Child Growth and Development

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Sample questions from Child Growth and Development

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 15-month-old is seen in the pediatric clinic for a well-child visit. The child walks independently, uses three words, and weighs 10.2 kg. The parent reports the child has not received the measles-mumps-rubella (MMR) vaccine. Which action should the nurse take?

   • A.Administer the MMR vaccine today if no contraindication is identified.
   • B.Delay the MMR vaccine until the child is 4 years old.
   • C.Recommend that the parent arrange the vaccine at the next visit in 1 year.
   • D.Give the MMR vaccine only if the child has had a known measles exposure.

   Rationale: The first MMR dose is routinely given at 12 to 15 months, so an eligible 15-month-old should receive it now. Waiting until age 4 or until exposure leaves the child unnecessarily unprotected, and postponing a year is not indicated. The nurse should verify the immunization history and screen for contraindications before administration.

2. 2.A 7-year-old is scheduled for a tonsillectomy at an ambulatory surgery center. The child is alert, has a temperature of 36.9 C (98.4 F), and asks whether the procedure will hurt. Which actions should the nurse take? Select all that apply.

   • A.Encourage the child to choose a flavor of clear liquid to drink after surgery when permitted.
   • B.Tell the child that the procedure will not hurt at all.
   • C.Explain the sequence of events using concrete, age-appropriate language.
   • D.Invite the child to ask questions and express worries.
   • E.Use a toy or picture to demonstrate the expected equipment.

   Rationale: School-age children benefit from clear, concrete preparation, opportunities to ask questions, and visual or play-based demonstrations. Offering a choice within safe limits supports a sense of control, including a permitted postoperative drink choice. Saying there will be no pain is misleading and may damage trust if discomfort occurs.

3. 3.A 6-month-old is admitted for bronchiolitis and has an oxygen saturation of 96% on room air. The infant is alert but has nasal congestion and takes only half of usual feedings. Which task is appropriate for the nurse to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Assess the infant's work of breathing after a feeding.
   • B.Decide whether the infant needs supplemental oxygen.
   • C.Measure and record the infant's intake and urine output.
   • D.Teach the caregiver how to use a bulb syringe.

   Rationale: Measuring and recording intake and output is a routine, predictable task that can be delegated to a competent UAP. Respiratory assessment, oxygen decisions, and caregiver teaching require nursing judgment and remain the nurse's responsibility. The nurse should review the recorded data and act on concerning trends.

4. 4.A 3-year-old is admitted to the pediatric unit for dehydration from gastroenteritis. The child has a heart rate of 148/min, dry mucous membranes, and capillary refill of 3 seconds. Which action should the nurse take first?

   • A.Offer a large cup of water and wait 2 hours to assess the response.
   • B.Notify the provider and prepare to administer the prescribed isotonic IV fluid bolus.
   • C.Give an antidiarrheal medication from the unit supply.
   • D.Ask the caregiver to record the child's next 24 hours of intake at home.

   Answer and rationale are in the full material.

5. 5.A 5-year-old with asthma is admitted with wheezing and a respiratory rate of 34/min. Oxygen saturation is 93% on room air, and the child is speaking in short phrases. Which action should the nurse take first?

   • A.Offer a large meal to reduce fatigue.
   • B.Encourage the child to walk in the hallway to mobilize secretions.
   • C.Begin teaching the caregiver how to prevent future asthma triggers.
   • D.Administer the prescribed short-acting bronchodilator and reassess respiratory status.

   Answer and rationale are in the full material.