PrepU CH 1

The nursing student is discussing infant mortality rates with the nursing professor. Which statements by the student indicate knowledge of this subject? Select all that apply.

"Infant mortality in the United States due to preterm births has significantly decreased in recent years." "Compared to other developed countries, the United States' infant mortality rate is one of the highest." "Sudden infant death syndrome is one of the common causes of infant mortality in the United States." "One of the highest infant mortality rates is among Non-Hispanic African Americans."

Which statement by the nurse best indicates an understanding of infant mortality?

"Infant mortality rates are most impacted by premature birth rates."

The pediatric nurse knows that the state of children's health in the United States is evaluated by specific determinants and measures of health status. These determinants include:

race and ethnicity.

A student nurse shares an interest in pediatric nursing. When discussing her thoughts about pediatric nursing, which statements are consistent with the philosophies of pediatric nursing care? Select all that apply.

"The child should be included as much as possible in the plan of care." "Since health care can be scary for a child, it's important to make them feel secure." "I believe the family should be included in all aspects of the plan of care and treatment."

A newly hired nurse is receiving education about the role of the facility's ethics committee during the orientation period. Which statements indicate an understanding of the role of this group? Select all that apply.

"This group will review each case presented and formulate a decision for the facility." "Education concerning ethics is a role of the committee." "The role of the ethics committee has increased over the years."

The nurse is caring for a 12-year-old child with a depressive disorder. When providing teaching about the disorder and the importance of treatment to the child's parents, the nurse accurately includes which teaching points? Select all that apply.

"We need to monitor your child's academic performance since this is often affected." "Substance abuse is common during the adolescent years if mental health issues are present during childhood." "It's important to be aware that having a depressive disorder as a child increases the chance of mental health issues as an adult."

The parents of a child on a pediatric unit are concerned with the plan of care the physician has provided. The parents ask the nurse if they may seek a second opinion if they are not in agreement with the plan of care. How should the nurse respond?

"You can always seek a second opinion if not in agreement with the current plan of care."

Which child represents an increasingly common pediatric medical scenario currently present in the United States?

9-year-old girl diagnosed with type 2 diabetes

A child has been injured and his parents are not available. Which individuals may provide consent for the care in the event the parents have provided documentation allowing for this? Select all that apply.

A babysitter A teacher A family friend A clergy member

A child has been hospitalized after experiencing abuse at the hands of his parents, who have been charged with the related crimes. How will decisions be made for his continued care?

A guardian ad litem may be appointed.

The home health nurse is visiting a child diagnosed 5 years ago with cystic fibrosis. The child has 3 healthy siblings. The mother and father tell the nurse that the father, who is the insurance carrier for the family, recently lost his job and all benefits. The nurse suggests which federal program as being the most helpful to the family at this time?

Affordable Care Act

The nurse is caring for a 16-year-old female who has been brought to the clinic by her mother seeking information about contraceptives. What action by the nurse will best promote the client's autonomy?

After a review of suitable contraceptive options, ask the client which is of the greatest interest.

A terminally ill 15-year-old tells the nurse that she wants to stop all treatments and go home despite her parents' directives to provide extraordinary means to keep their child alive. What is the best resource available to this nurse to help solve this dilemma?

An institutional ethics committee

A new nurse asks what he can do to promote evidence-based practice. What information should be included in the response? Select all that apply.

Ask pertinent clinical questions. Be attuned to client concerns. Participate in professional development activities.

The nurse is caring for a child who underwent an appendectomy 12 hours ago. The child has reported incisional pain. When the nurse attempts to administer the prescribed analgesic the child's mother declines the medication. What initial action by the nurse is most appropriate?

Ask the child's mother to elaborate on her concerns about the medication.

The nurse is providing care to a 6-year-old child following surgery. The nurse asks the child to rate the pain using the Faces of Pain scale. Which phase of the nursing process is the nurse demonstrating?

Assessment

An instructor is describing the issues of research involving children. What information would the instructor include?

Children are considered vulnerable subjects at high risk for injury.

The nurse is caring for a pediatric client who has been admitted after a serious automobile accident. Which actions would best promote veracity in the nurse's actions?

Clearly explain the planned care to the child.

A nurse is providing care to a child on an oncology unit. The nurse is both administering chemotherapy to the child and teaching the parents about the actions, side effects, and complications of the drug. These actions best describe which nursing role?

Clinical nurse specialist

Morbidity data indicates that support is needed from pediatric nursing groups to establish improved and additional services for children with what health issues?

Mental health and behavioral disorders

Morbidity rates among children are most highly associated with which cause?

Environmental factors

The nurse is caring for a 16-year-old boy with injuries from a car accident. Which activity describes the nurse's manager role?

Facilitating return to school by working with the school nurse

Following the discharge of a child who has a chronic health condition from the hospital, the nurse case manager follows up with a visit to the home and meets with the family and child. This visit best represents which philosophy of pediatric nursing?

Family-centered care

What is a current trend in child health care?

Health promotion rather than health restoration is stressed.

The nurse is caring for a 7-year-old boy with cystic fibrosis whose parents are intensely interested in all aspects of his condition and care. Which is the most effective way of advocating for this child and family?

Helping parents access the area's multidisciplinary cystic fibrosis clinic

When describing the State Children's Health Insurance Program (SCHIP) to a group of families, what information would the nurse include?

It provides health insurance to children whose families are not eligible for Medicaid but cannot afford to purchase health insurance.

The nurse is caring for a 2-year-old boy who needs a lumbar puncture. His mother is present. What would prevent informed consent from being obtained?

Learning the mother is not the custodial parent

In 2007 the World Factbook published statistics that showed the United States still lagged behind other industrialized nations in the incidence of infant mortality. What is one reason that the United States has a higher infant mortality rate than other countries?

Low birth weight

The parent of an 11-year-old girl with an inoperable brain tumor confides to the nurse that her daughter's physician is "pushing them" to convince their daughter to participate in a controversial treatment that has a high risk for side effects. She further states that she told him twice that they were not interested. What would be the nurse's best response to this situation?

Meet with the physician and disclose the concerns of the family; refer the case to the institutional ethics committee if not resolved.

A nurse is preparing a community health program to discuss the best indicator to measure the state of children's health in the United States. What is the best measure?

Mortality rate for infants and children

A child is in need of emergency care. The child's parents want to provide consent via telephone. What actions by the nurse are appropriate in this matter? Select all that apply.

Obtain another nurse to also listen to the consent being provided from the parents. Cosign the consent with the other witness after obtaining the parental permission.

During an emergency department visit for an asthma attack a child receives care from two nurses. Which interventions best represent care that provides atraumatic therapeutic care? Select all that apply.

One nurse uses distraction techniques while the other nurse starts an IV. One nurse talks with the family while the other nurse assists the radiology technician in obtaining a chest x-ray.

A nurse is caring for a child. Which individual would the nurse identify as being primarily responsible for initiating and coordinating health care?

Parents

A nurse caring for children and their families must respect the rights of the parents and guardians and their charges relevant to child health issues. Which statements best describe these rights? Select all that apply.

Parents are able to raise the child according to their religion. Parents and guardians can give permission for treatment. The mother of the child assumes parental responsibility when the couple is not married.

Based on 2010 childhood mortality rate statistics, how can the nurse best help parents of children between the ages of 1 and 4 years prevent childhood death? Select all that apply.

Providing resources such as poison control center numbers to the parents during a well child visit Teaching proper seat belt restraint using car seats or booster seats during parenting classes Ensuring parents are using proper child dosing devices, such as properly marked syringes, when administering medications at home Assessing the environment for child proof devices such as locks on cabinets during a home visit

The nurse is reviewing documentation on a client's chart. The physician has referred to parens patriae. When considering this notation, what should be included in the client's plan of care?

Recognize the child's care has been ordered by the state.

A group of students are reviewing information about the Education for All Handicapped Children Act and its amendments. The students demonstrate understanding of this information when they identify what services as among those that may be provided? Select all that apply.

Speech therapy Special education Psychological services

During the weekly team meetings, the physician and case manager discuss the client's planned assent. What activity should the nurse most anticipate?

The client will have a conference with the physician about the planned course of care and treatment.

To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups?

Teach injury prevention and proper safety practices.

The nurse is running an education program for early grade-school children. Which topic would address the number one cause of death for this age group?

The importance of crossing streets safely

A 15-year-old with leukemia tells the nurse that she wants to file for emancipation in order to control her own treatment plan. How does the nurse explain the process? Select all that apply.

The minor must be at least 14 years of age. The process is governed by individual state laws. The minor must demonstrate the ability to manage financial affairs.

The nurse is working in a pediatric facility whose mission statement strongly emphasizes providing family-centered care. What nursing intervention best exemplifies this facility's belief?

The nurse plans a meeting with the parents, child, and case worker to discuss care alternatives for the child

The nurse is caring for a variety of children on a medical unit. Which actions by the nurse best exemplify culturally competent care? Select all that apply.

The nurse provides pamphlets that are in Spanish for the parents of a Spanish-speaking Hispanic child The nurse allows a Muslim family and their child time for daily prayer routine The nurse ensures specific religious dietary restrictions are maintained for a pediatric client as requested by the parents The nurse asks the parents of a Jewish child if there are any dietary restrictions for the child The nurse is admitting a child to the unit and asks the parents if they have a religious preference

A child with a serious health condition has been hospitalized to undergo treatments. After a week of treatment the physicians have determined that the child has only weeks to live. What is the most likely initial course of action the nurse can anticipate?

The physician will confer with the parents to outline the severity of the child's condition.

The client is a 1-year-old girl from a low-income family presenting with a vitamin D deficiency and anemia. What assistance program would you recommend to the child's young mother?

WIC

The nurse provides soy milk and fresh vegetables to a pregnant woman who is single, and the mother of a toddler. Which federal program is the nurse implementing?

WIC Food Package Revised

Which nursing activity requires the pediatric nurse to implement the ethical principle of nonmaleficence?

Weighing the potential harm caused by a child's chemotherapy with its potential benefits

A nurse is reviewing the medical record of a terminally ill child who has a DNAR order. The nurse interprets this as refraining from:

performing cardiopulmonary resuscitation.

In order to advocate for children and families, the nurse must first acknowledge that the basic system in which health behavior and care are organized, secured, and performed is the:

family.

Pediatric nurses are developing more home care and community-based services for children with chronic illnesses because:

increasing numbers of children live with chronic disabilities due to advances in health care that allow children with formerly fatal diseases to survive.

After teaching a group of nursing students about major threats to children's health, the instructor determines that the teaching was successful when the students state that:

the prevalence of chronic disease is increasing.