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Quiz Session - Attempts With Random Questions

PNCB CPN Exam Questions

Page 8 of 20

141.

During a routine clinic visit, a pediatric nurse observes a 4-year-old girl who seems unable to engage with playroom activities that involve group interaction. Which aspect should the nurse assess further to understand her cognitive and developmental needs?

  • Her interaction with similar-aged peers at her preschool

  • Her ability to recite the alphabet and count to ten

  • How frequently she watches television shows

  • Her ability to understand how to engage in play

Correct answer: Her interaction with similar-aged peers at her preschool

Assessing her interaction with peers provides insights into her social skills, peer relationships, and potential developmental issues. These insights are critical aspects of her cognitive and developmental health.

Knowing her ability to recite the alphabet and count to ten, while indicating cognitive milestones, does not directly assess her ability to socially interact or her comfort in group play situations. The frequency of watching television shows is less relevant to her development than understanding her interactions in a social play setting. Assessing her ability to understand play is important, but not as immediately relevant as observing her actual interactions in a social context, which provides more direct evidence of her social development and integration skills.

142.

What should a nurse advise parents about maintaining their child's oral health during the transition from milk teeth to permanent teeth?

  • Continue brushing twice a day and flossing regularly.

  • Decrease brushing during the time teeth are naturally falling out to minimize gum trauma.

  • Switch to an adult-formula toothpaste immediately after the first tooth falls out.

  • Flossing should be paused during the transition until all permanent teeth have erupted.

Correct answer: Continue brushing twice a day and flossing regularly.

Maintaining consistent oral hygiene habits, such as brushing twice a day and flossing regularly, is crucial for dental health during the transition from milk teeth to permanent teeth.

Decreasing brushing is not advised as it can lead to an increased risk of dental decay and gum disease; regular brushing must be maintained. Switching to an adult-formula toothpaste is not necessary immediately after the first tooth falls out; toothpaste appropriate for the child's age should be used. Flossing should not be paused; it is important to continue flossing to maintain gum health and prevent interdental decay.

143.

A 3-year-old with dehydration is brought to the emergency department. The child is lethargic and has sunken eyes. What should the nurse do first?

  • Start an IV line to administer fluids

  • Initiate oral rehydration therapy

  • Document the assessment to support legal interventions for negligence

  • Measure urine output

Correct answer: Start an IV line to administer fluids

Starting an IV line for fluid administration is crucial in rapidly addressing severe dehydration in a lethargic child with sunken eyes, providing immediate rehydration.

Oral rehydration therapy is typically used for mild to moderate dehydration and may not be effective quickly enough in severe cases or with a lethargic child. Documenting the assessment is a necessary step in care but does not address the immediate need to correct dehydration. The potential assessment for negligence is secondary to addressing the patient’s physiological status Measuring urine output is important for monitoring but is secondary to initiating rehydration.

144.

A 13-year-old expresses curiosity about smoking cigarettes after seeing older peers smoking. What should the nurse emphasize in response?

  • Health risks associated with smoking

  • High cost of purchasing cigarettes

  • Social benefits of choosing not to smoke

  • Legality of underage smoking

Correct answer: Health risks associated with smoking

Emphasizing the health risks associated with smoking directly addresses the major immediate and long-term consequences of smoking, providing a strong deterrent for a young individual considering smoking.

While the cost of cigarettes is a practical consideration, it does not convey the severe health implications of smoking, which are more likely to influence long-term behavior. Discussing the social benefits of not smoking might be motivational, but it does not address the direct negative impacts of smoking itself and may not apply to adolescents considering smoking. The legality of underage smoking is important but less likely to influence behavior compared to understanding the serious health risks, which have more immediate and personal consequences.

145.

Which advice should a pediatric nurse give to parents for supporting their 8-year-old's cognitive development?

  • Encourage a variety of reading materials at home

  • Limit reading to school assignments to avoid fatigue

  • Focus on memorizing facts as a foundation for understanding abstract concepts

  • Discourage questions and encourage independence

Correct answer: Encourage a variety of reading materials at home

Encouraging a variety of reading materials promotes intellectual curiosity and cognitive development, providing diverse language exposure and knowledge. A wide variety of reading materials also increases their exposure to diverse perspectives and topics.

Limiting reading to only school assignments can restrict cognitive development and miss opportunities for more extensive learning and engagement with diverse topics. Focusing solely on memorizing facts can hinder the development of critical thinking and understanding of complex concepts, which are important for cognitive growth. Discouraging questions limits a child’s opportunity to learn and understand their world, undermining their cognitive and social development.

146.

A 4-year-old child in the pediatric unit who parents are staying with her has been identified as a fall risk. What measure should the nurse implement to enhance safety?

  • Provide the child with slip-resistant socks

  • Place the child in a room close to the nurse's station

  • Check on the child once every hour

  • Prevent the child from getting out of bed by using bedrails

Correct answer: Provide the child with slip-resistant socks

Slip-resistant socks help prevent slipping during ambulation and are an appropriate method of reducing the risk of falls in this patient.

Placing the patient in a room close to the nurse's station is not necessary if the patient’s parents will be present with her, as they will be with the patient and recognize if the patient engages in behaviors that increase the risk of falls. Checking on the child hourly could be an effective intervention if the child is unsupervised; however, this is not the case. Preventing the child from getting out of bed by using bedrails could increase the risk of falls if the child attempts to get out of bed despite the bedrails.

147.

A 15-year-old with a terminal illness expresses a desire to attend religious services as part of their end-of-life care. However, the patient is too weak to leave the hospital. How can the nurse best support the patient’s spiritual needs?

  • Arrange for a religious leader to visit the hospital

  • Suggest watching the service online if available

  • Recommend the family pray at the patient's bedside

  • Advise the patient to read religious texts instead

Correct answer: Arrange for a religious leader to visit the hospital

Arranging for a religious leader to visit satisfies the patient's spiritual needs in a direct and meaningful way, providing comfort during a critical time.

Watching the service online, although a viable option, does not provide the same personal interaction and spiritual fulfillment that a direct visit can offer. Family prayers at the bedside are supportive but do not replace the specific desire to participate in organized religious services and may not be relevant to the patient’s specific situation. Reading religious texts is a supportive action but does not substitute for the communal and interactive aspects of attending services and may not be relevant for some religions.

148.

A child is admitted for elective surgery, and the family expresses anxiety about post-operative care. How should the nurse address their concerns in the care plan?

  • Meet with the family prior to the operation to discuss and adjust the care plan as needed

  • Assure the family that concerns are common and encourage questions once the procedure is complete

  • Provide detailed written instructions and ask if they have any questions

  • Encourage the family to speak with the surgeon about their concerns

Correct answer: Meet with the family prior to the operation to discuss and adjust the care plan as needed

Meeting with the family allows the nurse to address their concerns and adjust the care plan accordingly. This can significantly reduce anxiety and improve post-operative care outcomes, fostering a collaborative environment where family concerns are directly incorporated into the care plan.

Merely reassuring the family and encouraging questions after the procedure may not adequately address their immediate anxieties or specific concerns about post-operative care. Questions about the post-operative phase should also be addressed as soon as possible, and should not be delayed until after the procedure. Providing written instructions is helpful, but it may not fully address all concerns if the family has specific anxieties or needs further clarification on care procedures. Encouraging discussion with the surgeon is useful but avoids the nurse's responsibility to teach and answer questions the family may have.

149.

In a pediatric unit, a toddler is found climbing out of the crib. What is the most appropriate immediate action by the nurse to prevent potential injury?

  • Arranging for the toddler not to be left alone in the room

  • Placing the toddler in a crib with higher sides

  • Lowering the crib sides when the toddler is sleeping

  • Teaching the toddler why climbing is dangerous

Correct answer: Arranging for the toddler not to be left alone in the room

Ensuring that the toddler is not left alone provides immediate supervision to prevent any potential injury from climbing or other activities. This measure is particularly essential in managing the safety of a child who has demonstrated the ability to climb out of a crib.

Placing the toddler in a crib with higher sides may delay but not adequately prevent the risk of climbing out again, which could lead to falls and injuries. It does not address the immediate need for supervision. Lowering the crib sides when the toddler is sleeping does not prevent the child from climbing out when awake and therefore does not address the immediate risk of injury. Teaching the toddler why climbing is dangerous is not likely to be effective due to limited impulse control at this age.

150.

A nurse is planning activities for a group of children ranging in age from 3 to 8 years old in a pediatric outpatient clinic. Which activity would best cater to the developmental stages of all the children in this group?

  • Provide a selection of age-diverse toys

  • Organize a detailed craft activity to develop fine motor skills

  • Set up an outdoor competitive sport

  • Encourage the use of age-diverse video games and puzzles

Correct answer: Provide a selection of age-diverse toys

Providing a selection of toys that cater to a wide age range ensures that each child can find something appropriate and engaging, accommodating their varied developmental stages.

A detailed craft activity might be too challenging for younger children in this age group and could frustrate them if the tasks exceed their fine motor skills. Organizing outdoor competitive sports can be difficult for younger children to participate in effectively and safely, making this activity unsuitable for the entire age range. Age-diverse video games and puzzles may still be too complex for the youngest in this group, potentially leading to exclusion or frustration among younger children.

151.

During a busy shift, a pediatric nurse must decide which task to delegate to a nursing assistant. Which task should the nurse delegate?

  • Recording intake and output for a child with gastroenteritis

  • Administering oral medications to a stable patient

  • Checking a child with unstable vital signs

  • Educating a family about their child’s newly diagnosed asthma

Correct answer: Recording intake and output for a child with gastroenteritis

Delegating the task of recording intake and output for a child with gastroenteritis to a nursing assistant is appropriate as it involves monitoring and documenting basic patient data, which does not require the advanced clinical judgment of a nurse.

Administering oral medications to any patient, even if stable, should not be delegated to a nursing assistant. This task requires clinical knowledge and skills specific to licensed nursing personnel. Checking on a child with unstable vital signs should not be delegated to a nursing assistant, as it requires clinical judgment and potentially immediate intervention that is beyond the scope of a nursing assistant’s responsibilities. Educating a family about their child’s newly diagnosed asthma involves in-depth knowledge and teaching skills specific to registered nurses, making it inappropriate to delegate to a nursing assistant.

152.

A 3-year-old patient is brought in for a wellness exam. The nurse needs to review the child's medication history. Which question is most appropriate to assess the child's current medication use?

  • "Does your child currently take any over-the-counter medications?”

  • “Was your child ever prescribed antibiotics at any point in their life?”

  • "Do you have a regular pharmacy you use to fill prescriptions?”

  • "Who is responsible for giving your child their medications?”

Correct answer: "Does your child currently take any over-the-counter medications?”

Asking directly about the current use of over-the-counter medications is essential to accurately assess all medications the child is taking, which can affect the child's overall health and any treatment plans.

Information about past antibiotic use is less relevant to current medication use and its immediate impacts. While some prescription medications may be continued indefinitely, antibiotics are typically only given on a short-term basis. Knowing whether the patient has a regular pharmacy helps with logistics but does not provide direct information about the medications the child is taking. Getting the name of the pharmacy may be helpful to contact them for a medication list; however, asking merely if the patient has a pharmacy will not yield this information. Knowing who administers medications doesn’t give specific information on what medications the child is currently taking.

153.

A nurse learns that a child's family is experiencing financial difficulties and cannot afford nutritional food. Which is the best recommendation for the nurse to make?

  • Refer the family to local social services for food assistance programs

  • Advise the family to buy only low-cost food items

  • Suggest a budget rearrangement to allocate more funds for food

  • Recommend nutrition education classes for economical meal planning

Correct answer: Refer the family to local social services for food assistance programs

Referring the family to local social services for food assistance ensures access to nutritional food without creating a financial burden. This approach addresses immediate needs effectively by linking the family with resources specifically designed to support those in financial difficulty.

Buying only low-cost food items may not ensure nutritional quality, which is crucial for health, especially in children. Suggesting a budget rearrangement does not solve the problem if the overall income is insufficient for basic needs, and may lead to further financial stress. While nutrition education is beneficial, it does not address the immediate issue of financial inability to purchase food, which can lead to malnutrition and health problems.

154.

What is an important milestone to discuss with parents of a 6-month-old regarding cognitive development?

  • Recognizing familiar faces

  • Solving simple puzzles

  • Speaking at least 10 words

  • Recognizing basic shapes

Correct answer: Recognizing familiar faces

At 6 months old, recognizing familiar faces is an important cognitive milestone, indicating healthy social and cognitive development.

Solving simple puzzles is not a milestone expected at 6 months, as this age group does not yet have the motor skills or cognitive ability to engage in such complex tasks. Speaking at least 10 words by 6 months is beyond the developmental expectation for this age, as most infants start to produce single words closer to their first birthday. Recognizing basic shapes is a more advanced cognitive task not typical for a 6-month-old, who is still developing basic visual and cognitive skills.

155.

A pediatric nurse notices that during consultations, one parent always answers while the other remains silent, looking uneasy. What is the most appropriate action for the nurse to take next?

  • Ask the silent parent directly about their views on the child's treatment plan

  • Continue discussing the treatment plan with the more vocal parent, following their preferred family norms

  • Suggest that parents alternate attending future meetings

  • Focus the discussion on topics that do not have the potential to be sensitive

Correct answer: Ask the silent parent directly about their views on the child's treatment plan

Engaging the silent parent directly ensures that both parents are involved and have a voice in the child's care, promoting a more comprehensive understanding of the family dynamics and the child’s needs.

Continuously discussing the plan with the more vocal parent may overlook important insights or concerns the other parent might have, potentially leading to an incomplete understanding of the child's needs. While alternating attendance might seem fair, it does not ensure that both parents are heard during the same discussions, which is crucial for coherent treatment planning. Avoiding sensitive topics might miss important aspects of the child's care; it's important to engage in discussions that might reveal important health-related information.

156.

In a case where a pediatric patient’s DNR status must be decided, what is the most important action for the nurse to take?

  • Set up a consultation to discuss DNR implications and ensure that the family understands them

  • Explain that the DNR order will be based primarily on the patient’s prognosis

  • Explain that the DNR decision can be reversed at any time if the family wants

  • Ensure the family understands that a DNR order requires aggressive treatment measures to be stopped

Correct answer: Set up a consultation to discuss DNR implications and ensure that the family understands them

Setting up a consultation to discuss do-not-resuscitate (DNR) implications and ensuring that the family understands them is the most important of the potential actions. This intervention provides the necessary information for making an informed decision that respects the patient’s wishes and medical needs, ultimately ensuring clarity and agreement on how end-of-life care should be approached.

Stating that the DNR order will be based primarily on the prognosis does not provide a full understanding of what a DNR entails and how it fits into broader end-of-life care plans. It is important to discuss all aspects, including the family's values and the patient’s comfort. While it's true that a DNR decision can be reversed, focusing on this during the initial discussion may give the impression that it is not a final decision, which could complicate future care planning and discussions. Ensuring the family understands that a DNR order requires stopping aggressive treatment measures would be misleading, as a DNR specifically refers to not performing CPR. Other forms of care, including palliative and supportive care, often continue and are not affected by a DNR order.

157.

A 6-year-old patient was recently diagnosed with type 1 diabetes and is with his parents in the clinic for a follow-up. The parents appear overwhelmed with the care routine. What is the most appropriate action by the nurse to develop their coping skills?

  • Offer educational resources and ask how they have managed the diabetes care at home

  • Suggest they speak to a social worker to discuss their feelings

  • Advise them to relax as they will get used to the routine

  • Recommend joining a support group for parents of children with chronic conditions

Correct answer: Offer educational resources and ask how they have managed the diabetes care at home

Providing educational resources ensures that the parents are well-informed about managing type 1 diabetes, and asking about their management techniques helps identify areas where they might need additional support or information.

While talking to a social worker could be helpful, it doesn't directly develop their practical skills in managing the disease. Telling parents to relax may minimize their concerns and doesn't provide them with the tools or support needed to manage the disease effectively. Joining a support group is beneficial for emotional support but doesn’t address the immediate need to assess and improve their practical management skills.

158.

What is the typical age at which a child is expected to start walking independently?

  • 12 months

  • 9 months

  • 15 months

  • 18 months

Correct answer: 12 months

The earliest age a child is typically expected to start walking independently is around 12 months, although there can be normal variation from 9 to 18 months.

While some children may start walking as early as 9 months, it is not the standard expectation for independent walking. Fifteen months is within the normal range but not the typical age for walking. Eighteen months is still within a normal range but represents the upper limit of typical development for walking.

159.

A 10-year-old child living in a low-income urban area has frequent asthma exacerbations. In assessing this child, what is most important for the nurse to consider?

  • Proximity to industrial pollution

  • Type of materials the child’s house is made of

  • Preference for indoor or outdoor play

  • Interest in joining a local sports team

Correct answer: Proximity to industrial pollution

Assessing proximity to industrial pollution is crucial for a child with asthma, as pollutants can exacerbate respiratory symptoms and trigger severe asthma attacks. This factor directly impacts the child's health and requires environmental intervention.

While the type of materials a house is made out of can affect health, industrial pollution is a more significant and direct environmental hazard for triggering asthma exacerbations. Preference for indoor or outdoor play is relevant to understanding exposure risks but does not address the environmental factors like pollution that are critical to managing asthma. Interest in joining a sports team is important for social and physical development but does not directly relate to the environmental assessment needed for asthma management.

160.

What guidance should a nurse give to parents about their child's language development at 2 years old?

  • Recognize the use of two to four-word phrases as typical.

  • Expect a limited vocabulary with adult-like grammar.

  • Encourage silence during meals to promote digestion.

  • Discourage the use of gestures, as it may hinder verbal development.

Correct answer: Recognize the use of two- to four-word phrases as typical.

At 2 years old, it is typical for children to start using two- to four-word phrases; this marks progress in language development. Recognizing and encouraging this development is important for positive reinforcement and tracking normal growth.

Expecting adult-like grammar from a 2-year-old is unrealistic, as their cognitive and linguistic abilities are still basic at this age. Encouraging silence during meals does not have a direct relationship with language development and can unnecessarily restrict verbal expression. Discouraging the use of gestures can hinder verbal development because gestures are a normal part of language development, helping children communicate their needs and thoughts before they can form complete sentences.

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