Maternal And Child Health Nursing NCLEX Quiz 20

1. Which of the following would be most appropriate for a nurse to use when describing menarche to a 13-year-old?

A female’s first menstruation or menstrual “periods.”

The first year of menstruation or “period.”

The entire menstrual cycle or from one “period” to another

The onset of uterine maturation or peak growth

Menarche refers to the onset of the first menstruation or menstrual period and refers only to the first cycle. Uterine growth and broadening of the pelvic girdle occur before menarche.

Explanation

Menarche refers to the onset of the first menstruation or menstrual period and refers only to the first cycle. Uterine growth and broadening of the pelvic girdle occur before menarche.

2. Which of the following suggestions should the nurse offer the parents of a 4-year-old boy who resists going to bed at night?

“Allow him to fall asleep in your room. then move him to his own bed.”

“Tell him that you will lock him in his room if he gets out of bed one more time.”

“Encourage active play at bedtime to tire him out so he will fall asleep faster.”

“Read him a story and allow him to play quietly in his bed until he falls asleep.”

Preschoolers commonly have fears of the dark. being left alone especially at bedtime. and ghosts. which may affect the child’s going to bed at night. Quiet play and time with parents is a positive bedtime routine that provides security and also readies the child for sleep.Option A: The child should sleep in his own bed.Option B: Telling the child about locking him in his room will viewed by the child as a threat. Additionally. a locked door is frightening and potentially hazardous.Option C: Vigorous activity at bedtime stirs up the child and makes more difficult to fall asleep.

Explanation

Preschoolers commonly have fears of the dark. being left alone especially at bedtime. and ghosts. which may affect the child’s going to bed at night. Quiet play and time with parents is a positive bedtime routine that provides security and also readies the child for sleep.Option A: The child should sleep in his own bed.Option B: Telling the child about locking him in his room will viewed by the child as a threat. Additionally. a locked door is frightening and potentially hazardous.Option C: Vigorous activity at bedtime stirs up the child and makes more difficult to fall asleep.

3. The adolescent's inability to develop a sense of who he is and what he can become results in the sense of which of the following?

Shame

Guilt

Inferiority

Role diffusion

According to Erikson. role diffusion develops when the adolescent does not develop a sense of identity and a sense or where he fits in.Option A: Toddlers develop a sense of shame when they do not achieve autonomy.Option B: Preschoolers develop a sense of guilt when they do not develop a sense of initiative.Option C: School-age children develop a sense of inferiority when they do not develop a sense of industry.

Explanation

According to Erikson. role diffusion develops when the adolescent does not develop a sense of identity and a sense or where he fits in.Option A: Toddlers develop a sense of shame when they do not achieve autonomy.Option B: Preschoolers develop a sense of guilt when they do not develop a sense of initiative.Option C: School-age children develop a sense of inferiority when they do not develop a sense of industry.

4. Which of the following skills is the most significant one learned during the school age period?

Collecting

Ordering

Reading

Sorting

The most significant skill learned during the school-age period is reading. During this time the child develops formal adult articulation patterns and learns that words can be arranged in structure.Options A. B. and D: Collective. ordering. and sorting. although important. are not most significant skills learned.

Explanation

The most significant skill learned during the school-age period is reading. During this time the child develops formal adult articulation patterns and learns that words can be arranged in structure.Options A. B. and D: Collective. ordering. and sorting. although important. are not most significant skills learned.

5. A hospitalized school ager states: "I'm not afraid of this place. I'm not afraid of anything." This statement is most likely an example of which of the following?

Regression

Repression

Reaction formation

Rationalization

Reaction formation is the school ager’s typical defensive response when hospitalized. In reaction formation. expression of unacceptable thoughts or behaviors is prevented (or overridden) by the exaggerated expression of opposite thoughts or types of behaviors.Option A: Regression is seen in toddlers and preschoolers when they retreat or return to an earlier level of development.Option B: Repression refers to the involuntary blocking of unpleasant feelings and experiences from one’s awareness.Option D: Rationalization is the attempt to make excuses to justify unacceptable feelings or behaviors.

Explanation

Reaction formation is the school ager’s typical defensive response when hospitalized. In reaction formation. expression of unacceptable thoughts or behaviors is prevented (or overridden) by the exaggerated expression of opposite thoughts or types of behaviors.Option A: Regression is seen in toddlers and preschoolers when they retreat or return to an earlier level of development.Option B: Repression refers to the involuntary blocking of unpleasant feelings and experiences from one’s awareness.Option D: Rationalization is the attempt to make excuses to justify unacceptable feelings or behaviors.

6. Which of the following activities. when voiced by the parents following a teaching session about the characteristics of school-age cognitive development would indicate the need for additional teaching?

Collecting baseball cards and marbles

Ordering dolls according to size

Considering simple problem-solving options

Developing plans for the future

The school-aged child is in the stage of concrete operations. marked by inductive reasoning. logical operations. and reversible concrete thought. The ability to consider the future requires formal thought operations. which are not developed until adolescence.Options A. B. and C: Collecting baseball cards and marbles. ordering dolls by size. and simple problem-solving options are examples of the concrete operational thinking of the schoolager.

Explanation

The school-aged child is in the stage of concrete operations. marked by inductive reasoning. logical operations. and reversible concrete thought. The ability to consider the future requires formal thought operations. which are not developed until adolescence.Options A. B. and C: Collecting baseball cards and marbles. ordering dolls by size. and simple problem-solving options are examples of the concrete operational thinking of the schoolager.

7. When providing therapeutic play. which of the following toys would best promote imaginative play in a 4-year-old?

Large blocks

Dress-up clothes

Wooden puzzle

Big wheels

Dress-up clothes enhance imaginative play and imagination. allowing preschoolers to engage in rich fantasy play.Options A and C: Building blocks and wooden puzzles are appropriate for encouraging fine motor development.Option D: Big wheels and tricycles encourage gross motor development.

Explanation

Dress-up clothes enhance imaginative play and imagination. allowing preschoolers to engage in rich fantasy play.Options A and C: Building blocks and wooden puzzles are appropriate for encouraging fine motor development.Option D: Big wheels and tricycles encourage gross motor development.

8. A 14-year-old boy has acne and according to his parents. dominates the bathroom by using the mirror all the time.Which of the following remarks by the nurse would be least helpful in talking to the boy and his parents?

“Teenagers are anxious about how their peers perceive them. So they spend a lot of time grooming.”

“A teen may develop a poor self-image when experiencing acne. Do you feel this way sometimes?”

“You appear to be keeping your face well washed. Would you feel comfortable discussing your cleansing method?”

Stating that this is probably the only concern the adolescent has and telling the parents not to worry about it or the time he spends on it shuts off further investigation and is likely to make the adolescent and his parents feel defensive.Option B: The statement about peer acceptance and time spent in front of the mirror for the development of self-image provides information about the adolescent’s needs to the parents and may help to gain trust with the adolescent.Option C: Asking the adolescent how he feels about the acne will encourage the adolescent to share his feelings.Option D: Discussing the cleansing method shows interest and concern for the adolescent and also can help to identify any patient-teaching needs for the adolescent regarding cleansing.

Explanation

Stating that this is probably the only concern the adolescent has and telling the parents not to worry about it or the time he spends on it shuts off further investigation and is likely to make the adolescent and his parents feel defensive.Option B: The statement about peer acceptance and time spent in front of the mirror for the development of self-image provides information about the adolescent’s needs to the parents and may help to gain trust with the adolescent.Option C: Asking the adolescent how he feels about the acne will encourage the adolescent to share his feelings.Option D: Discussing the cleansing method shows interest and concern for the adolescent and also can help to identify any patient-teaching needs for the adolescent regarding cleansing.

9. After teaching a group of parents about accident prevention for school agers. which of the following statements by the group would indicate the need for more teaching?

“Schoolagers are more active and adventurous than are younger children.”

“Schoolagers are more susceptible to home hazards than are younger children.”

“Schoolagers are unable to understand potential dangers around them.”

“Schoolargers are less subject to parental control than are younger children.”

The school ager’s cognitive level is sufficiently developed to enable good understanding of and adherence to rules. Thus. school agers should be able to understand the potential dangers around them.Option A: With growth comes greater freedom and children become more adventurous and daring.Option B: The school-aged child is also still prone to accidents and home hazards. especially because of increased motor abilities and independence. Plus the home hazards differ from other age groups. These hazards. which are potentially lethal but tempting. may include firearms. alcohol. and medications.Option D: School-age children begin to internalize their own controls and need less outside direction. Plus the child is away from home more often. Some parental or caregiver assistance is still needed to answer questions and provide guidance for decisions and responsibilities.

Explanation

The school ager’s cognitive level is sufficiently developed to enable good understanding of and adherence to rules. Thus. school agers should be able to understand the potential dangers around them.Option A: With growth comes greater freedom and children become more adventurous and daring.Option B: The school-aged child is also still prone to accidents and home hazards. especially because of increased motor abilities and independence. Plus the home hazards differ from other age groups. These hazards. which are potentially lethal but tempting. may include firearms. alcohol. and medications.Option D: School-age children begin to internalize their own controls and need less outside direction. Plus the child is away from home more often. Some parental or caregiver assistance is still needed to answer questions and provide guidance for decisions and responsibilities.

10. A child age 7 was unable to receive the measles. mumps. and rubella (MMR) vaccine at the recommended scheduled time. When would the nurse expect to administer MMR vaccine?

In a month from now

In a year from now

At age 10

At age 13

Based on the recommendations of the American Academy of Family Physicians and the American Academy of Pediatrics. the MMR vaccine should be given at the age of 10 if the child did not receive it between the ages of 4 to 6 years as recommended. Immunization for diphtheria and tetanus is required at age 13.

Explanation

Based on the recommendations of the American Academy of Family Physicians and the American Academy of Pediatrics. the MMR vaccine should be given at the age of 10 if the child did not receive it between the ages of 4 to 6 years as recommended. Immunization for diphtheria and tetanus is required at age 13.