PEDI Exam 5

A 6-year-old child needs to be hospitalized again because of a chronic illness. The clinic nurse overhears her school-age siblings tell her that they are "sick of Mom always sitting with her in the hospital and playing with her. . . . It isn't fair that you get everything and we have to stay with the neighbors." What is the nurse's best assessment of this situation? A. The siblings are immature and probably spoiled. B. The siblings need to better understand their sister's illness and needs. C. Jealousy and resentment are common reactions to the illness and hospitalization of a sibling. D. The family has ineffective coping mechanisms to deal with chronic illness.

C. Jealousy and resentment are common reactions to the illness and hospitalization of a sibling.

What represents the major stressor of hospitalization for children from middle infancy throughout the preschool years? A. Fear of pain B. Loss of control C. Separation anxiety D. Fear of bodily injury

C. Separation anxiety

During a home visit, the nurse and the preceptor are asked by parents how to discuss the death of their infant son with their 4-year-old daughter. Which of the following suggestions would be appropriate for the daughter's developmental level? Select all that apply. A. Have the child paint a picture while discussing how the baby will be "moving away." B. Play with puppets and talk about how the baby will be "able to visit Grandma" (who died last year). C. Use a book on death, written for preschoolers, to talk about how the "baby will die." D. Use a stuffed animal or doll to pretend that the baby "will go to sleep but won't wake up."

C. Use a book on death, written for preschoolers, to talk about how the "baby will die."

To enhance the partnership with parents the nurse should: A. Always give an answer, even if you aren't sure. B. Minimize discussing medical or technical terms. C. Explain that nurses spend more time with the child and understand the child better. D. Encourage the use of primary nursing or a designated case manager.

D. Encourage the use of primary nursing or a designated case manager.

The therapeutic management of children with beta-thalassemia major consists primarily of which of the following? A. Oxygen therapy B. Adequate hydration C. Supplemental iron D. Frequent blood transfusions

D. Frequent blood transfusions

What are typical responses of children who are hospitalized? SATA A. Separation anxiety B. Depression C. Regression D. Anger E. All of the above

E. All of the above

An 18-month-old child has just been admitted with croup. His parent is tearful and tells the nurse, "This is all my fault. I should have taken him to the doctor sooner so he wouldn't have to be here." What is appropriate in the care plan for this parent? A. Clarify misconception about the illness. B. Explain to the parent that the illness is not serious. C. Encourage the parent to maintain a sense of control. D. Assess further why the parent has excessive guilt feelings.

A. Clarify misconception about the illness.

Greg, age 2½ years, was admitted to the pediatric unit yesterday. His parents are making plans to visit as often as possible during his hospitalization. Greg's parents complain to the nurse that the child "cries, screams, and throws himself" whenever they leave the hospital to eat. The nurse should do which of the following? A. Explain that his behavior is a normal response to hospitalization. B. Explain that his behavior will diminish in a few days. C. Encourage the parents not to leave the child's room. D. Encourage the parents to leave when the child is asleep.

A. Explain that his behavior is a normal response to hospitalization.

Prevention of hearing loss in preterm infants is directed toward which of the following? A. Maintaining therapeutic levels of ototoxic antibiotics B. Performing hearing tests annually for the first 6 years of life C. Providing daily hearing stimulation while in the NICU D. Clapping hands behind the preterm infant to elicit a startle reflex

A. Maintaining therapeutic levels of ototoxic antibiotics

For case management to be the most effective, who is the most appropriate case manager? A. One nurse B. The insurance company C. A panel of experts D. A multidisciplinary team

A. One nurse

The nurse and preceptor visit a family with a dying toddler. The parents want to know where they are allowed to receive palliative care. The nurse should respond with which of the following? Select all that apply. A. Pediatric hospital B. Community hospital C. Home

A. Pediatric hospital B. Community hospital C. Home

When a preschool child is hospitalized without adequate preparation, how would the child likely view this hospitalization? A. Punishment B. Loss of parental love C. Threat to child's self-image D. Loss of companionship with friends

A. Punishment

During the course review, the nurse recognizes that the principles of palliative care include which of the following? Select all that apply A. The child and family are the units of care. B. The process will hasten the child's death if that is the family's wish. C. Children and parents must have reached a point of giving up hope of a cure before hospice can be started. D. Hospice involves an interdisciplinary team. E. Goals of care should be discussed thoroughly and openly by the adults.

A. The child and family are the units of care. D. Hospice involves an interdisciplinary team.

When assessing a child's abilities, which statement is the most appropriate when asking parents about their children's ability to dress themselves? A."Is your child dressing herself yet?" B. "Tell me about your child's dressing habits." C. "I assume you are dressing your child." D. "How often to you have to dress your child?"

B. "Tell me about your child's dressing habits."

Which child is most at risk for anemia? A. 6-month-old infant who is breastfeeding well B. 13-month-old infant who is weaning to a whole milk diet C. 10-year-old who eats school lunch daily D. 12-year-old vegetarian

B. 13-month-old infant who is weaning to a whole milk diet

The nurse is preparing a 9-year-old boy before obtaining a blood specimen by venipuncture. The child tells the nurse he does not want to lose his blood. Which of the following is an appropriate response by the nurse? A. Explain that it will not be painful. B. Discuss with him how his body is always in the process of making blood. C. Suggest to him that he not worry about losing just a little bit of blood. D. Tell the child that he will not even need a Band-Aid afterward because it is a simple procedure.

B. Discuss with him how his body is always in the process of making blood.

What is an appropriate nursing intervention to minimize separation anxiety in a hospitalized toddler? A. Provide for privacy. B. Encourage parents to room-in. C. Explain procedures and routines. D. Encourage contact with children of the same age

B. Encourage parents to room-in.

Normalization refers to: A. Return to a system and set of priorities based on family values. B. Establishing a normal pattern of living. C. Integrating children into normal classroom or childcare settings. D. Using a developmental approach

B. Establishing a normal pattern of living.

A child with sensorineural hearing defects will benefit from hearing aids. A. True B. False

B. False

What is usually the greatest threat to a hospitalized adolescent? A. Fear of pain B. Fear of altered body image C. Restricted motor activity D. Separation from home and family

B. Fear of altered body image

The grandmother of an infant diagnosed with trisomy 21 reports that the 3-month-old is slow with nipple feedings. The most appropriate response by the nurse is which of the following? A. This is an ominous sign of severe cognitive impairment. B. This is common for children with Down syndrome. C. This is unrelated to the fragile X syndrome. D. This may indicate additional gastrointestinal disorders.

B. This is common for children with Down syndrome.

The nurse and preceptor are discussing children's reactions to death and dying. The nurse recognizes that typically children begin to have an understanding that death is universal and irreversible at what age? A. 3 years old B. 5 years old C. 7 years old D. 9 years old

C. 7 years old

A 4-year-old child with anemia is receiving oral iron supplements. What dietary recommendation would the nurse provide to this family? A. Administer the iron with a dairy product. B. Administer the iron with apple juice. C. Administer the iron with orange juice. D. Administer the iron prior to breakfast.

C. Administer the iron with orange juice.

A 3-year-old child is being admitted for 1 week of hospitalization. Her parents tell the nurse that they are going to buy her "a lot of new toys because she will be in the hospital." What understanding of the child's age guides the response by the nurse? A. New toys make hospitalization easier. B. New toys are usually better than older ones for children of this age. C. At this age, children often need the comfort and reassurance of familiar toys from home. D. Buying new toys for a hospitalized child is a maladaptive way to cope with parental guilt.

C. At this age, children often need the comfort and reassurance of familiar toys from home.

The nurse realizes that the first step in parental coping with a chronic illness in a child is which of the following? A. Gaining a working knowledge of the disorder B. Learning about available resources C. Experiencing shock and denial D. Establishing a support system

C. Experiencing shock and denial

What is important understanding for a nurse working in an outpatient surgery center for children? A. Children's anxiety is minimal in such a center. B. Waiting is not stressful for parents in such a center. C. Families need to be prepared for what to expect after discharge. D. Accurate and complete discharge teaching is the responsibility of the surgeon.

C. Families need to be prepared for what to expect after discharge.

What is a common initial reaction of parents to illness or injury and hospitalization in their child? A. Relief B. Anger C. Frustration D. Depression

C. Frustration

As a nurse, how can you help care for a sibling of a hospitalized child? SATA a. Arrange visits b. Encourage nightly phone calls c. Have the parents buy the sibling a lot of gifts d. Identify extended family members

a. Arrange visits b. Encourage nightly phone calls d. Identify extended family members

What is the leading cause of death in young children with sickle cell disease? a. Bacterial infection b. Stroke c. Heart failure d. Vasocclusive crisis

a. Bacterial infection

What can be used to treat or manage hemophilia? SATA a. DDAVP b. Aspirin c. Blood transfusion d. RICE

a. DDAVP c. Blood transfusion d. RICE

As a nurse, how can you promote creative expression for a hospitalized child? SATA a. Reading b. Puzzles c. Music d. Dance

a. Reading b. Puzzles c. Music d. Dance

A parent brings their child to the ER with a pencil in their eye, what nursing intervention is most important? a. Use a fox shield to cover the injured eye and put any type of patch over the other eye b. Pull the object out and prepare for repair c. Keep the child upright d. Prevent the child from coughing

a. Use a fox shield to cover the injured eye and put any type of patch over the other eye

Which of these are NOT part of the 4 stages of MOURNING? SATA a. Shock and disbelief b. Anger c. Disorganization and despair d. Expression of grief e. Reorganization f. Denial

b. Anger f. Denial

A hospitalized preschooler is withdrawing from others. What stage of separation anxiety do you suspect they're in? a. Detachment b. Despair c. Denial d. Protest

b. Despair

What is NOT an aspect of family-centered care for the family of a child with a disability? a. Focus on the family as a unit b. Don't trust the parents and insist on providing total care to their disabled child c. Respect the central role of the family and be culturally sensitive d. Encourage the family to express their feelings

b. Don't trust the parents and insist on providing total care to their disabled child

What are clinical manifestations of thalassemia? SATA a. Flushed skin b. Enlarged liver c. Chest pain d. Anorexia

b. Enlarged liver c. Chest pain d. Anorexia

Which of these interventions is most important when caring for a visually impaired child in the hospital setting? a. Tell their parents to bring them a trinket from home b. Orient the child to their surroundings and clear the floor of clutter c. Speak at a consistent rate so they can read your lips d. Perform total care, such as feeding, toileting, and hygiene

b. Orient the child to their surroundings and clear the floor of clutter

What is not a clinical manifestation of anemia? a. Flushed skin b. Growth retardation c. Decreased heart rate d. Hemodilution

c. Decreased heart rate

A teenager has learned that they have 6 months to live, what is their most likely reaction? a. Immediately accept it and start saying goodbye b. Worry about the fact that they won't be with their parents if they die c. Struggle to accept the fact and think that they probably won't die d. Feel guilty and think that they caused this to happen

c. Struggle to accept the fact and think that they probably won't die

What is the most common chromosomal disorder? a. Fragile X syndrome b. Munchausen syndrome c. Trisomy 21 d. Klinefelter syndrome

c. Trisomy 21

What is the best way to promote trust among families with a hospitalized child? a. Tell them everything b. Switch up routines c. Avoid painful procedures d. Assign the same nurse as much as possible

d. Assign the same nurse as much as possible

When does autism spectrum disorder usually present in children? a. Between 2-6 months b. Between ages 3-5 c. At birth d. Between 18-36 months

d. Between 18-36 months

What is used to treat hemosiderosis? a. Blood transfusion b. Warm compress c. Morphine d. Deferoxamine

d. Deferoxamine

A child with a disability should get clear and consistent discipline from parents A. True B. False

True