milk; allow nipples to air-dry several times a day.

            d)  Wear a supportive brassiere during the day, but take it off at night; wear nursing pads to absorb leaking milk; dry nipples with a cloth or napkins several times a day.

 

Answer: b) Self-breast care includes: Wear a supportive brassiere day and night; wear nursing pads to absorb leaking milk; allow nipples to air-dry several times a day.

 

373)  An expectant mother plans on breastfeeding and asks you when she should start to breastfeed.  When should the mother start breastfeeding?

            a) As soon as possible (preferably in birthing room)

            b) One day after birth

            c) One week after birth (formula milk with vitamin K until baby has started producing vitamin K him/herself)

            d) Two weeks after birth (formula milk with vitamin K until baby has started producing vitamin K him/herself)

 

Answer: a) Breastfeeding should start as soon as possible (preferably in birthing room)

 

374)  A new mother has just started breastfeeding her baby and wants to know how often she should feed the baby.  You tell her that she should:

            a) offer breast every 2-3 hours or on demand

            b) offer breast every 2-3 hours, then alternate with formula milk

            c) offer breast every 4 hours, or on demand; baby will need less milk at night, so every 6 hours is fine

            d) baby needs to be trained to drink at set times, so mother should find a schedule that suits her; as long as baby is fed at least 3 times a day, baby will be healthy

 

Answer: a) The mother should offer breast every 2-3 hours or on demand

 

375)  An infant is about to be discharged (after birth).  What should he be immunized with?

            a) Hepatitis B

            b) Diphthera, Tetanus, Pertussis

            c) Hepatitis A

            d) Inactivated Polio

 

Answer: a) Infant should be immunized against Hepatitis B (1st dose) after birth before discharge

 

376)  A baby is 2 months old.  What should she be immunized against?

            a)  Diphthera, Tetanus, Pertussis; Haemophilus influenzae b conjugate vaccine; Inactivated polio, Pneumococcal; Rotavirus vaccine

            b)Diphthera, Tetanus, Pertussis; Pneumococcal; Rotavirus vaccine; Measles, mumps, rubella; Pneumococcal; Rotavirus vaccine

            c)  Diphthera, Tetanus, Pertussis; Pneumococcal; Rotavirus vaccine

            d) Measles, mumps, rubella; Pneumococcal; Rotavirus vaccine

 

Answer: At 2 months, baby is given vaccines for: a)  Diphthera, Tetanus, Pertussis; Haemophilus influenzae b conjugate vaccine; Inactivated polio, Pneumococcal; Rotavirus vaccine

 

377)  You are going through the US immunization schedule with new parents.  When should a child be immunized against varicella?

            a) dose at 2 and 4mo. IM

            b)1st dose after birth before discharge, 2nd at 4wk after 1st dose, 3rd at ≥24wk. IM

            c)1st dose 12–15 mo, 2nd at 4–6yr. Sub-Q

            d)1st dose at 6mo; yearly ≥59mo. IM

 

Answer: c)Varicella immunization schedule: 1st dose 12–15 mo, 2nd at 4–6yr. Sub-Q

 

378) You are going through the US immunization schedule with new parents.  They are especially concerned about the flu, which has been going around. When should a child be immunized against influenza?

            a) dose at 2 and 4mo. IM

            b)1st dose after birth before discharge, 2nd at 4wk after 1st dose, 3rd at ≥24wk. IM

            c)1st dose 12–15 mo, 2nd at 4–6yr. Sub-Q

            d)1st dose at 6mo; yearly ≥59mo. IM

 

Answer: d)influenza immunization: 1st dose at 6mo; yearly ≥59mo. IM

 

379)  You are going through the US immunization schedule with new parents.  When should a child be immunized against Haemophilus influenzae b?

            a) dose at 2 and 4mo. IM

            b)1st dose after birth before discharge, 2nd at 4wk after 1st dose, 3rd at ≥24wk. IM

            c)1st dose 12–15 mo, 2nd at 4–6yr. Sub-Q

            d)1st dose at 6mo; yearly ≥59mo. IM

 

Answer: a) Haemophilus influenzae b conjugate vaccine should be dosed at 2 and 4mo. IM

 

380)  Parents who have been overseas come back with a four-month old baby.  They are missing some immunizations, specifically the child has not been given the Rotavirus vaccine.  What do you tell the parents:

            a) first dose is given at 4 months, so parents are just in time

            b) first dose should have been given at 2 months old, but an extra dose can be given later on to make up for missed dose

            c) since vaccination does not start until the baby is 12 months old, nothing more needs to be done until then

            d) the vaccine cannot be initiated after the baby is 12 weeks old

 

Answer: d) the Rotavirus vaccine cannot be initiated after the baby is 12 weeks old

 

381)  A child has just finished their childhood Diphtheria, tetanus, pertussis (DtaP) immunizations.  You tell the parents that boosters are still required periodically.  When should boosters be administered after that?

            a) Every year

            b) Every 5 years

            c) Every 10 years

            d) Every 20 years

 

Answer: c) Diphtheria, tetanus, pertussis immunizations should be boosted every 10 years

 

382)  You are administering an immunization to two-year-old toddler.  Which muscle should you apply the needle to?

            a) vastus lateralis or ventrogluteal

            b) vastus lateralis or deltoid

            c) vastus lateralis only

            d) deltoid

 

Answer: d) deltoid may be used for immunizations on those 18 months or over

 

383)  You are measuring the vital signs of a toddler.  The father mentions that his blood pressure is slightly high at 170/120. What is expected blood pressure for a toddler?

            a) 60-80/30-60

            b) 90-100/50-65

            c)  110-140/60-8

            d )110-140/60-90

 

Answer:Blood pressure for toddler should be 90-100/50-65

 

384)  You are measuring the vital signs of an adolescent.  He has been feeling dizzy lately and is worried that it's due to low blood pressure. What is expected for an adolescent?

            a) 60-80/30-60

            b) 90-100/50-65

            c) 110-140/60-80

            d )110-140/60-90

 

Answer: c)Blood pressure for adolescent should be  110-140/60-8

 

385)  You are measuring the vital signs of a newborn. She had low blood pressure in the first few days, and the parents are anxious. What is expected for a newbornt?

            a) 60-80/30-60

            b) 90-100/50-65

            c) 110-140/60-80

            d )110-140/60-90

 

Answer: a)Blood pressure for a newborn should be 60-80/30-60

 

386)  You are measuring the vital signs of a newborn.  He had an irregular heart rate when he was first born, and his parents are worried.  What is the expected heart rate of a newborn?

            a) 50 - 90

            b) 60 - 100

            c) 60 - 110

            d) 80 - 180

 

Answer:d) Newborn's expected heart rate is: 80 - 180

 

387)  You are measuring the vital signs of a school age child.  He had an irregular heart rate when he was first born, and his parents are worried.  What is the expected heart rate of a school age child?

            a) 50 - 90

            b) 60 - 100

            c) 60 - 110

            d) 80 - 180

 

Answer: c) School age child's expected heart rate is: 60 - 110

 

388))  You are measuring the vital signs of an adult.  She has been under a lot of stress lately and is worried that she is not exercising enough..  What is the expected heart rate of an adult?

            a) 50 - 90

            b) 60 - 100

            c) 60 - 110

            d) 80 - 180

 

Answer: b) Adult's expected heart rate is:  60 - 100

 

389) An adult comes into the clinic and you measure her respirations.  She wants to know what the normal range for adults is as she is going to start a marathon soon and wants to keep track of her respirations.  What is the expected number of respirations for adults?

            a) 12-20

            b) 16-20

            c) 18-26

            d) 24-32

 

Answer: a) Adults are expected to respirate 12-20 times

 

390)  An toddler comes into the clinic and you measure her respirations.  The father wants to know what the normal range for toddlers is as she is going to start a father-daughter marathon soon and he wants to keep track of her respirations.  What is the expected number of respirations for toddlers?

            a) 12-20

            b) 16-20

            c) 18-26

            d) 24-32

 

Answer: d) Toddlers are expected to respirate 24-32 times

 

391) An adolescent comes into the clinic and you measure her respirations.  She wants to know what the normal range for adolescents is as she is going to start swimming wants to keep track of her respirations.  What is the expected number of respirations for adolescents?

            a) 12-20

            b) 16-20

            c) 18-26

            d) 24-32

 

Answer: b) Adolescents are expected to respirate 16-20 times

 

392)  A mother has started breastfeeding her baby and wants to know if she should breastfeed using only one breast, or both.  You tell her that she should:

            a)  alternate starting breast; use one breast for one feeding, and the alternate breast for the next one in order to not dry out the breasts

            b) use the same starting breast so child is familiarized with procedure; use one breast for one feeding, and the alternate breast for the next one in order to not dry out the breasts

            c) use the same starting breast so child is familiarized with procedure; both breasts should be used at each feeding to increase milk production.

            d) alternate starting breast and use both breasts at each feeding to increase milk production

 

Answer: d) When breastfeeding, mothers should alternate starting breast and use both breasts at each feeding to increase milk production

 

393) A father is arguing with his wife over how lay their child down after breastfeeding.  He believes infant should be down on his back, whereas the mother believes the child should be placed on his stomach.  How should infant be placed down after feeding.

            a) Infant should be placed on back with back roll and pillow

            b) Infant should be placed on stomach with back roll and pillow

            c) Infant should be placed on side with back roll or supine

            d) Infant should be placed on stomach on surface cleared of obstacles

 

Answer: c) Infant should be placed on side with back roll or supine after feeding

 

394) A mother is feeding her infant and would like to know if the infant's burping is normal.  She asks you for advice about burping the child.  The infant should be burped:

            a) before feeding

            b) during feeding

            c) during and after feeding

            d) after feeding

 

Answer: c) Infant should be burped during and after feeding

 

395)  A new mother tells you that she is going to be away from her baby for a few days.  The father will be taking care of the baby, but she wants to know if the breast milk can be stored.  You inform her that:

            a) breast milk cannot be stored

            b) breast milk can be refrigerated for 72 hours, then must be discarded

            c) breast milk can be refrigerated for 24 hours or frozen for six months or less

            d) breast milk can be refrigerated for 72 hours or frozen for six months or less

 

Answer: d) breast milk can be refrigerated for 72 hours or frozen for six months or less

 

396)  A breastfeeding mother has swollen, hard, hot, tender and dry breasts four days postpartum.  What is this called?

            a) breast engorgement

            b) lactosis engorgio

            c) inverted nipples

            d) materna irratatio

 

Answer: a) breast engorgement is when breasts are  swollen, hard, hot, tender and dry

 

397) A new mother has engorged breasts that are swollen, hard, hot and tender.  What can she do to ameliorate the symptoms?

            a) stop breastfeeding

            b) breastfeed every two hours and empty breasts entirely by pumping; apply ice between feedings 15 min on and 45 off

            c) breastfeed every two hours, by stop when breasts are halfway empty; apply warm packs between feedings 15 min on and 45 off

            d) stop breastfeeding; apply warm packs between feedings 15 min on and 45 off

 

Answer: b) Care for breast engorgement: breastfeed every two hours and empty breasts entirely by pumping; apply ice between feedings 15 min on and 45 off

 

398)  A new mother's breasts are engorged.  She wants to know the cause of the breast engorgement and asks if it is due to the fact that she is breastfeeding.  Breast engorgement is due to:

            a) an infection

            b) vascular congestion before secreting milk

            c) the baby is sucking too hard

            d) a side effect of the antibiotics administered after labor

 

Answer: b) breast engorgement is due to vascular congestion before secreting milk

 

399)  A breastfeeding patient has inverted nipples.  You advise her on ways to draw the nipple out.  Which of the follow shouldn't the patient do?

            a) wear breast shield to draw nipple out

            b) use electric breast pump before attempting latching-on

            c) apply ice and tug and roll nipple with hands before feeding

            d) breast massage and warm compress before feeding

 

Answer: d) breast massage and warm compress before feeding does not help with inverted nipples

 

400) A new mother is going to formula feed her child. You teach her how to prepare the formula and inform her that formula should be prepared:

            a) every feeding

            b) once every half-a-day

            c) once a day

            d) once every week

 

Answer: c) baby formula should be prepared once a day

 

 

401) You are weighing an infant.  His weight has doubled since the last time you weighed him.  How much weight do you expect him to gain in his first year?

            a) weight doubles

            b) weight triples

            c) weight quadruples

            d) weight quintuples

 

Answer:  b) Infant weight triples and chest approaches head circumference

 

402) A father is concerned that his five-month old daughter is not sitting yet.  When should a baby start sitting?

            a) By 4 months

            b) By 5 months

            c) By 6 months

            d) By 7 months

 

Answer:  d) Babies should be sitting by 7 months

 

403) A grandfather is concerned that his five-month old granddaughter is not crawling yet.  When should a baby start crawling?

            a) By 5 months

            b) By 7 months

            c) By 9 months

            d) By 11 months

 

Answer:  c) Babies should be crawling 9 months

 

404)  A grandfather is concerned that his five-month old granddaughter is not crawling yet.  When should a baby start crawling?

            a) By 5 months

            b) By 7 months

            c) By 9 months

            d) By 11 months

 

Answer:  c) Babies should be crawling 9 months

           

405) A baby started walking holding on to rails when he is ten-months old.  His mother wants to know if this is normal.  When should babies start walking by?

            a) 7 months

            b) 9 months

            c) 11 months

            d) 13 months

 

Answer: c) 11 months

 

406)   A mother comes in and is concerned because her baby can turn from abdomen to back, but cannot turn back to her abdomen.  You inform the mother that this is:

            a) normal; babies turn from abdomen to back by 5 months and back to abdomen by 6 months

            b) normal; babies turn from abdomen to back by 3 months and back to abdomen by 6 months

            c) abnormal; babies should be able to turn both ways at the same time

            d) abnormal; babies should turn from back to abdomen before abdomen to back

 

Answer: a) normal; babies turn from abdomen to back by 5 months and back to abdomen by 6 months

 

407) A father is very concerned because his baby has not laughed.  He is worried that he is doing something improperly.  When should babies laugh by?

            a) at birth

            b) 2 months

            c) 4 months

            d) 6 months

 

Answer: c) Babies should laugh by 4 months

 

408) A mother is concerned because her baby is crying often when she leaves it alone.  She mentions that this did not happen when the baby was a newborn.  When does “separation anxiety” begin?

            a) 1 – 2 months

            b) 2-6 months

            c) 4 – 8 months

            d) 10 – 12 months

 

Answer: c) Separation anxiety begins by 4 – 8 months

 

409) A grandparent is concerned that her newborn granddaughter is equally happy with family and strangers.  She fears that the baby will not have a healthy fear of strangers.  You reassure her that fear of strangers develops with time.  When does fear of strangers develop? 

            a) 4 months

            b) 6 – 8 months

            c) 10 – 12 months

            d) 2 years old

 

Answer: b) 6 – 8 months is when babies start fearing strangers

 

410) You are explaining the cognitive development of infants to a class of students.  You explain that object permanence develops at 9 – 10 months.  What is object permanence?  

            a) realization of the difference between real objects versus visual representations of ones (ie. Person and photo of person)

            b) understanding of death and mortality

            c) recognition of parents

            d) realization that objects moved out of sight still exist

 

Answer: d) object permanence: realization that objects moved out of sight still exist

 

 

411)  You are explaining the cognitive development of infants to a group of parents.  You explain that many reflexes are replaced by voluntary activity during infanthood.  What is this phase called?  

            a) sensorimotor phase

            b) locomotor phase

            c) voluntarimotor phase

            d) voluntariloco phase

 

Answer: a) sensorimotor phase:   reflexes are replaced by voluntary activity

 

412) A parent comes in and tells you that she is trying to teach her two-week old daughter how rattles make sound when shaken.  You explain that the understanding of cause/effect takes time to develop.  When do babies start to understand cause/effect?

            a) By 1 – 4 months

            b) By 3 – 6 months

            c) By 7 months

            d) By 9 months

 

Answer:a) By 1 – 4 months, babies begin to understand cause/effect

 

413)  A parent comes in, worried that his son has not started to speak yet.  The son is one year old.  When should a child's first word be?

            a) 6 months

            b) 10 months

            c) 1 year old

            d) 15 months

 

Answer: b) Baby should say 1 word by 10 months

 

414) A mother comes in worried that her daughter has not started babbling, even though she is six months old.  She remembers her first child babbling at a younger age.  When should babies start babbling by? 

            a) 3 months

            b) 5 months

            c) 7 months

            d) 9 months

 

Answer: a) Babies babble by 3 months

 

415) You are helping select toys for the hospital's infant room.  What kind of toys should you look for?

            a) Large enough to prevent aspiration; should be simple secondary to short attention span; black/white or bright mobiles; stuffed animals, rattles, teething rings, push-pull toys, blocks, books with textures

            b) Large enough to prevent aspiration; should be simple secondary to short attention span; mobiles in pastel colors; stuffed animals, plastic blocks, books in light pastels

            c) Small enough to fit in mouth; should be simple secondary to short attention span; black/white mobiles; black/white stuffed animals, rattles, teething rings, push-pull toys, blocks, books with textures

            d) Small enough to fit in mouth; should be simple secondary to short attention span; pastel mobiles; pastel stuffed animals, rattles with lead paint, teething rings, push-pull toys, blocks, books with textures

 

Answer: a) Toys for infants: large enough to prevent aspiration; should be simple secondary to short attention span; black/white or bright mobiles; stuffed animals, rattles, teething rings, push-pull toys, blocks, books with textures

 

416)  A parent comes in worried that her baby is playing along rather than with own children.  You explain that solitary play is normal for infants.  What does solitary play involve?

            a) Involves own body and caregiver's body; becomes more interactive and shows toy preferences by 8 months; involve sensorimotor skills 6-12 months

            b) Involves own body and caregiver's body; becomes more interactive and shows toy preferences by 3-6 months; involve sensorimotor skills 6-12 months

            c) Involves own body; becomes more interactive and shows toy and color preferences by 8 months; involve sensorimotor skills and music by 6-12 months

            d) Involves own body; becomes more interactive and shows toy preferences by 3-6 months; involve sensorimotor skills 6-12 months

 

Answer: d) Infant play involves own body; becomes more interactive and shows toy preferences by 3-6 months; involve sensorimotor skills 6-12 months

 

417)  You are visiting a household that has just had a baby.  You inspect their car and give them advice on how to prevent motor vehicle injuries.  What is your advice for infants?

            a) Use rear-facing car seat with 5-point harness; do not leave in car unattended

            b) Use front-facing car seat with 5-point harness; do not leave in car unattended

            c)  Use rear-facing car seat with 4-point harness; do not leave in car unattended for more than 15 minutes

            d) Use front-facing car seat with 4-point harness; do not leave in car unattended

 

Answer: a) Use rear-facing car seat with 5-point harness; do not leave in car unattended

 

418)  You are visiting a household that has just had a baby.  You look around and pointed out areas that can be improved to prevent injuries.  Specifically, what should the parents do to prevent poisoning?

            a) Store agents in locked cabinet, avoid secondhand smoke or drugs; keep poison control center number by telephone; use natural cleaning agents (eg. vinegar, baking soda) rather than toxic ones

            b) Store agents in low and locked cabinet, avoid secondhand smoke; use natural cleaning agents (eg. vinegar, baking soda) rather than toxic ones

            c) Store agents in high/locked cabinet, avoid secondhand smoke; keep poison control center number by telephone

            d) Store agents in locked cabinet keep poison control center number by telephone; use natural cleaning agents (eg. vinegar, baking soda) rather than toxic ones

 

Answer: c) Injury Prevention (Poisoning) - store agents in high/locked cabinet, avoid secondhand smoke; keep poison control center number by telephone

 

419)  You are coaching the parents of a newborn baby about burns prevention.  Which of the following should  they not do?

            a) set water heater at 120 degrees F

            b) use sink for baths

            c) put inserts in electric outlets and smoke/heat detectors throughout house

            d) avoid exposure to sun

 

Answer: b) Parents should NOT use sink for infant baths

 

420) You are coaching the parents of a newborn baby about falls prevention.  Which of the following is not recommended?

            a) place gates at top/bottom of stairs

            b) use restraints with infant seat, high chair, walker, or swing

            c) supervise when on raised surface

            d) Carpet or put rugs on all potentially slippery flooring

 

Answer: d) Carpet or put rugs on all potentially slippery flooring

 

421) A mother whose infant is hospitalised is concerned about the physical and emotional pain her baby is undergoing.  You explain that infants are only emotionally traumatized by intrusive procedures after a certain age.  At what are infants emotionally traumatized by intrusive procedures? 

            a) After 3 months old

            b) After 6 months old

            c) After 9 months old

            d) After one year old

 

Answer: b) After 6 months old, infants are emotionally traumatized by intrusive procedures

 

422) An infant (3 months old) has to undergo a painful procedure.  What should you do? 

            a) Meet needs immediately to increase trust.  Provide nipple dipped in sucrose solution during painful procedure, give ordered meds.

            b) As infant is not emotionally traumatized by intrusive procedures, ignore signs of distress and focus on practical matters.

            c) Meet needs immediately, give ordered meds, provide consistent caregiver, massage, distraction

            d) Use distraction, thermotherapy, massage and meds as ordered.  Support therapeutic play with dolls and medical equipment.

 

Answer: a) When infants under six months undergo painful procedure, meet needs immediately to increase trust.  Provide nipple dipped in sucrose solution during painful procedure, give ordered meds.

 

423)  You are explaining toilet training regimens to new parents.  A father asks when should they expect their child to be toilet-trained.  You explain that daytime and night control varies.  When is a child expected to gain daytime bowel/bladder control by? 

            a) 6 months

            b) 1 year

            c) 2 years

            d) 3 years

 

Answer: c) Child expected to gain daytime bowel/bladder control by 2 years old

 

424)  You are explaining toilet training regimens to new parents.  A father asks when should they expect their child to be toilet-trained.  You explain that daytime and night control varies.  When is a child expected to gain night bowel/bladder control by? 

            a) 6 months – 1 year

            b) 1- 2 years

            c) 2 – 3 yearss

            d) 3 - 4 years

 

Answer: d) Child is expected to gain night control by 3 - 4 years

 

 

425)  You are monitoring the growth of a toddler.  Which of the following conditions is expected?

            a) Physiological anorexia

            b) Anorexia bulimia

            c) Menarche

            d) Obstipation

 

Answer: a) Physiological anorexia (decreased in appetite) is expected for toddlers

 

426) A child is teething.  The parents are uncertain about how many teeth are expected since they themselves have different counts of teeth due to past oral procedures.  How many teeth are expected of toddlers?

            a) 16

            b) 20

            c) 24

            d) 26

 

Answer: b) Toddlers are expected to have 20 teeth

 

427) A father comes into the office and mentions that his toddler is walking.  He wants to know when the toddler will start running so they can enter the father-son marathon together.  When do children start running by?

            a) 14 months

            b) 18 months

            c) 20 months

            d) 22 months

 

Answer: b) Toddlers can run by 18 months

 

428) A grandmother comes in and tells you that she wants to make clothes for her newborn grandchild.  She wants to know how big the baby will be when he is 2.5 years old.  How much will his weight have increased by compared to his  birth weight?

            a) 2 times

            b) 4 times

            c) 6 times

            d) 8 times

 

Answer:  b) Weight increases by 4 times

 

429)  You are giving a lecture on the physical changes toddlers undergo.  Which of the following is not true?

            a) increased growth rate

            b) increased appetite

            c) decreased naps

            d) increased taste preferences

 

Answer: a) increased growth rate is not true; growth decreases

 

430)   You are giving a lecture on stages of developments, and talk about Freud's theory.  In regards to toddlers, what stage of development are they in?

            a) oral

            b) latency

            c)  phallic

            d) anal

 

Answer: d) anal stage of development - toddler

 

431)  You are coaching a mother who is about to adopt a toddler.  You spend some time talking about the psychosocial changes toddlers experience compared to newborns.  Which of the following shouldn't the mother expect?

            a) notes sex role differences and explores own body

            b) may have security object

            c) may fear sleep, engines, animals

            d) may have imaginary friend

 

Answer: d) may have imaginary friend is not expected of toddlers; part of preschool age

 

432)  A patient is concerned because her toddler is showing signs of sibling rivalry with the newborn.  She asks you for advice on how to ameliorate that.  You suggest:

            a) supervise interaction, give individual attention, include in newborn care, provide doll for imitative play

            b)  leave the two alone to bond, give individual attention, avoid toddler seeing you caring for newborn, buy additional toys for toddler

            c)  leave the two alone to bond, give individual attention, avoid toddler seeing you caring for newborn, explain that newborn does not replace toddler

            d) supervise interaction, give individual attention, avoid toddler seeing you caring for newborn, explain that newborn does not replace toddler

 

Answer: a) How to address sibling rivalry: supervise interaction, give individual attention, include in newborn care, provide doll for imitative play

 

433)  You are explaining cognitive changes in toddlers to a group of parents.  Which of the following cognitive changes do not happen in toddlerhood?

            a) Increased sense of time

            b) Increased concept of ownership (“mine”)

            c) Beginning of memory

            d) Understanding of morality, right/wrong

 

Answer: d) Understanding of morality, right/wrong happens in preschool age, not toddler

 

434)  You are helping with a study on language acquisition and monitoring a sample group of toddlers.  What is the expected language acquisition of toddlres?

            a) 10 words by 15 month, more than 100 words by 18 month and more than 1000 words by 2 years old; sentences by 2 years old

            b) 50 words by 15 month, more than 1000 words by 18 month; sentences by 18 months

            c) 4 – 6 words by 15 month, more than 10 words by 18 month and more than 100 words by 2 years old;  simple sentences by 2 years old

            d) 4 – 6 words by 15 month, more than 10 words by 18 month and more than 300 words by 2 years old; sentences by 2 years old

 

Answer: d) toddler speech patterns: 4 – 6 words by 15 month, more than 10 words by 18 month and more than 300 words by 2 years old; sentences by 2 years old

 

435) You are observing toddlers in the hospital's daycare.  What kind of play do expect them to do? 

            a) individual play

            b) associative play

            c) parallel play

            d) rule-oriented play

 

Answer: c) parallel play (playing along, but not with) is expected of toddlers

 

436)  You are making a house visit by request and giving advice to parents on injury prevention.  Which of the following should be followed to prevent motor vehicle injuries?

            a) Use rear-facing seat at <15lb and forward-facing seat at 15-30lb.  Special restraints used until 40lb or 5 years old

            b) Use rear-facing seat at <20lb and forward-facing seat at 20-40lb.  Special restraints used until 60lb or 8 years old

            c)Use forward-facing seat at <15lb and rear-facing seat at 15-30lb.  Special restraints used until 40lb or 5 years old

            d)Use forward-facing seat at <20lb and rear-facing seat at 20-40lb.  Special restraints used until 60lb or 6 years old

 

Answer: b) Use rear-facing seat at <20lb and forward-facing seat at 20-40lb.  Special restraints used until 60lb or 8 years old

 

437)   You are making a house visit by request and giving advice to parents on injury prevention.  Which of the following should not be followed to prevent drowning?

            a) supervise when in/near water

            b) no swimming until over the age of 3 or more than 40lb

            c) fence/cover pool/hot tub

            d) know CPR

 

Answer: b) no swimming until over the age of 3 or more than 40lb does not prevent drowning incidents in toddlers

 

438)  You are making a house visit by request and giving advice to parents on injury prevention.  Which of the following should not be followed to prevent suffocation/aspiration?

            a) avoid foods that may occlude airways

            b) avoid toy boxes with heavy hinged lids, clothing with drawstrings, and appliances that cannot be opened inside

            c) avoid polyester sheets; use breathable fabrics instead

            d) keep garage door openers inaccessible

 

Answer: c) avoid polyester sheets; use breathable fabrics instead is not part of the suffocation/aspiration injury prevention advice

 

439) A toddler is being admitted to the hospital and you coach the patient and parents about the stages of separation anxiety.  Which of the following is expected during the protest stage?

            a) flat affect, unresponsive to stimuli, altered sleep, decreased appetite

            b) inconsolable crying and rejects others

            c) lack of preference for parents, friendly to all

            d) acceptance, social, keen to make friends

 

Answer: b) protest stage of separation anxiety: inconsolable crying and rejects others

 

440)  A toddler is being admitted to the hospital and you coach the patient and parents about the stages of separation anxiety.  Which of the following is expected during the despair stage?

            a) flat affect, unresponsive to stimuli, altered sleep, decreased appetite

            b) inconsolable crying and rejects others

            c) lack of preference for parents, friendly to all

            d) acceptance, social, keen to make friends

 

Answer:a) despair stage: flat affect, unresponsive to stimuli, altered sleep, decreased appetite

 

441)  A toddler is being admitted to the hospital and you coach the patient and parents about the stages of separation anxiety.  Which of the following is expected during the detachment/denial stage?

            a) flat affect, unresponsive to stimuli, altered sleep, decreased appetite

            b) inconsolable crying and rejects others

            c) lack of preference for parents, friendly to all

            d) acceptance, social, keen to make friends

 

Answer:c) detachment/denial stage:lack of preference for parents, friendly to all

 

442)  A four-year old comes in for his annual check up.  His father father is concerned because the patient had gained 15 pounds in the last year.  What is the normal annual weight gain for preschoolers?

            a) 5 lb/yr

            b) 10 lb/yr

            c) 15 lb/yr

            d) 20 lb/yr

 

Answer: a) average weight increase for preschoolers: 5 lb/yr

 

443)  A four-year old comes in for his annual check up.  His father father is concerned because the patient had not gained any height in the last year.  What is the normal increase in height for preschoolers?

            a) 0-1 in/yr

            b) 1-2 in/yr

            c) 2-2.5 in/yr

            d) 2.5-3 in/yr

 

Answer: d) average height increase for preschoolers: 2.5-3 in/yr

 

444)  You are tracking the growth of a five-year old patient.  Which of the following would you not expect?

            a) that she dresses and washes herself

            b) that she skips, hops, jumps rope, skates, holds pencil and utensils with fingers

            c) that she has started to get her permanent teeth

            d) that her immune responses have increased from toddlerhood

 

Answer: c) that she has started to get her permanent teeth does not occur during the preschool stage

 

445) A parent is quite concerned about the speech development of their preschooler.  You lay out key milestones for them.  Which of the following milestones do not occur during the preschool stage?

            a) asks the meaning of new words

            b) stuttering and stammering common

            c) talks incessantly

            d) uses all parts of speech

 

Answer: c) talks incessantly is not necessarily true; part of toddler stage rather than preschool

 

446)  You are giving a workshop on the cognitive changes of preschoolers to educators.  You explain that depending on the stage of development, some concepts would be too difficult for them.  Which of the following would be too difficult for preschoolers?

            a) intuitive thought by 4-5 yr

            b) curious about immediate world

            c) understands past, present, future

            d) grasps concepts of conservation

 

Answer: d) grasps concepts of conservation applies to school-age children

 

447)  A parent comes in frustrated that her two-year-old cannot answer when she asks the child what he wants to do in the future.  You explain that the child is cognitively unable to grasp her question.  What conceptual understanding is he lacking that makes him unable to think about career choices?

            a) understanding of past, present, future

            b) concepts of conservation

            c) concrete operations

            d) inductive reasoning

 

Answer: a) understanding of past, present, future is a preschool age cognitive development

 

448)  Parents come in concerned that their 9-year old son has not underwent puberty yet.  They remember their daughter undergoing puberty sooner.  What is your response?

            a) Puberty begins earlier in females (10 yr) than males (12 yr)

            b) Puberty begins earlier in females (8 yr) than males (10 yr)

            c) Puberty begins at the same time for females and males (10 yr) but varies depending on individuals

            d) Puberty begins earlier for males (10 yr) than females (12 yr)

 

Answer: a) Puberty begins earlier in females (10 yr) than males (12 yr)

 

449)  You are measuring the height of an 8-year-old and noted that her height increased 3 inches from last year.  What is the average height increase for school-age children?

            a) 1 in/yr

            b) 2 in/yr

            c) 3 in/yr

            d) 4 in/yr

 

Answer: b) 2 in/yr is average height increase for school age students

 

450)   You are measuring the weight of an 8-year-old and noted that her weight increased 3 pounds from last year.  You have to flag peculiarities to the doctor.  What is the average weight increase for school-age children?

            a) 1-3 lb/yr

            b) 2.5-4.5 lb/yr

            c) 3-5 lb/yr

            d) 4.5-6.5 lb/yr

 

Answer: d) 4.5-6.5 lb/yr is average weight increase for school age students

 

451)  You are visiting a school and explaining about puberty a class of adolescent boys.  Which of the following is not part of the physical changes of male puberty?

            a) enlargement of scrotum, testes, and penis

            b) pubic, axillary, facial, and body hair

            c) nocturnal emissions and mature spermatoza

            d) bone precedes muscular development

 

Answer: d) bone precedes muscular development is not part of male puberty

 

452)  A student visits the school nurse and asks about sexually transmitted infections (STIs).  What should the nurse do to prevent STIs?

            a) Teach sex education and STI prevention (abstinence or decrease number of partners, use of condoms).  Role-play resisting peer pressure

            b) Teach sex education and promote abstinence as both the best contraception and STI prevention.  Examine case studies of teenage pregnancy and/or teens with STIs

            c) Give student pamphlets on sex education and inform school/parents of inquiries

            d) Phone home and inform parents on student's inquiry.

 

Answer: a) Teach sex education and STI prevention (abstinence or decrease number of partners, use of condoms).  Role-play resisting peer pressure

 

453) A patient comes into the clinic complaining about constipation.  What is the medical definition of constipation? 

            a)  ≥7 days without bowel movement; painful, blood-streaked bowel movements; stool retention without soiling; stomach pain

            b) ≥3 days without bowel movement; painful, blood-streaked bowel movements; stool retention with or without soiling; long intervals between bowel movements

            c) ≥5 days without bowel movement; may be painful; blood-streaked bowel movements, or streaked with green; stool retention without soiling

            d)  ≥5 days without bowel movement; painless, blood-streaked bowel movements; stool retention with or without soiling; gastrointestinal pain

 

Answer: constipation - b) ≥3 days without bowel movement; painful, blood-streaked bowel movements; stool retention with or without soiling; long intervals between bowel movements

 

454)  You are writing down the symptoms of a patient who is complaining about constipation.  What are the signs and symptoms of constipation?

            a) Distended abdomen, rectal fullness, straining at stool, blood or green-streaked bowel movements, increased bowel sounds

            b) Distended abdomen, rectal flatness, straining at stool, blood-streaked bowel movements, increased bowel sounds

            c) Distended abdomen, rectal fullness, straining at stool, blood-streaked bowel movements, decreased bowel sounds

            d) Flat abdomen, rectal fullness, straining at stool, increased bowel movements, decreased bowel sounds

 

Answer: c) Signs and symptoms of constipation: Distended abdomen, rectal fullness, straining at stool, blood-streaked bowel movements, decreased bowel sounds

 

455) A patient has impaction and the doctor remarks that there are a few different treatments.  Which of the following is contraindicated? 

            a) oral mineral oil

            b) enemas

            c)  suppositories

            d) rectal stimulation with cotton-tipped applicator

 

Answer: d) rectal stimulation with cotton-tipped applicator (or thermometer) is contraindicated because of pain and anal fissures

 

456)  A patient comes into the clinic complaining of constipation.  Which of the following shouldn't be assessed?

            a) age at onset

            b) bowel habits

            c) stools for frequency, amount, color, and consistency

            d) weight

 

Answer: d) weight is not assessed for constipation

 

457)  A patient has just recovered from constipation.  What should the nurse teach the patient to prevent future occurrences?

            a)  Dietary restriction and bowel training (sit on toilet same time daily for at least 10min, best in AM or PM after a meal)

            b) Dietary modifications (fiber—whole-grain cereals, bran, vegetables, legumes, raw fruit, dried prunes) and bowel training (sit on toilet same time daily for at least 10min, best in AM or PM after a meal)

            c) Take complete course of antibiotics; void routinely and on urge; owel training (sit on toilet same time daily for at least 10min, best in AM or PM after a meal)

            d) Dietary modifications (fiber—whole-grain cereals, bran, vegetables, legumes, raw fruit, dried prunes); teach to void after sexual activity

 

Answer: b) After constipation, teach dietary modifications (fiber—whole-grain cereals, bran, vegetables, legumes, raw fruit, dried prunes) and bowel training (sit on toilet same time daily for at least 10min, best in AM or PM after a meal)

 

458)  A patient comes into the clinic complaining of nausea and vomiting.  Which of the following is not a complication caused by nausea and vomiting?

            a) dehydration

            b) malnutrition

            c) electrolyte imbalances

            d) metabolic alkalosis

 

Answer: b) malnutrition is not a listed complication caused by vomiting and nausea

 

459)  A patient comes in feeling nauseous and complaining of vomiting.  What other common signs and symptoms accompany nausea?

            a) salivation, pallor, diaphoresis, increased pulse, visible peristaltic waves with projectile vomiting

            b) salivation, pallor, fever, constipation, decreased pulse, visible peristaltic waves with projectile vomiting

            c) salivation, pallor, stomach pain, constipation, decreased pulse, visible peristaltic waves with projectile vomiting

            d) salivation, pallor, stomach pain, increased pulse, visible peristaltic waves with projectile vomiting

 

Answer: a) common signs and symptoms of nausea and vomiting: salivation, pallor, diaphoresis, increased pulse, visible peristaltic waves with projectile vomiting

 

460)  A patient comes in with fever and diarrhea along with vomiting.  What are those symptoms of?

            a) infection

            b) GI obstruction

            c) intracranial pressure, metabolic disorder

            d) appedicitis, pancreatitis, or peptic ulcer disease

 

Answer: a) fever and diarrhea along with vomiting : infection

 

461)  A patient comes in with constipation and vomiting  What are those symptoms of?

            a) infection

            b) GI obstruction

            c) intracranial pressure, metabolic disorder

            d) appedicitis, pancreatitis, or peptic ulcer disease

 

Answer: b) constipation & vomiting: GI obstruction

 

 

462)  A patient comes into the medical clinic after vomiting.  Upon questioning, he also complained of localized abdomen pain. What are those symptoms of?

            a) infection

            b) GI obstruction

            c) intracranial pressure, metabolic disorder

            d) appedicitis, pancreatitis, or peptic ulcer disease

 

Answer: d) localized abdomen pain & vomiting: appedicitis, pancreatitis, or peptic ulcer disease

 

463)  A patient has just vomited.  You noticed that she vomited curdled vomitus with mucus.  What is this usually a symptom of?

            a) decreased gastric emptying or high intestinal obstruction

            b) hypertrophic pyloric stenosis

            c) increased intracranial pressure

            d) metabolic disorder

 

Answer: a) curdled vomitus with mucus is symptom of: decreased gastric emptying or high intestinal obstruction

 

464) A patient has been vomiting for the last few hours.  What should you not do?

            a) provide hygiene after vomiting

            b) reintroduce fluids/foods slowly

            c) prevent aspiration

            d) monitor urinary functioning, I&O

 

Answer: d) monitor urinary functioning, I&O is not required for vomiting

 

465)  A patient has been having diarrhea; the doctor is worried that complications will ensue due to the duration the patient has had diarrhea for.  Which of the following is not a complication of diarrhea?

            a) metabolic acidosis

            b) malnutrition

            c) eversion of bladder

            d) dehydration

 

 

Answer: c) eversion of bladder is not a complication of diarrhea