A mother brings a 23-month-old child for a well-child check. She apologizes, stating, “It’s my allergies, not a cold, that is causing me to sniffle so much.” The mother reports that the toddler seems “slower at doing things” than her older children did. The nurse notices that the child sits in the mother’s lap without fear or hesitation and responds to the mother’s questions, but fails to look at the mother’s face when being spoken to. These behaviors are supportive of what additional assessment?

Indications of physical abuse of the child by the caregiver.

Evidence of cocaine abuse by the caregiver affecting the child.

Autistic behaviors demonstrated by the child.

Attention deficit hyperactive disorder (ADHD) characteristics demonstrated by the child.

Answer and Explanation

The Correct Answer is C

Choice A reason: Lack of eye contact and developmental delay don’t directly indicate physical abuse, which typically shows fear or physical signs. Autistic behaviors like poor eye contact are more likely, making this incorrect, as the toddler’s behaviors align better with autism in the well-child assessment.

Choice B reason: Cocaine abuse by the caregiver might affect development but isn’t linked to specific behaviors like poor eye contact. Autistic traits better explain the toddler’s symptoms, making this speculative and incorrect compared to the nurse’s assessment of developmental concerns in the child.

Choice C reason: Poor eye contact and slower development at 23 months suggest autistic behaviors, common in autism spectrum disorder. This aligns with pediatric developmental screening, making it the correct additional assessment for the nurse to consider based on the toddler’s observed behaviors during the check.

Choice D reason: ADHD typically presents later with hyperactivity and inattention, not poor eye contact or developmental delay at 23 months. Autistic behaviors are more fitting, making this incorrect, as the toddler’s symptoms align better with autism than ADHD in the well-child evaluation.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Choice A reason: Socializing with healthy peers may motivate but doesn’t directly teach self-care skills for chronic illness. A contract with rewards engages the child actively, making this less focused and incorrect compared to a structured strategy ensuring school-aged children achieve treatment goals effectively.

Choice B reason: Co-writing a contract with rewards engages the child in setting and achieving self-care goals, fostering responsibility and motivation. This aligns with pediatric chronic illness management, making it the most effective strategy to help school-aged children master treatment goals with caregiver involvement.

Choice C reason: Reinforcing the importance of goals educates but lacks active engagement compared to a reward-based contract. Contracts promote accountability, making this less effective and incorrect for directly helping chronically ill children achieve self-care treatment goals in a structured, motivating way.

Choice D reason: A sticker chart tracks progress but is less collaborative than a contract, which involves the child in goal-setting. Contracts better foster ownership, making this less engaging and incorrect compared to the co-written contract strategy for achieving self-care goals in school-aged children.

A. Gown, handwashing, and gloves B. Handwashing and gloves C. Mask and handwashing D. Gown, gloves, and mask

Correct Answer is C

Explanation

Choice A reason: Gown, handwashing, and gloves are used for contact precautions, not droplet precautions, which require a mask to prevent respiratory droplet transmission. Pneumonia spreads via droplets, making gowns and gloves excessive, and this combination incorrect for the specific infection control needed in this scenario.

Choice B reason: Handwashing and gloves protect against contact transmission but do not address respiratory droplets in pneumonia, which requires a mask. Droplet precautions prioritize airway protection, making this incomplete and incorrect for the nurse’s protective measures in caring for a child with pneumonia.

Choice C reason: Droplet precautions for pneumonia require a mask to block respiratory droplets and handwashing to prevent fomite transmission. This combination aligns with infection control guidelines for droplet-borne infections, making it the correct choice for the nurse’s protective measures in this clinical scenario.

Choice D reason: Gown, gloves, and mask are used for airborne or contact precautions, not droplet precautions. Pneumonia requires only a mask and handwashing, as droplets are the primary transmission mode, making this excessive and incorrect for the specific precautions needed for this child’s care.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is working with a group of chronically ill school-aged children and their caregivers. Which strategy would be most effective in helping the children reach their self-care treatment goals?

Correct Answer is B

Explanation

The nurse is reviewing a client’s chart and notes that the child is in droplet precautions for pneumonia. What protection would she need to take in caring for the child?

Correct Answer is C

Explanation

The nurse administering the preoperative medications to the child going to surgery would anticipate which of the following related to giving preoperative medications?

The nurse asks the parents of a child about the family health history. The father asks the nurse why she needs this information. The nurse would explain that the family health history is gathered for what reason?

The nurse is presenting a post-conference seminar to a group of nursing students on the topic of suctioning of a child. Which statement made by a student demonstrates a need for further instruction on this procedure?

The nurse is doing discharge teaching for a child who has had a tonsillectomy. The nurse tells the client and family that the child should have plenty of fluids. In addition, the nurse would explain to the child’s caregiver that the child may:

The nurse is collecting data on a 4-month-old child brought to the clinic by the caregiver. The nurse observes the child’s mouth and notes a white coating that looks like milk curds. Which of the following questions would be most important for the nurse to ask the caregiver?

The nurse is meeting with a group of high school boys to discuss various health topics. After the session on testicular self-exam, the nurse determines the session is successful when one of the students responds with which comment?