enfant 5
Anisometropia
1. Different refractive strength in each eye
Myopia
2. Ability to see objects clearly at close range but not at a distance
Amblyopia
3. Reduced visual acuity in one eye
Astigmatism
4. Unequal curvatures in refractive apparatus
Hyperopia
5. Ability to see objects at a distance but not at a close range
The nurse understands that which gestational disorders can cause a cognitive impairment in the newborn? (Select all that apply.) a. Prematurity b. Postmaturity c. Low birth weight d. Physiological jaundice e. Large for gestational age
ABC
A feeling of guilt that the child "caused" the disability or illness is especially common in which age group? a. Toddler b. Preschooler c. School-age child d. Adolescent
B
The nurse is teaching parents the signs of a hearing impairment in a child. What should the nurse include as signs? (Select all that apply.) a. Outgoing behavior b. Yelling to express pleasure c. Asking to have statements repeated d. Foot stamping for vibratory sensation e. Failure to develop intelligible speech by age 24 months
BCDE
What characterizes a school-aged child's concept of death? (Select all that apply.) a. Have a mature understanding of death b. Can respond to logical explanations of death c. Personify death as the devil or the bogeyman d. Have a deeper understanding of death in a concrete sense e. Fear the mutilation and punishment associated with death
BCDE
What risk factors can cause a sensorineural hearing impairment in an infant? (Select all that apply.) a. Cat scratch disease b. Bacterial meningitis c. Childhood case of measles d. Childhood case of chicken pox e. Administration of aminoglycosides for more than 5 days
BCE
The nurse is teaching parents the signs of a hearing impairment in infants. What should the nurse include as signs? (Select all that apply.) a. Lack of a fencing reflex b. Lack of a startle reflex to a loud sound c. Awakened by loud environmental noises d. Failure to localize a sound by 6 months of age e. Response to loud noises as opposed to the voice
BDE
18. The nurse is often the individual who is in the optimum position to suggest tissue donation to a family (after consultation with the practitioner). What will occur if a family chooses organ or tissue donation? a. The funeral will be delayed. b. Cremation is the preferred method of burial. c. Written consent is required for tissue or organ donation. d. An open casket cannot be used subsequent to this procedure.
C
At which age do most children have an adult concept of death as being inevitable, universal, and irreversible? a. 4 to 5 years b. 6 to 8 years c. 9 to 11 years d. 12 to 16 years
C
Autism is a complex developmental disorder. The diagnostic criteria for autism include delayed or abnormal functioning in which area with onset before age 3 years? a. Parallel play b. Gross motor development c. Ability to maintain eye contact d. Growth below the fifth percentile
C
The American Association on Intellectual and Developmental Disabilities (AAIDD), formerly the American Association on Cognitive Impairment, classifies cognitive impairment based on what parameter? a. Age of onset b. Subaverage intelligence c. Adaptive skill domains d. Causative factors for cognitive impairment
C
The nurse asks the mother of a child with a chronic illness many questions as part of the assessment. The mother answers several questions, then stops and says, "I don't know why you ask me all this. Who gets to know this information?" The nurse should respond in what manner? a. Determine why the mother is so suspicious. b. Determine what the mother does not want to tell. c. Explain who will have access to the information. d. Explain that everything is confidential and that no one else will know what is said.
C
The nurse is counseling a pregnant 35-year-old woman about estimated risk of Down syndrome. What is the estimated risk for a woman who is 35 years of age? a. One in 1200 b. One in 900 c. One in 350 d. One in 100
C
The nurse is discussing sexuality with the parents of an adolescent girl who has a moderate cognitive impairment. What factor should the nurse consider when dealing with this issue? a. Sterilization is recommended for any adolescent with cognitive impairment. b. Sexual drive and interest are very limited in individuals with cognitive impairment. c. Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct. d. Sexual intercourse rarely occurs unless the individual with cognitive impairment is sexually abused.
C
The nurse is teaching feeding strategies to a parent of a 12-month-old infant with Down syndrome. What statement made by the parent indicates a need for further teaching? a. "If the food is thrust out, I will reefed it." b. "I will use a small, long, straight-handled spoon." c. "I will place the food on the top of the tongue." d. "I know the tongue thrust doesn't indicate a refusal of the food."
C
The sibling of a 4-year-old girl dies from sudden infant death syndrome. The parents are concerned because the 4-year-old girl showed more outward grief when her cat died than now. How should the nurse explain this reaction to the parents? a. The child is not old enough to have a concept of death. b. This suggests maladaptive coping, and referral is needed for counseling. c. The death may be so painful and threatening that the child must deny it for now. d. The child is not old enough to have formed a significant attachment to her sibling.
C
What action should the school nurse take for a child who has a hematoma (black eye) with no hemorrhage into the anterior chamber? a. Apply a warm moist pack. b. Have the child keep the eyes open. c. Apply ice for the first 24 hours. d. Refer to an ophthalmologist immediately.
C
The nurse is assessing a child with Down syndrome. The nurse recognizes that which are possible comorbidities that can occur with Down syndrome? (Select all that apply.) a. Diabetes mellitus b. Hodgkin's disease c. Congenital heart defects d. Respiratory tract infections e. Acute megakaryoblastic leukemia
CDE
The nurse should plan which actions to assist the stuttering child? (Select all that apply.) a. Ask the child to stop and start over. b. Promise a reward for proper speech. c. Set a good example by speaking clearly. d. Give the child plenty of time to finish sentences. e. Look directly at the child while he or she is speaking.
CDE
2. What physiologic defect is responsible for causing anemia? a. Increased blood viscosity b. Depressed hematopoietic system c. Presence of abnormal hemoglobin d. Decreased oxygen-carrying capacity of blood
D
A 7-year-old child is in the end stages of cancer. The parents ask you how they will know when death is imminent. What physical sign is indicative of approaching death? a.Hunger b.Tachycardia c.Increased thirst d.Difficulty swallowing
D
Many of the clinical features of Down syndrome present challenges to caregivers. Based on these features, what intervention should be included in the child's care? a. Delay feeding solid foods until the tongue thrust has stopped. b. Modify the diet as necessary to minimize the diarrhea that often occurs. c. Provide calories appropriate to the child's mental age. d. Use a cool-mist vaporizer to keep the mucous membranes moist and secretions liquefied.
D
The school nurse is caring for a child with a penetrating eye injury. Emergency treatment includes what intervention? a. Place a cool compress on eye during transport to the emergency department. b. Irrigate the eye copiously with a sterile saline solution. c. Remove the object with a lightly moistened gauze pad. d. Apply a Fox shield to the affected eye and any type of patch to the other eye.
D
What factor is most important for parents implementing do not resuscitate (DNR) orders? a. Parents' beliefs about euthanasia b. Presence of other children in the home c. Experiences of the health care team with other children in this situation d. Acknowledgment by health care team that child has no realistic chance for cure
D
What finding by the nurse is most characteristic of chronic sorrow? a. Lack of acceptance of child's limitation b. Lack of available support to prevent sorrow c. Periods of intensified sorrow when experiencing anger and guilt d. Periods of intensified sorrow at certain landmarks of the child's development
D
What nursing intervention is especially helpful in assessing feelings of parental guilt when a disability or chronic illness is diagnosed? a. Ask the parents if they feel guilty. b. Observe for signs of overprotectiveness. c. Talk about guilt only after the parents mention it. d. Discuss the meaning of the parents' religious and cultural background.
D
What suggestion by the nurse for parents regarding stuttering in children is most helpful? a. Offer rewards for proper speech. b. Encourage the child to take it easy and go slow when stuttering. c. Help the child by supplying words when he or she is experiencing a block. d. Give the child plenty of time and the impression that you are not in a hurry.
D
What is the major health concern of children in the United States? a. Acute illness b. Chronic illness c. Congenital disabilities d. Nervous system disorders
b
When communicating with dying children, what should the nurse remember? a. Adolescent children tend to be concrete thinkers. b. Games, art, and play provide a good means of expression. c. When children can recite facts, they understand the implications of those facts. d. If children's questions direct the conversation, the assessment will be incomplete.
b
27. The nurse understands that a school-age child may react to death with what reaction? a. Joking b. Having no reaction c. Fearing the unknown d. Seeing it as a distant event
c
A 12-year-old child has failed several courses of chemotherapy. An experimental drug is available that his parents want him to receive. He has told his parents and the oncologists that he is ready to die and does not want any more chemotherapy. The nurse recognizes what to be true? a.Parents and child both need support in the decision making. b.Twelve-year-olds are minors and cannot give consent or refuse treatments. c.The oncologists needs to make the decision because the parents and child disagree. d.The parents have the right and responsibility to make decisions for their children younger than age 18 years.
A
A child's parents ask the nurse many questions about their child's illness and its management. The nurse does not know enough to answer all the questions. What nursing action is most appropriate at this time? a. Tell them, "I don't know, but I will find out." b. Suggest that they ask the physician these questions. c. Explain that the nurse cannot be expected to know everything. d. Answer questions vaguely so they do not lose confidence in the nurse.
A
For case management to be most effective, who should be recognized as the most appropriate case manager? a. Nurse b. Panel of experts c. Multidisciplinary team d. Insurance company
A
One of the supervisors for a home health agency asks the nurse to give a family of a child with a chronic illness a survey evaluating the nurses and other service providers. How should the nurse recognize this request? a. Appropriate to improve quality of care b. Improper because it is an invasion of privacy c. Inappropriate unless nurses and other providers agree to participate d. Not acceptable because the family lacks remembering necessary to evaluate professionals
A
The community nurse is planning prevention measures designed to avoid conditions that can cause cognitive impairment. Taking folic acid supplements during pregnancy to prevent neural tube defects is which type of prevention strategy? a. Primary b. Secondary c. Tertiary d. Rehabilitative
A
The family and child have decided that hospice care best meets their needs during the terminal phase of illness. The nurse recognizes that the parents understand the principles of this care when they make which statement? a. "It will be good to be at home and care for our child." b. "What a relief it will be not to need any more medicines." c. "We are going to miss the support of the hospice team when our child dies." d. "We know that once hospice care starts, we will not be able to return to the hospital if the care is difficult."
A
The mother of a young child with cognitive impairment asks for suggestions about how to teach her child to use a spoon for eating. The nurse should make which recommendation? a. Do a task analysis first. b. Do not expect this task to be learned. c. Continue to spoon feed the child until the child tries to do it alone. d. Offer only finger foods so spoon feeding is unnecessary.
A
The nurse is planning care for a 3-year-old boy who has Down syndrome and is on continuous oxygen. He recently began walking around furniture. He is spoon fed by his parents and eats some finger foods. What goal is the most appropriate to promote normal development? a. Encourage mobility. b. Encourage assistance in self-care. c. Promote oral-motor development. d. Provide opportunities for socialization.
A
The nurse is talking to the parent of a child with special needs. The parent has expressed worry about how to support the siblings at home. What suggestion is appropriate for the nurse to give to the parent? a. "You should help the siblings see the similarities and differences between themselves and your child with special needs." b. "You should explain that your child with special needs should be included in all activities that the siblings participate in even if they are reluctant." c. "You should give the siblings many caregiving tasks for your child with special needs so the siblings feel involved." d. "You should intervene when there are differences between your child with special needs and the siblings."
A
The nurse is teaching a preschool child with a cognitive impairment how to throw a ball overhand. What teaching strategy should the nurse use for this child? a. Demonstrate how to throw a ball overhand. b. Explain the reason for throwing a ball overhand. c. Show pictures of children throwing balls overhand. d. Explain to the child how to throw the ball overhand.
A
The nurse notes that the parents of a critically ill child spend a large amount of time talking with the parents of another child who is also seriously ill. They talk with these parents more than with the nurses. How should the nurse interpret this situation? a. Parent-to-parent support is valuable. b. Dependence on other parents in crisis is unhealthy. c. This is occurring because the nurses are unresponsive to the parents. d. This has the potential to increase friction between the parents and nursing staff.
A
The nurse should suspect a hearing impairment in an infant who fails to demonstrate which behavior? a. Babbling by age 12 months b. Eye contact when being spoken to c. Startle or blink reflex to sound d. Gesturing to indicate wants after age 15 months
A
The parents of a child born with disabilities ask the nurse for advice about discipline. The nurse's response should be based on remembering that discipline is which? a. Essential for the child b. Not needed unless the child's behavior becomes problematic c. Best achieved with punishment for misbehavior d. Too difficult to implement with a special needs child
A
The parents of a child on a ventilator tell the nurse that their insurance company wants the child to be discharged. They explain that they do not want the child home "under any circumstances." What principle should the nurse consider when working with this family? a. Desire to have the child home is essential to effective home care. b. Parents should not be expected to care for a technology-dependent child. c. Having a technology-dependent child at home is better for both the child and the family. d. Parents are not part of the decision-making process because of the costs of hospitalization.
A
The potential effects of chronic illness or disability on a child's development vary at different ages. What developmental alteration is a threat to a toddler's normal development? a. Hindered mobility b. Limited opportunities for socialization c. Child's sense of guilt that he or she caused the illness or disability d. Limited opportunities for success in mastering toilet training
A
What manifestation observed by the nurse is suggestive of parental overprotection? a. Gives inconsistent discipline b. Facilitates the child's responsibility for self-care of illness c. Persuades the child to take on activities of daily living even when not able d. Encourages social and educational activities not appropriate to the child's level of capability
A
What nursing intervention is most appropriate in promoting normalization in a school-age child with a chronic illness? a. Give the child as much control as possible. b. Ask the child's peer to make the child feel normal. c. Convince the child that nothing is wrong with him or her. d. Explain to parents that family rules for the child do not need to be the same as for healthy siblings.
A
What nursing intervention is most appropriate when providing comfort and support for a child when death is imminent? a. Limit care to essentials. b. Avoid playing music near the child. c. Whisper to the child instead of using a normal voice. d. Explain to the child the need for constant measurement of vital signs.
A
What observation in a child should indicate the need for a referral to a specialist regarding a communication impairment? a. At 2 years of age, the child fails to respond consistently to sounds. b. At 3 years of age, the child fails to use sentences of more than five words. c. At 4 years of age, the child has impaired sentence structure. d. At 5 years of age, the child has poor voice quality.
A
What statement is most descriptive of a school-age child's reaction to death? a. Very interested in funerals and burials b. Little understanding of words such as "forever" c. Imagine the deceased person to be still alive d. Can explain death from a religious or spiritual point of view
A
What technique facilitates lip reading by a hearing-impaired child? a. Speak at an even rate. b. Avoid using facial expressions. c. Exaggerate pronunciation of words. d. Repeat in exactly the same way if child does not understand.
A
When is an autopsy required? a. In the case of a suspected suicide b. When a person has a known terminal illness c. With a hospice patient who dies at home d. With the victim of a motor vehicle collision
A
A child has a slight (26-40 dB) degree of hearing loss. The nurse recognizes this amount of hearing loss can have what effect? (Select all that apply.) a. No speech defects b. Difficulty hearing faint speech c. Usually is unaware of the hearing difficulty d. Can distinguish vowels but not consonants e. Unable to understand conversational speech
ABC
The nurse is teaching coping strategies to parents of a child with a chronic illness. What coping strategies should the nurse include? (Select all that apply.) a. Listen to the child. b. Accept the child's illness. c. Establish a support system. d. Learn to care for the child's illness one day at a time. e. Do not share information with the child about the illness.
ABCD
What are supportive interventions that can assist a preschooler with a chronic illness to meet developmental milestones? (Select all that apply.) a. Encourage socialization. b. Encourage mastery of self-help skills. c. Provide devices that make tasks easier. d. Clarify that the cause of the child's illness is not his or her fault. e. Discuss planning for the future and how the condition can affect choices.
ABCD
The nurse is assessing coping behaviors of a family with a child with a chronic illness. What indicates avoidance coping behaviors? (Select all that apply.) a. Refuses to agree to treatment b. Avoids staff, family members, or child c. Is unable to discuss possible loss of the child d. Recognizes own growth through a passage of time e. Makes no change in lifestyle to meet the needs of other family members
ABCE
The nurse is preparing an education program on hearing impairment for a group of new staff nurses. What concepts should be included? (Select all that apply.) a. A child with a slight hearing loss is usually unaware of a hearing difficulty. b. A clinical manifestation of a hearing impairment in children is avoidance of social interaction. c. A child with a severe hearing loss may hear a loud voice if nearby. d. Children with sensorineural hearing loss can benefit from the use of a hearing aid. e. A clinical manifestation of hearing impairment in an infant is lack of the startle reflex. f. Identification of a hearing loss after the first year is essential to facilitate language development in children.
ABCE
The nurse should plan which actions to facilitate lipreading for a child with a hearing impairment? (Select all that apply.) a. Face the child directly. b. Speak at eye level. c. Keep sentences short. d. Speak at a fast, even-paced rate. e. Establish eye contact and show interest.
ABCE
The nurse is assessing coping behaviors of a family with a child with a chronic illness. What indicates approach coping behaviors? (Select all that apply.) a. Plans realistically for the future b. Verbalizes possible loss of the child c. Uses magical thinking and fantasy d. Realistically perceives the child's condition e. Does not share the burden of the disorder with others
ABD
What are supportive interventions that can assist an infant with a chronic illness to meet developmental milestones? (Select all that apply.) a. Encourage consistent caregivers. b. Encourage periodic respite from demands of care. c. Encourage one family member to be the primary caretaker. d. Encourage parental "rooming in" during hospitalization. e. Withhold age-appropriate developmental tasks until the child is older.
ABD
What are indications for a referral regarding a communication impairment in a school-age child? (Select all that apply.) a. Barely audible voice quality b. Vocal pitch inappropriate for age c. Intonation noted during speaking d. Maintains a rhythm while speaking e. Distortion of sounds after age 7 years
ABE
What are supportive interventions that can assist a toddler with a chronic illness to meet developmental milestones? (Select all that apply.) a. Give choices. b. Provide sensory experiences. c. Avoid discipline and limit setting. d. Discourage negative and ritualistic behaviors. e. Encourage independence in as many areas as possible.
ABE
What are common respiratory symptoms dying children experience? (Select all that apply.) a. Cough b. Eupnea c. Wheezing d. Shortness of breath e. Decrease in secretions
ACD
What are supportive interventions that can assist an adolescent with a chronic illness to meet developmental milestones? (Select all that apply.) a. Encourage activities appropriate for age. b. Avoid discussing planning for the future. c. Provide instruction on interpersonal and coping skills. d. Emphasize good appearance and wearing of stylish clothes. e. Understand that the adolescent will not have the same sexual needs.
ACD
What characterizes a preschooler's concept of death? (Select all that apply.) a. Belief their thoughts can cause death. b. They have a concrete understanding of death. c. Death is seen as temporary and gradual. d. Death is seen as a departure, a kind of sleep. e. They usually have some sense of the meaning of death.
ACDE
What are supportive interventions that can assist a school-age child with a chronic illness to meet developmental milestones? (Select all that apply.) a. Encourage socialization. b. Discourage sports activities. c. Encourage school attendance. d. Provide instructions on assertiveness. e. Educate teachers and classmates about the child's condition.
ACE
What does the nurse recognize as physical signs of approaching death? (Select all that apply.) a. Mottling of skin b. Decreased sleeping c. Cheyne-Stokes respirations d. Loss of the sense of hearing e. Decreased appetite and thirst
ACE
The clinic nurse is assessing an infant. What are early signs of cognitive impairment the nurse should discuss with the health care provider? (Select all that apply.) a. Head lag at 11 months of age b. No pincer grasp at 4 months of age c. Colicky incidents at 3 months of age d. Unable to speak two to three words at 24 months of age e. Unresponsiveness to the environment at 12 months of age
ADE
The nurse is teaching parents of a child with a cognitive impairment signs that indicate the child is developmentally ready for dressing training. What signs should the nurse include that indicate the child is developmentally ready for dressing training? (Select all that apply.) a. Can follow verbal commands b. Can sit quietly for 1 to 2 minutes c. Can master every task of dressing d. Can follow physical gestures or cues e. Can relate clothing to the appropriate body part
ADE
What characterizes a toddler's concept of death? (Select all that apply.) a. They are unable to comprehend an absence of life. b. They may recognize the fact of physical death. c. They understand the universality and inevitability of death. d. The are affected more by the change in lifestyle than the concept of death. e. They can only think about events in terms of their own frame of reference—living.
ADE
A 5-year-old child will be starting kindergarten next month. She has cerebral palsy, and it has been determined that she needs to be in a special education classroom. Her parents are tearful when telling the nurse about this and state that they did not realize her disability was so severe. What is the best interpretation of this situation? a. This is a sign the parents are in denial. b. This is a normal anticipated time of parental stress. c. The parents need to learn more about cerebral palsy. d. The parents' expectations are too high.
B
A child in the terminal stage of cancer has frequent breakthrough pain. Nonpharmacologic methods are not helpful, and the child is exceeding the maximum safe dose for opiate administration. What approach should the nurse implement? a. Add acetaminophen for the breakthrough pain. b. Titrate the opioid medications to control the child's pain as specified in the protocol. c. Notify the practitioner that immediate hospitalization is indicated for pain management. d. Help the parents and child understand that no additional medication can be given because of the risk of respiratory depression.
B
An 8-year-old girl has been uncooperative and angry since the diagnosis of cancer was made. Her parents tell the nurse that they do not know what to do "because she is always so mad at us." What nursing action is most appropriate at this time? a. Explain to child that anger is not helpful. b. Help the parents deal with her anger constructively. c. Ask the parents to find out what she is angry about. d. Encourage the parents to ignore the anger at this time.
B
Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability. After the shock phase, a period of adjustment usually follows. This is often characterized by what response? a. Denial b. Guilt and anger c. Social reintegration d. Acceptance of the child's limitations
B
The nurse has attended a professional development program about palliative care for the pediatric population. What statement by the nurse should indicate a correct understanding of the program? a. "Palliative care provides interventions that hasten death." b. "Palliative care promotes the optimal functioning and quality of life." c. "Palliative care does not provide pain and symptom management like hospice care." d. "Palliative care is not well received in hospitals that provide end-of-life care for children."
B
The nurse has been assigned as a home health nurse for a child who is technology dependent. The nurse recognizes that the family's background differs widely from the nurse's own. The nurse believes some of their lifestyle choices are less than ideal. What nursing intervention is most appropriate to institute? a. Change the family. b. Respect the differences. c. Assess why the family is different. d. Determine whether the family is dysfunctional.
B
The nurse has been visiting an adolescent with recently acquired tetraplegia. The teen's mother tells the nurse, "I'm sick of providing all the care while my husband does whatever he wants to, whenever he wants to do it." What reaction should be the nurse's initial response? a. Refer the mother for counseling. b. Listen and reflect the mother's feelings. c. Ask the father in private why he does not help. d. Suggest ways the mother can get her husband to help.
B
The nurse is assessing the coping behaviors of the parents of a child recently diagnosed with a chronic illness. What behavior should the nurse consider an "approach behavior" that results in movement toward adjustment? a. Being unable to adjust to a progression of the disease or condition b. Anticipating future problems and seeking guidance and answers c. Looking for new cures without a perspective toward possible benefit d. Failing to recognize the seriousness of the child's condition despite physical evidence
B
The nurse is making a home visit 48 hours after the death of an infant from sudden infant death syndrome (SIDS). What intervention is an appropriate objective for this visit? a. Give contraceptive information. b. Provide information on the grief process. c. Reassure parents that SIDS is not likely to occur again. d. Thoroughly investigate the home situation to verify SIDS as the cause of death.
B
The nurse is providing support to a family that is experiencing anticipatory grief related to their child's imminent death. What statement by the nurse is therapeutic? a. "Your other children need you to be strong." b. "You have been through a very tough time." c. "His suffering is over; you should be happy." d. "God never gives us more than we can handle."
B
The nurse is talking with a 10-year-old boy who wears bilateral hearing aids. The left hearing aid is making an annoying whistling sound that the child cannot hear. What intervention is the most appropriate nursing action? a. Ignore the sound. b. Suggest he reinsert the hearing aid. c. Ask him to reverse the hearing aids in his ears. d. Suggest he raise the volume of the hearing aid.
B
The regulation of red blood cell (RBC) production is thought to be controlled by which physiologic factor? a. Hemoglobin b. Tissue hypoxia c. Reticulocyte count d. Number of RBCs
B
What description applies to fragile X syndrome? a. Chromosomal defect affecting only females b. Second most common genetic cause of cognitive impairment c. Most common cause of uninherited cognitive impairment d. Chromosomal defect that follows the pattern of X-linked recessive disorders
B
What intervention should be included in the nursing care of a child with autism spectrum disorder (ASD)? a. Assign multiple staff to care for the child. b. Communicate with the child at his or her developmental level. c. Provide a wide variety of foods for the child to try. d. Place the child in a semiprivate room with a roommate of a similar age.
B
What is a primary goal in caring for a child with cognitive impairment? a. Developing vocational skills b. Promoting optimum development c. Finding appropriate out-of-home care d. Helping child and family adjust to future care
B
What is a principle of palliative care that can be included in the care of children? a.Maintenance of curative therapy b.Child and family as the unit of care c.Exclusive focus on the spiritual issues the family faces d.Extensive use of opiates to ensure total pain control
B
What is the single most prevalent cause of disability in children and responsible for the recent increase in childhood disability? a. Cancer b. Asthma c. Seizures d. Heart disease
B
The nurse is planning to use an interpreter with a non-English-speaking family. What should the nurse plan with regard to the use of an interpreter? (Select all that apply.) a. Use a family member. b. The nurse should speak slowly. c. Use an interpreter familiar with the family's culture. d. The nurse should speak only a few sentences at a time. e. The nurse should speak to the interpreter during interactions.
B,C,D
The parent of a child with a chronic illness tells the nurse, "I feel so hopeless in this situation." The nurse should take which actions to foster hopefulness for the family? (Select all that apply.) a. Avoid topics that are lighthearted. b. Convey a personal interest in the child. c. Be honest when reporting on the child's condition. d. Do not initiate any playful interaction with the child. e. Demonstrate competence and gentleness when delivering care.
BCE
A 2-week-old infant with Down syndrome is being seen in the clinic. His mother tells the nurse that he is difficult to hold, that "he's like a rag doll. He doesn't cuddle up to me like my other babies did." What is the nurse's best interpretation of this lack of clinging or molding? a. Sign of detachment and rejection b. Indicative of maternal deprivation c. A physical characteristic of Down syndrome d. Suggestive of autism associated with Down syndrome
C
A 5-year-old child has bilateral eye patches in place after surgery yesterday morning. Today he can be out of bed. What nursing intervention is most important at this time? a. Speak to him when entering the room. b. Allow him to assist in feeding himself. c. Orient him to his immediate surroundings. d. Reassure him and allow his parents to stay with him.
C
A critically injured child has died and is being removed from a ventilator in the pediatric intensive care unit. What is a priority nursing intervention for the family at this time? a. Ensure that parents are in the waiting room while the ventilator is removed. b. Help the parents understand that the child is already dead and no further interventions are necessary. c. Control the environment around the child and family to provide privacy. d. Encourage them to wait to see their child until the funeral home has prepared the body.
C
A father calls the emergency department nurse saying that his daughter's eyes burn after getting some dishwasher detergent in them. The nurse recommends that the child be seen in the emergency department or by an ophthalmologist. The nurse also should recommend which action before the child is transported? a. Keep the eyes closed. b. Apply cold compresses. c. Irrigate the eyes copiously with tap water for 20 minutes. d. Prepare a normal saline solution (salt and water) and irrigate the eyes for 20 minutes.
C
A mother states that she brought her child to the clinic because the 3-year-old girl was not keeping up with her siblings. During physical assessment, the nurse notes that the child has pale skin and conjunctiva and has muscle weakness. The hemoglobin on admission is 6.4 g/dl. After notifying the practitioner of the results, what nursing priority intervention should occur next? a. Reduce environmental stimulation to prevent seizures. b. Have the laboratory repeat the analysis with a new specimen. c. Minimize energy expenditure to decrease cardiac workload. d. Administer intravenous fluids to correct the dehydration.
C
A newborn assessment shows a separated sagittal suture, oblique palpebral fissures, a depressed nasal bridge, a protruding tongue, and transverse palmar creases. These findings are most suggestive of which condition? a. Microcephaly b. Cerebral palsy c. Down syndrome d. Fragile X syndrome
C
A preschooler is found digging up a pet bird that was recently buried after it died. What is the best explanation for this behavior? a. He has a morbid preoccupation with death. b. He is looking to see if a ghost took it away. c. He needs reassurance that the pet has not gone somewhere else. d. The loss is not yet resolved, and professional counseling is needed.
C
A school-age child is diagnosed with a life-threatening illness. The parents want to protect their child from knowing the seriousness of the illness. The nurse should provide which explanation? a.This attitude is helpful to give parents time to cope. b.This will help the child cope effectively by denial. c.Terminally ill children know when they are seriously ill. d.Terminally ill children usually choose not to discuss the seriousness of their illness.
C
The nurse is teaching parents of a child with cataracts about the upcoming treatment. The nurse should give the parents what information about the treatment of cataracts? a. "The treatment may require more than one surgery." b. "It is corrected with biconcave lenses that focus rays on the retina." c. "Cataracts require surgery to remove the cloudy lens and replace it." d. "Treatment is with a corrective lenses; no surgery is necessary."
C
What behavior seen in children should be addressed by the nurse who is providing care to a child with a chronic illness? a. An infant who is uncooperative b. A toddler who expresses loneliness c. A preschooler who refuses to participate in self-care d. An adolescent who is showing independence
C
What condition is defined as reduced visual acuity in one eye despite appropriate optical correction? a. Myopia b. Hyperopia c. Amblyopia d. Astigmatism
C
What explanation best describes how preschoolers react to the death of a loved one? a. Grief is acute but does not last long at this age. b. Children this age are too young to have a concept of death. c. Preschoolers may feel guilty and responsible for the death. d. They express grief in the same way that the adults in the preschoolers' life are expressing grief.
C
What intervention is most appropriate for fostering the development of a school-age child with disabilities associated with cerebral palsy? a. Provide sensory experiences. b. Help develop abstract thinking. c. Encourage socialization with peers. d. Give choices to allow for feeling of control.
C
What intervention is most appropriate to facilitate social development of a child with a cognitive impairment? a. Provide age-appropriate toys and play activities. b. Avoid exposure to strangers who may not understand cognitive development. c. Provide peer experiences, such as infant stimulation and preschool programs. d. Emphasize mastery of physical skills because they are delayed more often than verbal skills.
C
What is a major premise of family-centered care? a. The child is the focus of all interventions. b. Nurses are the authorities in the child's care. c. Parents are the experts in caring for their child. d. Decisions are made for the family to reduce stress.
C
When communicating with other professionals about a child with a chronic illness, what is important for nurses to do? a. Ask others what they want to know. b. Share everything known about the family. c. Restrict communication to clinically relevant information. d. Recognize that confidentiality is not possible in home care.
C
What characterizes an infant's concept of death? (Select all that apply.) a. Death is seen as temporary. b. Death is seen as a departure, a kind of sleep. c. Death has no significance before 6 months of age. d. They believe that death is a consequence of their thoughts. e. Anxiety is not created by death but by loss, even temporary, of the parent.
CE
A 12-year-old boy is in the final phase of dying from leukemia. He tells the nurse who is giving him opiates for pain that his grandfather is waiting for him. How should the nurse interpret this situation? a. The boy is experiencing side effects of the opiates. b. The boy is making an attempt to comfort his parents. c. He is experiencing hallucinations resulting from brain anoxia. d. He is demonstrating readiness and acceptance that death is near.
D
A child with a serious chronic illness will soon go home. The case manager requests that the family provide total care for the child for a couple of days while the child is still hospitalized. How should the request be viewed? a. Improper because of legal issues b. Supportive because families are usually eager to get involved c. Unacceptable because the family will have to assume the care soon enough d. Important because it can be beneficial to the transition from hospital to home
D
At which developmental period do children have the most difficulty coping with death, particularly if it is their own? a. Toddlerhood b.Preschool c.School age d.Adolescence
D
How might the quality of life for a terminally ill child and his family be enhanced by nurses? a. Tell the family what is best. b. Leave the family alone to deal with their tragedy. c. Remain objective and uninvolved with family grieving. d. Advocate for and implement pain and symptom relief measures.
D
One of the techniques that has been especially useful for learners having cognitive impairment is called fading. What description best explains this technique? a. Positive reinforcement when tasks or behaviors are mastered b. Repeated verbal explanations until tasks are faded into the child's development c. Negative reinforcement for specific tasks or behaviors that need to be faded out d. Gradually reduces the assistance given to the child so the child becomes more independent
D
Secondary prevention for cognitive impairment includes what activity? a. Genetic counseling b. Avoidance of prenatal rubella infection c. Preschool education and counseling services d. Newborn screening for treatable inborn errors of metabolism
D
Several nurses tell their nursing supervisor that they want to attend the funeral of a child for whom they had cared. They say they felt especially close to both the child and the family. The supervisor should recognize that attending the funeral serves what purpose? a. It is improper because it increases burnout. b. It is inappropriate because it is unprofessional. c. It is proper because families expect this expression of concern. d. It is appropriate because it can assist in the resolution of personal grief.
D
The camp nurse is choosing a toy for a child with cognitive impairment to play with during swimming time. What toy should the nurse choose to encourage improvement of developmental skills? a. Dive rings b. An inner tube c. Floating ducks d. A large beach ball
D
The nurse is performing a physical assessment on a 3-year-old child. The parents state that the child excessively rubs the eyes and often tilts the head to one side. What visual impairment should the nurse suspect? a. Strabismus b. Astigmatism c. Hyperopia, or farsightedness d. Myopia, or nearsightedness
D
The nurse outlines short- and long-term goals for a 10-year-old child with many complex health problems. Who should agree on these goals? a. Family and nurse b. Child, family, and nurse c. All professionals involved d. Child, family, and all professionals involved
D
An adolescent with long-term, complex health care needs will soon be discharged from the hospital. The nurse case manager has been assigned to the teen and family. The adolescent's care involves physical therapy, occupational therapy, and speech therapy in addition to medical and nursing care. Who should be the decision maker in the adolescent's care? a. Adolescent b. Nurse case manager c. Adolescent and family d. Multidisciplinary health care team
c
Parents ask the nurse, "When should palliative care be initiated?" What is the best response by the nurse? a. "When curative care is not feasible." b. "When the child's prognosis is uncertain." c. "It should be included along the continuum of care." d. "It should begin when curative treatments are no longer appropriate."
c
Parents tell the nurse they do not want to let their school-age child know his illness is terminal. What response should the nurse make to the parents? a. "Have you discussed this with your health care provider?" b. "I would do the same thing in your position; it is better the child doesn't know." c. "I understand you want to protect your child, but often children realize the seriousness of their illness." d. "I praise you for that decision; it can be so difficult to be truthful about the seriousness of your son's illness."
c
The nurse observes that a seriously ill child passively accepts all painful procedures. The nurse should recognize that this is most likely an indication that the child is experiencing what emotional response? a. Hopefulness b. Chronic sorrow c. Belief that procedures are a deserved punishment d. Understanding that procedures indicate impending death
c
The parents of a child with cognitive impairment ask the nurse for guidance with discipline. What should the nurse's recommendation be based on? a. Discipline is ineffective with cognitively impaired children. b. Cognitively impaired children do not require discipline. c. Behavior modification is an excellent form of discipline. d. Physical punishment is the most appropriate form of discipline.
c
Parents ask for help for their other children to cope with the changes in the family resulting from the special needs of their sibling. What strategy does the nurse recommend? a. Explain to the siblings that embarrassment is unhealthy. b. Encourage the parents not to expect siblings to help them care for the child with special needs. c. Provide information to the siblings about the child's condition only as requested. d. Invite the siblings to attend meetings to develop plans for the child with special needs.
d
What should the nurse determine to be the priority intervention for a family with an infant who has a disability? a. Focus on the child's disabilities to understand care needs. b. Institute age-appropriate discipline and limit setting. c. Enforce visiting hours to allow parents to have respite care. d. Foster feelings of competency by helping parents learn the special care needs of the infant.
d
