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Question 1 of 5.

A 2-year-old child returns to the clinic after completing a 10-day course of amoxicillin prescribed to relieve an infection in his right ear. After completing the medication, the child has become fussy and has a low-grade fever. On physical examination, his right tympanic membrane is bulging and he is tugging at his ear. The nurse should:

A. Suggest to the mother that a decongestant be used.

B. Tell the mother the health care provider will probably repeat the 10-day course of amoxicillin.

C. Suggest that the child should see an ear, nose, and throat specialist for myringotomy tubes.

D. Report the assessment to the health care provider with the probability that another antibiotic will be used for a 10-day course.

Explanation: Persistent symptoms like fussiness, fever, a bulging tympanic membrane, and ear tugging after completing amoxicillin suggest treatment failure, possibly due to resistant bacteria. The nurse should report these findings to the health care provider, who may prescribe a different antibiotic for another 10-day course.

Question 2 of 5.

After reading the vaccine information sheets, the parent of a 2-month-old infant is hesitant to consent to the recommended vaccinations. The nurse should first ask the parent:

A. Did you know that vaccinations are required by law for school entry?

B. What personal beliefs or safety concerns do you have about vaccinations?

C. Would you prefer that fewer vaccines are given at a time?

D. Can you please sign this vaccine waiver form?

Explanation: Addressing the parent's specific concerns fosters trust and encourages informed decision-making.

Question 3 of 5.

A parent brings a 4-month-old to the clinic for a regular well visit and expresses concern that the infant is not developing appropriately. Which findings in the infant would indicate the need for further developmental screening?

A. Has no interest in peek-a-boo games.

B. Does not turn front to back.

C. Does not babble.

D. Continues to have head lag.

Explanation: Head lag at 4 months suggests delayed motor development, requiring further evaluation.

Question 4 of 5.

The parent of a 9-month-old infant is concerned that the infant's front soft spot is still open. The nurse should tell the parent:

A. I will measure your baby's head to see if it is a normal size.

B. Your infant will need to be referred for more testing.

C. You should contact your physician immediately.

D. It is normal because this soft spot usually closes between 12 and 18 months.

Explanation: The anterior fontanelle typically closes between 12-18 months, so this is normal.

Question 5 of 5.

A mother brings her 18-month-old to the clinic because the child 'eats ashes, crayons, and paper.' Which of the following information about the toddler should the nurse assess first?

A. Evidence of eruption of large teeth.

B. Amount of attention from the mother.

C. Any changes in the home environment.

D. Intake of a soft, low-roughage diet.

Explanation: Changes in the home environment may contribute to pica, which requires immediate assessment.

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