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4 | Page D. Yes, for only a few months, due to advancement of technology in medicine. 42. One of the infants were observed to have (+) dimpling, abnormal tufts of hair at the lower part of his back. You know that this condition is caused by which of the following? A. It occurs when the upper end of the neural tube fails to close in early intrauterine life. B. It occurs when the spinal cord and the meninges protrude through the vertebrae that affects the motor and sensory function. C. It occurs when the posterior laminae of the vertebrae fail to fuse. D. It occurs when the meninges covering the spinal cord herniates through unformed vertebrae. 43. Before the surgery for the myelomeningocele, proper positioning is essential to avoid drying and pressure on the exposed membrane. Sterile gloves and sterile linens are used when caring for the patient and positioned correctly. Which of the following is the correct preoperative positioning of the patient? A. Supine position, with a rolled sterile linen adjacent to the exposed membrane to tilt the body. B. Side-lying position, with rolled blanket in front of the patient C. Side-lying, with rolled blanket behind their back above the disorder and another rolled blanker below the disorder. D. Comfort of the patient is more important, position the patient however they want. 44. You notice a seepage of clear fluid from the defect, which of the following will confirm that the fluid is CSF leakage? A. Check for evidence of glucose B. Check for smell and appearance C. Check for evidence of protein D. Report to physician 45. Even after the surgery and management of neural tube disorders, impaired bladder elimination is likely to be observed depending on the affected level of the defect. One of your interventions include strengthening the parents’ confidence and understanding of clean intermittent catheterization for the patient. Which of the following will require additional teaching when said or done by the patient? A. Always use sterile equipment and catheterize at least every 4 hours. B. Wash around your child’s urinary meatus with a clean washcloth or paper towel and warm, soapy water. C. Coat the tip of a clean catheter with water-soluble lubricant. D. To reuse the catheter, clean it with soap and water, rinse with clear water. Situation: You encounter different ages of pediatric patients in the outpatient clinic you are working for. To understand your patients better, you review on different theoretical foundations of development. 46. In psychosocial development by Freud, which of the following is true about ages 1 to 3 years old? A. Preferred method of oral gratification affects the child’s personality development B. The climate surrounding toilet training can have lasting effects on children's personalities. C. The genitalia become an interesting and sensitive area of the body. D. Centers around the controversial issues of the Oedipus and Electra complexes. 47. According to Erikson’s psychosocial development, what age group does a child develop a conscience in which they are no longer guided only by the outsiders, but they have an inner voice that warns? A. 6 to 12 years old B. 1 to 3 years old C. 3 to 6 years old D. 12 to 18 years old 48. According to Piaget’s cognitive development, 5-year-old Emma now thinks that all women who has big bellies are pregnant after she asked her mother why her Aunt Hera has a big belly. The mother responded that her Aunt Hera has a baby inside of her belly. Which of the following reflects this kind of reasoning? A. Transductive B. Intuitive C. Inductive D. Egocentric 49. According to Kohlberg, how does an individual reach the most advanced level of moral development? A. When correct behavior is defined in terms of general individual rights and standards that have been examined and agreed on by the entire society. B. When behavior meets with approval and pleases or helps others and is considered good. C. When one in which self-chosen ethical principles guide decisions of conscience. D. There is no “most advanced level” of moral development since it is ever-evolving and abstract. 50. Which of the following correctly describes self-concept? A. Refers to a personal, subjective judgment of one's worthiness derived from and influenced by the social groups in the immediate environment B. Refers to value that an individual places on oneself and refers to an overall evaluation of oneself C. Refers to the subjective concepts and attitudes that individuals have toward their own bodies. D. Includes all of the notions, beliefs, and convictions that constitute an individual's self-knowledge Situation: Children who are admitted to hospitalization are susceptible to stressors because of the presence of change and the limited coping mechanisms to resolve the stressors. 51. When a child experiences separation anxiety, which of the following is the introductory stage observed in the child? A. Stage of protest B. Stage of despair C. Stage of detachment D. Stage of denial 52. During the following days of hospitalization, you notice that your patient appears to have finally adjusted to being in the hospital. She appears to form new relationships with the hospital staff, becomes more interested in the surroundings, and plays with others. She becomes more withdrawn when the parents are around. Which of the following will you advise the parents? A. Parents to stay for short but intimate periods with the patient. B. Scold the child for the negative behavior C. Increase interaction of the hospital staff that the patient has already formed new relationships with D. Explain to the parents about the stage of detachment, encourage parent-child interaction 53. For non-critical admitted pediatric patients, how can you best minimize disruption in the child’s routine? A. Write down a daily schedule in collaboration with the patient, parent, and the nurse. B. Preserve parent-child interaction at all times. C. Do not limit the number of times a parent can visit the child. D. Keep the child in cribs or play yards. 54. How can you best reassure a preschool child after blood extraction? A. Explain to the child about how bleeding would stop after needle is removed and applied pressure. B. Draw how the bleeding stops after the needle is removed. C. Let the parent remove the needle instead. D. Apply a band-aid to the site of removal. 55. Which of the following will you not include in educating the parents about supporting siblings of the patients during hospitalization? A. Trade off staying at the hospital with spouse or have a surrogate who knows the siblings well stay in the home. B. Withheld information about the child's condition to young siblings to not scare them.