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Quiz Session - Attempts With Random Questions

PNCB CPN Exam Questions

Page 4 of 20

61.

A pediatric nurse notices that a 10-year-old boy has become quiet and withdrawn after his sister was hospitalized for a serious illness. How should the nurse assess his coping mechanism?

  • Engage him in a conversation to understand his feelings about his sister’s condition

  • Recognize that this is the patient’s coping mechanism and support his behaviors

  • Encourage him to spend more time with friends to distract himself

  • Schedule a psychiatric evaluation to support the child through the traumatic event

Correct answer: Engage him in a conversation to understand his feelings about his sister’s condition

Engaging the boy in conversation about his feelings provides an opportunity to assess his emotional and psychological well-being, helping to identify any needs for further support or intervention.

Simply supporting the behavior without understanding it risks missing signs of depression or anxiety that may require intervention. Encouraging social distraction might temporarily relieve stress but does not address the underlying emotional impact of his sister's illness. While a psychiatric evaluation could be beneficial, it's more appropriate for the nurse to first understand his feelings and determine the level of impact before escalating to specialist interventions.

62.

What is the recommended age for a child to receive their first dental health check-up?

  • By 1 year of age or within 6 months after the first tooth erupts

  • At the age of 3 when most primary teeth are visible

  • When the child starts school

  • Only if dental problems are observed by the parents

Correct answer: By 1 year of age or within 6 months after the first tooth erupts

Receiving a dental check-up by 1 year of age or within 6 months after the first tooth erupts ensures early detection of any dental issues and promotes good oral hygiene habits from a young age. 

Waiting until age 3 may delay the detection of early dental issues and does not take advantage of preventive care opportunities. Starting dental visits only when the child enrolls in school misses critical early years for preventing and managing dental issues. Relying solely on parental observation of dental problems can result in missed early dental issues that professionals could catch.

63.

A nurse is assessing the nutritional status of an 18-month-old toddler during a clinic visit. Which method is most effective to gauge the toddler's nutritional intake?

  • Reviewing a 24-hour dietary recall provided by the parent

  • Measuring upper chest circumference

  • Asking the parents how many bowel movements that patient typically has in 24 hours

  • Asking the toddler if they are hungry or want a snack then gauging their response

Correct answer: Reviewing a 24-hour dietary recall provided by the parent

A 24-hour dietary recall is an effective method to gauge a toddler's nutritional intake as it provides a detailed account of what the child has consumed in a typical day. This offers direct insights into their dietary habits and nutritional adequacy.

Measuring upper chest circumference is less specific for assessing nutritional status compared to dietary intake data and does not provide direct information about the quality or quantity of food consumed. The frequency of bowel movements can indicate digestive health but is not a direct measure of nutritional intake and can vary widely based on factors other than diet. Asking a toddler if they are hungry or want a snack and gauging their response is not a reliable method for assessing nutritional status. Young children's immediate hunger cues do not accurately reflect overall dietary intake or nutritional health.

64.

A pediatric nurse feels emotionally impacted by the death of a patient they have cared for over several years. Which action is most appropriate to address the nurse's needs?

  • Engage in a one-on-one session with a grief counselor

  • Suppress these feelings to maintain professional interactions with the team

  • Consider resigning from the current position and finding a less stressful area of nursing

  • Avoid talking about the incident with colleagues to keep the workplace positive

Correct answer: Engage in a one-on-one session with a grief counselor

Engaging in a one-on-one session with a grief counselor provides a direct and supportive way to address the emotional impact of a patient’s death. This action helps the nurse process their feelings healthily and professionally, maintaining their ability to provide care while addressing their emotional needs.

Suppressing the feelings to maintain professional interactions might lead to unresolved grief and could affect the nurse’s emotional well-being and professional performance. Considering resignation as a reaction to emotional impact is an extreme measure that does not address the nurse’s immediate need for emotional support and could disrupt their career unnecessarily. Avoiding talking about the incident with colleagues denies the nurse the support that could be offered by peers, potentially isolating them and exacerbating the emotional distress.

65.

In educating parents about safe sleep practices for infants, which of the following should the nurse emphasize?

  • Avoid using soft bedding and keep the crib bare.

  • Babies should sleep on their backs in the parent's bed for the first year.

  • Place babies to sleep in the position they find to be most comfortable.

  • Use sleep positioners to keep the baby on their back.

Correct answer: Avoid using soft bedding and keep the crib bare.

Avoiding soft bedding and keeping the crib bare minimizes risks of suffocation and sudden infant death syndrome (SIDS), following established safe sleep practices.

Babies should sleep on their backs, ideally in their own crib or bassinet and not in the parent's bed, to reduce the risk of SIDS. Babies should always be placed on their backs to sleep, as this position has been shown to decrease the risk of SIDS. Sleep positioners are not recommended due to the associated risks of suffocation; the safest environment is a bare crib.

66.

In a community with a high prevalence of type 2 diabetes, a school nurse is tasked with developing a health promotion activity for children. Which approach would be most effective?

  • Create a program that integrates both dietary education and regular exercise

  • Focus on general physical activities without specific dietary modifications

  • Conduct lessons focused primarily on the genetics of diabetes

  • Promote an increase in competitive sports

Correct answer: Create a program that integrates both dietary education and regular exercise

Integrating dietary education with regular exercise addresses both major aspects of diabetes prevention and management, providing a comprehensive approach to health promotion.

Focusing only on general physical activities omits the crucial component of dietary management, which is essential for preventing and managing type 2 diabetes. Lessons focused solely on the genetics of diabetes might provide knowledge but lack actionable prevention strategies like diet and exercise. Promoting competitive sports exclusively can alienate less athletic children and does not address dietary habits, a key element in diabetes management.

67.

A pediatric nurse observes a 10-year-old child who appears unkempt and is frequently absent from school. The child is quiet and withdrawn during the examination. What is the most appropriate initial action for the nurse?

  • Conduct a private, detailed interview with the child about home life and personal feelings

  • Immediately report the case to Child Protective Services

  • Ask the child direct questions about parental neglect with a sibling present

  • Recognize that being untidy and having absences from school is expected in some children of this age

Correct answer: Conduct a private, detailed interview with the child about home life and personal feelings

A private interview allows the nurse to assess potential issues like neglect or abuse safely and confidentially, without causing further distress or alerting potential abusers. It also helps in building trust with the child to facilitate open communication.

Reporting to child protective services should follow the preliminary assessment, not precede it. Asking direct questions about neglect in the presence of another child can lead to discomfort or misleading answers, jeopardizing accurate assessment. Normalizing potential neglect or poor attendance risks overlooking serious underlying issues that need addressing.

68.

A pediatric nurse starts her shift and reviews his patient assignments, which include a newly admitted 7-year-old with abdominal pain suspected to be appendicitis, a 12-year-old recovering from a tonsillectomy experiencing mild pain, a 9-year-old with chemotherapy-induced nausea and vomiting, and a 2-year-old with an untreated tibia fracture. 

Which patient requires the most immediate attention?

  • The 7-year-old

  • The 12-year-old

  • The 9-year-old

  • The 2-year-old

Correct answer: The 7-year-old

The 7-year-old with abdominal pain suspected to be appendicitis requires the most immediate attention to assess for the risk of appendicitis rupture, which can lead to life-threatening complications if not treated promptly.

While the 12-year-old experiencing mild pain post-tonsillectomy needs pain management, it does not present an immediate life-threatening situation compared to suspected appendicitis. The 9-year-old with chemotherapy-induced nausea and vomiting requires management to alleviate symptoms and ensure hydration, but this is not as urgent as the potential for appendicitis rupture. Although an untreated tibia fracture in a 2-year-old needs urgent care to manage pain and prevent complications, the potential severity and complications of untreated appendicitis are more immediately life-threatening.

69.

A child in the pediatric ICU has multiple specialists involved in their care. What role does the nurse play to ensure effective care coordination?

  • Act as the primary communicator between specialists and the family

  • Allow specialists to communicate independently without interference

  • Focus on providing direct care as prescribed by specialists

  • Coordinate all communication and interaction between the specialists

Correct answer: Act as the primary communicator between specialists and the family

Acting as the primary communicator between specialists and the family ensures that the nurse plays a central role in care coordination, facilitating clear and consistent communication and supporting the family in understanding complex care issues.

Allowing specialists to communicate independently could lead to fragmented care and confusion if messages are not consistent or if the family does not fully understand the information from different specialists. Focusing only on providing direct care as prescribed by specialists neglects the nurse’s role in care coordination and advocacy, which are critical for holistic patient care. Coordinating all communication and interaction between the specialists only, without involving the family, may lead to a lack of transparency and decreased family involvement in the care process.

70.

A pediatric nurse is preparing educational materials on preventing poisoning in toddlers. What is the key message?

  • Keep all cleaning agents and medications in original containers, out of children's reach and sight.

  • Store all household chemicals above the child's reach.

  • Teach toddlers that medicines are yucky and that they should never eat them.

  • Teach children the colors and shapes of dangerous chemicals.

Correct answer: Keep all cleaning agents and medications in original containers, out of children's reach and sight.

Keeping hazardous materials in their original containers and out of reach and sight helps prevent accidental poisonings by reducing children's access to and curiosity about these substances.

Storing chemicals above reach is not sufficient; keeping them out of sight and in their original containers provides clearer labeling and additional safety. Telling toddlers that medicines are "yucky" does not effectively prevent curiosity and accidental ingestion; secure storage is necessary. Teaching about colors and shapes does not effectively mitigate risk, as toddlers may not have the understanding or impulse control to avoid dangerous substances.

71.

Which activity best supports motor development for a 6-month-old infant?

  • Providing a mobile mounted above the crib to encourage reaching

  • Encouraging the infant to walk using a baby walker

  • Offering various textures of food to explore with the hands

  • Engaging in peek-a-boo games to develop social interaction

Correct answer: Providing a mobile mounted above the crib to encourage reaching

A mobile above the crib encourages a 6-month-old to reach up and touch, which helps develop hand-eye coordination and fine motor skills.

Encouraging a 6-month-old to walk using a baby walker can interfere with natural walking development and pose safety risks. Offering various textures of food is good for sensory development but does not specifically support motor skills related to movement and coordination like reaching does. Peek-a-boo games are beneficial for social and emotional development but do not specifically enhance motor skills like reaching and grabbing.

72.

A pediatric nurse is caring for a family whose child has been diagnosed with a terminal illness. The parents are visibly distressed and unsure how to discuss the situation with their child. What is the most appropriate action for the nurse to take in supporting the family at this time?

  • Educate the parents on ways to communicate effectively with their child about the illness

  • Suggest that the parents avoid discussing the illness until they feel ready to do so

  • Recommend that the parents wait for the child to ask questions before providing any information

  • Advise the parents to let the healthcare team lead discussions with the child

Correct answer: Educate the parents on ways to communicate effectively with their child about the illness

Educating parents on effective communication techniques empowers them to have open, honest conversations with their child about the illness. This approach supports a family-centered care model and helps ensure that the child is appropriately informed in a sensitive and supportive manner.

Suggesting that parents avoid discussing the illness can lead to confusion and distress for the child, who may sense something is wrong but doesn't understand what it is. Waiting for the child to ask questions before providing information might result in the child feeling isolated or fearful if they sense something is being withheld from them. While the healthcare team is a valuable resource, advising parents to let professionals handle all discussions can prevent them from having meaningful, reassuring conversations with their child.

73.

A nurse observes that a 4-year-old child has significantly poor hygiene, appears underweight, and is withdrawn during the visit. Which of the following actions is most appropriate for the nurse to take first?

  • Documenting the observations in detail

  • Providing a meal and clean clothes to the child immediately

  • Calling the child's teacher for more information

  • Engaging the child in play to observe adult interactions

Correct answer: Documenting the observations in detail

Detailed documentation of a child's condition and any signs of neglect or abuse is critical, as it forms the basis for any further investigation or intervention and ensures all details are legally noted.

Providing immediate care like a meal and clean clothes, while supportive, does not address the underlying issues or ensure that the child's needs are formally assessed and documented. Calling the child's teacher may provide additional information but should follow after documenting initial observations to ensure all interactions and observations are noted in a timely and professional manner. Engaging the child in play could be a useful technique for further observation, but it does not substitute the need for immediate and detailed documentation of the child's current state.

74.

A 2-year-old toddler is in the pediatric unit with non-contagious conditions. What type of play should the nurse encourage to aid in the child's development while hospitalized?

  • Supervised play with soft, large blocks

  • Independent play with complex model kits

  • Competitive games with other pediatric patients

  • Use of electronic tablets for watching age-appropriate movies

Correct answer: Supervised play with soft, large blocks

Supervised play with large, soft blocks is ideal for a 2-year-old as it enhances motor skills and cognitive development safely. This intervention is suitable for the child's age and developmental stage.

Complex model kits are inappropriate for toddlers due to their complexity and small parts, which pose a choking hazard. They are typically beyond the child’s developmental ability. Competitive games are not suitable for a 2-year-old as they do not yet understand or engage in structured competition, and such activities may lead to frustration. Electronic tablets do not encourage physical engagement or interaction, which are crucial for the developmental needs of toddlers. Prolonged screen time can also be harmful at this young age.

75.

During a home visit, a pediatric nurse assesses a child with end-stage renal disease. The family expresses interest in non-pharmacological methods to improve their child’s well-being. What should the nurse suggest?

  • Begin a guided play therapy program

  • Implement a strict dietary regimen to manage symptoms

  • Initiate daily vigorous exercise to boost physical strength

  • Explain that non-pharmacological methods will not improve the child’s well-being

Correct answer: Begin a guided play therapy program

Beginning a guided play therapy program can provide emotional support, improve psychological well-being, and offer a creative outlet for expression, which are all crucial for a child with end-stage renal disease. This approach directly addresses the family’s interest in non-pharmacological methods to improve their child's well-being.

Implementing a strict dietary regimen might help manage specific symptoms but does not directly improve overall well-being and can be restrictive, potentially impacting the child's enjoyment of food and social interactions. Initiating daily vigorous exercise could be physically overwhelming for a child with end-stage renal disease and may lead to adverse effects rather than improving well-being. Stating that non-pharmacological methods will not improve the child’s well-being is not only incorrect but also dismissive of the potential benefits of such approaches, which can complement medical treatments and enhance quality of life.

76.

A 14-year-old student shows signs of social withdrawal and expresses feelings of hopelessness. What is the most immediate action for the school nurse?

  • Arrange for a mental health evaluation.

  • Recommend more social interaction without adult interference.

  • Suggest attempts to suppress the feelings, as they are typical of adolescence.

  • Encourage the student to focus more on academics.

Correct answer: Arrange for a mental health evaluation.

Arranging a mental health evaluation is crucial to understand the underlying issues and provide appropriate interventions. It prioritizes the student's mental health and addresses the symptoms professionally.

Recommending more social interaction without guidance can be overwhelming and may not be helpful if the student feels socially anxious or depressed. It could increase feelings of hopelessness if these interactions are negative or if there is an underlying psychological pathology. Suggesting that feelings of hopelessness are typical and advising suppression can invalidate the student's experiences and deter them from seeking help, possibly worsening their condition. Encouraging a focus on academics when a student shows signs of social withdrawal and hopelessness can exacerbate stress and feelings of inadequacy.

77.

A 7-year-old child with a chronic musculoskeletal condition experiences frequent pain and anxiety. Which intervention is most appropriate to include in this child's care plan to improve comfort and quality of life?

  • Integrate a regular schedule of therapeutic massage

  • Increase the dosage of the child’s pain medication periodically

  • Restrict physical activities to minimize pain episodes

  • Consult with hospice on the best methods of promoting patient comfort

Correct answer: Integrate a regular schedule of therapeutic massage

Integrating therapeutic massage into the care plan can effectively address both pain and anxiety, providing comfort and improving quality of life without the risks associated with increasing medication dosages. This approach offers a holistic benefit that can enhance physical and emotional well-being.

Increasing the dosage of pain medication periodically might address pain but does not address the underlying anxiety, and could lead to medication dependency or side effects. Restricting physical activities may reduce pain episodes, but it can also lead to decreased physical fitness and social isolation, which can negatively impact overall quality of life. Consulting with hospice may be premature if the child's condition is not at a terminal stage, and it might not directly address the specific needs related to a chronic musculoskeletal condition.

78.

A nurse is caring for a 12-year-old child whose parent has recently passed away. Which approach best supports the child during their hospital stay?

  • Offer the child extra attention, checking in frequently and providing comfort

  • Help them maintain normal a routine to avoid any sense of change

  • Encourage the child to participate in group activities to avoid feeling isolated

  • Limit interactions to give the child space

Correct answer: Offer the child extra attention, checking in frequently and providing comfort

Offering extra attention and frequent check-ins can provide a sense of security and emotional support to a child in distress, especially after a significant loss like the death of a parent. Providing comfort reassures the child that they are not alone and that their feelings are acknowledged and important.

While maintaining a routine can provide stability, it does not directly address the emotional and psychological needs of a child grieving the loss of a parent. The child might need more than just routine to feel supported during such a vulnerable time. Additionally, trying to avoid a sense of change may inadvertently promote denial of the loss instead of healthy adaption. Encouraging participation in group activities may be beneficial later, but it assumes the child is ready to engage socially, which may not be the case immediately following a parent's death. Limiting interactions could increase feelings of isolation and neglect in a child who has just lost a significant caregiver. It's important to balance giving space with ensuring the child does not feel abandoned during their hospital stay.

79.

A family is considering hospice care for their child who has a terminal illness. What is the most appropriate initial action for the pediatric nurse to facilitate this transition?

  • Discuss the benefits and process of hospice care with the family

  • Initiate transfer the child to a hospice facility

  • Suggest the family consider delaying hospice care to try more aggressive treatments

  • Ensure that the family does not discuss hospice with their child until a decision is made

Correct answer: Discuss the benefits and process of hospice care with the family

Discussing the benefits and process of hospice care with the family is an essential initial action as it helps them understand what hospice entails and how it can support their child's end-of-life care. This conversation can address fears, clarify misconceptions, and facilitate a smoother transition to hospice care.

Initiating the transfer to a hospice facility without first ensuring the family fully understands and agrees with this decision can lead to distress and potential conflict. The family needs to be part of the decision-making process. Suggesting the family delay hospice care to try more aggressive treatments can be counterproductive if the treatments are unlikely to improve the child’s condition and may lead to unnecessary suffering. Ensuring that the family does not discuss hospice with the child until a decision is made can deprive the child of the opportunity to express their preferences and needs, which is important for ensuring that care respects the child's wishes.

80.

Which recommendation should a nurse provide to parents for a child who is starting kindergarten regarding social development?

  • Promote interactive play with peers to develop social skills

  • Encourage playing alone to foster independence

  • Limit time with peers to avoid overstimulation

  • Focus solely on academic skills to prepare for school demands

Correct answer: Promote interactive play with peers to develop social skills

Promoting interactive play with peers at the start of kindergarten helps children develop crucial social skills, such as sharing, turn-taking, and communication, which are essential for successful integration into school life.

Encouraging playing alone does not foster the social skills necessary for a child entering a social learning environment like kindergarten. Limiting time with peers could hinder the development of social skills needed for adapting to the social dynamics of a classroom. Focusing solely on academic skills overlooks the importance of social development, which is equally crucial for a well-rounded kindergarten experience.

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