Chapter 30: Basic Pediatric Nursing Care [Cooper and Gosnell: Foundations and Adult Health Nursing, 7th Edition]
Pediatric nursing: (select all that apply) a. Must enjoy working with children b. Must have keen observation skills c. Must not have own kids d. Must be honest
A B D
The nurse is aware that visual acuity evaluation in a child is best assessed after the age of _____ years.
6
The mother of a 3-year-old expresses concern about her daughter's slowed growth rate. What would be the most informative response by the nurse? a. "Three-year-olds have typically finished a growth spurt, and you may notice a decreased rate in your daughter's growth." b. "Children's growth is hereditary. She may be of small stature like you." c. "The growth of a 3-year-old is associated with their nutrition. How is she eating?" d. "Your daughter is healthy and happy. Don't worry about her growth right now."
A
When the nurse is inserting a feeding tube in an 8-month-old, what safety reminder device (SRD) should the nurse most likely use? a. Mummy b. Clove hitch c. Jacket device d. Elbow device
A
What is the purpose of Pediatric nursing: (select all that apply) a. Preventing disease or injury b. Assisting all children to achieve and maintain an optimum level of health and development. c. Treating and rehabilitation children who have health deviations d. Giving immunization shots
A B C
The nurse uses many communication strategies when talking with children. Which strategies would be appropriate for the pediatric nurse? (Select all that apply.) a. Using a calm, unhurried voice in a positive way to give directions or information. b. Avoid phrases that may be misinterpreted c. Avoid to give more information than the child can understand. d. As a general guide, use sentences whose sum of words is equal to the child's age in years plus one. e. Always offer children a choice to allow the child control of his or her situation. f. Address all communication to the parent and ask the parent to give the information to the child.
A B C D
Children with special needs refers to infants and children with: (select all that apply) a. congenital abnormalities b. chronic physical conditions c. chronic developmental conditions d. chronic behavioral conditions e. chronic emotional conditions conditions
A B C D E
What should the nurse do to minimize an unpleasant-tasting drug? (Select all that apply ) a. Have the child hold his/her nose shut b. Squirt the drug in the mouth with a syringe c. Administer the drug through a straw d. Enlist the parent's assistance e. Pour the drug over ice
A C
The nurse clarifies that the family-centered care approach terminates which policies? (Select all that apply.) a. Rigid visiting hours b. Freedom to choose which medications to take c. Exclusion of family during procedures d. Discouraging family to stay overnight e. Restricting parents from reading the chart f. Age restrictions on visitors
A C D E F
The nurse welcomes the presence of the family in a pediatric unit because it reduces the stressors of hospitalization. Which are common stressors for the hospitalized child? (Select all that apply.) a. Separation b. Lack of love c. Fear of pain d. Unfamiliar food e. Loss of control f. Anxiety
A C E F
Dr. ________ is referred to as the father of pediatrics: Initiated the establishment of milk station in NY showing how to sanitize milk for children.
Abraham Jacobi
A 3-month-old at the clinic is to receive an intramuscular injection. What is the most appropriate site for this injection? a. Dorsogluteal muscle b. Vastus lateralis muscle c. Deltoid muscle d. Rectus femoral muscle
B
An 8-year-old child asks how a blood pressure is taken. What would be the most appropriate response? a. "This small machine will measure your systolic and diastolic pressure." b. "The armband will hug your arm and tell me how well your blood is going through your arm." c. "The armband will cut off your circulation for a while and then we can hear when it comes back." d. "When you are ill we need to know if your blood is still moving in your body."
B
Following a lumbar puncture of a 2-year-old, what should the nurse do? a. Keep the child flat for several hours b. Allow the child to play quietly at will c. Hold the child in a flexed position for 5 minutes d. Stand the child upright immediately
B
How should an infant be positioned after a feeding? a. On the stomach b. On the right side c. On the left side d. On the back
B
The nurse must know how to compute medication doses correctly for children. Which is correct regarding the dosage calculation for children? a. A child dose is half the adult dose. b. The proportional amount of BSA to body weight is calculated. c. Unit doses are used in pediatrics and are based on a child's weight. d. The BSA of an adult divided by the BSA of a child multiplied by the adult dose equals the child's dose.
B
The nurse recognizes that a tuft of hair on the sacrum area is: a. A normal findings b. An indication of spina bifida occulta c. An overgrowth of hair which will fall off on its own d. A pituitary gland disorder
B
The pediatric nurse who uses the developmental approach in her practice will focus on: a. Family b. Strengths of the child c. Vital signs d. Disease of the child
B
What activity by an infant would cause a false elevation of the tympanic temperature? a. Having a bowel movement b. Crying vigorously c. Having just eaten d. Having been in a cold room
B
What is a disadvantage of using a mist tent with a toddler? a. The nurse must remove the restless child. b. The wet bedding and clothing must be changed frequently. c. The mist tent must be opened at least once every hour. d. All objects must be kept outside of the tent.
B
What is the maximum amount of time that a nurse should suction an artificial airway? a. 10 second b. 5 seconds c. 30 seconds d. 15 seconds
B
What is the purpose of a mist tent? a. To provide a constant oxygen supply b.To liquefy respiratory secretions c. To aid in lowering temperature d. To improve the infant's hydration
B
What was founded by Lillian Wald? a. National Commission on Children b. Henry Street Settlement c. White House Conference d. U.S. Children's Bureau
B
When a safety reminder device (SRD) is used to protect a child, what is a responsibility of the nurse? a. Apply it loosely b. Remove it every 2 hours c. Place it over clothing d. Apply only one type
B
Where is the typical IV insertion site in an infant younger than 9 months of age? a. Radial vein b. Scalp vein c. Femoral vein d. Brachial vein
B
Why must the pediatric nurse be cautious about medicating infants and young children? a. They are less susceptible to medication effects than adults. b. They are more susceptible to medication effects than adults. c. They are equally susceptible to medication effects as adults. d. They are more susceptible to drug interactions than adults.
B
An 18-month-old child is having difficulty maintaining his respiratory status. The child's physician orders oxygen therapy per nasal cannula. Which statements are true regarding oxygen therapy for children? (Select all that apply.) a. A nasal cannula is an effective oxygen delivery device even if the child breathes through the mouth. b. Maintaining cannula placement may be difficult as the child is able to remove it from the nares. c. To assess adequate oxygenation, the nurse checks cannula placement and oxygen saturation using a pulse oximeter every 2 hours and PRN. d. Oxygen flow by nasal cannula allows constant oxygen delivery even while eating and talking, because the mouth remains unobstructed. e. Encourage the child to cry because crying ensures the child has adequate oxygen supply.
B C D
A child's refraction does not reach 20/20 until about the age of: a. 2 yrs old b. 4 yrs old c. 6 yrs old d. 12 months old
C
After observing parental behavior that leads the nurse to suspect child abuse, when should the nurse report the abuse? a. If the parent confesses to child abuse b. If the child admits to being abused c. Whenever maltreatment of a child is suspected d. When the type of abuse can be determined
C
An off-duty LPN/LVN is buying groceries and observes a child sitting in the cart ahead. The child raises her shirt and picks at some scabs on her abdomen. The LPN/LVN recognizes that the wounds look like the result of cigarette burns. What is the best response as a health care professional? a. Assess for signs and symptoms of infection, and refer the child's mother to a physician. b. Ignore the observations as the LPN is off duty as a nurse and there is nothing that can be done. c. Notify the appropriate agency that that there is reason to believe a child has been abused. d. Hand the mother a brochure on managing stress.
C
Because pain is often underestimated in children, how will the nurse best assess a child's pain? a. Observe the child's activity. b. Observe the child's facial expressions. c. Use accepted pain assessment tools, such as the Wong-Baker FACES scale. d. Monitor vital signs for elevated pulse or blood pressure.
C
The hospital environment can be frightening and traumatic for children. How can the pediatric nurse help alleviate these stressors? a. Adhere to strict visiting hours as parents visit, because the child feeds off of parental anxieties leading to more crying. b. Keep nurse time with the child at a minimum by performing tasks and procedures as quickly as possible. c. During pre-admission, offer the parents and child a tour of the pediatric unit and inviting the parents to room-in with the child during hospitalization. d. Keep the television on at all times while the child is in the hospital to distract the child and muffle unfamiliar noises.
C
The mother of a child with diabetes asks the nurse in charge of the family-centered pediatric unit if she might see her child's laboratory reports. What response by the nurse is the most appropriate? a. "Although the actual reports are not shared, I can tell you the blood sugar is 200 mg." b. "I'll write them down for you and bring them to your room." c. "Come to the conference room where we can have privacy while you look at them." d. "I'll notify the physician that you wish to see the reports."
C
The nurse clarifies that child abuse and neglect are complicated and preventable problems falling under which broader term? a. Child abandonment b. Child mismanagement c. Child maltreatment d. Child torment
C
What is one way to enhance the nutrition of the hospitalized toddler? a. Reward with sweets for eating meals b. Discourage participation in noneating activities c. Offer nutritious fluids frequently d. Leave nutritious finger foods out for the child to eat
C
What is the correct way to assess for the presence of jaundice in an African American child? a. Examine the sclera b. Press the edge of the pinna c. Apply pressure to the gum d. Compare the color on the soles of the feet
C
What is the preferred IM injection site for a 2-year-old? a. Deltoid muscle b. Upper thigh c. Vastus lateralis d. Gluteus
C
What is the special category that encompasses children who have congenital abnormalities, malignancies, gastrointestinal (GI) diseases, or central nervous system (CNS) anomalies? a. Very dependent children b. Children requiring special education c. Children with special needs d. Children requiring long-term care
C
What should be done before initiating a Gavage feeding? a. Hold the feeding tube under water to check for bubbling b. Check for gastric distention c. Aspirate stomach contents d. Ensure the sterility of feeding equipment
C
What should be included in the teaching plan for the parents of a 3-year-old child who has been prescribed an opioid analgesic? a. The opioid is likely to cause significant respiratory depression. b. The medicine is prescribed with the knowledge that addiction may occur. c. The opioid is very effective as a pain control method. d. The opioid is only to be given in cases of severe pain.
C
What should be the focus of a practice where the pediatric nurse uses a developmental approach? a. Stimulation of the child to reach expected norms b. Age-centered care plans c. Strengths and abilities of the child d. Characteristics for the particular age
C
What was one of the major strides in pediatric care made by Dr. Abraham Jacobi? a. Pediatric wards in hospitals b. Free inoculations against smallpox c. Milk stations in the city of New York d. Serving nutritious foods in orphanages
C
When attempting to provide information to the parents of a child undergoing surgery, the nurse notes that the parents appear confused and do not seem to remember what they are being told. What is the most probable cause of the parents' forgetfulness? a. Noisy environment b. Serious nature of surgery c. Increased level of parents' anxiety d. Developmental age of the child
C
When communicating with parents suspected of child abuse, what should the nurse be sure to do? a. Tell them the law requires reporting of the incident b. Be sympathetic to their needs c. Interact with them in a nonjudgmental manner d. Suggest psychiatric counseling
C
When the newly admitted 2-year-old who was potty-trained before admission begins to wet the bed, the mother is frightened. What statement by the nurse will be most helpful to the mother? a. "Don't be concerned. Accidents happen." b. "Let's put a diaper on your child until this gets better." c. "The stress of hospitalization makes children regress a little." d. "Your child will relearn 'potty-training' if you are patient."
C
When the pediatric nurse is attempting to establish a trusting relationship with a child, what is the most important and lasting thing to do? a. Convey respect b. Talk with the child c. Be honest d. Talk with family
C
A 4-year-old child has a respiratory infection. The physician has ordered Rocephin IM for treatment. Which statement by the LPN/LVN will best prepare the child for the injection? a. "This shot will hurt but you are a big girl, so don't cry." b. "The doctor says you need a shot of medicine to get better since you keep spitting out the other medicine." c. "I am going to give you a shot. It will feel like a mosquito bite and will burn for a short time afterward." d. "Other kids tell me different things about how this feels. Some say it feels like a cat scratch. Will you tell me how it felt to you after we are done?
D
A disfiguring facial wound would have the most significant developmental impact on which child? a. 4-year-old b. 6-year-old c. 10-year-old d. 14-year-old
D
An LPN/LVN hears a 1-year-old Vietnamese patient crying shortly after the parents enter the room. The LPN/LVN enters and observes an object in the mother's hand and bright red welts on the toddler's skin. What is the appropriate nursing intervention? a. Immediately notify social services for the possibility of child abuse. b. Immediately notify the RN and report the observations. c. Quickly approach the parents and ask them to leave the room. d. Ask the parent to explain what is occurring.
D
Some infants and children require Gavage feedings. What is the best technique to check placement of the feeding tube before initiating the feeding? a. Aspirate for stomach contents per policy and procedure. b. Inject a small amount of air through a syringe into the feeding tube while simultaneously listening with a stethoscope over the stomach area for the sound of gurgling. c. Contact radiology for an x-ray to confirm proper placement. d. Aspirate for stomach contents and then inject air into the feeding tube while listening for gurgling sounds per policy and procedure.
D
The nurse addresses the local PTA about accident prevention for adolescents. What is most important for the nurse to highlight during the session? a. Teaching of traffic dangers, keeping sharp objects out of reach, and avoiding use of pillows b. Wearing seat belts, teaching fire safety, and the need to inform parents of whereabouts c. Teaching proper use of protective gear in sports; review acceptable behavior in a moving car; and practicing fire drills d. Education and review of basic first aid; setting consequences for substance abuse, especially drinking; and discussing the dangers of swimming alone
D
The parents ask about preparation of their toddler for hospital admission. When does the nurse suggest that the parents tell their toddler of the admission? a. A week prior b. 2 weeks prior c. The day of admission d. Only two or three days before
D
What is the best time to bathe an infant? a. At bedtime b. Early in the morning c. After a feeding d. Before a feeding
D
What is the correct order for assessing vital signs in an infant to ensure the accuracy of measurements? a. Respiration, temperature, pulse b. Pulse, respiration, temperature c. Temperature, pulse, respiration d. Respiration, pulse, temperature
D
What observation in an emergency department should lead a nurse to suspect child abuse in a child with a fractured arm? a. Lack of parental concern for the severity of the injury b. The child not answering questions concerning the injury c. Parents not asking about the child's condition d. Inconsistency between the injury and the parents' explanation of it
D
When assessing a neonate, the pediatric nurse should alert the head nurse or physician about which assessment finding? a. Temperature of 99 F b. Heart rate of 150 bpm c. Respiration rate of 40-50 bpm d. A tuft of hair on the sacrum
D
When discussing growth and development with the parents of a child, the nurse explains that nutrition is the single most important influence on: a. cognitive development. b. secondary sexual characteristics. c. the production of blood cells. d. the growth of bones and muscle.
D
When measuring the head circumference of an infant, where should the nurse place the tape measure? a. Across the eyebrows and around the occipital lobe b. Over the zygomatic arches and around the parietal areas c. Around forehead and around the crown of the head d. Above the eyebrows and pinnas, and around the occipital lobe
D
When using anticipatory guidance to prepare a 5-year-old for an IM injection, what statement by the nurse would be most appropriate? a. "Ethan, I'm going to give you a shot." b. "Ethan, the doctor wants you to have some medicine, and it will hurt." c. "Ethan, some medicine can only be given with a needle." d. "Ethan, I am going to give you some medicine that will sting, but only for a little while."
D
Why does obtaining the respirations of an infant require a modified approach from that of an adult? a. Infants breathe through their noses b. Infants have very rapid respirations c. Infants' respirations are thoracic in nature d. Infants' respiratory movements are abdominal
D
________ regarded as the founder of public health: Founded the Henry Street Settlement which provided nursing services and social assistance
Lillian Wald
The pediatric nurse, along with the primary caregiver(s), has a special duty to ________ the child and the family.
teach
