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A nurse is assessing the growth and development of a 14-year-old boy. He reports that his 13-year-old sister is 2 inches taller than he is. The nurse should advise the boy that the growth spurt in adolescent boys, compared with the growth spurt of adolescent girls:
- A. Occurs at the same time.
- B. Occurs 2 years earlier.
- C. Occurs 2 years later.
- D. Occurs 1 year earlier.
Correct Answer: C
Rationale: Boys' growth spurts occur about 2 years later than girls', typically around 13-15 years.
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An 8-year-old has a body mass index (BMI) for age at the 90th percentile, but has no other risk factors. The nurse should:
- A. Refer for a weight management program.
- B. Prescribe a low-calorie diet.
- C. Order fasting glucose levels.
- D. Initiate daily exercise logs.
Correct Answer: A
Rationale: A BMI at the 90th percentile indicates overweight. A weight management program promotes healthy habits. Diet prescription, glucose testing, or exercise logs are premature without further risk assessment.
The parents of an 18-year-old preparing to enter college ask if their daughter should have the meningococcal (MCV4) vaccine. The nurse should tell the parents:
- A. It is only necessary to have the vaccine if your daughter will be living in a dormitory.'
- B. We recommend the vaccine, but it needs to be given as a series of three injections.'
- C. Let's review your records. The vaccine may have already been given a few years ago.'
- D. We highly recommend this vaccine, but we will need to do a pregnancy screening first.'
Correct Answer: C
Rationale: Checking vaccination records confirms whether the MCV4 vaccine, recommended for adolescents, was previously administered.
The parents of a preschooler ask the nurse how to handle their child's temper tantrums. Which of the following should the nurse include in the teaching plan? Select all that apply.
- A. Putting the child in 'time-out.'
- B. Telling the child to go to his bedroom.
- C. Ignoring the child.
- D. Putting the child to bed.
- E. Spanking the child.
- F. Trying to reason with the child.
Correct Answer: A,C
Rationale: Time-out and ignoring the tantrum are effective strategies to reduce attention-seeking behavior.
Which statements by the mother of a toddler should lead the nurse to suspect that the child is at risk for iron deficiency anemia?
- A. He drinks over three cups of milk per day.
- B. I can't keep enough apple juice in the house; he must drink over 10 oz per day.
- C. He refuses to eat more than two different kinds of vegetables.
- D. He doesn't like meat; I don't think that he will eat small amounts of it.
- E. He sleeps 12 hours every night and takes a 2-hour nap.
Correct Answer: A,C,D
Rationale: Excess milk, limited vegetables, and low meat intake reduce iron intake, increasing anemia risk. Apple juice and sleep patterns are unrelated.
Immediately on return to the nursing unit after surgical repair of a cleft palate, in which of the following positions should the nurse place the child?
- A. On the back with the head in a position of comfort.
- B. In low Fowler's position with the head turned to the side.
- C. Lying on the abdomen with the head turned to the side.
- D. In reverse Trendelenburg with the head tilted forward.
Correct Answer: C
Rationale: Lying on the abdomen with the head turned to the side facilitates drainage and reduces the risk of aspiration post-surgery.