Ped ch 1 Prep U

A nurse is caring for a child. Which individual would the nurse identify as being primarily responsible for initiating and coordinating healthcare? a) Social worker b) Community c) Parents d) Case manager

c) Parents

A nurse is working as part of a research team evaluating children for participation in a research study. The nurse demonstrates respect for persons when the nurse obtains assent from children over which age? a) 12 b) 16 c) 18 d) 7

D) 7 Respect for persons requires that the subject is able to independently and autonomously volunteer to participate in a study. Because infants and children do not have this ability, parents must consent on behalf of their children. Cognitively intact children over the age of seven years should always be asked to give their assent.

A family that makes too much money to qualify for Medicaid, but who cannot afford to purchase health insurance, should be referred to the Children's Health Insurance Program (CHIP). a) True b) False

True The Balanced Budget Act of 1997 authorized the Children's Health Insurance Program (CHIP), as Title XXI of the Social Security Act. The purpose of this program is to expand health insurance to children whose families make too much money to qualify for Medicaid, but who cannot afford to purchase health insurance.

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 of the following is the most effective way of advocating for this child and family? a) Helping parents access the area's multidisciplinary cystic fibrosis clinic b) Locating the best price on a high-frequency chest compression vest c) Teaching the parents how to perform chest physiotherapy d) Assisting the parents in getting the child on a lung transplant list

c) Teaching the parents how to perform chest physiotherapy

The nurse is caring for a 7-year-old boy with cystic fibrosis whose parents are intensely interested in all aspects of the child's condition and care. Which of the following interventions is least important for empowering these health care consumers? a) Teaching the parents how to perform chest physiotherapy b) Keeping the family apprised of all developments in care c) Educating the parents about the lung transplant list d) Locating the best deal on a high frequency chest compression vest

d) Locating the best deal on a high frequency chest compression vest

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 which of the following as a service that may be provided? Select all that apply. a) Speech therapy b) Psychological services c) Infant stimulation d) Special education e) Financial assistance

• Speech therapy • Infant stimulation • Psychological services • Special education Services that may be provided via the Education for All Handicapped Children Act and its amendment include: assessments; speech therapy; physical therapy; occupational therapy; infant stimulation; counseling; home visits; case management; psychological services; health services; special education; and family training. It does not provide financial assistance.

A 15-year-old with leukemia tells the nurse that she wants to file for emancipation in order to control her own treatment plan. The nurse explains the process by stating (select all answers that apply): a) The minor must live with parents or guardians. b) The minor must demonstrate the ability to manage financial affairs. c) The minor must be married or in the armed forces. d) The minor must be able to claim a share of the parent's income by law. e) The minor must be at least 14 years of age. f) The process is governed by individual state laws.

• The minor must demonstrate the ability to manage financial affairs. • The process is governed by individual state laws. • The minor must be at least 14 years of age. Conditions that state law may require before approving a declaration of emancipation may include: The minor is at least 14 years of age, willingly lives separate and apart from parents or guardians with their consent or acquiescence, demonstrates ability to manage financial affairs, and has a source of income other than criminal activity. A valid marriage or service in the armed forces usually qualifies as acceptable conditions for a declaration of emancipation, but is not a requirement.

The parents of a 9-year-old agree to allow their child to participate in a research project involving drug trials for a new drug for attention deficit hyperactivity disorder. Which of the following rights of the child are related to beneficence? Select all that apply. a) The parents and child are informed of the possible adverse effects of the research. b) The parents and child are told of the direct and indirect benefits of participation. c) The parents and child are aware they can withdraw from the study at any time without prejudice. d) The parents and child are told the physical and nonphysical risks associated with the research. e) The parents and child are told whom to contact in the agency if they have any questions or concerns. f) The parents and child are made aware of strategies to protect their identifies.

- The parents and child are told the physical and nonphysical risks associated with the research. - The parents and child are informed of the possible adverse effects of the research. - The parents and child are told of the direct and indirect benefits of participation. For issues related to beneficence, the parents and child should know the risks, adverse effects, and expected benefits of the research. Being fully informed of strategies to safeguard identity is an issue of confidentiality. Knowing they can withdraw at any time is a right of refusal, and knowing whom to contact for information is a basic right.

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 of the following best describes these rights? Select all answers that apply.

1) The mother of the child assumes parental responsibility when the couple is not married. 2) Parents are able to raise the child according to their religion. 3) Parents and guardians can give permission for treatment. Explanation: Parents' rights relevant to child health issues include the right to give consent (or permission) to treatment, provide direction and guidance to their child, be assured of the privacy and confidentiality of health information, and raise their child according to their own religion, culture, and philosophical convictions. Court appointed guardians are usually attorneys. The right to health and education are generally viewed as entitlements for children. Only when parental choices put a child at substantial risk for harm does the moral focus turn t

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? a) Low birth weight b) Home deliveries c) Early pre-natal care d) Low adolescent delivery rates

A) Low birth weight Many factors may be associated with high infant mortality rates and poor health. Low birth weight and late or nonexistent prenatal care are main factors in the poor rankings in infant mortality

The nurse is talking with the mother of a 2-year-old girl during a scheduled visit. Which of the following teaching subjects best supports the emphasis on preventive care? a) Showing the mother how to teach hand washing to her child b) Describing physical changes taking place in her child c) Discussing with the mother anticipated developmental milestones d) Reminding the mother that the child will imitate her

A) Showing the mother how to teach hand washing to her child Teaching hand washing helps to prevent infection, emphasizes preventive care, and is basic to avoiding many common illnesses. Reminding the mother that the child will imitate her may promote safe parental role-modeling but does not reach the level of prevention that hand washing does. Knowing about developmental milestones and typical physical changes in toddlers does not directly promote preventive care.

When describing the State Children's Health Insurance Program (SCHIP) to a group of families, which of the following would the nurse include? a) Medicaid enrollment is necessary to receive a basic set of comprehensive services for children for health promotion and early treatment. b) It provides health insurance to children whose families are not eligible for Medicaid but cannot afford to purchase health insurance. c) The program provides monthly payments to income-eligible individuals, including children who are blind or disabled. d) States use federal funds for preventive, primary, and specialty care programs for pregnant women, mothers, infants, children, and adolescents.

B) It provides health insurance to children whose families are not eligible for Medicaid but cannot afford to purchase health insurance. The State Children's Health Insurance Program (SCHIP) is designed to expand health insurance to children whose families make too much money to qualify for Medicaid, but who cannot afford to purchase health insurance. The Early and Periodic Screening, Diagnostic and Treatment Program (EPSDT) is a program whose goal is to ensure that children enrolled in Medicaid receive a basic set of comprehensive services to promote health and identify and treat health problems at early stages. Supplemental Security Income (SSI) provides monthly payments to income-eligible individuals who are older than age 65, blind, or disable. The Maternal and Child Health Services Block Grant provides federal funds to the states for preventive, primary, and specialty care for pregnant women, mothers, infants, children, and adolescents

The nurse providing care to the fifth-grade child and his family reviews the nursing care plan, noting that teaching about pubertal changes is one of the individualized interventions. The nurse chooses not to address this. How should the nurse's action be evaluated? a) This nurse has not met the standard of care that constitutes adequate nursing practice identified in Pediatric Nursing: Scope of Standards and Practice. b) Nurses make clinical decisions—this action is acceptable. c) The intervention on the nursing care plan came from the family, not the nurse—the nurse may omit it. d) Sexuality education is a function of the schools—the nurse need not assume the function.

B) Nurses make clinical decisions—this action is acceptable. Correct response: This nurse has not met the standard of care that constitutes adequate nursing practice identified in Pediatric Nursing: Scope of Standards and Practice. The nurse is not meeting professional role expectations. Implementing the interventions identified in the plan of care is expected. Nurses include families in developing the care plan. This is part of family-centered care. Nurses make clinical decisions but would omit teaching only if data indicated it a wise choice. Sexuality education falls to the school, family, and nurse.

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: a) Prevalence of asthma episodes b) Race and ethnicity c) Causes of mortality d) Chronic health conditions

B) Race and ethnicity Determinants of health generally include such factors as age, poverty, race and ethnicity, health insurance coverage, and health behaviors and risk factors. Measures of health status for children include, but are not limited to, prevalence of asthma episodes, chronic health conditions, and causes of mortality

The nurse is talking with the mother of a 2-year-old girl during a scheduled visit. Which of the following teaching subjects least supports the emphasis on preventive care? a) Explaining how to toddler proof the house b) Reminding that child will imitate parents c) Describing self-care for brushing teeth d) Explaining how to teach self hand washing

B) Reminding that child will imitate parents Reminding the mother that the child will imitate her parents may prevent the child from imitating dangerous behavior, but this is less likely to be a danger. Explaining how to toddler proof the house helps prevent injury to the child. Explaining how to teach self hand washing helps to prevent infection. Describing self-care for brushing teeth helps prevent dental caries. These interventions help avoid common health problems.

The line at the well-child walk-in clinic is long, with closing time near. Which child does the nurse assess based on knowledge of morbidity data? a) The teen needing a sports assessment b) The foreign-born adopted child c) The toddler with a "poor appetite" d) The infant at the 25th percentile on the growth chart

B) The foreign-born adopted child The adopted foreign-born child is at risk for health problems often due to poor health surveillance prior to adoption. The infant at the 25th percentile is within the range of normal. "Poor appetite" in a toddler is common due to slowed growth following infancy. Most teens are healthy. The sports assessment can occur later

The nurse is caring for a 14-year-old boy with a debilitating illness who wants to attend school. Which of the following interventions addresses the child's physical health but not his quality of life? a) Helping the child modify trendy clothing to his needs b) Adapting technologies for use outside of the home c) Consulting with the school nurse at the child's school d) Assessing the child's daily oxygen supplement needs

D) Assessing the child's daily oxygen supplement needs Assessing the child's daily oxygen supplement needs addresses the child's physical health but not the contemporary issue of quality of life. Helping the child modify trendy clothing to his needs, consulting with the school nurse, and adapting technologies for use outside of the home will improve the child's quality of life by building independence and self-esteem.

The nurse is caring for a 16-year-old boy with injuries from a car accident. Which of the following activities describes the nurse's manager role? a) Changing dressings covering the skin abrasions b) Teaching the mother cast care c) Discussing driving safety with the teen d) Facilitating return to school by working with the school nurse

D) Facilitating return to school by working with the school nurse Much of an adolescent's life revolves around school and peers. In helping the teen return to school and friends the nurse and the school nurse are achieving continuity of care and a supportive environment for healing. Teaching the mother cast care addresses the mother's learning needs and the teaching role of the nurse. Discussing driving safety with the teen is important and a factor in many adolescent injuries and deaths but is not a management activity. Changing dressings is a direct care activity of the nurse.

You are going to provide an education program to early grade-school children. Which of the following topics would address the number one cause of death for this age group? a) Prevention of infection and communicable disease b) Exercise and good nutrition c) The importance of immunizations d) The importance of crossing streets safely

D) The importance of crossing streets safely Motor-vehicle accidents are a leading cause of death in this age group.

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 which of the following? a) Birth rates for teen moms have dramatically increased. b) Infectious diseases continue to be prevalent. c) Infant mortality rates have dropped. d) The prevalence of chronic disease is increasing.

D) The prevalence of chronic disease is increasing. Many childhood infectious diseases, such as mumps and measles, have all but disappeared in North America because of the emphasis placed on immunization against certain preventable diseases. However, the prevalence of chronic diseases is increasing. The incidence of overweight and obesity in young children and teens is increasing rapidly. The birth rate for teen moms has seen a significant downward trend. Infant mortality rates have increased due to the numbers of infants born weighing less than 750 grams

The nurse providing care to the fifth-grade child and his family reviews the nursing care plan, noting that teaching about pubertal changes is one of the individualized interventions. The nurse chooses not to address this. How should the nurse's action be evaluated? a) Nurses make clinical decisions—this action is acceptable. b) The intervention on the nursing care plan came from the family, not the nurse—the nurse may omit it. c) Sexuality education is a function of the schools—the nurse need not assume the function. d) This nurse has not met the standard of care that constitutes adequate nursing practice identified in Pediatric Nursing: Scope of Standards and Practice.

D) This nurse has not met the standard of care that constitutes adequate nursing practice identified in Pediatric Nursing: Scope of Standards and Practice. The nurse is not meeting professional role expectations. Implementing the interventions identified in the plan of care is expected. Nurses include families in developing the care plan. This is part of family-centered care. Nurses make clinical decisions but would omit teaching only if data indicated it a wise choice. Sexuality education falls to the school, family, and nurse

An important role of the nurse caring for children and their families is that of child advocate. Which one of the following interventions best reflects this role? a) Accurately documenting and reporting patient conditions b) Teaching parents the proper way to administer insulin to their child c) Administering medications to patients on a timely basis d) Working to change agency policy to better serve families

d) Working to change agency policy to better serve families An advocate acts to safeguard and to advance the interests of the child and family, as a means to help meet their healthcare needs. Advocacy ranges from calling an agency on behalf of a child, to writing letters to legislators to improve their understanding of an issue, to working to change agency policy to better meet the needs of the families it serves.

Pediatric nurses are developing more home care and community-based services for children with chronic illnesses because: a) More disabilities are occurring in children because many women are delaying pregnancy and giving birth to babies later in life. b) Disability and chronic illness have increased with the appearance of more genetic abnormalities. c) Uninsured families can access these services. Pediatric nurses are developing more home care and community-based services for children with chronic illnesses because: e) There are fewer positions for nurses in institutions providing acute care.

b) Disability and chronic illness have increased with the appearance of more genetic abnormalities. Advances in healthcare leading to more children living with chronic illness or disability is true. The statements about genetic disease and older women may contain some truth but account for few numbers added to the chronic illness total. Acute care pediatric nursing positions are decreasing in community hospitals but are more available in medical centers. Uninsured families may or may not be able to access nonhospital care

A group of students are reviewing information about Medicaid. The students demonstrate a need for additional study when they identify which of the following? a) It provides compensation for healthcare services. b) The federal government is responsible for administering it. c) The states determine income-eligibility criteria. d) It is financed by state funds.

b) The federal government is responsible for administering it. Medicaid is a form of health insurance for low-income and disabled individuals. It is financed by federal and state funds and administered by the states. Medicaid is not a direct provider of service, but rather provides compensation for healthcare services. Federal guidelines define the scope of basic services, the extent of coverage, and certain administrative requirements. The states administer the program and determine income eligibility criteria, specific services to be covered, and payment levels and methods

Nurses can help to decrease the United States' mortality rate by advocating for improved access to healthcare for which ethnic groups in particular? Select all that apply. a) Mexican-Americans b) American Indians and Native Alaskans c) Asian-Americans d) Puerto Rican-Americans e) African-Americans

• African-Americans • American Indians and Native Alaskans • Puerto Rican-Americans