Peds Final Exam

Which legal or ethical offense would be committed if a nurse tells family members the condition of a newborn baby without first consulting the parents? 1. A breach of privacy 2. Negligence 3. Malpractice 4. A breach of ethics

Answer: 1 Explanation: 1. A breach of privacy would have been committed in this situation, because it violates the right to privacy of this family. The right to privacy is the right of a person to keep his or her person and property free from public scrutiny, including other family members. Negligence and malpractice are punishable legal offenses and are more serious. A breach of ethics would not apply to this situation. 2. A breach of privacy would have been committed in this situation, because it violates the right to privacy of this family. The right to privacy is the right of a person to keep his or her person and property free from public scrutiny, including other family members. Negligence and malpractice are punishable legal offenses and are more serious. A breach of ethics would not apply to this situation. 3. A breach of privacy would have been committed in this situation, because it violates the right to privacy of this family. The right to privacy is the right of a person to keep his or her person and property free from public scrutiny, including other family members. Negligence and malpractice are punishable legal offenses and are more serious. A breach of ethics would not apply to this situation. 4. A breach of privacy would have been committed in this situation, because it violates the right to privacy of this family. The right to privacy is the right of a person to keep his or her person and property free from public scrutiny, including other family members. Negligence and malpractice are punishable legal offenses and are more serious. A breach of ethics would not apply to this situation.

While assessing the development of a 9-month-old infant, the nurse asks the mother if the child actively looks for toys when they are placed out of sight. Which developmental task is the nurse assessing this infant for? 1. Object permanence 2. Centration 3. Transductive reasoning 4. Conservation

Answer: 1 Explanation: 1. A child who has developed object permanence has the ability to understand that even though something is out of sight, it still exists. In centration, a child focuses only on a particular aspect of a situation. Transductive reasoning happens when a child connects two events in a cause-effect relationship because they have occurred at the same time. Conservation describes when a child knows that matter is not changed when its form is altered. 2. A child who has developed object permanence has the ability to understand that even though something is out of sight, it still exists. In centration, a child focuses only on a particular aspect of a situation. Transductive reasoning happens when a child connects two events in a cause-effect relationship because they have occurred at the same time. Conservation describes when a child knows that matter is not changed when its form is altered. 3. A child who has developed object permanence has the ability to understand that even though something is out of sight, it still exists. In centration, a child focuses only on a particular aspect of a situation. Transductive reasoning happens when a child connects two events in a cause-effect relationship because they have occurred at the same time. Conservation describes when a child knows that matter is not changed when its form is altered. 4. A child who has developed object permanence has the ability to understand that even though something is out of sight, it still exists. In centration, a child focuses only on a particular aspect of a situation. Transductive reasoning happens when a child connects two events in a cause-effect relationship because they have occurred at the same time. Conservation describes when a child knows that matter is not changed when its form is altered.

When conducting a health history on a late school-age client, what would the nurse document as a dysmorphic feature? 1. A repaired cleft palate 2. A 10 percent burn to the face 3. A severed finger 4. A flat anterior fontanel

Answer: 1 Explanation: 1. A dysmorphic feature was present at birth. A cleft palate, even though repaired, would be included in a health history as a dysmorphic feature. The burns and a severed digit were not present at birth, and would not be considered dysmorphic. A soft fontanel would be considered normal. 2. A dysmorphic feature was present at birth. A cleft palate, even though repaired, would be included in a health history as a dysmorphic feature. The burns and a severed digit were not present at birth, and would not be considered dysmorphic. A soft fontanel would be considered normal. 3. A dysmorphic feature was present at birth. A cleft palate, even though repaired, would be included in a health history as a dysmorphic feature. The burns and a severed digit were not present at birth, and would not be considered dysmorphic. A soft fontanel would be considered normal. 4. A dysmorphic feature was present at birth. A cleft palate, even though repaired, would be included in a health history as a dysmorphic feature. The burns and a severed digit were not present at birth, and would not be considered dysmorphic. A soft fontanel would be considered normal.

A family with a child who had a cleft lip and palate at birth are planning another pregnancy. What intervention should be recommended prior to conception? 1. A genetic family history 2. A family pedigree 3. A genetic physical assessment 4. A maternal health history

Answer: 1 Explanation: 1. A genetic family history is recommended when there is history of a congenital anomaly, such as cleft lip and palate. A pedigree is a more comprehensive family history, and could follow a genetic family history if needed. The previous anomaly is already known, so a genetic history would be recommended over a genetic physical assessment. A maternal health history is not comprehensive enough for this case. 2. A genetic family history is recommended when there is history of a congenital anomaly, such as cleft lip and palate. A pedigree is a more comprehensive family history, and could follow a genetic family history if needed. The previous anomaly is already known, so a genetic history would be recommended over a genetic physical assessment. A maternal health history is not comprehensive enough for this case. 3. A genetic family history is recommended when there is history of a congenital anomaly, such as cleft lip and palate. A pedigree is a more comprehensive family history, and could follow a genetic family history if needed. The previous anomaly is already known, so a genetic history would be recommended over a genetic physical assessment. A maternal health history is not comprehensive enough for this case. 4. A genetic family history is recommended when there is history of a congenital anomaly, such as cleft lip and palate. A pedigree is a more comprehensive family history, and could follow a genetic family history if needed. The previous anomaly is already known, so a genetic history would be recommended over a genetic physical assessment. A maternal health history is not comprehensive enough for this case.

The nurse is measuring an abdominal girth on a child with abdominal distension. Identify the area on the child's abdomen where the tape measure should be placed for an accurate abdominal girth. 1. Just above the umbilicus, around the largest circumference of the abdomen 2. Below the umbilicus 3. Just below the sternum 4. Just above the pubic bone

Answer: 1 Explanation: 1. An abdominal girth should be taken around the largest circumference of the abdomen, in this case, just above the umbilicus. The circumference below the umbilicus or just below the sternum would not be an accurate abdominal girth. 2. An abdominal girth should be taken around the largest circumference of the abdomen, in this case, just above the umbilicus. The circumference below the umbilicus or just below the sternum would not be an accurate abdominal girth. 3. An abdominal girth should be taken around the largest circumference of the abdomen, in this case, just above the umbilicus. The circumference below the umbilicus or just below the sternum would not be an accurate abdominal girth. 4. An abdominal girth should be taken around the largest circumference of the abdomen, in this case, just above the umbilicus. The circumference below the umbilicus or just below the sternum would not be an accurate abdominal girth.

An adolescent client has a long leg cast secondary to a fractured femur. Which action by the nurse would effectively facilitate the adolescent's return to school? 1. Meet with teachers and administrators at the school to make sure entrances and classrooms are wheelchair accessible. 2. Develop an individualized health plan (IHP) that focuses on long-term needs of the adolescent. 3. Prior to the student's return to school, meet with all of the other students to emphasize the special needs of the injured teen. 4. Meet with parents of the injured student to encourage homebound schooling until a short leg cast is applied.

Answer: 1 Explanation: 1. An adolescent with a long leg cast secondary to a fractured femur will be dependent on a wheelchair for mobility. It is essential that the environment be wheelchair accessible prior to the adolescent's return to school. While an IHP might be developed, short-term needs would be the focus. It is not necessary to meet all of the students to discuss the adolescent's needs. There is no reason to encourage the adolescent to stay at home for schooling if he is ready to return. 2. An adolescent with a long leg cast secondary to a fractured femur will be dependent on a wheelchair for mobility. It is essential that the environment be wheelchair accessible prior to the adolescent's return to school. While an IHP might be developed, short-term needs would be the focus. It is not necessary to meet all of the students to discuss the adolescent's needs. There is no reason to encourage the adolescent to stay at home for schooling if he is ready to return. 3. An adolescent with a long leg cast secondary to a fractured femur will be dependent on a wheelchair for mobility. It is essential that the environment be wheelchair accessible prior to the adolescent's return to school. While an IHP might be developed, short-term needs would be the focus. It is not necessary to meet all of the students to discuss the adolescent's needs. There is no reason to encourage the adolescent to stay at home for schooling if he is ready to return. 4. An adolescent with a long leg cast secondary to a fractured femur will be dependent on a wheelchair for mobility. It is essential that the environment be wheelchair accessible prior to the adolescent's return to school. While an IHP might be developed, short-term needs would be the focus. It is not necessary to meet all of the students to discuss the adolescent's needs. There is no reason to encourage the adolescent to stay at home for schooling if he is ready to return.

A neonatal nurse who encourages parents to hold their baby and provides opportunities for Kangaroo Care most likely is demonstrating concern for which aspect of the infant's psychosocial development? 1. Attachment 2. Assimilation 3. Centration 4. Resilience

Answer: 1 Explanation: 1. Attachment is a strong emotional bond between a parent and child that forms the foundation for the fulfillment of the basic need of trust in the infant. Assimilation describes the child's incorporation of new experiences, centration is the ability to consider only one aspect of a situation at a time, and resilience is the ability to maintain healthy function even under significant stress and adversity. 2. Attachment is a strong emotional bond between a parent and child that forms the foundation for the fulfillment of the basic need of trust in the infant. Assimilation describes the child's incorporation of new experiences, centration is the ability to consider only one aspect of a situation at a time, and resilience is the ability to maintain healthy function even under significant stress and adversity. 3. Attachment is a strong emotional bond between a parent and child that forms the foundation for the fulfillment of the basic need of trust in the infant. Assimilation describes the child's incorporation of new experiences, centration is the ability to consider only one aspect of a situation at a time, and resilience is the ability to maintain healthy function even under significant stress and adversity. 4. Attachment is a strong emotional bond between a parent and child that forms the foundation for the fulfillment of the basic need of trust in the infant. Assimilation describes the child's incorporation of new experiences, centration is the ability to consider only one aspect of a situation at a time, and resilience is the ability to maintain healthy function even under significant stress and adversity.

A student nurse asks, "What is carrier testing?" Which response by the nurse educator is most appropriate to answer the student nurse's question? 1. "Carrier testing involves testing an asymptomatic individual for carrier status for a genetic condition." 2. "Carrier testing is used to establish a diagnosis of a genetic disorder in an individual who is symptomatic or has had a positive screening test." 3. "Carrier testing is testing to identify a fetus with a genetic disease or condition. Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors." 4. "Carrier testing follows in vitro fertilization (IVF) testing to identify embryos with a particular genetic condition."

Answer: 1 Explanation: 1. Carrier testing involves testing an asymptomatic individual for carrier status for a genetic condition. Diagnostic testing is testing to identify a fetus with a genetic disease or condition. Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Prenatal testing is testing to identify a fetus with a genetic disease or condition. Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Pre-implantation testing follows in vitro fertilization (IVF) testing to identify embryos with a particular genetic condition. 2. Carrier testing involves testing an asymptomatic individual for carrier status for a genetic condition. Diagnostic testing is testing to identify a fetus with a genetic disease or condition. Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Prenatal testing is testing to identify a fetus with a genetic disease or condition. Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Pre-implantation testing follows in vitro fertilization (IVF) testing to identify embryos with a particular genetic condition. 3. Carrier testing involves testing an asymptomatic individual for carrier status for a genetic condition. Diagnostic testing is testing to identify a fetus with a genetic disease or condition. Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Prenatal testing is testing to identify a fetus with a genetic disease or condition. Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Pre-implantation testing follows in vitro fertilization (IVF) testing to identify embryos with a particular genetic condition. 4. Carrier testing involves testing an asymptomatic individual for carrier status for a genetic condition. Diagnostic testing is testing to identify a fetus with a genetic disease or condition. Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Prenatal testing is testing to identify a fetus with a genetic disease or condition. Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors. Pre-implantation testing follows in vitro fertilization (IVF) testing to identify embryos with a particular genetic condition.

The nurse is assigned to a child in a spica cast for a fractured femur suffered in an automobile accident. The child's teenage brother was driving the car, which was totaled. The nurse learns that the father lost his job three weeks ago and the mother has just accepted a temporary waitress job. Which nursing diagnosis will the nurse use when planning care for this child and family? 1. Compromised Family Coping Related to the Effects of Multiple Simultaneous Stressors 2. Impaired Social Interaction (Parent and Child) Related to the Lack of Family or Respite Support 3. Interrupted Family Processes Related to Child with Significant Disability Requiring Alteration in Family Functioning 4. Risk for Caregiver Role Strain Related to Child with a Newly Acquired Disability and the Associated Financial Burden

Answer: 1 Explanation: 1. Compromised Family Coping Related to the Effects of Multiple Simultaneous Stressors best fits the multiple crises to which this family is responding. The spica cast may require alteration in family functioning; however, fractures are generally not considered a significant long-term disability. Lack of family members and lack of respite support was not mentioned in the scenario. 2. Compromised Family Coping Related to the Effects of Multiple Simultaneous Stressors best fits the multiple crises to which this family is responding. The spica cast may require alteration in family functioning; however, fractures are generally not considered a significant long-term disability. Lack of family members and lack of respite support was not mentioned in the scenario. 3. Compromised Family Coping Related to the Effects of Multiple Simultaneous Stressors best fits the multiple crises to which this family is responding. The spica cast may require alteration in family functioning; however, fractures are generally not considered a significant long-term disability. Lack of family members and lack of respite support was not mentioned in the scenario. 4. Compromised Family Coping Related to the Effects of Multiple Simultaneous Stressors best fits the multiple crises to which this family is responding. The spica cast may require alteration in family functioning; however, fractures are generally not considered a significant long-term disability. Lack of family members and lack of respite support was not mentioned in the scenario.

A nurse is working with a pediatric client. When obtaining an accurate family assessment, which initial step is the most appropriate? 1. Establish a trusting relationship with the family. 2. Select the most relevant family-assessment tool. 3. Focus primarily upon the mother, while learning her greatest concern. 4. Observe the family in the home setting, since this step always proves indispensable.

Answer: 1 Explanation: 1. Establishment of a trusting relationship between the family and the nurse is the essential preliminary step in obtaining an accurate family assessment. There is benefit when the tool used matches the family's strengths and resources; however, selecting the most relevant family-assessment tool is not indispensable to accuracy in the assessment. Focusing primarily upon the mother while learning her greatest concern is counterproductive and prevents the nurse from acknowledging multiple perceptions held by the family's members. Observing the family in the home setting is only recommended in some cases. 2. Establishment of a trusting relationship between the family and the nurse is the essential preliminary step in obtaining an accurate family assessment. There is benefit when the tool used matches the family's strengths and resources; however, selecting the most relevant family-assessment tool is not indispensable to accuracy in the assessment. Focusing primarily upon the mother while learning her greatest concern is counterproductive and prevents the nurse from acknowledging multiple perceptions held by the family's members. Observing the family in the home setting is only recommended in some cases. 3. Establishment of a trusting relationship between the family and the nurse is the essential preliminary step in obtaining an accurate family assessment. There is benefit when the tool used matches the family's strengths and resources; however, selecting the most relevant family-assessment tool is not indispensable to accuracy in the assessment. Focusing primarily upon the mother while learning her greatest concern is counterproductive and prevents the nurse from acknowledging multiple perceptions held by the family's members. Observing the family in the home setting is only recommended in some cases. 4. Establishment of a trusting relationship between the family and the nurse is the essential preliminary step in obtaining an accurate family assessment. There is benefit when the tool used matches the family's strengths and resources; however, selecting the most relevant family-assessment tool is not indispensable to accuracy in the assessment. Focusing primarily upon the mother while learning her greatest concern is counterproductive and prevents the nurse from acknowledging multiple perceptions held by the family's members. Observing the family in the home setting is only recommended in some cases.

The nurse is assessing a family's effective coping strategies and ineffective defensive strategies. Which family-social-system theory is the nurse using in this assessment of the family? 1. Family-stress theory 2. Family-development theory 3. Family-systems theory 4. Family life-cycle theory

Answer: 1 Explanation: 1. Family-stress theory indicates an array of coping strategies that effectively help reduce stress, in contrast with the defensive strategies of dysfunctional families. Family-development theory suggests developmental tasks for families in each stage. Family-systems theory looks at the relationships among and between family members and the environment. The family life cycle is not a family social system theory. 2. Family-stress theory indicates an array of coping strategies that effectively help reduce stress, in contrast with the defensive strategies of dysfunctional families. Family-development theory suggests developmental tasks for families in each stage. Family-systems theory looks at the relationships among and between family members and the environment. The family life cycle is not a family social system theory. 3. Family-stress theory indicates an array of coping strategies that effectively help reduce stress, in contrast with the defensive strategies of dysfunctional families. Family-development theory suggests developmental tasks for families in each stage. Family-systems theory looks at the relationships among and between family members and the environment. The family life cycle is not a family social system theory. 4. Family-stress theory indicates an array of coping strategies that effectively help reduce stress, in contrast with the defensive strategies of dysfunctional families. Family-development theory suggests developmental tasks for families in each stage. Family-systems theory looks at the relationships among and between family members and the environment. The family life cycle is not a family social system theory.

Personalized healthcare for health promotion and maintenance can be based on environmental factors and which other item? 1. The genes a person inherited 2. Common conditions with known treatment strategies 3. Teaching strategies 4. The health of the person

Answer: 1 Explanation: 1. Personalized healthcare is based on environmental factors and the genes the person inherited. Common conditions and the current health of the person are not part of personalized healthcare. Teaching strategies are not part of personalized healthcare. 2. Personalized healthcare is based on environmental factors and the genes the person inherited. Common conditions and the current health of the person are not part of personalized healthcare. Teaching strategies are not part of personalized healthcare. 3. Personalized healthcare is based on environmental factors and the genes the person inherited. Common conditions and the current health of the person are not part of personalized healthcare. Teaching strategies are not part of personalized healthcare. 4. Personalized healthcare is based on environmental factors and the genes the person inherited. Common conditions and the current health of the person are not part of personalized healthcare. Teaching strategies are not part of personalized healthcare.

A child who is dependent on a ventilator is being discharged from the hospital. Prior to discharge, the home-health nurse discusses development of an emergency plan of care with the family. Which is the most essential part of the plan? 1. Acquisition of a backup generator 2. Designation of an emergency shelter site 3. Provision for an alternate heating source if power is lost 4. Notifying the power company that the child is on life support

Answer: 1 Explanation: 1. Prior to discharge to home, it is essential that the family acquire a generator so that the child's life support will continue to function effectively should power be lost. While all other actions are very important, it is most essential that the ventilator has power to continue to function at all times. 2. Prior to discharge to home, it is essential that the family acquire a generator so that the child's life support will continue to function effectively should power be lost. While all other actions are very important, it is most essential that the ventilator has power to continue to function at all times. 3. Prior to discharge to home, it is essential that the family acquire a generator so that the child's life support will continue to function effectively should power be lost. While all other actions are very important, it is most essential that the ventilator has power to continue to function at all times. 4. Prior to discharge to home, it is essential that the family acquire a generator so that the child's life support will continue to function effectively should power be lost. While all other actions are very important, it is most essential that the ventilator has power to continue to function at all times.

While inspecting a 5-year-old child's ears, the nurse notes that the right pinna protrudes outward and that there is a mass behind the right ear. In light of these findings, which vital-sign parameter would the nurse assess on priority? 1. Temperature 2. Heart rate 3. Respirations 4. Blood pressure

Answer: 1 Explanation: 1. Swelling behind an ear could indicate mastoiditis, and the presence of a fever would indicate a higher index of suspicion for this. There could also be changes in other vital-sign parameters, but they would not be specific for the presence of infection. 2. Swelling behind an ear could indicate mastoiditis, and the presence of a fever would indicate a higher index of suspicion for this. There could also be changes in other vital-sign parameters, but they would not be specific for the presence of infection. 3. Swelling behind an ear could indicate mastoiditis, and the presence of a fever would indicate a higher index of suspicion for this. There could also be changes in other vital-sign parameters, but they would not be specific for the presence of infection. 4. Swelling behind an ear could indicate mastoiditis, and the presence of a fever would indicate a higher index of suspicion for this. There could also be changes in other vital-sign parameters, but they would not be specific for the presence of infection.

The nurse is counseling the parents of a 6-1/2-month-old infant. Which age-appropriate toy is most appropriate for the nurse to suggest to these parents? 1. Soft, fluid-filled ring that can be chilled in the refrigerator 2. Colorful rattle 3. Jack-in-the-box toy 4. Push-and-pull toy

Answer: 1 Explanation: 1. Teething toys would be appropriate for this age. The rattle might be better enjoyed by a 3- to 6-month-old infant, and the jack-in-the-box and push-and-pull toys are better suited for a 9- to 12-month-old child. 2. Teething toys would be appropriate for this age. The rattle might be better enjoyed by a 3- to 6-month-old infant, and the jack-in-the-box and push-and-pull toys are better suited for a 9- to 12-month-old child. 3. Teething toys would be appropriate for this age. The rattle might be better enjoyed by a 3- to 6-month-old infant, and the jack-in-the-box and push-and-pull toys are better suited for a 9- to 12-month-old child. 4. Teething toys would be appropriate for this age. The rattle might be better enjoyed by a 3- to 6-month-old infant, and the jack-in-the-box and push-and-pull toys are better suited for a 9- to 12-month-old child.

A supervisor is reviewing documentation of the nurses in the unit. Which client documentation is the most accurate and contains all the required part for a narrative entry? 1. "2/2/05 1630 Catheterized using an 8 French catheter, 45 mL clear yellow urine obtained, specimen sent to lab, squirmed and cried softly during insertion of catheter. Quiet in mother's arms following catheter removal. M. May RN" 2. "1/9/05 2 pm nasogastric tube placement confirmed and irrigated with 30 ml sterile water. Suction set at low, intermittent. Oxygen via nasal canal at 2 L/min. Nares patent, pink, and nonirritated. K. Earnst RN" 3. "4:00 tracheostomy dressing removed with dime-size stain of dry serous exudate. Site cleansed with normal saline. Dried with sterile gauze. New sterile tracheostomy sponge and trach ties applied. Respirations regular and even throughout the procedure. F. Luck RN" 4. "Feb. '05 Port-A-Cath assessed with Huber needle. Blood return present. Flushed with NaCl solution, IV gamma globulins hung and infusing at 30 cc/hr. Child smiling and playful throughout the procedure. P. Potter, RN"

Answer: 1 Explanation: 1. The client record should include the date and time of entry, nursing care provided, assessments, an objective report of the client's physiologic response, exact quotes, and the nurse's signature and title. 2. The client record should include the date and time of entry, nursing care provided, assessments, an objective report of the client's physiologic response, exact quotes, and the nurse's signature and title. 3. The client record should include the date and time of entry, nursing care provided, assessments, an objective report of the client's physiologic response, exact quotes, and the nurse's signature and title. 4. The client record should include the date and time of entry, nursing care provided, assessments, an objective report of the client's physiologic response, exact quotes, and the nurse's signature and title.

Several children arrived at the emergency department accompanied by their fathers. Which father may legally sign emergency medical consent for treatment? 1. The divorced one from the binuclear family 2. The stepfather from the blended or reconstituted family 3. The divorced one when the single-parent mother has custody 4. The nonbiologic one from the heterosexual cohabitating family

Answer: 1 Explanation: 1. The divorced father from the binuclear family may sign informed consent because he has equal legal rights with the mother under joint-custody arrangements. The nonbiologic stepfather from the blended or reconstituted family, the divorced biologic father when the single-parent mother has custody, and the nonbiologic father from the heterosexual cohabitating family are without legal authority to seek emergency medical care for the child. 2. The divorced father from the binuclear family may sign informed consent because he has equal legal rights with the mother under joint-custody arrangements. The nonbiologic stepfather from the blended or reconstituted family, the divorced biologic father when the single-parent mother has custody, and the nonbiologic father from the heterosexual cohabitating family are without legal authority to seek emergency medical care for the child. 3. The divorced father from the binuclear family may sign informed consent because he has equal legal rights with the mother under joint-custody arrangements. The nonbiologic stepfather from the blended or reconstituted family, the divorced biologic father when the single-parent mother has custody, and the nonbiologic father from the heterosexual cohabitating family are without legal authority to seek emergency medical care for the child. 4. The divorced father from the binuclear family may sign informed consent because he has equal legal rights with the mother under joint-custody arrangements. The nonbiologic stepfather from the blended or reconstituted family, the divorced biologic father when the single-parent mother has custody, and the nonbiologic father from the heterosexual cohabitating family are without legal authority to seek emergency medical care for the child.

The telephone triage nurse at a pediatric clinic knows each call is important. Which call would require attentiveness from the nurse because of an increased risk of mortality? 1. A 3-week-old infant born at 35 weeks' gestation with gastroenteritis 2. A term 2-week-old infant of American Indian descent with an upper respiratory infection 3. A postterm 4-week-old infant non-Hispanic black descent with moderate emesis after feeding 4. A 1-week-old infant born at 40 weeks' gestation with symptoms of colic

Answer: 1 Explanation: 1. The leading causes of death in the neonatal period (birth to 28 days of age) are short gestation, low birth weight, and congenital malformations. The preterm infant experiencing gastroenteritis at 3 weeks of age is at the greatest risk for mortality; therefore, would require extra attentiveness from the registered nurse. 2. The leading causes of death in the neonatal period (birth to 28 days of age) are short gestation, low birth weight, and congenital malformations. The preterm infant experiencing gastroenteritis at 3 weeks of age is at the greatest risk for mortality; therefore, would require extra attentiveness from the registered nurse. 3. The leading causes of death in the neonatal period (birth to 28 days of age) are short gestation, low birth weight, and congenital malformations. The preterm infant experiencing gastroenteritis at 3 weeks of age is at the greatest risk for mortality; therefore, would require extra attentiveness from the registered nurse. 4. The leading causes of death in the neonatal period (birth to 28 days of age) are short gestation, low birth weight, and congenital malformations. The preterm infant experiencing gastroenteritis at 3 weeks of age is at the greatest risk for mortality; therefore, would require extra attentiveness from the registered nurse.

A three-generation pedigree is constructed around the designated "index" patient. Based on this knowledge, which explanation of the term proband is the most accurate? 1. The "index" patient has the disorder of interest. 2. One parent of the "index" patient has the disorder of interest. 3. The "index" patient does not have the disorder of interest. 4. Siblings of the "index" patient do not have the disorder of interest.

Answer: 1 Explanation: 1. The proband indicates that the "index" patient has the disorder of interest. A consultand is an "index" patient seeking genetic counseling for a disorder she is not affected by at present. 2. The proband indicates that the "index" patient has the disorder of interest. A consultand is an "index" patient seeking genetic counseling for a disorder she is not affected by at present. 3. The proband indicates that the "index" patient has the disorder of interest. A consultand is an "index" patient seeking genetic counseling for a disorder she is not affected by at present. 4. The proband indicates that the "index" patient has the disorder of interest. A consultand is an "index" patient seeking genetic counseling for a disorder she is not affected by at present.

he nurse in a pediatric acute care unit is assigned the following tasks. Which task is not appropriate for the nurse to complete? 1. Diagnose an 8-year-old with acute otitis media and prescribe an antibiotic. 2. Listen to the concerns of an adolescent about being out of school for a lengthy surgical recovery. 3. Provide information to a mother of a newly diagnosed 4-year-old diabetic about local support-group options. 4. Diagnose a 6-year-old with Diversional Activity Deficit related to placement in isolation.

Answer: 1 Explanation: 1. The role of the pediatric nurse includes providing nursing assessment, directing nursing care interventions, and educating client and family at developmentally appropriate levels; client advocacy, case management, minimization of distress, and enhancement of coping. Advanced practice nurse practitioners perform assessment, diagnosis, and management of health conditions. 2. The role of the pediatric nurse includes providing nursing assessment, directing nursing care interventions, and educating client and family at developmentally appropriate levels; client advocacy, case management, minimization of distress, and enhancement of coping. Advanced practice nurse practitioners perform assessment, diagnosis, and management of health conditions. 3. The role of the pediatric nurse includes providing nursing assessment, directing nursing care interventions, and educating client and family at developmentally appropriate levels; client advocacy, case management, minimization of distress, and enhancement of coping. Advanced practice nurse practitioners perform assessment, diagnosis, and management of health conditions. 4. The role of the pediatric nurse includes providing nursing assessment, directing nursing care interventions, and educating client and family at developmentally appropriate levels; client advocacy, case management, minimization of distress, and enhancement of coping. Advanced practice nurse practitioners perform assessment, diagnosis, and management of health conditions.

The nurse is assessing an infant client during a health supervision visit. Which assessment findings are considered normal variations for this client? Select all that apply. 1. Sucking pads in the mouth 2. A rounded chest 3. Hearing breath sounds over the entire chest 4. Pubertal development 5. Knock-knees

Answer: 1, 2, 3 Explanation: 1. Normal variations for the infant client include sucking pads in the mouth, a rounded chest, and hearing breath sounds over the entire chest. Pubertal development and knock-knees are not normal variations for the infant client. 2. Normal variations for the infant client include sucking pads in the mouth, a rounded chest, and hearing breath sounds over the entire chest. Pubertal development and knock-knees are not normal variations for the infant client. 3. Normal variations for the infant client include sucking pads in the mouth, a rounded chest, and hearing breath sounds over the entire chest. Pubertal development and knock-knees are not normal variations for the infant client. 4. Normal variations for the infant client include sucking pads in the mouth, a rounded chest, and hearing breath sounds over the entire chest. Pubertal development and knock-knees are not normal variations for the infant client. 5. Normal variations for the infant client include sucking pads in the mouth, a rounded chest, and hearing breath sounds over the entire chest. Pubertal development and knock-knees are not normal variations for the infant client.

The nurse is assessing a toddler's development of communication skills. The nurse recognizes that a toddler communicates in what ways? Select all that apply. 1. Expressive jargon 2. Interpersonal skills and contact with other children 3. Uses all parts of speech 4. Temper tantrums 5. Enjoys talking

Answer: 1, 2, 4, 5 Explanation: 1. Toddlers use expressive jargon as a communication skill. 2. Toddlers learn interpersonal skills while being in contact with other children. 3. Preschool-age children can use all parts of speech with frequent errors. 4. Toddlers use temper tantrums occasionally as a communication skill. 5. Toddlers enjoy talking.

Which of the following are components of family-centered care? Select all that apply. 1. Recognizing and building on family strengths 2. Meeting the emotional, social, and developmental needs of the child and family 3. Respect all parenting practices 4. Support all cultural practices 5. Encourage parent-to-parent support

Answer: 1, 2, 5 Explanation: 1. Recognizing and building on family strengths are one of the components of family-centered care. 2. Meeting the emotional, social, and developmental needs of the child and family are included in the components of family-centered care. 3. Respecting all parenting practices is not one of the components of family-centered care. 4. Supporting all cultural practices is not one of the components of family-centered care. 5. Encouraging parent-to-parent support is one of the components of family-centered care.

A 7-year-old child presents to the clinic with an exacerbation of asthma symptoms. On physical examination, the nurse would expect which assessment findings? Select all that apply. 1. Wheezing 2. Increased tactile fremitus 3. Decreased vocal resonance 4. Decreased tactile fremitus 5. Bronchophony

Answer: 1, 3, 4 Explanation: 1. Wheezing is caused by air passing through mucus or fluids in a narrowed lower airway, which is a condition present in asthma exacerbations. The air trapping in the lungs that occurs in asthma causes a decrease in the sensation of vibrations felt, not an increase in tactile fremitus, which is indicative of pneumonia. Bronchophony is an increase in the intensity and clarity of transmitted sounds. This is also indicative of pneumonia but not asthma, which causes a decrease in vocal resonance. 2. Wheezing is caused by air passing through mucus or fluids in a narrowed lower airway, which is a condition present in asthma exacerbations. The air trapping in the lungs that occurs in asthma causes a decrease in the sensation of vibrations felt, not an increase in tactile fremitus, which is indicative of pneumonia. Bronchophony is an increase in the intensity and clarity of transmitted sounds. This is also indicative of pneumonia but not asthma, which causes a decrease in vocal resonance. 3. Wheezing is caused by air passing through mucus or fluids in a narrowed lower airway, which is a condition present in asthma exacerbations. The air trapping in the lungs that occurs in asthma causes a decrease in the sensation of vibrations felt, not an increase in tactile fremitus, which is indicative of pneumonia. Bronchophony is an increase in the intensity and clarity of transmitted sounds. This is also indicative of pneumonia but not asthma, which causes a decrease in vocal resonance. 4. Wheezing is caused by air passing through mucus or fluids in a narrowed lower airway, which is a condition present in asthma exacerbations. The air trapping in the lungs that occurs in asthma causes a decrease in the sensation of vibrations felt, not an increase in tactile fremitus, which is indicative of pneumonia. Bronchophony is an increase in the intensity and clarity of transmitted sounds. This is also indicative of pneumonia but not asthma, which causes a decrease in vocal resonance. 5. Wheezing is caused by air passing through mucus or fluids in a narrowed lower airway, which is a condition present in asthma exacerbations. The air trapping in the lungs that occurs in asthma causes a decrease in the sensation of vibrations felt, not an increase in tactile fremitus, which is indicative of pneumonia. Bronchophony is an increase in the intensity and clarity of transmitted sounds. This is also indicative of pneumonia but not asthma, which causes a decrease in vocal resonance

A new parent group inquires about the stages through which their children will progress as they grow older. The nurse is discussing Piaget's developmental stages. In what order would the nurse expect the child to progress through Piaget's stages of development? 1. Sensorimotor 2. Formal operational 3. Preoperational 4. Concrete operational

Answer: 1, 3, 4, 2 Sensorimotor Preoperational Concrete operational Formal operational Explanation: Sensorimotor (birth to 2 years), preoperational (2 to 7 years), concrete operational (7 to 11 years), formal operational (11 years to adulthood).

While in the pediatrician's office for their child's 12-month well-child exam, the parents ask the nurse for advice on age-appropriate toys for their child. Based on the child's developmental level, which types of toys would the nurse suggest? Select all that apply. 1. Soft toys that can be manipulated 2. Small toys that can pop apart and go back together 3. Jack-in-the-box toys 4. Toys with black and white patterns 5. Push-and-pull toys

Answer: 1, 3, 5 Explanation: 1. Both gross and fine motor skills are becoming more developed, and children at this age enjoy toys that can help them refine these skills. They tend to enjoy more colorful toys at this age and are more mobile and thus have less interest in placing toys in their mouths and more interest in toys that can be manipulated. 2. Both gross and fine motor skills are becoming more developed, and children at this age enjoy toys that can help them refine these skills. They tend to enjoy more colorful toys at this age and are more mobile and thus have less interest in placing toys in their mouths and more interest in toys that can be manipulated. 3. Both gross and fine motor skills are becoming more developed, and children at this age enjoy toys that can help them refine these skills. They tend to enjoy more colorful toys at this age and are more mobile and thus have less interest in placing toys in their mouths and more interest in toys that can be manipulated. 4. Both gross and fine motor skills are becoming more developed, and children at this age enjoy toys that can help them refine these skills. They tend to enjoy more colorful toys at this age and are more mobile and thus have less interest in placing toys in their mouths and more interest in toys that can be manipulated. 5. Both gross and fine motor skills are becoming more developed, and children at this age enjoy toys that can help them refine these skills. They tend to enjoy more colorful toys at this age and are more mobile and thus have less interest in placing toys in their mouths and more interest in toys that can be manipulated.

The nurse is conducting a health surveillance visit with a 6-month-old infant. Which methods are appropriate to monitor the infant's growth pattern since birth? Select all that apply. 1. Weight the infant twice and average together 2. Measure the infant's height 3. Measure the infant's head circumference 4. Determine the infant's body mass index 5. Plot the infant's growth on appropriate chart

Answer: 1, 3, 5 Explanation: 1. In order to determine the infant's growth pattern, the nurse will obtain two weights and average them together, measure the infant's head circumference, and obtain the infant's length, not height. After the measurements have been obtained the nurse will plot the measurements on the appropriate growth chart and monitor the infant's growth pattern. Body mass index is not determined during infancy. 2. In order to determine the infant's growth pattern, the nurse will obtain two weights and average them together, measure the infant's head circumference, and obtain the infant's length, not height. After the measurements have been obtained the nurse will plot the measurements on the appropriate growth chart and monitor the infant's growth pattern. Body mass index is not determined during infancy. 3. In order to determine the infant's growth pattern, the nurse will obtain two weights and average them together, measure the infant's head circumference, and obtain the infant's length, not height. After the measurements have been obtained the nurse will plot the measurements on the appropriate growth chart and monitor the infant's growth pattern. Body mass index is not determined during infancy. 4. In order to determine the infant's growth pattern, the nurse will obtain two weights and average them together, measure the infant's head circumference, and obtain the infant's length, not height. After the measurements have been obtained the nurse will plot the measurements on the appropriate growth chart and monitor the infant's growth pattern. Body mass index is not determined during infancy. 5. In order to determine the infant's growth pattern, the nurse will obtain two weights and average them together, measure the infant's head circumference, and obtain the infant's length, not height. After the measurements have been obtained the nurse will plot the measurements on the appropriate growth chart and monitor the infant's growth pattern. Body mass index is not determined during infancy.

The nurse is performing an assessment of the ecological systems of childhood. What will the nurse include when assessing mesosystems? Select all that apply. 1. Parental involvement in school 2. Local political influences 3. Libraries in the community 4. Influences of the religious community 5. Age of each family member

Answer: 1, 4 Explanation: 1. When assessing a child's mesosystem, the nurse will assess parental involvement in school and the influences of the religious community on the child and family. Local political influences and the libraries in the community are assessed in an exosystem assessment. The age of each family member is assessed during chronosystem assessment. 2. When assessing a child's mesosystem, the nurse will assess parental involvement in school and the influences of the religious community on the child and family. Local political influences and the libraries in the community are assessed in an exosystem assessment. The age of each family member is assessed during chronosystem assessment. 3. When assessing a child's mesosystem, the nurse will assess parental involvement in school and the influences of the religious community on the child and family. Local political influences and the libraries in the community are assessed in an exosystem assessment. The age of each family member is assessed during chronosystem assessment. 4. When assessing a child's mesosystem, the nurse will assess parental involvement in school and the influences of the religious community on the child and family. Local political influences and the libraries in the community are assessed in an exosystem assessment. The age of each family member is assessed during chronosystem assessment. 5. When assessing a child's mesosystem, the nurse will assess parental involvement in school and the influences of the religious community on the child and family. Local political influences and the libraries in the community are assessed in an exosystem assessment. The age of each family member is assessed during chronosystem assessment.

The nurse must assess each of the 2-year-olds listed below. Which one should be evaluated first? 1. A child with a temperature of 101 degrees F 2. A child who has stridor 3. A child who has absent Babinski sign 4. A child who has a pot belly appearance

Answer: 2 Explanation: 1. A child with stridor is at risk for airway compromise; a child with a temperature of 101 degrees F, while sick, is not as ill as the child with stridor; and the child with an absent Babinski sign and the pot-bellied child are normal. 2. A child with stridor is at risk for airway compromise; a child with a temperature of 101 degrees F, while sick, is not as ill as the child with stridor; and the child with an absent Babinski sign and the pot-bellied child are normal. 3. A child with stridor is at risk for airway compromise; a child with a temperature of 101 degrees F, while sick, is not as ill as the child with stridor; and the child with an absent Babinski sign and the pot-bellied child are normal. 4. A child with stridor is at risk for airway compromise; a child with a temperature of 101 degrees F, while sick, is not as ill as the child with stridor; and the child with an absent Babinski sign and the pot-bellied child are normal.

The nurse notes a history of a grade III heart murmur in a small infant. When assessing the heart, the nurse would expect to: 1. Auscultate a quiet but easily heard murmur. 2. Auscultate a moderately loud murmur without a palpable thrill. 3. Auscultate a very loud murmur with easily palpable thrill. 4. Listen without a stethoscope and hear a murmur at chest wall.

Answer: 2 Explanation: 1. A quiet but easily heard murmur is a grade II. A moderately loud murmur without palpable thrill is a grade III. A very loud murmur with easily palpable thrill is a grade V. A murmur heard at the chest wall without the aid of a stethoscope is a grade VI. 2. A quiet but easily heard murmur is a grade II. A moderately loud murmur without palpable thrill is a grade III. A very loud murmur with easily palpable thrill is a grade V. A murmur heard at the chest wall without the aid of a stethoscope is a grade VI. 3. A quiet but easily heard murmur is a grade II. A moderately loud murmur without palpable thrill is a grade III. A very loud murmur with easily palpable thrill is a grade V. A murmur heard at the chest wall without the aid of a stethoscope is a grade VI. 4. A quiet but easily heard murmur is a grade II. A moderately loud murmur without palpable thrill is a grade III. A very loud murmur with easily palpable thrill is a grade V. A murmur heard at the chest wall without the aid of a stethoscope is a grade VI.

The nurse is providing care for several pediatric clients. Which client would require an Individualized Health Plan (IHP) prior to returning to school? 1. A school-age client who has recently developed a penicillin allergy 2. An adolescent client newly diagnosed with insulin-dependent diabetes mellitus 3. A school-age client who has been treated for head lice 4. An adolescent client who has missed two weeks of school due to mononucleosis

Answer: 2 Explanation: 1. An IHP that ensures appropriate management of the child's healthcare needs must be developed for a child newly diagnosed with a chronic illness such as diabetes. A child who is allergic to penicillin will not receive this medication any longer and therefore should not encounter any problems related to it at school. A child who has been treated for head lice can return to school and does not need an IHP. While a child who has missed two weeks of school will need to make arrangements for makeup work, an IHP is not needed. 2. An IHP that ensures appropriate management of the child's healthcare needs must be developed for a child newly diagnosed with a chronic illness such as diabetes. A child who is allergic to penicillin will not receive this medication any longer and therefore should not encounter any problems related to it at school. A child who has been treated for head lice can return to school and does not need an IHP. While a child who has missed two weeks of school will need to make arrangements for makeup work, an IHP is not needed. 3. An IHP that ensures appropriate management of the child's healthcare needs must be developed for a child newly diagnosed with a chronic illness such as diabetes. A child who is allergic to penicillin will not receive this medication any longer and therefore should not encounter any problems related to it at school. A child who has been treated for head lice can return to school and does not need an IHP. While a child who has missed two weeks of school will need to make arrangements for makeup work, an IHP is not needed. 4. An IHP that ensures appropriate management of the child's healthcare needs must be developed for a child newly diagnosed with a chronic illness such as diabetes. A child who is allergic to penicillin will not receive this medication any longer and therefore should not encounter any problems related to it at school. A child who has been treated for head lice can return to school and does not need an IHP. While a child who has missed two weeks of school will need to make arrangements for makeup work, an IHP is not needed.

A school-age client tells you that "Grandpa, Mommy, Daddy, and my brother live at my house." Which type of family will the nurse identify in the medical record based on this description? 1. Binuclear family 2. Extended family 3. Gay or lesbian family 4. Traditional nuclear family

Answer: 2 Explanation: 1. An extended family contains a parent or a couple who share the house with their children and another adult relative. A binuclear family includes the divorced parents who have joint custody of their biologic children, while the children alternate spending varying amounts of time in the home of each parent. A gay or lesbian family is comprised of two same-sex domestic partners; they may or may not have children. The traditional nuclear family consists of an employed provider parent, a homemaking parent, and the biologic children of this union. 2. An extended family contains a parent or a couple who share the house with their children and another adult relative. A binuclear family includes the divorced parents who have joint custody of their biologic children, while the children alternate spending varying amounts of time in the home of each parent. A gay or lesbian family is comprised of two same-sex domestic partners; they may or may not have children. The traditional nuclear family consists of an employed provider parent, a homemaking parent, and the biologic children of this union. 3. An extended family contains a parent or a couple who share the house with their children and another adult relative. A binuclear family includes the divorced parents who have joint custody of their biologic children, while the children alternate spending varying amounts of time in the home of each parent. A gay or lesbian family is comprised of two same-sex domestic partners; they may or may not have children. The traditional nuclear family consists of an employed provider parent, a homemaking parent, and the biologic children of this union. 4. An extended family contains a parent or a couple who share the house with their children and another adult relative. A binuclear family includes the divorced parents who have joint custody of their biologic children, while the children alternate spending varying amounts of time in the home of each parent. A gay or lesbian family is comprised of two same-sex domestic partners; they may or may not have children. The traditional nuclear family consists of an employed provider parent, a homemaking parent, and the biologic children of this union.

Pediatric nurses have foundational knowledge obtained in nursing school and add specific competencies related to the pediatric client. Which would be considered an additional specific expected competency of the pediatric nurse? 1. Physical assessment 2. Anatomical and developmental differences 3. Nursing process 4. Management of healthcare conditions

Answer: 2 Explanation: 1. Assessing anatomical and developmental differences would be a specific expected competency for the pediatric nurse that would not be learned in nursing school. Physical assessment, nursing process, and management of health conditions are all foundational knowledge learned in nursing school. 2. Assessing anatomical and developmental differences would be a specific expected competency for the pediatric nurse that would not be learned in nursing school. Physical assessment, nursing process, and management of health conditions are all foundational knowledge learned in nursing school. 3. Assessing anatomical and developmental differences would be a specific expected competency for the pediatric nurse that would not be learned in nursing school. Physical assessment, nursing process, and management of health conditions are all foundational knowledge learned in nursing school. 4. Assessing anatomical and developmental differences would be a specific expected competency for the pediatric nurse that would not be learned in nursing school. Physical assessment, nursing process, and management of health conditions are all foundational knowledge learned in nursing school.

A 2-month-old infant with bronchopulmonary dysplasia (BPD) is being prepared for discharge from the neonatal intensive-care unit (NICU). The infant will continue to receive oxygen via nasal cannula at home. Prior to discharge, the home-health nurse assesses the home. Which finding poses the greatest risk to this infant? 1. Small toys strewn on the floor 2. A woodstove used for heating 3. A sibling who has an ear infection 4. Paint peeling on the walls

Answer: 2 Explanation: 1. Assessment of the home environment is essential prior to discharge of a medically fragile infant. The use of a woodstove poses great risk to the infant who already has fragile lungs. Oxygen and woodstove heat will produce a flammable reaction. Small toy pieces and paint peeling from the wall will pose a choking risk to the older infant who is crawling. Ear infections are not contagious. 2. Assessment of the home environment is essential prior to discharge of a medically fragile infant. The use of a woodstove poses great risk to the infant who already has fragile lungs. Oxygen and woodstove heat will produce a flammable reaction. Small toy pieces and paint peeling from the wall will pose a choking risk to the older infant who is crawling. Ear infections are not contagious. 3. Assessment of the home environment is essential prior to discharge of a medically fragile infant. The use of a woodstove poses great risk to the infant who already has fragile lungs. Oxygen and woodstove heat will produce a flammable reaction. Small toy pieces and paint peeling from the wall will pose a choking risk to the older infant who is crawling. Ear infections are not contagious. 4. Assessment of the home environment is essential prior to discharge of a medically fragile infant. The use of a woodstove poses great risk to the infant who already has fragile lungs. Oxygen and woodstove heat will produce a flammable reaction. Small toy pieces and paint peeling from the wall will pose a choking risk to the older infant who is crawling. Ear infections are not contagious.

A 7-year-old child is admitted for acute appendicitis. The parents are questioning the nurse about expectations during the child's recovery. Which information tool would be most useful in answering a parent's questions about the timing of key events? 1. Healthy People 2020 2. Clinical pathways 3. Child mortality statistics 4. National clinical practice guidelines

Answer: 2 Explanation: 1. Clinical pathways are interdisciplinary documents provided by a hospital to suggest ideal sequencing and timing of events and interventions for specific diseases to improve efficiency of care and enhance recovery. This pathway serves as a model outlining the typical hospital stay for individuals with specified conditions. Healthy People 2020 contains objectives set by the U.S. government to improve the health and reduce the incidence of death in the twenty-first century. Child mortality statistics can be compared with those from other decades for the evaluation of achievement toward health-care goals. National clinical practice guidelines promote uniformity in care for specific disease conditions by suggesting expected outcomes from specific interventions. 2. Clinical pathways are interdisciplinary documents provided by a hospital to suggest ideal sequencing and timing of events and interventions for specific diseases to improve efficiency of care and enhance recovery. This pathway serves as a model outlining the typical hospital stay for individuals with specified conditions. Healthy People 2020 contains objectives set by the U.S. government to improve the health and reduce the incidence of death in the twenty-first century. Child mortality statistics can be compared with those from other decades for the evaluation of achievement toward health-care goals. National clinical practice guidelines promote uniformity in care for specific disease conditions by suggesting expected outcomes from specific interventions. 3. Clinical pathways are interdisciplinary documents provided by a hospital to suggest ideal sequencing and timing of events and interventions for specific diseases to improve efficiency of care and enhance recovery. This pathway serves as a model outlining the typical hospital stay for individuals with specified conditions. Healthy People 2020 contains objectives set by the U.S. government to improve the health and reduce the incidence of death in the twenty-first century. Child mortality statistics can be compared with those from other decades for the evaluation of achievement toward health-care goals. National clinical practice guidelines promote uniformity in care for specific disease conditions by suggesting expected outcomes from specific interventions. 4. Clinical pathways are interdisciplinary documents provided by a hospital to suggest ideal sequencing and timing of events and interventions for specific diseases to improve efficiency of care and enhance recovery. This pathway serves as a model outlining the typical hospital stay for individuals with specified conditions. Healthy People 2020 contains objectives set by the U.S. government to improve the health and reduce the incidence of death in the twenty-first century. Child mortality statistics can be compared with those from other decades for the evaluation of achievement toward health-care goals. National clinical practice guidelines promote uniformity in care for specific disease conditions by suggesting expected outcomes from specific interventions.

A nurse caring for a school-age client notices some swelling in the child's ankles. The nurse presses against the ankle bone for five seconds, then releases the pressure and notices a markedly slow disappearance of the indentation. Which priority nursing assessment is appropriate? 1. Skin integrity, especially in the lower extremities 2. Urine output 3. Level of consciousness 4. Range of motion and ankle mobility

Answer: 2 Explanation: 1. Dependent, pitting edema, especially in the lower extremities, can be a symptom of both kidney and cardiac disorders. Decreases in urine output can also indicate compromise in both the renal and cardiac systems. Changes in level of consciousness, if present, would more than likely be a later effect in this situation. While ankle edema could lead to both decreased ankle mobility and compromise in skin integrity, diagnosing and treating the underlying cause of the edema is most important. 2. Dependent, pitting edema, especially in the lower extremities, can be a symptom of both kidney and cardiac disorders. Decreases in urine output can also indicate compromise in both the renal and cardiac systems. Changes in level of consciousness, if present, would more than likely be a later effect in this situation. While ankle edema could lead to both decreased ankle mobility and compromise in skin integrity, diagnosing and treating the underlying cause of the edema is most important. 3. Dependent, pitting edema, especially in the lower extremities, can be a symptom of both kidney and cardiac disorders. Decreases in urine output can also indicate compromise in both the renal and cardiac systems. Changes in level of consciousness, if present, would more than likely be a later effect in this situation. While ankle edema could lead to both decreased ankle mobility and compromise in skin integrity, diagnosing and treating the underlying cause of the edema is most important. 4. Dependent, pitting edema, especially in the lower extremities, can be a symptom of both kidney and cardiac disorders. Decreases in urine output can also indicate compromise in both the renal and cardiac systems. Changes in level of consciousness, if present, would more than likely be a later effect in this situation. While ankle edema could lead to both decreased ankle mobility and compromise in skin integrity, diagnosing and treating the underlying cause of the edema is most important.

When discussing inheritance with parents of a child with a genetic disorder, which statement by the parents indicates they understand inheritance risk? 1. "This child has a genetic disorder, so future children will not have it." 2. "Each pregnancy carries the same percent risk of inheritance." 3. "I cannot have any more children, because they will all have the disorder." 4. "There is a good chance future children will be normal."

Answer: 2 Explanation: 1. Each pregnancy carries the same percent risk of having a child with the disorder in question. The other statements indicate the need for further education regarding inheritance risk. 2. Each pregnancy carries the same percent risk of having a child with the disorder in question. The other statements indicate the need for further education regarding inheritance risk. 3. Each pregnancy carries the same percent risk of having a child with the disorder in question. The other statements indicate the need for further education regarding inheritance risk. 4. Each pregnancy carries the same percent risk of having a child with the disorder in question. The other statements indicate the need for further education regarding inheritance risk.

The nurse, talking with the parents of a toddler who is struggling with toilet training, reassures them that their child is demonstrating a typical developmental stage. According to Erikson, which developmental stage will the nurse document in the medical record for this toddler? 1. Trust versus mistrust 2. Autonomy versus shame and doubt 3. Initiative versus guilt 4. Industry versus inferiority

Answer: 2 Explanation: 1. Erikson's stage of "autonomy versus shame and doubt" marks a period of time when the toddler is trying to gain some independence while still wanting to please adults. 2. Erikson's stage of "autonomy versus shame and doubt" marks a period of time when the toddler is trying to gain some independence while still wanting to please adults. 3. Erikson's stage of "autonomy versus shame and doubt" marks a period of time when the toddler is trying to gain some independence while still wanting to please adults. 4. Erikson's stage of "autonomy versus shame and doubt" marks a period of time when the toddler is trying to gain some independence while still wanting to please adults.

A 12-year-old pediatric client is in need of surgery. Which member of the healthcare team is legally responsible for obtaining informed consent for an invasive procedure? 1. Nurse 2. Physician 3. Unit secretary 4. Social worker

Answer: 2 Explanation: 1. Informed consent is legal preauthorization for an invasive procedure. It is the physician's legal responsibility to obtain this, because it consists of an explanation about the medical condition, a detailed description of treatment plans, the expected benefits and risks related to the proposed treatment plan, alternative treatment options, the client's questions, and the guardian's right to refuse treatment. 2. Informed consent is legal preauthorization for an invasive procedure. It is the physician's legal responsibility to obtain this, because it consists of an explanation about the medical condition, a detailed description of treatment plans, the expected benefits and risks related to the proposed treatment plan, alternative treatment options, the client's questions, and the guardian's right to refuse treatment. 3. Informed consent is legal preauthorization for an invasive procedure. It is the physician's legal responsibility to obtain this, because it consists of an explanation about the medical condition, a detailed description of treatment plans, the expected benefits and risks related to the proposed treatment plan, alternative treatment options, the client's questions, and the guardian's right to refuse treatment. 4. Informed consent is legal preauthorization for an invasive procedure. It is the physician's legal responsibility to obtain this, because it consists of an explanation about the medical condition, a detailed description of treatment plans, the expected benefits and risks related to the proposed treatment plan, alternative treatment options, the client's questions, and the guardian's right to refuse treatment.

What is the pediatric nurse's best defense against an accusation of malpractice or negligence? 1. Following the physician's written orders 2. Meeting the scope and standards of practice for pediatric nursing 3. Being a nurse practitioner or clinical nurse specialist 4. Acting on the advice of the nurse manager

Answer: 2 Explanation: 1. Meeting the scope and standards of practice for pediatric nursing would cover the pediatric nurse against an accusation of malpractice or negligence because the standards are rigorous and cover all bases of excellent nursing practice. Following the physician's written orders or acting on the advice of the nurse manager are not enough to defend the nurse from accusations because the orders and/or advice may be wrong or unethical. Being a clinical nurse specialist or nurse practitioner does not defend the nurse against these accusations if he or she does not follow the Society of Pediatric Nurses standards of practice. 2. Meeting the scope and standards of practice for pediatric nursing would cover the pediatric nurse against an accusation of malpractice or negligence because the standards are rigorous and cover all bases of excellent nursing practice. Following the physician's written orders or acting on the advice of the nurse manager are not enough to defend the nurse from accusations because the orders and/or advice may be wrong or unethical. Being a clinical nurse specialist or nurse practitioner does not defend the nurse against these accusations if he or she does not follow the Society of Pediatric Nurses standards of practice. 3. Meeting the scope and standards of practice for pediatric nursing would cover the pediatric nurse against an accusation of malpractice or negligence because the standards are rigorous and cover all bases of excellent nursing practice. Following the physician's written orders or acting on the advice of the nurse manager are not enough to defend the nurse from accusations because the orders and/or advice may be wrong or unethical. Being a clinical nurse specialist or nurse practitioner does not defend the nurse against these accusations if he or she does not follow the Society of Pediatric Nurses standards of practice. 4. Meeting the scope and standards of practice for pediatric nursing would cover the pediatric nurse against an accusation of malpractice or negligence because the standards are rigorous and cover all bases of excellent nursing practice. Following the physician's written orders or acting on the advice of the nurse manager are not enough to defend the nurse from accusations because the orders and/or advice may be wrong or unethical. Being a clinical nurse specialist or nurse practitioner does not defend the nurse against these accusations if he or she does not follow the Society of Pediatric Nurses standards of practice.

When assessing the cognitive development, which technique would be appropriate to test the remote memory of a 5-year-old? 1. Say the name of an object and after 5 minutes ask the child to tell you what you said the object was. 2. Ask the child to repeat his address. 3. Ask the child to say a poem and listen to the child's speech articulation. 4. Have the child point to various parts of the body as you name them.

Answer: 2 Explanation: 1. Repeating the name of an object after 5 to 10 minutes is assessing recent memory. Asking the child to repeat his address is assessing remote memory. Listening to speech articulation and pointing to body parts both assess communication skills. 2. Repeating the name of an object after 5 to 10 minutes is assessing recent memory. Asking the child to repeat his address is assessing remote memory. Listening to speech articulation and pointing to body parts both assess communication skills. 3. Repeating the name of an object after 5 to 10 minutes is assessing recent memory. Asking the child to repeat his address is assessing remote memory. Listening to speech articulation and pointing to body parts both assess communication skills. 4. Repeating the name of an object after 5 to 10 minutes is assessing recent memory. Asking the child to repeat his address is assessing remote memory. Listening to speech articulation and pointing to body parts both assess communication skills.

A nurse is planning care for a family who is undergoing genetic screening. Which expected outcome will the nurse include in the plan of care for this family? 1. Consult an attorney before making a decision. 2. Make a voluntary decision related to genetic health issues. 3. Not consider the influence of genetics on health promotion. 4. Look closely at the present before considering the future as it relates to genetic screening.

Answer: 2 Explanation: 1. The goal of nursing care is to allow informed, voluntary decisions when it comes to genetic screening. 2. The goal of nursing care is to allow informed, voluntary decisions when it comes to genetic screening. 3. The goal of nursing care is to allow informed, voluntary decisions when it comes to genetic screening. 4. The goal of nursing care is to allow informed, voluntary decisions when it comes to genetic screening.

The nurse recognizes that the pediatric client is from a cultural background different from that of the hospital staff. Which goal is most appropriate for this client when planning nursing care? 1. Overlook or minimize the differences that exist. 2. Facilitate the family's ability to comply with the care needed. 3. Avoid inadvertently offending the family by imposing the nurse's perspective. 4. Encourage complementary beneficial cultural practices as primary therapies.

Answer: 2 Explanation: 1. The incorporation of the family's cultural perspective into the care plan is most likely to result in the family's ability to accept medical care and comply with the regimen prescribed. Since culture develops from social learning, attempts to ignore or minimize cultural consideration will result in mistrust, suspicion, or offenses that can have negative effects upon the health of children by reducing the resources available to promote health and prevent illness. Complementary therapy may be used later if other primary therapies prove to be ineffective. 2. The incorporation of the family's cultural perspective into the care plan is most likely to result in the family's ability to accept medical care and comply with the regimen prescribed. Since culture develops from social learning, attempts to ignore or minimize cultural consideration will result in mistrust, suspicion, or offenses that can have negative effects upon the health of children by reducing the resources available to promote health and prevent illness. Complementary therapy may be used later if other primary therapies prove to be ineffective. 3. The incorporation of the family's cultural perspective into the care plan is most likely to result in the family's ability to accept medical care and comply with the regimen prescribed. Since culture develops from social learning, attempts to ignore or minimize cultural consideration will result in mistrust, suspicion, or offenses that can have negative effects upon the health of children by reducing the resources available to promote health and prevent illness. Complementary therapy may be used later if other primary therapies prove to be ineffective. 4. The incorporation of the family's cultural perspective into the care plan is most likely to result in the family's ability to accept medical care and comply with the regimen prescribed. Since culture develops from social learning, attempts to ignore or minimize cultural consideration will result in mistrust, suspicion, or offenses that can have negative effects upon the health of children by reducing the resources available to promote health and prevent illness. Complementary therapy may be used later if other primary therapies prove to be ineffective.

The telephone triage nurse receives a call from a parent who states that her 18-month-old is making a crowing sound when he breathes and is hard to wake up. Which action by the nurse is the most appropriate? 1. Obtain the history of the illness from the parent. 2. Advise the parent to hang up and call 9-1-1. 3. Make an appointment for the child to see the healthcare provider. 4. Reassure the parent and provide instructions on home care for the child.

Answer: 2 Explanation: 1. The nurse should immediately recognize the symptoms of severe upper respiratory distress and advise the parent to call 9-1-1. Crowing is heard when there is severe narrowing of the airway. The other actions would be appropriate in nonemergency situations. 2. The nurse should immediately recognize the symptoms of severe upper respiratory distress and advise the parent to call 9-1-1. Crowing is heard when there is severe narrowing of the airway. The other actions would be appropriate in nonemergency situations. 3. The nurse should immediately recognize the symptoms of severe upper respiratory distress and advise the parent to call 9-1-1. Crowing is heard when there is severe narrowing of the airway. The other actions would be appropriate in nonemergency situations. 4. The nurse should immediately recognize the symptoms of severe upper respiratory distress and advise the parent to call 9-1-1. Crowing is heard when there is severe narrowing of the airway. The other actions would be appropriate in nonemergency situations.

The nurse is working on parenting skills with a group of mothers. Which mother would need the fewest discipline-related suggestions? 1. Authoritarian 2. Authoritative 3. Indifferent 4. Permissive

Answer: 2 Explanation: 1. The parental style that results in positive outcomes for the behavior and learning of its children is the authoritative style. Nurses have observed that children from homes using this parental style more frequently have personalities manifesting self-reliance, self-control, and social competence. These parents should be praised for using the preferred approach. Children in the authoritarian parenting family are denied opportunity to develop some skills in the areas of self-direction, communication, and negotiation. Under the permissive parental style, children do not learn the socially acceptable limits of behaviors. The indifferent parental style results in children who often exhibit destructive behaviors and delinquency. 2. The parental style that results in positive outcomes for the behavior and learning of its children is the authoritative style. Nurses have observed that children from homes using this parental style more frequently have personalities manifesting self-reliance, self-control, and social competence. These parents should be praised for using the preferred approach. Children in the authoritarian parenting family are denied opportunity to develop some skills in the areas of self-direction, communication, and negotiation. Under the permissive parental style, children do not learn the socially acceptable limits of behaviors. The indifferent parental style results in children who often exhibit destructive behaviors and delinquency. 3. The parental style that results in positive outcomes for the behavior and learning of its children is the authoritative style. Nurses have observed that children from homes using this parental style more frequently have personalities manifesting self-reliance, self-control, and social competence. These parents should be praised for using the preferred approach. Children in the authoritarian parenting family are denied opportunity to develop some skills in the areas of self-direction, communication, and negotiation. Under the permissive parental style, children do not learn the socially acceptable limits of behaviors. The indifferent parental style results in children who often exhibit destructive behaviors and delinquency. 4. The parental style that results in positive outcomes for the behavior and learning of its children is the authoritative style. Nurses have observed that children from homes using this parental style more frequently have personalities manifesting self-reliance, self-control, and social competence. These parents should be praised for using the preferred approach. Children in the authoritarian parenting family are denied opportunity to develop some skills in the areas of self-direction, communication, and negotiation. Under the permissive parental style, children do not learn the socially acceptable limits of behaviors. The indifferent parental style results in children who often exhibit destructive behaviors and delinquency.

There are several tools that help with obtaining a cultural assessment of a client and his family. Which tool would be appropriate to gather 12 major concepts of cultural assessment? 1. Sunrise enabler 2. Model for cultural competence 3. Transcultural assessment model 4. Health traditions model

Answer: 2 Explanation: 1. The sunrise enabler examines influences on care and culture. The model for cultural competence will gather information on 12 major concepts. The transcultural assessment model is based on 6 phenomena. The health traditions model is predicated on holistic health. 2. The sunrise enabler examines influences on care and culture. The model for cultural competence will gather information on 12 major concepts. The transcultural assessment model is based on 6 phenomena. The health traditions model is predicated on holistic health. 3. The sunrise enabler examines influences on care and culture. The model for cultural competence will gather information on 12 major concepts. The transcultural assessment model is based on 6 phenomena. The health traditions model is predicated on holistic health. 4. The sunrise enabler examines influences on care and culture. The model for cultural competence will gather information on 12 major concepts. The transcultural assessment model is based on 6 phenomena. The health traditions model is predicated on holistic health.

Parents of a child with a congenital heart defect ask what the chances are of recurrence in future pregnancies. Which response by the nurse is the most appropriate? 1. "There is a 50 percent chance of recurrence in a future pregnancy." 2. "There is a very low chance of recurrence." 3. "It should not happen again with a future pregnancy." 4. "There is a strong chance of recurrence."

Answer: 2 Explanation: 1. There is a very low rate of recurrence with congenital heart defects. The other statements are not appropriate for the nurse to make in this situation. 2. There is a very low rate of recurrence with congenital heart defects. The other statements are not appropriate for the nurse to make in this situation. 3. There is a very low rate of recurrence with congenital heart defects. The other statements are not appropriate for the nurse to make in this situation. 4. There is a very low rate of recurrence with congenital heart defects. The other statements are not appropriate for the nurse to make in this situation.

The community-health nurse is planning an education session for recently hired teachers at a child-care center. Which item is priority for the community-health nurse to include in the educational session? 1. The schedule for immunizations 2. Principles of infection control 3. How to interpret healthcare records 4. How to take a temperature

Answer: 2 Explanation: 1. While all of the information is nice to know, it is most essential that teachers know principles of infection control to decrease the spread of germs that can cause disease in young children. 2. While all of the information is nice to know, it is most essential that teachers know principles of infection control to decrease the spread of germs that can cause disease in young children. 3. While all of the information is nice to know, it is most essential that teachers know principles of infection control to decrease the spread of germs that can cause disease in young children. 4. While all of the information is nice to know, it is most essential that teachers know principles of infection control to decrease the spread of germs that can cause disease in young children.

The nurse is counseling the parents of a 13-year-old regarding the behaviors they may encounter after telling the child about their plans to divorce. Which behaviors could the child demonstrate? Select all that apply. 1. Sorrow 2. Skipping school 3. Risk-taking 4. Withdraw from friends and activities 5. Temper tantrums

Answer: 2, 3 Explanation: 1. Preschool behaviors include: fear, anxiety, worry, self-blame, sorrow, grief, anger, regression, searching and questioning, temper tantrums, crankiness and aggression, loneliness, unhappiness, and depression. 2. Adolescent behaviors include: panic, fear, depression, guilt, risk-taking, fear of loneliness and abandonment, denial, anger, sadness, aggressiveness, skipping or dropping out of school, use of drugs and alcohol, and sexual acting out. 3. Adolescent behaviors include: panic, fear, depression, guilt, risk-taking, fear of loneliness and abandonment, denial, anger, sadness, aggressiveness, skipping or dropping out of school, use of drugs and alcohol, and sexual acting out. 4. School age behaviors include: worry, anxiety depression, sadness, insecurity, fantasy, grief, guilt, self-blame, inability to concentrate on schoolwork, lower academic achievement, regression, aggression, confusion, anger resentment, behavioral problems at school and home, manipulation of parents, withdrawal from friends and activities, fear, and loneliness. 5. Preschool behaviors include: fear, anxiety, worry, self-blame, sorrow, grief, anger, regression, searching and questioning, temper tantrums, crankiness and aggression, loneliness, unhappiness, and depression.

The nurse is planning care for a school-age client and family who have expressed wanting to use complementary and alternative modalities (CAM) in the treatment plan. Which interventions can the nurse safely implement into the plan of care? Select all that apply. 1. Substituting an herbal remedy for a prescribed medication 2. Encouraging the parents to share which modalities they would like to implement 3. Educating on the benefits and risks for each modality 4. Using essential oils to decrease nausea 5. Discouraging the use of faith-based therapies

Answer: 2, 3, 4 Explanation: 1. Appropriate interventions for this client and family include encouraging the parents to share which modalities they want to implement, educating about the risks and benefits of each modality, and using modalities that are safe, such the use of essential oils to decrease nausea. An herbal remedy should not be substituted for a prescribed medication, but can be used if deemed safe with the prescribed medication. Discouraging the use of faith-based therapies does not support the client and family who want to use CAM in the treatment plan. 2. Appropriate interventions for this client and family include encouraging the parents to share which modalities they want to implement, educating about the risks and benefits of each modality, and using modalities that are safe, such the use of essential oils to decrease nausea. An herbal remedy should not be substituted for a prescribed medication, but can be used if deemed safe with the prescribed medication. Discouraging the use of faith-based therapies does not support the client and family who want to use CAM in the treatment plan. 3. Appropriate interventions for this client and family include encouraging the parents to share which modalities they want to implement, educating about the risks and benefits of each modality, and using modalities that are safe, such the use of essential oils to decrease nausea. An herbal remedy should not be substituted for a prescribed medication, but can be used if deemed safe with the prescribed medication. Discouraging the use of faith-based therapies does not support the client and family who want to use CAM in the treatment plan. 4. Appropriate interventions for this client and family include encouraging the parents to share which modalities they want to implement, educating about the risks and benefits of each modality, and using modalities that are safe, such the use of essential oils to decrease nausea. An herbal remedy should not be substituted for a prescribed medication, but can be used if deemed safe with the prescribed medication. Discouraging the use of faith-based therapies does not support the client and family who want to use CAM in the treatment plan. 5. Appropriate interventions for this client and family include encouraging the parents to share which modalities they want to implement, educating about the risks and benefits of each modality, and using modalities that are safe, such the use of essential oils to decrease nausea. An herbal remedy should not be substituted for a prescribed medication, but can be used if deemed safe with the prescribed medication. Discouraging the use of faith-based therapies does not support the client and family who want to use CAM in the treatment plan.

A nurse is working with pediatric clients in a research facility. The nurse recognizes that federal guidelines are in place that delineate which pediatrics clients must give assent for participation in research trials. Based upon the client's age, the nurse would seek assent from which children? Select all that apply. 1. The precocious 4-year-old commencing as a cystic fibrosis research-study participant. 2. The 7-year-old leukemia client electing to receive a newly developed medication, now being researched. 3. The 10-year-old commencing in an investigative study for clients with precocious puberty. 4. The 13-year-old client commencing participation in a research program for Attention Deficit Hyperactivity Disorder (ADHD) treatments.

Answer: 2, 3, 4 Explanation: 1. Federal guidelines mandate that research participants 7 years old and older must receive developmentally appropriate information about healthcare procedures and treatments and give assent. 2. Federal guidelines mandate that research participants 7 years old and older must receive developmentally appropriate information about healthcare procedures and treatments and give assent. 3. Federal guidelines mandate that research participants 7 years old and older must receive developmentally appropriate information about healthcare procedures and treatments and give assent. 4. Federal guidelines mandate that research participants 7 years old and older must receive developmentally appropriate information about healthcare procedures and treatments and give assent.

The nurse is planning care for an adolescent client who will be hospitalized for several weeks following a traumatic brain injury. Which interventions will enhance family-centered care for this client and family? Select all that apply. 1. Making all ADL decisions for the adolescent and family 2. Asking the adolescent what foods to include during meal time 3. Allowing the family time to pray each day with the adolescent 4. Encouraging the adolescent's friends to visit during visiting hours 5. Leaving all questions for the healthcare provider

Answer: 2, 3, 4 Explanation: 1. Interventions that will enhance family-centered care for this client and family include asking the adolescent to be an active member of care by making food choices, allowing the family to pray each day with the adolescent, and encouraging the adolescent's friends to visit during visiting hours. These interventions each promote the concepts of family-centered care. Making all decisions for the adolescent and family and leaving all questions for the healthcare provider do not promote the concepts of family-centered care. 2. Interventions that will enhance family-centered care for this client and family include asking the adolescent to be an active member of care by making food choices, allowing the family to pray each day with the adolescent, and encouraging the adolescent's friends to visit during visiting hours. These interventions each promote the concepts of family-centered care. Making all decisions for the adolescent and family and leaving all questions for the healthcare provider do not promote the concepts of family-centered care. 3. Interventions that will enhance family-centered care for this client and family include asking the adolescent to be an active member of care by making food choices, allowing the family to pray each day with the adolescent, and encouraging the adolescent's friends to visit during visiting hours. These interventions each promote the concepts of family-centered care. Making all decisions for the adolescent and family and leaving all questions for the healthcare provider do not promote the concepts of family-centered care. 4. Interventions that will enhance family-centered care for this client and family include asking the adolescent to be an active member of care by making food choices, allowing the family to pray each day with the adolescent, and encouraging the adolescent's friends to visit during visiting hours. These interventions each promote the concepts of family-centered care. Making all decisions for the adolescent and family and leaving all questions for the healthcare provider do not promote the concepts of family-centered care. 5. Interventions that will enhance family-centered care for this client and family include asking the adolescent to be an active member of care by making food choices, allowing the family to pray each day with the adolescent, and encouraging the adolescent's friends to visit during visiting hours. These interventions each promote the concepts of family-centered care. Making all decisions for the adolescent and family and leaving all questions for the healthcare provider do not promote the concepts of family-centered care.

When completing a pedigree, which factors should be included? Select all that apply. 1. Full siblings only 2. Begin with the proband 3. Mark each generation with a Roman numeral 4. Include at least three generations 5. Use only standard pedigree symbols

Answer: 2, 3, 4, 5 Explanation: 1. It is important to include half-siblings in addition to full siblings, as half-siblings have half the genetic history that the full siblings do. The other answers are all important to include in a pedigree. 2. It is important to include half-siblings in addition to full siblings, as half-siblings have half the genetic history that the full siblings do. The other answers are all important to include in a pedigree. 3. It is important to include half-siblings in addition to full siblings, as half-siblings have half the genetic history that the full siblings do. The other answers are all important to include in a pedigree. 4. It is important to include half-siblings in addition to full siblings, as half-siblings have half the genetic history that the full siblings do. The other answers are all important to include in a pedigree. 5. It is important to include half-siblings in addition to full siblings, as half-siblings have half the genetic history that the full siblings do. The other answers are all important to include in a pedigree.

A nurse and the family of an 8-year-old with acute renal failure are reviewing family strengths helpful in managing stressors. Which family strengths should the nurse recommend this family utilize? Select all that apply. 1. Meeting member needs 2. Support by extended family 3. Effective communication 4. Receiving and giving love 5. Prior life experiences

Answer: 2, 3, 5 Explanation: 1. Meeting member needs is one of the roles of a family. Strengths that enable families to develop and adapt to stressors include: education, prior experiences, finances, effective communication, collaborative problem solving, emotional awareness, emotional stability and developing shared meaning about the experience. 2. Support by extended family is one of the family strengths. 3. Effective communication is one of the family strengths. 4. Receiving and giving love is one of the roles of a family. Strengths that enable families to develop and adapt to stressors include: education, prior experiences, finances, effective communication, collaborative problem solving, emotional awareness, emotional stability and developing shared meaning about the experience. 5. Prior life experiences are one of the family strengths.

The nurse is assessing a school-age child's extraocular movements. The nurse recognizes which cranial nerves that involve testing extraocular movements? Select all that apply. 1. VII 2. III 3. IV 4. XII 5. VI

Answer: 2, 3, 5 Explanation: 1. VII is the facial nerve and is not involved in testing extraocular movements. Cranial nerves III, IV, and VI dominate eye movements and pupil constriction. Cranial nerve VII dominates the person's ability to smile and frown and cranial nerve XII dominates tongue movements. 2. III is the nerve and is involved in testing extraocular movements. 3. IV is the nerve and is involved in testing extraocular movements. 4. XII is the hypoglossal nerve and is not involved in testing extraocular movements. Cranial nerves III, IV, and VI dominate eye movements and pupil constriction. Cranial nerve VII dominates the person's ability to smile and frown and cranial nerve XII dominates tongue movements. 5. VI is the nerve and is involved in testing extraocular movements.

A nurse from a pediatric clinic performs assignments and counsels parents. Which families should the nurse refer for genetic counseling? Select all that apply. 1. Female with hypoactive thyroid disease 2. Couple with multiple stillbirths 3. Couple with family history of heart disease 4. Couple with three years of infertility 5. Child born with ophthalmia neonatorum

Answer: 2, 4 Explanation: 1. A female with hypoactive thyroid disease should not be referred for genetic counseling. 2. A couple with multiple stillbirths should be referred for genetic counseling. 3. A couple with family history of heart disease should not be referred for genetic counseling. 4. The couple with three years of infertility should be referred for genetic counseling. 5. The family with a child born with a child born with ophthalmia neonatorum should not be referred for genetic counseling.

The nurse is preparing to assess a toddler client. Which activities would gain cooperation from the toddler? Select all that apply. 1. Asking the parents to wait outside 2. Allowing the client to sit in the parent's lap 3. Administering vaccinations prior to the assessment 4. Handing the client a stethoscope while taking the health history 5. Making a game out of the assessment process

Answer: 2, 4 Explanation: 1. Allowing the client to stay on the parents lap and allowing the client to play with instruments that will be used in the assessment process are activities the nurse can implement to gain the toddler's cooperation during the assessment process. Asking the parents to wait outside may cause the toddler to become fearful. Vaccinations should be administered at the end of the visit. While making a game out of the assessment process may be appropriate for older children, this is not an appropriate strategy for a toddler client. 2. Allowing the client to stay on the parents lap and allowing the client to play with instruments that will be used in the assessment process are activities the nurse can implement to gain the toddler's cooperation during the assessment process. Asking the parents to wait outside may cause the toddler to become fearful. Vaccinations should be administered at the end of the visit. While making a game out of the assessment process may be appropriate for older children, this is not an appropriate strategy for a toddler client. 3. Allowing the client to stay on the parents lap and allowing the client to play with instruments that will be used in the assessment process are activities the nurse can implement to gain the toddler's cooperation during the assessment process. Asking the parents to wait outside may cause the toddler to become fearful. Vaccinations should be administered at the end of the visit. While making a game out of the assessment process may be appropriate for older children, this is not an appropriate strategy for a toddler client. 4. Allowing the client to stay on the parents lap and allowing the client to play with instruments that will be used in the assessment process are activities the nurse can implement to gain the toddler's cooperation during the assessment process. Asking the parents to wait outside may cause the toddler to become fearful. Vaccinations should be administered at the end of the visit. While making a game out of the assessment process may be appropriate for older children, this is not an appropriate strategy for a toddler client. 5. Allowing the client to stay on the parents lap and allowing the client to play with instruments that will be used in the assessment process are activities the nurse can implement to gain the toddler's cooperation during the assessment process. Asking the parents to wait outside may cause the toddler to become fearful. Vaccinations should be administered at the end of the visit. While making a game out of the assessment process may be appropriate for older children, this is not an appropriate strategy for a toddler client.

The parents of a 1-year-old infant are concerned that this baby seems more shy and scared of new situations than their other child and ask the nurse if this is normal. The nurse knows that the infant is exhibiting a characteristic of the "slow-to-warm-up." Which statement to the parents is most appropriate by the nurse? 1. "Your infant is showing a regularity in patterns of eating." 2. "Your infant displays a predominately negative mood." 3. "Your infant initially reacts to new situations by withdrawing." 4. "Your infant has intense reactions to the environment."

Answer: 3 Explanation: 1. "Slow-to-warm-up" children adapt slowly to new situations and initially will withdraw. Showing regularity in patterns of eating is a characteristic of an "easy" child, and displaying a predominately negative mood and commonly having intense reactions to the environment are characteristics of "difficult" children. 2. "Slow-to-warm-up" children adapt slowly to new situations and initially will withdraw. Showing regularity in patterns of eating is a characteristic of an "easy" child, and displaying a predominately negative mood and commonly having intense reactions to the environment are characteristics of "difficult" children. 3. "Slow-to-warm-up" children adapt slowly to new situations and initially will withdraw. Showing regularity in patterns of eating is a characteristic of an "easy" child, and displaying a predominately negative mood and commonly having intense reactions to the environment are characteristics of "difficult" children. 4. "Slow-to-warm-up" children adapt slowly to new situations and initially will withdraw. Showing regularity in patterns of eating is a characteristic of an "easy" child, and displaying a predominately negative mood and commonly having intense reactions to the environment are characteristics of "difficult" children.

The school nurse is preparing a plan of care specific to several children in the school who have asthma. What is the initial action on the plan of care? 1. Call 911 to request emergency medical assistance. 2. Call the child's parents to come and pick up the child. 3. Have the child use his or her metered-dose inhaler. 4. Have the child lie down to see if the symptoms subside.

Answer: 3 Explanation: 1. A child with a history of asthma may have episodes of wheezing that can be controlled by prompt use of the child's rescue inhaler. An inhaler should be readily available in the school setting for a child previously diagnosed with asthma. This should be tried first. Emergency personnel should be notified if the inhaler does not provide relief and the child is in respiratory distress. Parents may be notified if the child does not feel well, but this is not the initial action. Having the child lie down will likely worsen his condition. 2. A child with a history of asthma may have episodes of wheezing that can be controlled by prompt use of the child's rescue inhaler. An inhaler should be readily available in the school setting for a child previously diagnosed with asthma. This should be tried first. Emergency personnel should be notified if the inhaler does not provide relief and the child is in respiratory distress. Parents may be notified if the child does not feel well, but this is not the initial action. Having the child lie down will likely worsen his condition. 3. A child with a history of asthma may have episodes of wheezing that can be controlled by prompt use of the child's rescue inhaler. An inhaler should be readily available in the school setting for a child previously diagnosed with asthma. This should be tried first. Emergency personnel should be notified if the inhaler does not provide relief and the child is in respiratory distress. Parents may be notified if the child does not feel well, but this is not the initial action. Having the child lie down will likely worsen his condition. 4. A child with a history of asthma may have episodes of wheezing that can be controlled by prompt use of the child's rescue inhaler. An inhaler should be readily available in the school setting for a child previously diagnosed with asthma. This should be tried first. Emergency personnel should be notified if the inhaler does not provide relief and the child is in respiratory distress. Parents may be notified if the child does not feel well, but this is not the initial action. Having the child lie down will likely worsen his condition.

A father is a known carrier of an X-linked condition, and asks when he will know whether his newborn son has the condition he carries. Which response by the nurse is the most appropriate? 1. "Genetic studies have been ordered, and they will take about a week to determine the results." 2. "We plan to run additional tests this afternoon, and should have results by the end of the day." 3. "Your son cannot have the condition because the condition is X-linked and cannot be passed on to him." 4. "There is a 50 percent chance you passed it on, but further tests are not recommended until he is a month old."

Answer: 3 Explanation: 1. A male child does not inherit any X chromosome from the father; therefore, the male child will not have the condition. 2. A male child does not inherit any X chromosome from the father; therefore, the male child will not have the condition. 3. A male child does not inherit any X chromosome from the father; therefore, the male child will not have the condition. 4. A male child does not inherit any X chromosome from the father; therefore, the male child will not have the condition.

During an examination, a nurse asks a 5-year-old child to repeat his address. What is the nurse evaluating with this action? 1. Recent memory 2. Language development 3. Remote memory 4. Social-skill development

Answer: 3 Explanation: 1. Asking children to remember addresses, phone numbers, and dates assesses remote-memory development. To evaluate recent memory, the nurse would have the child name something and then ask him to name it again in 10 to 15 minutes. Listening to how the child talks and his sentence structure evaluates the child's language development, and assessing how he interacts with others evaluates social-skill development. 2. Asking children to remember addresses, phone numbers, and dates assesses remote-memory development. To evaluate recent memory, the nurse would have the child name something and then ask him to name it again in 10 to 15 minutes. Listening to how the child talks and his sentence structure evaluates the child's language development, and assessing how he interacts with others evaluates social-skill development. 3. Asking children to remember addresses, phone numbers, and dates assesses remote-memory development. To evaluate recent memory, the nurse would have the child name something and then ask him to name it again in 10 to 15 minutes. Listening to how the child talks and his sentence structure evaluates the child's language development, and assessing how he interacts with others evaluates social-skill development. 4. Asking children to remember addresses, phone numbers, and dates assesses remote-memory development. To evaluate recent memory, the nurse would have the child name something and then ask him to name it again in 10 to 15 minutes. Listening to how the child talks and his sentence structure evaluates the child's language development, and assessing how he interacts with others evaluates social-skill development.

The nurse is taking a health history from a family of a 3-year-old child. Which statement by the nurse would most likely establish rapport and elicit an accurate response from the family? 1. "Does any member of your family have a history of asthma, heart disease, or diabetes?" 2. "Hello, I would like to talk with you and get some information on you and your child." 3. "Tell me about the concerns that brought you to the clinic today." 4. "You will need to fill out these forms; make sure that the information is as complete as possible."

Answer: 3 Explanation: 1. Asking the parents to talk about their concerns is an open-ended question and one which is more likely to establish rapport and an understanding of the parent's perceptions. Giving the family a list of items to answer at once may be confusing to the parents. Giving an introduction before asking the parents for information is likely to establish rapport, but giving an explanation of why the information would be needed would be even more effective at establishing rapport and also for getting more accurate, pertinent information. Simply asking the parents to fill out forms is very impersonal, and more information is likely to be obtained and clarified if the nurse is directing the interview. 2. Asking the parents to talk about their concerns is an open-ended question and one which is more likely to establish rapport and an understanding of the parent's perceptions. Giving the family a list of items to answer at once may be confusing to the parents. Giving an introduction before asking the parents for information is likely to establish rapport, but giving an explanation of why the information would be needed would be even more effective at establishing rapport and also for getting more accurate, pertinent information. Simply asking the parents to fill out forms is very impersonal, and more information is likely to be obtained and clarified if the nurse is directing the interview. 3. Asking the parents to talk about their concerns is an open-ended question and one which is more likely to establish rapport and an understanding of the parent's perceptions. Giving the family a list of items to answer at once may be confusing to the parents. Giving an introduction before asking the parents for information is likely to establish rapport, but giving an explanation of why the information would be needed would be even more effective at establishing rapport and also for getting more accurate, pertinent information. Simply asking the parents to fill out forms is very impersonal, and more information is likely to be obtained and clarified if the nurse is directing the interview. 4. Asking the parents to talk about their concerns is an open-ended question and one which is more likely to establish rapport and an understanding of the parent's perceptions. Giving the family a list of items to answer at once may be confusing to the parents. Giving an introduction before asking the parents for information is likely to establish rapport, but giving an explanation of why the information would be needed would be even more effective at establishing rapport and also for getting more accurate, pertinent information. Simply asking the parents to fill out forms is very impersonal, and more information is likely to be obtained and clarified if the nurse is directing the interview.

A 12-year-old child is admitted to the unit for a surgical procedure. The child is accompanied by two parents and a younger sibling. What is the level of involvement in treatment decision making for this child? 1. Emancipated minor 2. Mature minor 3. Assent 4. None

Answer: 3 Explanation: 1. Assent requires the ability to generally understand what procedure and treatments are planned, to understand what participation is required, and to make a statement of agreement or disagreement with the plan. Usually, in Piaget's stage of formal operations, 11- to 13-year-olds should be able to problem solve using abstract concepts and are able to give valid assent when parents sign the informed consent. An emancipated minor is a self-supporting adolescent who is not subject to the control of a parent or guardian. A mature minor is a 14- or 15-year-old whom the state law designates as being able to understand medical risks and who is thus permitted to give informed consent for treatment. 2. Assent requires the ability to generally understand what procedure and treatments are planned, to understand what participation is required, and to make a statement of agreement or disagreement with the plan. Usually, in Piaget's stage of formal operations, 11- to 13-year-olds should be able to problem solve using abstract concepts and are able to give valid assent when parents sign the informed consent. An emancipated minor is a self-supporting adolescent who is not subject to the control of a parent or guardian. A mature minor is a 14- or 15-year-old whom the state law designates as being able to understand medical risks and who is thus permitted to give informed consent for treatment. 3. Assent requires the ability to generally understand what procedure and treatments are planned, to understand what participation is required, and to make a statement of agreement or disagreement with the plan. Usually, in Piaget's stage of formal operations, 11- to 13-year-olds should be able to problem solve using abstract concepts and are able to give valid assent when parents sign the informed consent. An emancipated minor is a self-supporting adolescent who is not subject to the control of a parent or guardian. A mature minor is a 14- or 15-year-old whom the state law designates as being able to understand medical risks and who is thus permitted to give informed consent for treatment. 4. Assent requires the ability to generally understand what procedure and treatments are planned, to understand what participation is required, and to make a statement of agreement or disagreement with the plan. Usually, in Piaget's stage of formal operations, 11- to 13-year-olds should be able to problem solve using abstract concepts and are able to give valid assent when parents sign the informed consent. An emancipated minor is a self-supporting adolescent who is not subject to the control of a parent or guardian. A mature minor is a 14- or 15-year-old whom the state law designates as being able to understand medical risks and who is thus permitted to give informed consent for treatment.

The nurse is working on parenting skills with a mother of three children. The nurse demonstrates a strategy that uses reward to increase positive behavior. Which strategy will the nurse document in the medical record based on this description? 1. Time out 2. Reasoning 3. Behavior modification 4. Experiencing consequences of misbehavior

Answer: 3 Explanation: 1. Behavior modification identifies and gives rewards for desired behaviors. Time out and experiencing consequences of misbehavior show the child that unacceptable behavior brings undesirable outcomes. Reasoning attempts to use explanation to end misbehavior. 2. Behavior modification identifies and gives rewards for desired behaviors. Time out and experiencing consequences of misbehavior show the child that unacceptable behavior brings undesirable outcomes. Reasoning attempts to use explanation to end misbehavior. 3. Behavior modification identifies and gives rewards for desired behaviors. Time out and experiencing consequences of misbehavior show the child that unacceptable behavior brings undesirable outcomes. Reasoning attempts to use explanation to end misbehavior. 4. Behavior modification identifies and gives rewards for desired behaviors. Time out and experiencing consequences of misbehavior show the child that unacceptable behavior brings undesirable outcomes. Reasoning attempts to use explanation to end misbehavior.

The nurse is caring for a newly admitted infant diagnosed with "failure to thrive." The nurse begins to implement the healthcare provider prescribed orders by taking blood pressures in all four extremities. Which congenital cardiac defect does the nurse anticipate based on the prescribed order? 1. Tetralogy of Fallot 2. Pulmonary atresia 3. Coarctation of the aorta 4. Ventricular septal defect

Answer: 3 Explanation: 1. Normally, blood pressures in the lower extremities are the same as or higher than upper-extremity blood pressures. But in coarctation of the aorta, the narrowing of the aorta causes decreased blood flow to the lower extremities and thus lower-extremity blood-pressure readings are significantly lower than upper-extremity readings. There are minimal differences between upper and lower blood-pressure readings in tetralogy of Fallot, pulmonary atresia, and ventricular septal defect. 2. Normally, blood pressures in the lower extremities are the same as or higher than upper-extremity blood pressures. But in coarctation of the aorta, the narrowing of the aorta causes decreased blood flow to the lower extremities and thus lower-extremity blood-pressure readings are significantly lower than upper-extremity readings. There are minimal differences between upper and lower blood-pressure readings in tetralogy of Fallot, pulmonary atresia, and ventricular septal defect. 3. Normally, blood pressures in the lower extremities are the same as or higher than upper-extremity blood pressures. But in coarctation of the aorta, the narrowing of the aorta causes decreased blood flow to the lower extremities and thus lower-extremity blood-pressure readings are significantly lower than upper-extremity readings. There are minimal differences between upper and lower blood-pressure readings in tetralogy of Fallot, pulmonary atresia, and ventricular septal defect. 4. Normally, blood pressures in the lower extremities are the same as or higher than upper-extremity blood pressures. But in coarctation of the aorta, the narrowing of the aorta causes decreased blood flow to the lower extremities and thus lower-extremity blood-pressure readings are significantly lower than upper-extremity readings. There are minimal differences between upper and lower blood-pressure readings in tetralogy of Fallot, pulmonary atresia, and ventricular septal defect.

The nurse is assessing a group of children attending summer camp. The nurse will expect which children to most likely have problems perceiving a sense of belonging? 1. Children whose parents divorced recently 2. Children who gained a stepparent recently 3. Children recently placed into foster care 4. Children adopted as infants

Answer: 3 Explanation: 1. Children in foster care are more likely to have problems perceiving a sense of belonging. Children whose parents divorce often fear abandonment. Children who gain a stepparent may have problems trusting the new parent. Infants who are adopted at birth can have minimal problems with acceptance when parents follow preadoption counseling about disclosure. 2. Children in foster care are more likely to have problems perceiving a sense of belonging. Children whose parents divorce often fear abandonment. Children who gain a stepparent may have problems trusting the new parent. Infants who are adopted at birth can have minimal problems with acceptance when parents follow preadoption counseling about disclosure. 3. Children in foster care are more likely to have problems perceiving a sense of belonging. Children whose parents divorce often fear abandonment. Children who gain a stepparent may have problems trusting the new parent. Infants who are adopted at birth can have minimal problems with acceptance when parents follow preadoption counseling about disclosure. 4. Children in foster care are more likely to have problems perceiving a sense of belonging. Children whose parents divorce often fear abandonment. Children who gain a stepparent may have problems trusting the new parent. Infants who are adopted at birth can have minimal problems with acceptance when parents follow preadoption counseling about disclosure.

A nurse is assessing language development in all the infants presenting at the doctor's office for well-child visits. At which age range would the nurse expect a child to verbalize the words "dada" and "mama"? 1. 3 and 5 months 2. 6 and 8 months 3. 9 and 12 months 4. 13 and 18 months

Answer: 3 Explanation: 1. Children should be able to verbalize "mama" or "dada" to identify their parents by 1 year of age. 2. Children should be able to verbalize "mama" or "dada" to identify their parents by 1 year of age. 3. Children should be able to verbalize "mama" or "dada" to identify their parents by 1 year of age. 4. Children should be able to verbalize "mama" or "dada" to identify their parents by 1 year of age.

Which genetic test would be best for the prospective father who recently had a positive screen for a genetic condition? 1. Carrier testing 2. Predictive testing 3. Diagnostic testing 4. Prenatal testing

Answer: 3 Explanation: 1. Diagnostic testing is best for an individual who has a positive screen for a genetic disorder. Prenatal testing would be done with a pregnancy. Carrier testing is done with an asymptomatic individual who wishes to know whether he or she is a carrier of a condition. Predictive testing predicts the likelihood of a condition later in life. 2. Diagnostic testing is best for an individual who has a positive screen for a genetic disorder. Prenatal testing would be done with a pregnancy. Carrier testing is done with an asymptomatic individual who wishes to know whether he or she is a carrier of a condition. Predictive testing predicts the likelihood of a condition later in life. 3. Diagnostic testing is best for an individual who has a positive screen for a genetic disorder. Prenatal testing would be done with a pregnancy. Carrier testing is done with an asymptomatic individual who wishes to know whether he or she is a carrier of a condition. Predictive testing predicts the likelihood of a condition later in life. 4. Diagnostic testing is best for an individual who has a positive screen for a genetic disorder. Prenatal testing would be done with a pregnancy. Carrier testing is done with an asymptomatic individual who wishes to know whether he or she is a carrier of a condition. Predictive testing predicts the likelihood of a condition later in life.

Despite the availability of Children's Health Insurance Programs (CHIP), many eligible children are not enrolled. Which nursing intervention would be the most appropriate to help children become enrolled in CHIP? 1. Assess details of the family's income and expenditures 2. Case management to limit costly, unnecessary duplication of services 3. Advocate for the child by encouraging the family to investigate SCHIP eligibility 4. Educate the family about the need for keeping regular well-child-visit appointments

Answer: 3 Explanation: 1. In the role of an advocate, a nurse will advance the interests of another; by suggesting the family investigate its CHIP eligibility, the nurse is directing their action toward the child's best interest. Financial assessment is more commonly the function of a social worker. The case-management activity mentioned will not provide a source of funding nor will the educational effort described. 2. In the role of an advocate, a nurse will advance the interests of another; by suggesting the family investigate its CHIP eligibility, the nurse is directing their action toward the child's best interest. Financial assessment is more commonly the function of a social worker. The case-management activity mentioned will not provide a source of funding nor will the educational effort described. 3. In the role of an advocate, a nurse will advance the interests of another; by suggesting the family investigate its CHIP eligibility, the nurse is directing their action toward the child's best interest. Financial assessment is more commonly the function of a social worker. The case-management activity mentioned will not provide a source of funding nor will the educational effort described. 4. In the role of an advocate, a nurse will advance the interests of another; by suggesting the family investigate its CHIP eligibility, the nurse is directing their action toward the child's best interest. Financial assessment is more commonly the function of a social worker. The case-management activity mentioned will not provide a source of funding nor will the educational effort described.

Two 3-year-olds are playing in a hospital playroom together. One is working on a puzzle while the other is stacking blocks. Which type of play are these children exhibiting? 1. Cooperative play 2. Associative play 3. Parallel play 4. Solitary play

Answer: 3 Explanation: 1. Parallel play describes when two or more children play together, each engaging in their own activities. Cooperative play happens when children demonstrate the ability to cooperate with others and play a part in order to contribute to a unified whole. Associative play is characterized by children interacting in groups and participating in similar activities. In solitary play, a child plays alone. 2. Parallel play describes when two or more children play together, each engaging in their own activities. Cooperative play happens when children demonstrate the ability to cooperate with others and play a part in order to contribute to a unified whole. Associative play is characterized by children interacting in groups and participating in similar activities. In solitary play, a child plays alone. 3. Parallel play describes when two or more children play together, each engaging in their own activities. Cooperative play happens when children demonstrate the ability to cooperate with others and play a part in order to contribute to a unified whole. Associative play is characterized by children interacting in groups and participating in similar activities. In solitary play, a child plays alone. 4. Parallel play describes when two or more children play together, each engaging in their own activities. Cooperative play happens when children demonstrate the ability to cooperate with others and play a part in order to contribute to a unified whole. Associative play is characterized by children interacting in groups and participating in similar activities. In solitary play, a child plays alone.

The nurse in the pediatric clinic observes a parental lack of warmth and interest toward the child. Which parental style will the nurse most likely document in this situation? 1. Authoritarian 2. Authoritative 3. Indifferent 4. Permissive

Answer: 3 Explanation: 1. Parents displaying the indifferent parental style fail to demonstrate consistent warmth and interest in their children. Parents who favor the authoritarian style may exhibit a punitive attitude toward the child who is misbehaving but are not disinterested. Parents employing the authoritative style and the permissive style have children who report that "my parent loves me and shows affection regularly." 2. Parents displaying the indifferent parental style fail to demonstrate consistent warmth and interest in their children. Parents who favor the authoritarian style may exhibit a punitive attitude toward the child who is misbehaving but are not disinterested. Parents employing the authoritative style and the permissive style have children who report that "my parent loves me and shows affection regularly." 3. Parents displaying the indifferent parental style fail to demonstrate consistent warmth and interest in their children. Parents who favor the authoritarian style may exhibit a punitive attitude toward the child who is misbehaving but are not disinterested. Parents employing the authoritative style and the permissive style have children who report that "my parent loves me and shows affection regularly." 4. Parents displaying the indifferent parental style fail to demonstrate consistent warmth and interest in their children. Parents who favor the authoritarian style may exhibit a punitive attitude toward the child who is misbehaving but are not disinterested. Parents employing the authoritative style and the permissive style have children who report that "my parent loves me and shows affection regularly."

An adolescent client with cystic fibrosis suddenly becomes noncompliant with the medication regime. Which intervention by the nurse will most likely improve compliance for this client? 1. Give the child a computer-animated game that presents information on the management of cystic fibrosis. 2. Arrange for the physician to sit down and talk to the child about the risks related to noncompliance with medications. 3. Set up a meeting with some older teens with cystic fibrosis who have been managing their disease effectively. 4. Discuss with the child's parents the privileges that can be taken away, such as cell phone, if compliance fails to improve.

Answer: 3 Explanation: 1. Providing an adolescent with positive role models who are in his peer group is the intervention most likely to improve compliance. Interest in games may begin to wane, adults' opinions may be viewed negatively and challenged, and threatening punishment may further incite rebellion. 2. Providing an adolescent with positive role models who are in his peer group is the intervention most likely to improve compliance. Interest in games may begin to wane, adults' opinions may be viewed negatively and challenged, and threatening punishment may further incite rebellion. 3. Providing an adolescent with positive role models who are in his peer group is the intervention most likely to improve compliance. Interest in games may begin to wane, adults' opinions may be viewed negatively and challenged, and threatening punishment may further incite rebellion. 4. Providing an adolescent with positive role models who are in his peer group is the intervention most likely to improve compliance. Interest in games may begin to wane, adults' opinions may be viewed negatively and challenged, and threatening punishment may further incite rebellion.

Cultures have many different childrearing practices. Which culture is known to value the male child more than the female child, and often teaches children to avoid displaying emotion? 1. Mexican 2. Amish 3. Chinese 4. Navajo

Answer: 3 Explanation: 1. The Chinese culture values the male child more than the female child, and often teaches children to avoid showing emotion. The other cultures do not have this component. 2. The Chinese culture values the male child more than the female child, and often teaches children to avoid showing emotion. The other cultures do not have this component. 3. The Chinese culture values the male child more than the female child, and often teaches children to avoid showing emotion. The other cultures do not have this component. 4. The Chinese culture values the male child more than the female child, and often teaches children to avoid showing emotion. The other cultures do not have this component.

A family desires genetic testing for their adolescent. What response by the clinic nurse is appropriate? 1. "The child is a minor and cannot give consent." 2. "It is not advisable because insurance does not pay for this test." 3. "Let me discuss this with the adolescent and then we can discuss it more fully." 4. "There is a chance the adolescent might be discriminated against because of the test."

Answer: 3 Explanation: 1. The adolescent is old enough to understand the pros and cons of testing. It would be advisable to discuss the matter with the adolescent and then more fully with the parents. That the minor is not able to give consent is true, but this answer cuts off discussion and is not appropriate. Insurance and discrimination can play a role in the decision, but still are not the appropriate answers because they do not address the issue of the request for testing. 2. The adolescent is old enough to understand the pros and cons of testing. It would be advisable to discuss the matter with the adolescent and then more fully with the parents. That the minor is not able to give consent is true, but this answer cuts off discussion and is not appropriate. Insurance and discrimination can play a role in the decision, but still are not the appropriate answers because they do not address the issue of the request for testing. 3. The adolescent is old enough to understand the pros and cons of testing. It would be advisable to discuss the matter with the adolescent and then more fully with the parents. That the minor is not able to give consent is true, but this answer cuts off discussion and is not appropriate. Insurance and discrimination can play a role in the decision, but still are not the appropriate answers because they do not address the issue of the request for testing. 4. The adolescent is old enough to understand the pros and cons of testing. It would be advisable to discuss the matter with the adolescent and then more fully with the parents. That the minor is not able to give consent is true, but this answer cuts off discussion and is not appropriate. Insurance and discrimination can play a role in the decision, but still are not the appropriate answers because they do not address the issue of the request for testing.

A new mother is worried about a "soft spot" on the top of her newborn infant's head. The nurse informs her that this is a normal physical finding called the anterior fontanel. At what age will the nurse educate the mother that the soft spot will close? 1. 2 to 3 months of age 2. 6 to 9 months of age 3. 12 to 18 months of age 4. Approximately 2 years of age

Answer: 3 Explanation: 1. The anterior fontanel is located at the top of the head and is the opening at the intersection of the suture lines. As the infant grows, the suture lines begin to fuse, and the anterior fontanel closes at 12 to 18 months of age. 2. The anterior fontanel is located at the top of the head and is the opening at the intersection of the suture lines. As the infant grows, the suture lines begin to fuse, and the anterior fontanel closes at 12 to 18 months of age. 3. The anterior fontanel is located at the top of the head and is the opening at the intersection of the suture lines. As the infant grows, the suture lines begin to fuse, and the anterior fontanel closes at 12 to 18 months of age. 4. The anterior fontanel is located at the top of the head and is the opening at the intersection of the suture lines. As the infant grows, the suture lines begin to fuse, and the anterior fontanel closes at 12 to 18 months of age.

A mother of a school-age client who recently had surgery for the removal of tonsils and adenoids complains that the child has begun sucking his thumb again. Which coping mechanisms is the child using to cope with the surgery and hospitalization? 1. Repression 2. Rationalization 3. Regression 4. Fantasy

Answer: 3 Explanation: 1. The correct answer is regression, which is a return to an earlier behavior. Repression is the involuntary forgetting of uncomfortable situations, rationalization is an attempt to make unacceptable feelings acceptable, and fantasy is a creation of the mind to help deal with an unacceptable fear. 2. The correct answer is regression, which is a return to an earlier behavior. Repression is the involuntary forgetting of uncomfortable situations, rationalization is an attempt to make unacceptable feelings acceptable, and fantasy is a creation of the mind to help deal with an unacceptable fear. 3. The correct answer is regression, which is a return to an earlier behavior. Repression is the involuntary forgetting of uncomfortable situations, rationalization is an attempt to make unacceptable feelings acceptable, and fantasy is a creation of the mind to help deal with an unacceptable fear. 4. The correct answer is regression, which is a return to an earlier behavior. Repression is the involuntary forgetting of uncomfortable situations, rationalization is an attempt to make unacceptable feelings acceptable, and fantasy is a creation of the mind to help deal with an unacceptable fear.

The nurse notes some dysmorphic facial features when examining a toddler in the well-child clinic. Which measurement taken by the nurse would not be considered when looking at dysmorphic facial features? 1. Interpupillary distance 2. Intercanthal distance 3. The distance from the outer canthus to the pinna 4. Outer cantus distance

Answer: 3 Explanation: 1. The distance from the outer canthus to the pinna does not apply to the face. The other measurements would be necessary when evaluating facial dysmorphic features. 2. The distance from the outer canthus to the pinna does not apply to the face. The other measurements would be necessary when evaluating facial dysmorphic features. 3. The distance from the outer canthus to the pinna does not apply to the face. The other measurements would be necessary when evaluating facial dysmorphic features. 4. The distance from the outer canthus to the pinna does not apply to the face. The other measurements would be necessary when evaluating facial dysmorphic features.

Which nursing intervention is most appropriate when providing education to the pediatric client and family? 1. Giving primary care for high-risk children who are in hospital settings 2. Giving primary care for healthy children 3. Working toward the goal of informed choices with the family 4. Obtaining a physician consultation for any technical procedures at delivery

Answer: 3 Explanation: 1. The educator works with the family toward the goal of making informed choices through education and explanation. 2. The educator works with the family toward the goal of making informed choices through education and explanation. 3. The educator works with the family toward the goal of making informed choices through education and explanation. 4. The educator works with the family toward the goal of making informed choices through education and explanation.

Which statement by the nurse is most appropriate prior to giving an intramuscular injection to a 2-1/2-year-old child? 1. "We will give you your shot when your mommy comes back." 2. "This is medicine that will make you better. First we will hold your leg, then I will wipe it off with this magic cloth that kills the germs on your leg right here, then I will hold the needle like this and say 'one, two, three . . . go' and give you your shot. Are you ready?" 3. "It is all right to cry, I know that this hurts. After we are done you can go to the box and pick out your favorite sticker." 4. "This is a magic sword that will give you your medicine and make you all better."

Answer: 3 Explanation: 1. The most appropriate response would be to acknowledge the child's feelings and give her something to look forward to (picking out a sticker). Waiting for the mother to come back would be inappropriate because toddlers do not have an understanding of time. Giving elaborate descriptions and using colorful language are inappropriate. The instructions should not end with a "are you ready" statement because the toddler will say no. You also don't want to frighten and/or confuse the child by using statements such as use of a magic sword. 2. The most appropriate response would be to acknowledge the child's feelings and give her something to look forward to (picking out a sticker). Waiting for the mother to come back would be inappropriate because toddlers do not have an understanding of time. Giving elaborate descriptions and using colorful language are inappropriate. The instructions should not end with a "are you ready" statement because the toddler will say no. You also don't want to frighten and/or confuse the child by using statements such as use of a magic sword. 3. The most appropriate response would be to acknowledge the child's feelings and give her something to look forward to (picking out a sticker). Waiting for the mother to come back would be inappropriate because toddlers do not have an understanding of time. Giving elaborate descriptions and using colorful language are inappropriate. The instructions should not end with a "are you ready" statement because the toddler will say no. You also don't want to frighten and/or confuse the child by using statements such as use of a magic sword. 4. The most appropriate response would be to acknowledge the child's feelings and give her something to look forward to (picking out a sticker). Waiting for the mother to come back would be inappropriate because toddlers do not have an understanding of time. Giving elaborate descriptions and using colorful language are inappropriate. The instructions should not end with a "are you ready" statement because the toddler will say no. You also don't want to frighten and/or confuse the child by using statements such as use of a magic sword.

The community health nurse is assessing several families for various strengths and needs in regard to after-school and backup childcare arrangements. Which family type will benefit the most from this assessment and subsequent interventions? 1. The binuclear family 2. The extended family 3. The single-parent family 4. The traditional nuclear family

Answer: 3 Explanation: 1. The single-parent family most typically lacks social, emotional, and financial resources. Nursing considerations for such families should include referrals to options that will enable the parent to fulfill work commitments while providing the child with access to resources that can support the child's growth and development. The binuclear family, the extended family, and the traditional nuclear family generally have at least two adults who can share in the care and the nurturing of its children. 2. The single-parent family most typically lacks social, emotional, and financial resources. Nursing considerations for such families should include referrals to options that will enable the parent to fulfill work commitments while providing the child with access to resources that can support the child's growth and development. The binuclear family, the extended family, and the traditional nuclear family generally have at least two adults who can share in the care and the nurturing of its children. 3. The single-parent family most typically lacks social, emotional, and financial resources. Nursing considerations for such families should include referrals to options that will enable the parent to fulfill work commitments while providing the child with access to resources that can support the child's growth and development. The binuclear family, the extended family, and the traditional nuclear family generally have at least two adults who can share in the care and the nurturing of its children. 4. The single-parent family most typically lacks social, emotional, and financial resources. Nursing considerations for such families should include referrals to options that will enable the parent to fulfill work commitments while providing the child with access to resources that can support the child's growth and development. The binuclear family, the extended family, and the traditional nuclear family generally have at least two adults who can share in the care and the nurturing of its children.

While assessing a 10-month-old African American infant, the nurse notices that the sclerae have a yellowish tint. Which organ system should the nurse further evaluate to determine an ongoing disease process? 1. Cardiac 2. Respiratory 3. Gastrointestinal 4. Genitourinary

Answer: 3 Explanation: 1. This infant's sclerae are showing signs of jaundice, which most likely is secondary to a failure or malfunction of the liver in the gastrointestinal system. Cyanosis of the skin and mucous membranes is generally a sign of problems with the cardiac and/or respiratory system. Tenting of the skin and dry mucous membranes could be a sign of dehydration, and edema could be a sign of fluid overload. Both of these conditions could be secondary to problems with functioning of the genitourinary system. 2. This infant's sclerae are showing signs of jaundice, which most likely is secondary to a failure or malfunction of the liver in the gastrointestinal system. Cyanosis of the skin and mucous membranes is generally a sign of problems with the cardiac and/or respiratory system. Tenting of the skin and dry mucous membranes could be a sign of dehydration, and edema could be a sign of fluid overload. Both of these conditions could be secondary to problems with functioning of the genitourinary system. 3. This infant's sclerae are showing signs of jaundice, which most likely is secondary to a failure or malfunction of the liver in the gastrointestinal system. Cyanosis of the skin and mucous membranes is generally a sign of problems with the cardiac and/or respiratory system. Tenting of the skin and dry mucous membranes could be a sign of dehydration, and edema could be a sign of fluid overload. Both of these conditions could be secondary to problems with functioning of the genitourinary system. 4. This infant's sclerae are showing signs of jaundice, which most likely is secondary to a failure or malfunction of the liver in the gastrointestinal system. Cyanosis of the skin and mucous membranes is generally a sign of problems with the cardiac and/or respiratory system. Tenting of the skin and dry mucous membranes could be a sign of dehydration, and edema could be a sign of fluid overload. Both of these conditions could be secondary to problems with functioning of the genitourinary system.

The parents of an 8-year-old state that their son seems very interested in trying new activities. When the parents ask for suggested activities for this age child, the nurse recommends scouts as an activity that will foster growth and development. In which stage of Erikson's "psychosocial stages of development" is this child? 1. Trust versus mistrust 2. Initiative versus guilt 3. Industry versus inferiority 4. Identity versus role confusion

Answer: 3 Explanation: 1. Trust versus mistrust (birth to 1 year)—The task of the first year of life is to establish trust in the people providing care. Trust is fostered by provision of food, clean clothing, touch, and comfort. If basic needs are not met, the infant will eventually learn to mistrust others. Initiative versus guilt (3 to 6 years)—The young child initiates new activities and considers new ideas. This interest in exploring the world creates a child who is involved and busy. Constant criticism, on the other hand, leads to feelings of guilt and a lack of purpose. Identity versus role confusion (12 to 18 years)—In adolescence, as the body matures and thought processes become more complex, a new sense of identity or self is established. The self, family, peer group, and community are all examined and redefined. The adolescent who is unable to establish a meaningful definition of self will experience confusion in one or more roles of life. Industry versus inferiority (6 to 12 years)—The middle years of childhood are characterized by development of new interests and by involvement in activities. The child takes pride in accomplishments in sports, school, home, and community. If the child cannot accomplish what is expected, however, the result will be a sense of inferiority. 2. Trust versus mistrust (birth to 1 year)—The task of the first year of life is to establish trust in the people providing care. Trust is fostered by provision of food, clean clothing, touch, and comfort. If basic needs are not met, the infant will eventually learn to mistrust others. Initiative versus guilt (3 to 6 years)—The young child initiates new activities and considers new ideas. This interest in exploring the world creates a child who is involved and busy. Constant criticism, on the other hand, leads to feelings of guilt and a lack of purpose. Identity versus role confusion (12 to 18 years)—In adolescence, as the body matures and thought processes become more complex, a new sense of identity or self is established. The self, family, peer group, and community are all examined and redefined. The adolescent who is unable to establish a meaningful definition of self will experience confusion in one or more roles of life. Industry versus inferiority (6 to 12 years)—The middle years of childhood are characterized by development of new interests and by involvement in activities. The child takes pride in accomplishments in sports, school, home, and community. If the child cannot accomplish what is expected, however, the result will be a sense of inferiority. 3. Trust versus mistrust (birth to 1 year)—The task of the first year of life is to establish trust in the people providing care. Trust is fostered by provision of food, clean clothing, touch, and comfort. If basic needs are not met, the infant will eventually learn to mistrust others. Initiative versus guilt (3 to 6 years)—The young child initiates new activities and considers new ideas. This interest in exploring the world creates a child who is involved and busy. Constant criticism, on the other hand, leads to feelings of guilt and a lack of purpose. Identity versus role confusion (12 to 18 years)—In adolescence, as the body matures and thought processes become more complex, a new sense of identity or self is established. The self, family, peer group, and community are all examined and redefined. The adolescent who is unable to establish a meaningful definition of self will experience confusion in one or more roles of life. Industry versus inferiority (6 to 12 years)—The middle years of childhood are characterized by development of new interests and by involvement in activities. The child takes pride in accomplishments in sports, school, home, and community. If the child cannot accomplish what is expected, however, the result will be a sense of inferiority. 4. Trust versus mistrust (birth to 1 year)—The task of the first year of life is to establish trust in the people providing care. Trust is fostered by provision of food, clean clothing, touch, and comfort. If basic needs are not met, the infant will eventually learn to mistrust others. Initiative versus guilt (3 to 6 years)—The young child initiates new activities and considers new ideas. This interest in exploring the world creates a child who is involved and busy. Constant criticism, on the other hand, leads to feelings of guilt and a lack of purpose. Identity versus role confusion (12 to 18 years)—In adolescence, as the body matures and thought processes become more complex, a new sense of identity or self is established. The self, family, peer group, and community are all examined and redefined. The adolescent who is unable to establish a meaningful definition of self will experience confusion in one or more roles of life. Industry versus inferiority (6 to 12 years)—The middle years of childhood are characterized by development of new interests and by involvement in activities. The child takes pride in accomplishments in sports, school, home, and community. If the child cannot accomplish what is expected, however, the result will be a sense of inferiority.

Which aspect of an Emergency Medical Services (EMS) system is most indicative that EMS providers are prepared to provide emergency care to children? 1. Placement of small stretchers in emergency vehicles 2. Lists of hospitals in the area that treat children 3. Staff education related to assessment and treatment of children of all ages 4. Pediatric-sized equipment and supplies

Answer: 3 Explanation: 1. While size-appropriate equipment and lists of hospitals that treat children are essential parts of an EMS system, the aspect that is most indicative that EMS providers are actually prepared to take care of children is evidence of education related to assessment and emergency treatment. 2. While size-appropriate equipment and lists of hospitals that treat children are essential parts of an EMS system, the aspect that is most indicative that EMS providers are actually prepared to take care of children is evidence of education related to assessment and emergency treatment. 3. While size-appropriate equipment and lists of hospitals that treat children are essential parts of an EMS system, the aspect that is most indicative that EMS providers are actually prepared to take care of children is evidence of education related to assessment and emergency treatment. 4. While size-appropriate equipment and lists of hospitals that treat children are essential parts of an EMS system, the aspect that is most indicative that EMS providers are actually prepared to take care of children is evidence of education related to assessment and emergency treatment.

The nurse educator is presenting a lecture about risks to developmental progression. Which items will the educator include in the lecture? Select all that apply. 1. Family support 2. Access to the Internet 3. Recent loss of employment 4. Terminal illness of a family member 5. Hazards within the home environment

Answer: 3, 4, 5 Explanation: 1. Risk factors that can inhibit developmental progression include financial problems, stresses and worries, family and job instability, neighborhood and home hazards, and lack of resources. Family support and access to the Internet are both considered protective factors. 2. Risk factors that can inhibit developmental progression include financial problems, stresses and worries, family and job instability, neighborhood and home hazards, and lack of resources. Family support and access to the Internet are both considered protective factors. 3. Risk factors that can inhibit developmental progression include financial problems, stresses and worries, family and job instability, neighborhood and home hazards, and lack of resources. Family support and access to the Internet are both considered protective factors. 4. Risk factors that can inhibit developmental progression include financial problems, stresses and worries, family and job instability, neighborhood and home hazards, and lack of resources. Family support and access to the Internet are both considered protective factors. 5. Risk factors that can inhibit developmental progression include financial problems, stresses and worries, family and job instability, neighborhood and home hazards, and lack of resources. Family support and access to the Internet are both considered protective factors.

While being comforted in the emergency department, a young school-age sibling of a pediatric trauma victim blurts out to the nurse, "It's my fault! When we were fighting yesterday, I told him I wished he was dead!" Which response is most appropriate by the nurse? 1. Asking the child if she would like to sit down and drink some water 2. Sitting the child down in an empty room with markers and paper so that she can draw a picture 3. Calmly discussing the catheters, tubes, and equipment that the patient requires and explaining to the sibling why the patient needs them 4. Reassuring the child that it is normal to get angry and say things that we do not mean but that we have no control over whether or not an accident happens

Answer: 4 Explanation: 1. "Magical thinking" is the belief that events occur because of one's thoughts or actions, and the most therapeutic way to respond to this is to correct any misconceptions that children may have and reassure them that they are not to blame for any accidents or illness. 2. "Magical thinking" is the belief that events occur because of one's thoughts or actions, and the most therapeutic way to respond to this is to correct any misconceptions that children may have and reassure them that they are not to blame for any accidents or illness. 3. "Magical thinking" is the belief that events occur because of one's thoughts or actions, and the most therapeutic way to respond to this is to correct any misconceptions that children may have and reassure them that they are not to blame for any accidents or illness. 4. "Magical thinking" is the belief that events occur because of one's thoughts or actions, and the most therapeutic way to respond to this is to correct any misconceptions that children may have and reassure them that they are not to blame for any accidents or illness.

The nurse is preparing a three-generation family pedigree. A student asks the nurse the significance of the darkened circles. Which response by the nurse is the most appropriate? 1. "Males unaffected by the disease." 2. "Males affected by the disease." 3. "Females unaffected by the disease." 4. "Females affected by the disease."

Answer: 4 Explanation: 1. A circle is the standard symbol for a female, and darkening the circle represents a female affected by a disease. A male is represented by a square. 2. A circle is the standard symbol for a female, and darkening the circle represents a female affected by a disease. A male is represented by a square. 3. A circle is the standard symbol for a female, and darkening the circle represents a female affected by a disease. A male is represented by a square. 4. A circle is the standard symbol for a female, and darkening the circle represents a female affected by a disease. A male is represented by a square.

A child is being prepared for an invasive procedure. The mother of the child has legal custody but is not present. After details of the procedure are explained, who can provide legal consent on behalf of a minor child for treatment? 1. The divorced parent without custody 2. A cohabitating boyfriend of the child's mother 3. A grandparent who lives in the home with the child 4. A babysitter with written proxy

Answer: 4 Explanation: 1. A parent may grant proxy consent in writing to another adult so that children are not denied necessary healthcare. In the case of divorced parents, the parent with custody may be the only parent allowed by some states to give informed consent. Residence in the same household with a child does not authorize an adult to sign consent for treatment. 2. A parent may grant proxy consent in writing to another adult so that children are not denied necessary healthcare. In the case of divorced parents, the parent with custody may be the only parent allowed by some states to give informed consent. Residence in the same household with a child does not authorize an adult to sign consent for treatment. 3. A parent may grant proxy consent in writing to another adult so that children are not denied necessary healthcare. In the case of divorced parents, the parent with custody may be the only parent allowed by some states to give informed consent. Residence in the same household with a child does not authorize an adult to sign consent for treatment. 4. A parent may grant proxy consent in writing to another adult so that children are not denied necessary healthcare. In the case of divorced parents, the parent with custody may be the only parent allowed by some states to give informed consent. Residence in the same household with a child does not authorize an adult to sign consent for treatment.

During the newborn examination, the nurse assesses the infant for signs of developmental dysplasia of the hip. A finding that would strongly indicate this disorder would be: 1. soles are flat with prominent fat pads. 2. positive Babinski reflex. 3. metatarsus varus. 4. asymmetric thigh and gluteal folds.

Answer: 4 Explanation: 1. A positive Babinski reflex and flat soles are normal newborn findings. Metatarsus varus is an in-toeing of the feet that usually occurs secondary to intra-uterine positioning and frequently resolves on its own, but approximately 10 percent of infants with metatarsus varus also have developmental dysplasia of the hip. Asymmetric thigh and gluteal folds are a positive finding for developmental dysplasia of the hip requiring follow-up with ultrasound. 2. A positive Babinski reflex and flat soles are normal newborn findings. Metatarsus varus is an in-toeing of the feet that usually occurs secondary to intra-uterine positioning and frequently resolves on its own, but approximately 10 percent of infants with metatarsus varus also have developmental dysplasia of the hip. Asymmetric thigh and gluteal folds are a positive finding for developmental dysplasia of the hip requiring follow-up with ultrasound. 3. A positive Babinski reflex and flat soles are normal newborn findings. Metatarsus varus is an in-toeing of the feet that usually occurs secondary to intra-uterine positioning and frequently resolves on its own, but approximately 10 percent of infants with metatarsus varus also have developmental dysplasia of the hip. Asymmetric thigh and gluteal folds are a positive finding for developmental dysplasia of the hip requiring follow-up with ultrasound. 4. A positive Babinski reflex and flat soles are normal newborn findings. Metatarsus varus is an in-toeing of the feet that usually occurs secondary to intra-uterine positioning and frequently resolves on its own, but approximately 10 percent of infants with metatarsus varus also have developmental dysplasia of the hip. Asymmetric thigh and gluteal folds are a positive finding for developmental dysplasia of the hip requiring follow-up with ultrasound.

Which nursing role is not directly involved when providing family-centered approach to the pediatric population? 1. Advocacy 2. Case management 3. Patient education 4. Researcher

Answer: 4 Explanation: 1. A researcher is not involved in the family-centered approach to patient care of children and their families. Advocacy, case management, and patient education are all roles directly involved in the care of children and their families. 2. A researcher is not involved in the family-centered approach to patient care of children and their families. Advocacy, case management, and patient education are all roles directly involved in the care of children and their families. 3. A researcher is not involved in the family-centered approach to patient care of children and their families. Advocacy, case management, and patient education are all roles directly involved in the care of children and their families. 4. A researcher is not involved in the family-centered approach to patient care of children and their families. Advocacy, case management, and patient education are all roles directly involved in the care of children and their families.

The number of serious injuries in children has doubled in the past year. Based on this information, which is the most appropriate community nursing diagnosis? 1. Noncompliance Related to Inappropriate Use of Child Safety Seats 2. Risk for Injury Related to Inadequate Use of Bicycle Helmets 3. Altered Family Processes Related to Hospitalization of an Injured Child 4. Knowledge Deficit Related to Injury Prevention in Children

Answer: 4 Explanation: 1. All of these diagnoses might be appropriate in specific situations, but Knowledge Deficit Related to Injury Prevention in Children is the only one that is general to the problem as a whole and is therefore the most appropriate community nursing diagnosis. 2. All of these diagnoses might be appropriate in specific situations, but Knowledge Deficit Related to Injury Prevention in Children is the only one that is general to the problem as a whole and is therefore the most appropriate community nursing diagnosis. 3. All of these diagnoses might be appropriate in specific situations, but Knowledge Deficit Related to Injury Prevention in Children is the only one that is general to the problem as a whole and is therefore the most appropriate community nursing diagnosis. 4. All of these diagnoses might be appropriate in specific situations, but Knowledge Deficit Related to Injury Prevention in Children is the only one that is general to the problem as a whole and is therefore the most appropriate community nursing diagnosis.

A nurse is planning an education session on genetic testing. What would not concern the nurse when planning the session? 1. Cultural beliefs 2. Religious beliefs 3. Family values 4. Insurance reimbursement

Answer: 4 Explanation: 1. Cultural and religious beliefs and family values are all considerations when planning a teaching session on genetic testing. Insurance plays a factor in determining whether the test is done, but is not a consideration in the teaching session itself. 2. Cultural and religious beliefs and family values are all considerations when planning a teaching session on genetic testing. Insurance plays a factor in determining whether the test is done, but is not a consideration in the teaching session itself. 3. Cultural and religious beliefs and family values are all considerations when planning a teaching session on genetic testing. Insurance plays a factor in determining whether the test is done, but is not a consideration in the teaching session itself. 4. Cultural and religious beliefs and family values are all considerations when planning a teaching session on genetic testing. Insurance plays a factor in determining whether the test is done, but is not a consideration in the teaching session itself.

A young school-age client who has had a tracheostomy for several years is scheduled to begin school in the fall. The teacher is concerned about this child's being in her class and consults the school nurse. Which action by the nurse is the most appropriate? 1. Make arrangements for the child to go to a special school. 2. Ask the parents of the child to provide a caregiver during school hours. 3. Recommend that the child be home schooled. 4. Teach the teacher how to care for the child in the classroom.

Answer: 4 Explanation: 1. Section 504 of the Rehabilitation Act of 1973 guarantees access for children with disabilities to federally funded programs, including public schools. The child may need little extra attention while in the school setting, since he has had the tracheostomy for several years. The teacher should be taught how to care for the child if needed and the signs of distress. If needed, a health aide may be assigned to the child, but this is not the responsibility of the parents. 2. Section 504 of the Rehabilitation Act of 1973 guarantees access for children with disabilities to federally funded programs, including public schools. The child may need little extra attention while in the school setting, since he has had the tracheostomy for several years. The teacher should be taught how to care for the child if needed and the signs of distress. If needed, a health aide may be assigned to the child, but this is not the responsibility of the parents. 3. Section 504 of the Rehabilitation Act of 1973 guarantees access for children with disabilities to federally funded programs, including public schools. The child may need little extra attention while in the school setting, since he has had the tracheostomy for several years. The teacher should be taught how to care for the child if needed and the signs of distress. If needed, a health aide may be assigned to the child, but this is not the responsibility of the parents. 4. Section 504 of the Rehabilitation Act of 1973 guarantees access for children with disabilities to federally funded programs, including public schools. The child may need little extra attention while in the school setting, since he has had the tracheostomy for several years. The teacher should be taught how to care for the child if needed and the signs of distress. If needed, a health aide may be assigned to the child, but this is not the responsibility of the parents.

A new pediatric hospital will open soon. While planning nursing care, the hospital administration is considering two models of providing healthcare: family-focused care and family-centered care. Which action best demonstrates family-centered care? 1. Telling the family what must be done for the family's health 2. Assuming the role of an expert professional to direct the healthcare 3. Intervening for the child and family as a unit 4. Conferring with the family in deciding which healthcare option will be chosen

Answer: 4 Explanation: 1. The benefit of employing the family-centered-care philosophy is that the priorities and needs as seen by the family are addressed as a partnership between a family and a nurse develops. In family-focused care, the healthcare worker assumes the role of professional expert while missing the multiple contributions the family brings to the healthcare meeting. 2. The benefit of employing the family-centered-care philosophy is that the priorities and needs as seen by the family are addressed as a partnership between a family and a nurse develops. In family-focused care, the healthcare worker assumes the role of professional expert while missing the multiple contributions the family brings to the healthcare meeting. 3. The benefit of employing the family-centered-care philosophy is that the priorities and needs as seen by the family are addressed as a partnership between a family and a nurse develops. In family-focused care, the healthcare worker assumes the role of professional expert while missing the multiple contributions the family brings to the healthcare meeting. 4. The benefit of employing the family-centered-care philosophy is that the priorities and needs as seen by the family are addressed as a partnership between a family and a nurse develops. In family-focused care, the healthcare worker assumes the role of professional expert while missing the multiple contributions the family brings to the healthcare meeting.

What must a home-health nurse realize prior to accepting an assignment? 1. All decisions will be made by the healthcare provider. 2. The family will adapt their lifestyle to the needs of the nurse. 3. Independent decisions regarding emergency care of the child will be made by the nurse. 4. The family is in charge.

Answer: 4 Explanation: 1. The home-health nurse must realize that the family is in charge. The nurse must be flexible and adaptable to the lifestyle of the family. The family must provide informed consent for emergency care. 2. The home-health nurse must realize that the family is in charge. The nurse must be flexible and adaptable to the lifestyle of the family. The family must provide informed consent for emergency care. 3. The home-health nurse must realize that the family is in charge. The nurse must be flexible and adaptable to the lifestyle of the family. The family must provide informed consent for emergency care. 4. The home-health nurse must realize that the family is in charge. The nurse must be flexible and adaptable to the lifestyle of the family. The family must provide informed consent for emergency care.

The nurse is performing an assessment of a child's biologic family history. Which situation would necessitate the nurse's asking the mother for information should use the term "child's father" instead of "your husband"? 1. Traditional nuclear family 2. Traditional extended family 3. Two-income nuclear family 4. Cohabitating informal stepfamily

Answer: 4 Explanation: 1. The mother from the cohabitating informal stepfamily does not have a husband; the nurse should be asking about the "child's father." In the traditional nuclear family, the traditional extended family, and the two-income nuclear family, the child's father is the same person as the mother's husband. 2. The mother from the cohabitating informal stepfamily does not have a husband; the nurse should be asking about the "child's father." In the traditional nuclear family, the traditional extended family, and the two-income nuclear family, the child's father is the same person as the mother's husband. 3. The mother from the cohabitating informal stepfamily does not have a husband; the nurse should be asking about the "child's father." In the traditional nuclear family, the traditional extended family, and the two-income nuclear family, the child's father is the same person as the mother's husband. 4. The mother from the cohabitating informal stepfamily does not have a husband; the nurse should be asking about the "child's father." In the traditional nuclear family, the traditional extended family, and the two-income nuclear family, the child's father is the same person as the mother's husband.

The community-health nurse visits the child-care center. Which finding indicates the need for staff education? 1. A group of 2-year-olds are eating a snack of Cheerios. 2. Several 4-year-olds are outside playing on a slide. 3. An 18-month-old is pushing a toy truck. 4. A 2-month-old is sleeping in a crib on his stomach.

Answer: 4 Explanation: 1. To decrease the incidence of sudden infant death syndrome (SIDS), infants should be placed on their backs to sleep. All of the other examples are developmentally appropriate activities for the specified age group. 2. To decrease the incidence of sudden infant death syndrome (SIDS), infants should be placed on their backs to sleep. All of the other examples are developmentally appropriate activities for the specified age group. 3. To decrease the incidence of sudden infant death syndrome (SIDS), infants should be placed on their backs to sleep. All of the other examples are developmentally appropriate activities for the specified age group. 4. To decrease the incidence of sudden infant death syndrome (SIDS), infants should be placed on their backs to sleep. All of the other examples are developmentally appropriate activities for the specified age group.

While trying to inform a young school-age client about what will occur during an upcoming CT scan, the nurse notices that the child is engaged in a collective monologue, talking about a new puppy. Which response by the nurse is the most appropriate in this situation? 1. "Please stop talking about your puppy. I need to tell you about your CT scan." 2. Ignore the child's responses and continue discussing the procedure. 3. "I'll come back when you are ready to talk with me more about your CT scan." 4. "You must be so excited to have a new puppy! They are so much fun. Now, let me tell you again about going downstairs in a wheelchair to a special room."

Answer: 4 Explanation: 1. When a child becomes engaged in a collective monologue, it is best to respond to the content of his or her conversation and then attempt to reinsert facts about the content that needs to be covered. 2. When a child becomes engaged in a collective monologue, it is best to respond to the content of his or her conversation and then attempt to reinsert facts about the content that needs to be covered. 3. When a child becomes engaged in a collective monologue, it is best to respond to the content of his or her conversation and then attempt to reinsert facts about the content that needs to be covered. 4. When a child becomes engaged in a collective monologue, it is best to respond to the content of his or her conversation and then attempt to reinsert facts about the content that needs to be covered.

Place the nursing assessments of a toddler in the best order. 1. Examination of eyes, ears, and throat 2. Auscultation of chest 3. Palpation of abdomen 4. Developmental assessment

Answer: 4, 2, 3, 1 Developmental assessment Auscultation of chest Palpation of abdomen Examination of eyes, ears, and throat Explanation: In examining a toddler, it is usually best to go from least invasive to most invasive examination in order to build trust and cooperation. Developmental assessment involves visual inspection and activities that the toddler may view as games and will likely cooperate with. Auscultation is usually less threatening to the toddler than palpation, especially if the nurse were to use the stethoscope on a parent or a toy. The most uncomfortable, invasive exam for the toddler is most likely to be the examination of the eyes, ears, and throat, so that should be performed last.

The nurse is discussing genetic conditions with a family of a newborn. Which genetic conditions fall under the inheritance pattern of autosomal recessive conditions? Select all that apply. 1. Achondroplasia 2. Marfan syndrome 3. Hemophilia A 4. Cystic fibrosis 5. Sickle cell disease

Answer: 4, 5 Explanation: 1. Achondroplasia is not an autosomal recessive condition. Beta-thalassemia, cystic fibrosis, Gaucher disease, phenylketonuria, sickle cell disease, and Tay-sachs disease all are autosomal recessive conditions. 2. Marfan syndrome is not an autosomal recessive condition. Beta-thalassemia, cystic fibrosis, Gaucher disease, phenylketonuria, sickle cell disease, and Tay-sachs disease all are autosomal recessive conditions. 3. Hemophilia A is not an autosomal recessive condition. Beta-thalassemia, cystic fibrosis, Gaucher disease, phenylketonuria, sickle cell disease, and Tay-sachs disease all are autosomal recessive conditions. 4. Cystic fibrosis is an autosomal recessive condition. Beta-thalassemia, cystic fibrosis, Gaucher disease, phenylketonuria, sickle cell disease, and Tay-sachs disease all are autosomal recessive conditions. 5. Sickle cell disease is an autosomal recessive condition. Beta-thalassemia, cystic fibrosis, Gaucher disease, phenylketonuria, sickle cell disease, and Tay-sachs disease all are autosomal recessive conditions.

A three-week-old infant is returned post-pyloromyotomy three hours ago. The father is refusing pain medication for the infant and states, "The baby is hungry. Can I give the baby a bottle?" How should the nurse best advocate for the infant? Select all that apply. 1. Call the physician to ask if the child can feed yet. 2. The FLACC scale rating is 8 out of 10; try swaddling and rocking the infant. 3. Ask the parent to obtain a FLACC scale rating and let the nurse know what rating they get. 4. Educate the parent about the surgery and why the infant should not have anything by mouth. 5. Inform the parent about the meaning of the pain scale and the need for pain medication.

Answer: 4, 5 Explanation: 1. Calling the physician to ask if the infant can feed yet is not the best way to advocate for the infant. 2. Swaddling and rocking the infant may calm the child but is not the best way to advocate for the infant. 3. Asking the parent to obtain a FLACC scale rating and let the nurse know what rating they get. This is not the parents' duty. It is the nurse's responsibility to assess pain. 4. Educating the parent about the surgery and why the infant should not have anything by mouth is a good way to advocate for the infant. 5. Informing the parent about the meaning of the pain scale and the need for pain medication is a good way to advocate for the infant.