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Quiz Session - Attempts With Random Questions

PNCB CPN Exam Questions

Page 10 of 20

181.

A 4-month-old infant is at the clinic for a well-baby visit. What vaccine should the nurse prepare to administer?

  • DTaP

  • MMR

  • Tdap

  • Influenza

Correct answer: DTaP

DTaP vaccine, which protects against diphtheria, tetanus, and pertussis, is part of the routine immunization schedule for infants, including at 4 months of age.

The MMR (measles, mumps, rubella) vaccine is typically administered starting at 12 months of age, so it is not appropriate for a 4-month-old infant. Tdap is a booster vaccine for older children and adults, not for infants as young as 4 months. DTaP should be used for children in this age group. The annual influenza vaccine is generally recommended for children starting at 6 months of age, making it unsuitable for a 4-month-old.

182.

In preparing a care plan for a 12-year-old with significant visual impairments and a history of diabetes, the nurse should include what critical consideration?

  • Educating the child using audio materials about self-monitoring glucose levels

  • Providing a comprehensive combination of both video and audio teaching

  • Relying on parents to manage all diabetes care due to the patient’s visual impairments

  • Using Braille materials for diabetes education

Correct answer: Educating the child using audio materials about self-monitoring glucose levels

Audio materials accommodate the child’s visual impairments effectively, allowing for independent management of their condition by providing accessible information on glucose monitoring.

Combining video and audio does not consider the child's significant visual impairments, as video materials would not be beneficial. Relying solely on parents for diabetes care reduces the child’s opportunity for independence and self-management, which is crucial for long-term disease management. While Braille materials are a valuable tool, they assume proficiency in Braille, which the child may not have, making audio materials a more immediate and accessible option.

183.

A 6-month-old infant is brought to the clinic for a routine check-up. Which of the following findings would be a cause for concern?

  • No babbling or making sounds

  • Weight at the 20th percentile for age

  • Crying several times each day

  • Interested in grabbing objects and bring to their mouth

Correct answer: No babbling or making sounds

By 6 months, infants are expected to start making sounds and babbling as a part of normal speech and language development. The absence of these sounds can indicate developmental delays in communication.

Being in the 20th percentile for weight is within the normal range for infants. Percentile rankings from 5th to 95th are considered typical, reflecting variations in normal growth patterns. It is normal for infants to cry several times each day, as crying is a primary form of communication for them, indicating needs such as hunger, discomfort, or the need for sleep. An interest in grabbing objects and bringing them to their mouth is typical of sensory and motor development at this age, reflecting normal exploratory behaviors and hand-mouth coordination.

184.

A family new to the country is struggling to navigate the healthcare system for their children's vaccinations. What is the best action for the nurse to take?

  • Refer the family to community health navigators who specialize in assisting immigrants

  • Provide a list of required vaccinations and advise them to visit a clinic

  • Suggest that the family wait until the school year and consult with the school nurse

  • Recommend online resources that will facilitate an understanding of the local healthcare system

Correct answer: Refer the family to community health navigators who specialize in assisting immigrants

Referring the family to community health navigators who specialize in assisting immigrants ensures that they receive culturally competent support and guidance tailored to their specific needs. This approach helps the family understand and navigate the healthcare system effectively, facilitating access to necessary services like vaccinations.

Providing a list of vaccinations and advising them to visit a clinic does not address potential barriers they might face due to language or unfamiliarity with the healthcare system. Waiting until the school year and consulting with the school nurse delays necessary vaccinations and may not provide the comprehensive support needed to navigate the healthcare system. While online resources can be informative, they may not be accessible or understandable for families new to the country and do not provide the personalized assistance that health navigators can offer.

185.

A nurse is planning care for a child who is visibly distressed and hesitant about medical personnel due to past traumatic experiences in a healthcare setting. Which action best supports the principle of choice in trauma-informed care?

  • Allow the child to choose the timing for non-urgent procedures

  • Ensure that only female providers interact with the patient

  • Understand that the child’s apparent distress may be manipulative to avoid care

  • Have the child’s parents or friends provide as much of the care as possible

Correct answer: Allow the child to choose the timing for non-urgent procedures

Allowing the child to choose when to undergo non-urgent procedures empowers them and supports the principle of choice, an important aspect of trauma-informed care. This method helps reduce feelings of helplessness and anxiety by giving the child control over part of their care.

Assigning providers based on gender may be helpful in some cases but does not directly empower the child to make choices about their care. Assigning providers based on gender will depend on the patient and the specific background of their trauma. Assuming distress as manipulation undermines the principles of trauma-informed care, which emphasize understanding and addressing the root causes of a child’s behavior with empathy. While involving trusted individuals can be comforting, it does not necessarily provide the child with choices about their medical care, which is critical in trauma-informed approaches.

186.

During a consultation, a 12-year-old patient appears anxious about an upcoming surgery. How should the nurse tailor communication to address the patient's anxiety?

  • Provide reassurance using clear and concise information about the procedure

  • Avoid discussing the surgery details to prevent further anxiety

  • Focus on discussing the risks associated with the surgery to alleviate uncertainty and anxiety

  • Encourage the child to avoid discussing the surgery and focus on expressing their feelings

Correct answer: Provide reassurance using clear and concise information about the procedure

Providing reassurance with clear and concise information helps alleviate anxiety by demystifying the surgical process and addressing the patient's fears in a straightforward and supportive manner.

Avoiding discussion of the surgery details can increase anxiety by leaving the patient’s questions unanswered and their fears unaddressed. Focusing only on the risks could heighten anxiety rather than alleviate it, as it may lead the child to worry more about potential negative outcomes. Encouraging the child to avoid discussing the surgery and focus on other feelings does not address the root of their anxiety and may leave them feeling unsupported or isolated.

187.

A pediatric nurse is providing care for a 3-year-old child with burns who is clearly in pain. What is the most appropriate non-pharmacologic intervention to apply while awaiting pain medication?

  • Encourage the parents to hold the child’s hand

  • Engage the child in a quiet storytime

  • Apply a cool compress to unburned areas

  • Dim the lights in the room

Correct answer: Encourage the parents to hold the child’s hand

Encouraging parents to hold the child’s hand offers comfort and reassurance, helping reduce pain perception through emotional support, which is important while awaiting medication.

Engaging in storytime might provide a distraction but is less effective in providing immediate comfort compared to physical contact with the child’s caregiver. Applying a cool compress to unburned areas may be soothing but does not provide the same level of comfort or emotional support as parental touch. Dimming the lights can create a calming environment but is not as directly comforting as physical reassurance from a parent.

188.

A nurse is caring for a dying child who has significant respiratory distress. Which intervention should be prioritized to manage this symptom effectively?

  • Position the child to optimize comfort and breathing

  • Consider immediate intubation to relieve respiratory effort

  • Perform a STAT chest X-ray to determine the cause of the respiratory distress

  • Encourage the family to say their goodbyes as the condition deteriorates

Correct answer: Position the child to optimize comfort and breathing

Positioning the child to optimize comfort and breathing is the most immediate and effective intervention to manage significant respiratory distress in a dying child. This non-invasive measure can provide significant relief and is a primary step in palliative respiratory care.

Immediate intubation can be invasive and may not align with the goals of palliative care, especially if the focus is on comfort rather than prolonging life. It should be considered only if it aligns with the family’s and patient’s wishes, as it is more likely to prolong death than to improve well-being. Performing a STAT chest X-ray to determine the cause of the distress may be unnecessary in the context of a known terminal illness and could cause discomfort or unnecessary stress in the child’s final days. Encouraging the family to say their goodbyes as the condition deteriorates, while important, should not overshadow the need for immediate medical interventions that can provide comfort and improve breathing.

189.

A nurse is discussing future health behaviors with a 13-year-old and their parents. Which approach best facilitates an integrated plan of care for discussing sexual health?

  • Mediate a discussion on sexual health involving both the patient and the parents

  • Encourage the parents to discuss sexual health topics whenever the patient asks

  • Direct the conversation away from sexual health topics to avoid any discomfort

  • Provide the patient with private online resources to explore independently

Correct answer: Mediate a discussion on sexual health involving both the patient and the parents

Mediating a discussion allows the nurse to facilitate open communication between the patient and their parents, ensuring that the patient’s needs are addressed while also involving the parents in the educational process.

Encouraging parents to discuss sexual health only when the patient asks could lead to missed opportunities for proactive education and support, potentially leaving the patient uninformed. Directing the conversation away from sexual health topics avoids addressing an essential component of adolescent health and can contribute to stigma or discomfort around these topics. Providing the patient with private online resources alone might isolate them from direct dialogues with parents or healthcare providers, which are important for comprehensive understanding and support. The unguided use of online resources may also result in misinformation and increase the risk of patient harm.

190.

A 6-month-old infant is ready to start solid foods. What is the best first food to recommend to parents?

  • Cereal mixed with breast milk or formula

  • Whole cow's milk mixed with iron-fortified cereal

  • Honey-sweetened yogurt

  • Citrus fruit juice

Correct answer: Cereal mixed with breast milk or formula

Cereal mixed with breast milk or formula is easily digestible and provides iron, which is crucial for infants starting solids. This combination also helps the infant adjust to new textures while receiving familiar tastes.

Whole cow's milk is not recommended for infants under one year due to the risk of iron deficiency and intestinal irritation. Mixing it with cereal does not address these fundamental concerns. Honey is dangerous for infants under one year due to the risk of botulism, and yogurt might be too complex for a first food given potential dairy sensitivities. Citrus fruit juices can be too acidic for infants' delicate stomachs and do not provide the iron or suitable texture needed for the first solid foods.

191.

For a 12-year-old undergoing chemotherapy who is experiencing nausea and vomiting, which complementary approach should the nurse consider recommending to alleviate these symptoms?

  • Aromatherapy using peppermint oil

  • Administration of additional antiemetic drugs

  • Strict bed rest throughout treatment

  • Increased intake of fatty foods

Correct answer: Aromatherapy using peppermint oil

Aromatherapy using peppermint oil has been noted in the literature for its anti-nausea properties and can be a helpful complementary approach to managing chemotherapy-induced nausea and vomiting.

Administration of additional antiemetic drugs is a primary medical approach. Strict bed rest does not address the nausea directly and may not provide relief. Increased intake of fatty foods is likely to worsen nausea, not alleviate it.

192.

A 7-year-old child with a history of physical abuse is admitted for routine tests. What should the nurse prioritize to adhere to trauma-informed care principles?

  • Explain each step of the procedure clearly

  • Perform the tests quickly to minimize time in the hospital

  • Avoid causing stress by providing too much information at once

  • Conduct the tests without parental presence to reduce the child’s anxiety

Correct answer: Explain each step of the procedure clearly

Clear explanations of each procedure step can help mitigate fear and anxiety, making the experience less traumatic for a child with a history of abuse. This approach respects the child's need for predictability and transparency, which are core principles of trauma-informed care.

Performing tests quickly may seem efficient but can feel rushed and frightening to a child who needs a sense of control and understanding of what is happening to them. While avoiding overwhelming the child is important, not providing enough information can increase anxiety and fear, particularly for a child with a trauma history who may feel more secure knowing exactly what to expect. Conducting tests without parental presence can exacerbate anxiety and fear in a child who needs support and reassurance from trusted adults during medical procedures. The impact of parental presence may be negative in some situations, however, the situation should be assessed prior to deciding on parental involvement.

193.

During a wellness visit, a nurse learns that a 5-year-old is afraid of attending kindergarten. Which strategy should the nurse recommend to the parents to help the child build resilience?

  • Arrange for the child to visit the kindergarten with a parent before the school year begins

  • Tell the child that school is important and there is no need to be afraid

  • Recommend starting therapy if the child continues to express fear

  • Explain the risks associated with bullying and how to deal with being bullied in a healthy, effective way

Correct answer: Arrange for the child to visit the kindergarten with a parent before the school year begins

Arranging for the child to visit the kindergarten with a parent allows the child to become familiar with the new environment in a supportive setting, reducing fear and building confidence. This proactive approach helps the child visualize and understand what to expect, easing the transition and fostering resilience.

Simply telling the child that there is no need to be afraid does not constructively address their fears and can make them feel misunderstood or dismissed. Recommending therapy without first trying simpler supportive measures may not be necessary and could imply that the child's fear is more pathological than typical developmental anxiety. Discussing bullying risks does not address the specific fear of starting kindergarten and could increase anxiety rather than alleviate it.

194.

A 7-year-old child presents to the emergency room with acute respiratory distress and audible wheezing. What is the nurse's first action?

  • Administer high-flow oxygen via mask

  • Perform a thorough lung assessment

  • Prepare for an emergency tracheotomy

  • Educate the child on deep breathing techniques

Correct answer: Administer high-flow oxygen via mask

Administering high-flow oxygen is critical in cases of acute respiratory distress to ensure adequate oxygenation. Immediate oxygen delivery can prevent further respiratory compromise and stabilize the patient.

While a lung assessment is important, it is secondary to stabilizing the child’s breathing. Immediate action is required to address the child's compromised airway and breathing. An emergency tracheotomy is an invasive procedure that is typically reserved for cases where other airway management techniques have failed or are impractical. It is not the first-line response for acute wheezing. Educating the child on deep breathing techniques is not practical in a crisis where immediate physical intervention is necessary to ensure the child's oxygenation and survival.

195.

A pediatric nurse caring for a newborn patient who is 8 days old notices a significant increase in temperature. The infant is otherwise stable. Which action regarding communication should the nurse take?

  • Immediately page the neonatologist on call

  • Document the findings and compare with previous temperature trends

  • Monitor the patient to see if the elevation is sustained

  • Discuss the findings with the parent to reassure them

Correct answer: Immediately page the neonatologist on call

Immediately paging the neonatologist is the best intervention for a significant temperature increase in a newborn, as infants are particularly vulnerable to rapid changes in condition and elevations in temperature in the first 30 days of life can indicate a serious medical problem.

Documenting findings is secondary to immediate communication with a specialist who can assess the potential seriousness of the fever. Monitoring the patient for sustained elevation delays potential necessary immediate interventions in a newborn, who may deteriorate rapidly. Discussing findings with parents does not address the urgent need for medical evaluation by a neonatologist.

196.

A pediatric nurse is counseling a family on how to support their 4-year-old child's coping with hospitalization. Which advice is most appropriate?

  • Encourage the family to stay with the child as much as possible during hospitalization

  • Limit the child's interactions with the medical staff to reduce fear

  • Recommend using strict discipline to manage the child's behavior during the hospital stay

  • Suggest that the family minimize explanations about medical procedures to reduce anxiety

Correct answer: Encourage the family to stay with the child as much as possible during hospitalization

Having family present during hospitalization provides emotional support and comfort to the child, reducing anxiety and promoting a sense of safety. This approach is essential in helping the child cope with the stress of hospitalization and unfamiliar medical procedures.

Limiting the child’s interactions with medical staff can hinder the child's understanding of their care and reduce opportunities to build trust with healthcare providers, potentially increasing fear rather than alleviating it. Using strict discipline during a hospital stay can exacerbate the child's stress and fear, as it does not address the underlying emotional needs or the unusual circumstances of being hospitalized. Minimizing explanations about medical procedures can leave the child confused and frightened about what to expect, increasing anxiety rather than helping the child cope with the situation.

197.

During a multidisciplinary team meeting, a discussion arises about the optimal management for a 10-year-old patient with cerebral palsy experiencing frequent falls. The team includes a pediatric nurse, a physical therapist, an occupational therapist, and a neurologist. The nurse notices a gap in communication regarding the patient's recent medication adjustments. 

What is the most appropriate step for the nurse to take to facilitate effective care?

  • Inquire about the current medications and any recent changes from the neurologist

  • Alert the physical therapist to the increased risk of falls resulting from the gap

  • Ask the occupational therapist to suggest changes the team can make to address the deficiency

  • Advocate for hospital administration to support improvements in medication management

Correct answer: Inquire about the current medications and any recent changes from the neurologist

Inquiring about the current medications and any recent changes directly from the neurologist ensures that the nurse is informed of all relevant treatment updates, which is crucial for managing and understanding the patient’s condition and potential risks such as increased falls.

Alerting the physical therapist about the increased risk of falls may be important but should not precede assessment for any changes in medication that might contribute to the risk. Asking the occupational therapist to suggest changes addresses only part of the issue and skips the crucial step of understanding the full context of the patient’s medication management. Advocating for administrative support for medication management is a broader systemic approach and does not address the immediate need to clarify the patient's current treatment regimen.

198.

A nurse discusses internet safety with a group of preteens. What should be the focus to help them avoid cyberbullying and online exploitation?

  • Keeping social media profiles private

  • Sharing personal pictures online in a mature way

  • Using parental controls on devices

  • Having many online friends for social validation

Correct answer: Keeping social media profiles private

Keeping social media profiles private is a proactive strategy to safeguard personal information and reduce exposure to potential cyberbullies and online exploiters. This intervention directly enhances online safety by limiting who can view and interact with a preteen’s content.

Teaching how to share personal pictures online does not inherently safeguard against cyberbullying and can increase risks if not managed carefully. Instead, sharing personal pictures should be discouraged for preteens due to the potential for abuse and manipulation that can result. Parental controls are helpful but focus more on restricting access rather than empowering preteens with strategies to manage their interactions and privacy. Having many online friends for social validation can increase exposure to cyberbullying and does not emphasize critical thinking or safety in online environments.

199.

A 13-year-old expresses feeling overwhelmed by the pressure to perform academically and socially. What should the nurse suggest to help manage these feelings?

  • Identify activities that reduce stress, such as hobbies or sports.

  • Find ways to dedicate more time to study so that academic anxiety will be reduced.

  • Focus on either academic or social activities to reduce the stress caused by a bifurcated focus.

  • Understand these feelings of stress are common in teenagers and try to find ways to suppress them.

Correct answer: Identify activities that reduce stress, such as hobbies or sports.

Engaging in hobbies or sports can provide a healthy outlet for stress, promote relaxation, and offer a sense of accomplishment outside of academic and social pressures. This approach helps balance the teenager's life and reduces feelings of being overwhelmed.

Dedicating more time to study could increase academic anxiety rather than alleviate it, especially if the teen is already feeling overwhelmed. Choosing to focus solely on academic or social activities can lead to missing important experiences and skills in other areas. It may also increase stress by creating a feeling of missing out or underachievement. Suppression of stress is not a healthy coping mechanism as it can lead to further psychological issues.

200.

A pediatric nurse is planning care for a 12-year-old who has begun asking questions about puberty. Which resource is most appropriate to include in the educational plan?

  • An age-appropriate video explaining the changes during puberty

  • A detailed booklet on sexually transmitted diseases

  • A varied list of websites about comprehensive sexual health

  • Materials for family-planning clinics and contraceptive types

Correct answer: An age-appropriate video explaining the changes during puberty

An age-appropriate video can visually and engagingly explain puberty, making it easier for a 12-year-old to understand the natural changes they will experience.

A detailed booklet on sexually transmitted diseases is not tailored to the immediate informational needs about puberty and may be inappropriate given the patient's age and developmental stage. Providing a varied list of websites may overwhelm the child with too much information at once and lacks the guided, age-appropriate focus needed for understanding puberty. Materials focused on family planning and contraceptives are premature and not directly related to the initial educational needs about puberty for a 12-year-old.

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