Pets Exam #1

Ch11 The nurse is preparing information for an adolescent patient regarding a prescribed medication regimen. Which information does the nurse present to the patient? Page 206 1. The nurse directly verbalizes medication warnings to the patient. 2. The patient will receive administration clarification by the pharmacist. 3. Most medications are metabolized faster by adolescent patients. 4. Symbols or phrases are sufficient to warn adolescents of medicine-related risks.

1 Adolescents have the best understanding of medication warnings when directly informed verbally by health care personnel.

Ch9 A 4-year-old patient is on a regular regimen of oral medications for a chronic condition. The parent expresses frustration because of the difficulty in administering the liquid medications. Which advice will the nurse provide to the parent for managing the process? Page 180 1. Ask if the child wants a different flavor of medicine. 2. Inquire if the child prefers the medication at a certain time. 3. Make sure the medicine is sweet and refer to it as candy. 4. Put the medication in juice or milk as preferred by the child.

1 Allowing a 4-year-old to have some choices regarding medication flavor is likely to foster some cooperation. Ask the pharmacist for advice regarding adding flavors or changing medication manufacturers

Ch7 The nurse in a pediatric clinic is performing well-baby checks. The nurse is checking an infant who is 7 months old for developmental milestones. Which finding is of greatest concern to the nurse? Page 108 1.The infant is unable to raise the head when in a prone position. 2.The infant exhibits a Babinski reflex. 3.The infant opens and closes her hands to grasp objects. 4.The infant exhibits a lack of startle reflex to sound.

1 An infant should be able at the age of 2 to 3 months to raise the head and chest and support the upper body with arms while in a prone position. The finding that the infant at 7 months lies flat when placed prone is a matter of concern to the nurse.

Ch8 The neonatal nurse is assessing a term neonate in the delivery room. Which respiratory assessment finding at 15 minutes after birth causes concern to the nurse? Page 124 1. A single episode of apnea occurs for 18 seconds in a 1-minute period. 2. Respirations are irregular, sporadic, shallow, and diaphragmatic. 3. Acrocyanosis is pronounced in all four extremities. 4. Respiratory rate fluctuates between 30 and 60 breaths per minute.

1 Apnea, a cessation of breathing longer than 15 to 20 seconds, is indicative of an alteration in respiratory transitioning. This assessment finding is of greatest concern to the nurse.

Ch10 The nurse in a pediatric clinic is gathering physical assessment information during a yearly visit on a 6-year-old child. Which finding does the nurse expect during the assessment? Page 188 1. A weight gain of 6-1/2 pounds 2. A height increase of 5 inches 3. A blood pressure of 88/50 mm Hg 4. A pulse rate of 102 beats/min

1 Children in this age group should gain 3 kg/year in weight, which is comparable to 6.6 pounds.

Ch11 The nurse is aware that the prefrontal cortex of the adolescent brain is still developing. The processes of critical thinking and decision making are in a stage of development. Which example best identifies these changes? Page 200 1. Some awareness of personal limitations 2. Disinterested in politics and social issues 3. Capable of identifying and setting short-term goals 4. Exhibits confidence by not comparing self to peers

1 During adolescence, the nurse is aware there is beginning to be some awareness of personal limitations.

Ch11 The nurse is performing a physical examination on a male who is 15 years of age. The nurse notices the presence of gynecomastia. The patient states, "I hate my chest," pointing to his breasts. "It's embarrassing. I can't even take my shirt off in front of my friends." Which information does the nurse provide for this patient? Page 203 1. The condition is self-limiting. 2. Surgical removal is recommended. 3. It indicates the patient is overweight. 4. The male hormone testosterone is deficient.

1 Gynecomastia refers to abnormal breast development in boys. This is a self-limiting condition.

Ch10 The school nurse is attending a meeting with the teachers, school counselors, and parents of a student who has recently refused to attend school. The parents share that the student is either pretending to be ill or being untruthful about going to classes. Which initial intervention by the nurse is best? Page 194 1. Inquire about the student's feelings regarding school. 2. Ask the parents if they have noticed physical injuries. 3. Explain the impact of missing school to the student. 4. Suggest homeschooling until the problem is resolved.

1 Initially, the reasons for the student's behavior needs to be identified and addressed, and a good approach is to ask about the student's feelings. The nurse is particularly interested in psychological issues.

Ch10 A new nurse on a pediatric unit is learning to use eutectic mixture of lidocaine and prilocaine (EMLA) cream in preparation for painful procedures. A school-age patient is scheduled to receive intramuscular (IM) medication. Which behavior by the nurse indicates an understanding about the use of EMLA? Page 192 1. Medication is applied at least 45 minutes before the IM injection. 2. The cream is covered with a thin layer of gauze. 3. A thin layer of medication is applied to the area. 4. Cream remaining on the skin is gently rubbed in.

1 It is most effective to apply EMLA to the site for an IM at least 45 minutes before the procedure. The longer the medication is in place, the deeper it will penetrate.

Ch7 During a well-baby checkup, the father of an infant states, "Even if he is occupied with a toy, he cries as soon as he notices I have left the room." Which explanation by the nurse is best? Page 110 1. "Your baby does not know you exist if he cannot see you." 2. "Babies learn very quickly how to get an adult's attention." 3. "You should move the baby with you if you leave the room." 4. "Just ignore him; he will soon learn that you are still present."

1 Object permanence is one of the most important developments in the sensorimotor stage. The child will learn that an object exists even when it cannot be seen or heard. Prior to this, the child does not understand that someone or something did not disappear. Playing peek-a-boo is a good way to help the development of object permanence

Ch8 The registered nurse (RN) in a pediatric office is preparing to administer oral medication to an infant. Before the actual administration of the medication, which initial action does the nurse take? Page 157 1. Obtain an accurate weight of the infant. 2. Provide the caretaker with written information. 3. Assist the caretaker in holding the infant supine. 4. Acquire a calibrated syringe for administration.

1 Pediatric dosing must be precise to ensure adequate therapeutic levels; dosing is based on weight. The weight needs to be obtained first.

Ch9 The nurse is providing care for a 4-year-old patient whose tonsils were removed this morning. The nurse identifies the patient is in pain but not willing to speak. The nurse uses the Wong-Baker FACES Pain Scale for evaluation. Which indicator does the nurse expect the patient to use to describe the level of pain? Page 180 1. The frowning face out of a series of faces 2. A number between 7 and 10 from a scale of 0 to 10 3. An intense red color on a range from pink to deep red 4. The word that identifies the degree of pain (i.e., ouch, hurts bad)

1 The Wong-Baker FACES Pain Scale is a self-reporting rating scale that assigns a number value to a facial expression that is chosen by a child

Ch7 The nurse is counseling parents about management of their children who are 2, 4, and 6 years of age. One of the parents states, "We believe in Kohlberg's theory of social-moral development." The nurse is aware that the preconventional stage of this theory involves which characteristic? Page 115 1. Behavior is adjusted according to good/bad and right/wrong thinking. 2. A personal and functional value system is constructed by the child. 3. The focus of the child is on following rules and maintaining social order. 4. Value systems are independent of authority figures and peers.

1 The children in the family are all in the preconventional level of Kohlberg's theory. Stages include obedience and punishment orientation, and individualism and exchange. Characteristics include following rules set by those in authority and behavior adjusted according to good/bad and right/wrong thinking

Ch11 The nurse is collecting health data from a 16-year-old male patient. The patient states, "I need to tell you, I had sex with another boy, and I am very confused." Which comment by the nurse is most therapeutic? Page 205 1. "You can share your thoughts and feelings with me." 2. "Maybe you should speak with your parents." 3. "Why were you attracted to this boy?" 4. "Let's explore your feelings toward females."

1 The goal is to create an environment that makes the adolescent feel comfortable to discuss their concerns with the nurse. Therapeutic communication avoids opinions and judgments and attempts to explore the patient's thoughts and feelings

Ch3 The nurse is providing care to a 5-year-old child who is recovering from a tonsillectomy in the hospital. The nurse notes that the 9-year-old sibling is tending to the psychosocial needs of the patient, while the parents discuss their marital conflicts in front of the children. Which nursing diagnosis is appropriate for this family? Page 47 1.Dysfunctional family processes 2.Risk for parent-child attachment 3.Spiritual distress 4.Risk for impaired parenting

1 The marital conflicts can disrupt the family process.

Ch9 During a routine pediatric visit the nurse evaluates the cognitive skills of a toddler. The nurse draws a circle on paper and places the crayon in the toddler's right hand. The toddler shifts the crayon to the left hand and draws a circle. Which advice does the nurse provide to the parent? Page 174 1. Respect the toddler's preference of one hand over another. 2. Watch the toddler's tendency to alternately use both hands. 3. Reassure the parent that hand preference is not established until age 5 years. 4. Gently insist drawing instruments be placed in the right hand.

1 The nurse advises the parent to respect the toddler's preference of using one hand over the other.

Ch8 The nurse is interviewing a parent of a 9-month-old infant during a well-baby visit. Which statement by the parent causes the nurse concern about infant safety? Page 166 1. "He loves to get his toys out of a big plastic storage bag on the doorknob." 2. "He thinks the TV remote is a toy, so it is kept on a shelf too high for him to reach." 3. "When we eat cooked vegetables, I cut a few into bite size pieces so he can try them." 4. "It really disturbed me to see my neighbor's infant with a pacifier on a cord around the neck."

1 The nurse is concerned that the infant is getting toys out of a large plastic bag hanging on a doorknob. Plastic bags or wrappings are never kept where the infant can reach them because of the risk for suffocation or choking. If the bag is hung by a cord, there is an additional risk of choking.

Ch8 The nurse is teaching a class to parents about emergency care for newborns and infants. Which comment from a parent indicates a need for additional teaching? Page 160 1. "I will apply gentle tourniquet pressure for serious extremity bleeding." 2. "The most important behavior is to remain calm and get emergency help." 3. "A seriously injured child is moved only if they are in a dangerous situation." 4. "If a seizure occurs, the safest place for the child is on the floor with the head turned."

1 The parent who describes applying a tourniquet in any manner for serious extremity bleeding needs additional teaching. When bleeding occurs with an infant, pressure with a clean cloth needs to be applied to the bleeding site.

Ch1 The pediatric nurse is providing care to an 8-year-old client who has Down's syndrome and wants to ensure they are providing evidence-based care. Which of the following resources would best offer evidence-based practice guidelines related to the care of this patient? Page 9 1.Journal of Specialists in Pediatric Nursing 2.Journal of Child and Adolescent Psychiatric Nursing 3.National Database of Nursing Quality Indicators 4.American Journal of Maternal/Child Nursing

1 This may include evidence-based resources for special instances of Down's syndrome

Ch7 The nurse in a pediatric clinic is counseling a parent who expresses concern about a toddler who plays alone at day care and does not interact with the other children who are present. Which information does the nurse provide to alleviate the parent's concern? Page 113 1. Parallel play is being exhibited and is normal at this age. 2. The toddler is likely to grow into a shy, introverted adult. 3. It is important for the child to learn to be alone at this age. 4. The toddler is exhibiting the normal behavior of solitary play.

1 Using knowledge about Erikson's theory of psychosocial growth and development, the nurse needs to reassure the parent that the toddler is expected to exhibit parallel play. Parallel play is part of the autonomy versus shame and doubt stage of Erikson's theory; autonomy and independence is being developed.

Ch4 The nurse is attempting to collect information from the parents of a critically ill child brought to the emergency department. The parents are from a different country, and English is their second language. The child's father suddenly shouts, "I cannot talk with you, care for my child now!" Which response by the nurse is correct? Page 59 1."I will get an interpreter to help us understand each other." 2."This information is important for providing care for your child." 3."Getting angry will just complicate things; you need to calm down." 4."I know that you are frustrated, but getting this information is important."

1 When the nurse recognizes difficulty in communication with a patient's family member, the nurse needs to remain calm and contact an interpreter to aid in communication.

Ch7 The pediatric home-care nurse is visiting a toddler born with a genetically related illness. Which comment by the parent is the greatest cause for the nurse to assess for additional information? Page 116 1. "I am having more difficulty keeping her confined." 2. "A chronically ill child affects the entire family." 3. "The other children seem so accepting of the illness." 4. "Hospitalization would cause some severe stress."

1 When the parent states increasing difficulty keeping this toddler confined, the nurse needs to assess for additional information. The nurse needs to reinforce that play is what children do, and playing is important to learn the developmental skills needed to reach the most optimal functioning. Confinement may not be appropriate.

Ch9 The nurse is caring for a 1-year-old patient after surgery for an intracranial shunt replacement. The nurse selects the FLACC Scale (faces, legs, activity, cry, consolability) for assessment because of the toddler's inability to participate in pain evaluation. The nurse will recognize which assessment finding as an indication of some level of pain? Select all that apply. Page 179 1. Constantly frowns, clenched jaw, quivering chin 2. Squirms, shifting back and forth, tense 3. Cries steadily and loudly, sometimes screams or sobs 4. Legs are positioned normally and appear relaxed 5. Answers to name, sucks thumb, and holds toy

1,2,3 Constantly frowning, with clenched jaw and quivering chin are in the face category on the FLACC Pain Scale, and the score is 2. (2) Squirming, shifting back and forth, and appearing tense are in the activity category on the FLACC Pain Scale, and the score is 1. (3) Crying steadily and loudly, sometimes screaming or sobbing, are in the cry category on the FLACC Pain Scale, and the score is 2.

Ch11 The nurse is preparing to teach a class of adolescents about the increasing numbers of young people being sexually assaulted. Which advice by the nurse will promote adolescent safety from sex crimes? Select all that apply. Page 212 1. Go out with groups of friends. 2. Avoid alcohol and substance use. 3. Remain in public places. 4. Bring a friend along on a date. 5. Research a date's background.

1,2,3 Nurses should reinforce safety strategies for avoiding sexual assault, such as going out with a group of friends. The group needs to stay together and should not let a member go off with someone alone(1), Nurses should reinforce safety strategies for avoiding sexual assault, such as avoiding alcohol and substance use, which decreases the ability to think clearly or defend oneself (2), Nurses should reinforce safety strategies for avoiding sexual assault, such as remaining in public places. In addition, the public places should be well lit, well used, and in a safe area (3).

Ch7 A widowed man and parent of two children informs the nurse of an upcoming marriage to a woman who has three children. The expressed intention is to adopt the three stepchildren. Which definition of family will the nurse apply? Select all that apply. Page 115 1. A nuclear family, after the adoption of the stepchildren 2. A nonnuclear family, after the marriage has taken place 3. A blended family, after the marriage of the adults occurs 4. A nuclear family, before adoption if all children live in the home 5. A blended family, after the intention of marriage is expressed

1,2,3 The nuclear family is composed of a mother, a father, and a biological or adopted child or children. (2) The term nonnuclear family describes family forms other than traditional, such as single-parent homes, grandparents functioning in the role of parents, same-sex parents with a child or children, and blended families. (3) Blended families are those in which families from divorce are joined together by remarriage. This can also occur when a spouse has died and the remaining spouse remarries.

Ch10 The nurses at a community pediatric clinic are preparing a presentation about nutrition for the school-age child. Which information is important for the nurses to include? Select all that apply. Page 194 1. Over 35% of school-age children are considered to be obese or overweight. 2. Overweight children have an increased likelihood of being overweight adults. 3. Children with a high body mass index (BMI) have increased levels of lipids, insulin, and BP 4. Notably higher health risks exist for adults who were obese during childhood. 5. School-age children need comparatively more calories than infants or adolescents.

1,2,3,4 Approximately 20% of school children are obese, with a BMI defined as greater than the 95th percentile by the Centers for Disease Control and Prevention (CDC). (2) . It is a fact that overweight children have a greater risk of being overweight adults. The health consequences of obesity in children will have a negative effect on their morbidity and mortality as adults. (3) . A high BMI in children is linked with increased lipid levels, insulin levels, and blood pressure; these can lead to higher risks for atherosclerosis and obesity in adulthood. (4) The health consequences of obesity in children will have a negative effect on their morbidity and mortality as adults.

Ch9 A community center is offering classes taught by pediatric nurses on summer safety for toddlers and preschoolers. Which topics will the nurses include in the teaching plan? Select all that apply. Page 178-179 1. Safety near swimming areas 2. Dangers of toys being left in a pool 3. Safety related to flotation devices 4. Bicycle safety for riders or passengers 5. Safety during trampoline play

1,2,3,4,5 Childproof all swimming areas, including access to pools, ponds, and lakes. Never leave children unattended near swimming areas, even if they can swim. (2) Toys left in a pool are a dangerous temptation, because children may be tempted to retrieve them. (3) Use flotation devices specifically designed for child safety. Floating toys, rafts, and rings do not provide adequate safety. (4) Children should always wear a bicycle helmet whether they are riding a bike, or they are the passenger on a bicycle. Children need to know the safety rules for riding on bicycle paths, sidewalks, or on the street. (5) Trampolines are a safety risk for children of all ages, but toddlers and preschoolers should not be permitted to play on trampolines.

Ch7 The school nurse is asked to assess a student in the third grade who is failing to demonstrate academic success. Which statement(s) made by the child indicate an unmet need according to Maslow's hierarchy? Select all that apply. Page 117 1. "I have to go to bed at 10:00 every night." 2. "I worry because my parents fight all the time." 3. "Game and movie nights are always fun at my house." 4. "My grandma says I'm stupid just like my mother." 5. "I taught my little brother to ride a bike in just one day."

1,2,4 If the student in question goes to bed every night at 10:00 the nurse recognizes a physiological need that is not being met. Children need more sleep than adults. Sleep deprivation can impact the growth and development of a child and cause delays. (2) If the student in question expresses worry about fighting between parents, the nurse recognizes the child has the need to be protected from harm and may not feel safe. Fear and worry can interfere with developmental achievements. (4) . Negative feedback interferes with the development of esteem, which is related to the need to respect one's self and be respected by others.

Ch11 The health department informs the school nurse that a high school student has been identified with active tuberculosis (TB), and students are to be given a TB skin test. Which consideration does the nurse make in regards to student testing? Select all that apply. Page 206 1. Permission for testing is obtained from parents or guardians. 2. Students and parents/guardians are assured of confidentiality. 3. Only students who were in physical contact with the infected student are tested. 4. Students are informed the test administration will cause minor pain. 5. The rationale for the testing is explained to students and parents/guardians.

1,2,4,5 In a high school setting, a majority of students may be minors, and it is necessary for the nurse to obtain parent/guardian permission to administer a TB test (1), As in all situations of medical care, confidentiality is assured(2), The nurse must be honest about any pain during a medical procedure; the nurse will inform the students of expected minor pain (4), Before seeking parent/guardian permission, the nurse must explain the reasons the testing is being performed. Adolescents also need to know the rationales so they will be compliant and assent to the process(5)

Ch8 The nurse is providing teaching to parents who are expecting their first child. For which reason does the nurse understand this teaching to be so important? Select all that apply. Page 158 1. It provides information that defines health and normalcy. 2. It instructs parents about general, safe infant care. 3. It helps reduce the appearance of regressive behavior. 4. It encourages development of parent-infant interactions. 5. It presents methods to help maintain infant/child health.

1,2,4,5 The nurse includes developmental milestones, home infection control measures, the importance of immunizations, and the use of car seats and other safety equipment. (2)The nurse will discuss general health-care concerns, such as nutrition, oral health, the need for sleep, and appropriate hygiene care. (4) The nurse will share the importance of parent-infant interactions, including playing, cuddling, the importance of talking to the child, and separation anxiety. (5) The nurse will share information about nutrition, oral health, prevention of illness and infections, prevention of injury, and childproofing the home. The nurse emphasizes the importance of learning infant/child cardiopulmonary resuscitation (CPR). The nurse will also cover the care for an infant/child that is ill.

Ch7 The nurse is gathering information during a routine checkup for a preschool-age child who lives with grandparents. The grandmother expresses distress about "how loud and busy" the child is, and "how expensive it is to feed and clothe" the child. Which referrals does the nurse make to the grandmother? Select all that apply. Page 115 1. Community programs for the child aimed at playing and learning 2. Social service for determination of benefits available for the care of the child 3. Legal services to assist in obtaining financial support from the parents 4. Child protection services to survey the home and psychosocial environment 5. Caretaker programs and support groups for grandparents performing as parents

1,2,5 The grandmother's statement indicates stress related to the expected behavior of a preschool child. A referral for community programs for the child aimed at playing and learning is appropriate and beneficial. (2) . The nurse needs to make a referral to social services who can determine whether the household is entitled to assistance for raising a grandchild. Services can include food, clothing, childcare, and medical services, to name a few. (5) The nurse needs to be sensitive that the grandmother may be expressing caregiver stress. The nurse needs to make referrals to programs that can benefit the grandparents physically, psychosocially, and spiritually.

Ch9 The community pediatric nurses are making home visits to families who have children either above or below the normal ranges in weight and/or height. One nurse visits a home with three qualifying children under the age of 5 years who are all below the standards for their ages. Which interventions will the nurse introduce to the caretakers? Select all that apply. Page 182 1. Prepare food for a toddler to eat seven times a day. 2. Serve generous portions and insist on a clean plate. 3. Encourage grazing throughout the day. 4. Physically feed the children to assure better intake. 5. Serve a variety of foods to provide varied nutrients.

1,3 The nurse will suggest the caregivers make food available for toddlers to eat approximately seven times a day, consuming more meals than snacks. (3) Children should be allowed to graze throughout the day, as toddlers may not sit for three meals.

Ch10 The school nurse is discussing a student's reasons for leaving school to be homeschooled. The student has a chronic condition that causes mobility and strength deficits. The student states, "I want to stay in school, but I am always late for class. I can't manage getting around fast enough with all my books." Which suggestion by the nurse will best meet the needs of the student? Select all that apply. Page 197 1. Place the designated textbook in each class the student attends. 2. Plan for the student to leave class early to get to the next class. 3. Arrange for a set of textbooks to be left in the student's home. 4. Set up closed-circuit TV so the student "attends" from a set location. 5. Inquire if the parents are able to purchase a motorized wheelchair.

1,3 The problem the nurse is attempting to solve is the student's inability to get to class because of difficulty carrying heavy textbooks. The student will benefit if a textbook is left in each assigned class. (3) Arranging for a set of textbooks to remain in the student's home will eliminate the need to carry heavy books back and forth from school to home.

Ch8 The nurse in a pediatric emergency department is concerned when parents bring a 9-month-old infant in for possible injury. X-rays indicate the infant has a broken leg. Which information causes the nurse to report possible physical abuse to the nursing supervisor? Select all that apply. Page 167 1. The infant has been treated three times for injuries. 2. The parents insist on simple, noninvasive medical care. 3. The father states the infant climbed a stepladder and fell. 4. The infant buries his face in the mother's arm if the father talks. 5. The mother states she fell down the stairs with the baby.

1,3,4,5 Because of unexplained or repeated injuries such as welts, bruises, burns, fractured skull, broken bones, and especially spiral fractures, the nurse will report probable physical abuse to the nursing supervisor. (3)When the father states the infant climbed a stepladder and fell, the nurse will suspect physical abuse, because injury explanation is unlikely given the age or ability of the child. The nurse will report the situation to the nursing supervisor. (4) Fearful or detached behavior by the infant, especially when the father talks, is a probable sign of physical abuse. The nurse will report the behavior to the nursing supervisor. (5) Disagreement or inconsistency in the parent/caregiver explanation of the injury can be an indication of physical abuse. The nurse can seek clarification about details of the accident and/or inquire about injury to the mother during the fall. The nurse is likely to report probable physical abuse of the infant.

Ch7 The nurses on a pediatric unit are concerned about developmental delays in patients who are hospitalized frequently and for extended periods of time. Which interventions do the nurses initiate to alleviate the concerns? Select all that apply. Page 116 1. Design a play/recreational area with age-appropriate sections. 2. Provide nurses with allotted time to play with confined children. 3. Extend the services of the child life specialists to all patients. 4. Encourage family to bring favorite toys and books from home. 5. Have age-appropriate educational TV channels available.

1,3,5 Play is what children do and should not be overlooked when a child is in the hospital. Play is important for younger children to build the skills needed for development. All ages of pediatric patients can use play as a stress reducer. (3) Many pediatric facilities have a child life specialist on staff who can assist the child in fostering growth and developmental needs through play. An extension of services to meet the needs of all hospitalized children is appropriate. (5) . When hospitalized, patients will view TV as a distraction to the manifestations of illness and effects of treatment. However, with pediatric patients, TV provides an opportunity for skills development as well as entertainment.

Ch10 The school nurse attends a workshop focusing on the identification and prevention of bullying among school-age children. The nurse will be better able to identify both bullies and victims due to knowledge of which factors? Select all that apply. Page 194 1. Poor academic achievement 2. Jealousy over sexual attention 3. Lower education level of caregivers 4. Leader or follower personality types 5. Poor health status or increased health needs

1,3,5 The nurse will be able to associate poor academic achievement as a cause for either the bully or the victim. (3) . The nurse will recognize that bullies and victims frequently have parents and caregivers with a high school or lower educational level. (5) The nurse will recognize that poor health status, increased health needs, and mental health issues can be a factor in a child becoming either a bully or a victim.

Ch9 The parent of a toddler at age 2 years and a preschooler at age 4 years is sharing a concern about sibling rivalry. The parent states, "It is so upsetting to see them fighting with each other. I am afraid one of them will hurt the other." Which interventions will the parent and nurse design together in a plan for management? Select all that apply. Page 182 1. Set rules defining acceptable behavior. 2. Separate them to opposite sides of the room. 3. Teach children to be kind to each other. 4. Recognize the toddler has increased risk for injury. 5. Assist with appropriate expression of feelings.

1,3,5 Together the nurse and parent develop a plan that will set the rules for acceptable behavior. Rules will cover such behaviors such as no name calling, no pushing, and no slamming things. (3) The nurse and parent will identify ways to teach the children to be kind to each other by encouraging apologizing, sharing, and comforting each other when hurt. This intervention will foster positive feelings and behaviors. (5) . Children may be unable to express the proper feelings of anger and frustration. The nurse and parent will identify therapeutic methods designed for self-expression.

Ch11 The nurse is advocating for a transition to home care from a medical inpatient facility for an adolescent patient with a complex medical condition. Which assessment finding/information supports a transition to home for this patient? Select all that apply. Page 210 1. Home care is covered by the adolescent's primary and secondary health-care plan. 2. During home care a goal for mainstreaming the adolescent into school is set. 3. The adolescent's parents are older and will benefit from home-care assistance. 4. Home care allows for collaboration and management of care by a medical team. 5. A family member is concerned about the adolescent's complex medication regimen.

1,4 Home care decreases financial costs and travel costs. When the adolescent has primary and secondary health-care plans that cover home care, the nurse is assured that the transition will not be a financial burden (1), Home care allows collaboration with the adolescent's medical team and increases family satisfaction. The adolescent will be followed by a medical team that is set up to meet the adolescent's medical and psychosocial needs (4)

Ch10 The nurse is performing a routine physical assessment on a 7-year-old child. Which specific approaches does the nurse use for this child? Select all that apply. Page 193 1. Listen to information shared by the child. 2. Start the exam with obtaining vital signs. 3. Expect the child to be undressed and in a gown. 4. Visually inspect the child's general appearance. 5. Share which immunizations will be given today.

1,4 The nurse needs to listen to any information the child provides, especially if it pertains to any recent history or problems. (4)The nurse can gather initial assessment data by visually examining the child for general appearance, muscle tone, and skin condition.

Ch8 The nurse is providing information to parents of infants regarding home safety. Which information will the nurse present that is specific to this age group? Select any that apply. Page 165 1. Crib safety standards 2. Avoiding taking the infant out in public 3. Hazards of immunizations 4. Diaper rash prevention 5. Signs and symptoms of illness to report

1,4,5 Infants spend most of their time in cribs, which must be safe—no bumper pads, slats no more than 2-3/8 inches apart. (4) . Prevention is the best treatment for diaper rash, which can cause pain and possible infections because of a loss of skin integrity. (5) Parents need to understand the importance of calling a health-care provider if the infant has a fever, refuses to eat, has vomiting and/or diarrhea, is more fussy or quieter than usual or looks jaundiced, and if they are worried or have questions about the infant's growth or development.

Ch8 The nurse is preparing to teach to parents the importance of play in the newborn's and infant's life. Which information will the nurse plan to include in the class? Select all that apply. Page 151 1. Play is how infants learn about their environment and themselves. 2. Infants may be startled by their own images in a reflective toy. 3. Older siblings are encouraged to share their toys with the infant. 4. Toys should provide a means of sensory stimulation for the infant. 5. Toys can help with physical and fine motor development.

1,4,5 The nurse needs to explain that play is an important part of an infant's/child's development process. Play promotes learning about the environment and self. (4) . Infants explore the world with their mouths and imitate those around them. It is important to provide toys to initiate and promote learning through these methods. (5) Physical development is promoted through play activities. Early on, infants will begin to develop gross and fine motor development; toys should be selected that will promote this type of learning.

Ch8 The parent of an infant reports to the nurse a suspicion that the babysitter is neglecting the infant. The parent states, "I saw some disturbing things on a hidden nanny-cam." The nurse will support the decision to replace the babysitter if which behavior is observed? Select all that apply. Page 168 1. The infant is in the crib and ignored until time for the parent to arrive home. 2. The babysitter takes the infant out in the stroller for 1 hour on a cool day. 3. The infant cries and is given a bottle, which is propped up in the crib. 4. When the infant drops toys on the floor, the sitter tosses them back into the crib. 5. Prescribed medication is not given to the infant according to written instructions.

1,5 Consistent failure to respond to the child's need for stimulation, nurturing, encouragement, and protection, or failure to acknowledge the child's presence, is indicative of neglect. This observation would warrant support from the nurse to replace the babysitter. (5). Failure to provide the infant with prescribed medication according to written instructions is considered neglect and warrants replacement of the babysitter

Ch9 A parent tells the nurse a toddler is exhibiting signs of being ready to potty train. Which action by the parent will draw the nurse's approval? Select all that apply. Page 181 1. "I am initially teaching my son to urinate sitting down." 2. "He has to sit on the potty 10 minutes each hour." 3. "We are still using diapers to avoid messes." 4. "Accidents result in the loss of a favorite toy for the day." 5. "We are using treats, stickers, and new underwear as incentives."

1,5 The nurse will approve of the parent initially teaching a boy to sit to urinate. Once mastered, then move on to standing. The parent or caregiver may use flushable toilet targets for teaching purposes. (5) . Incentives are appropriate, and the nurse will approve of providing encouragement in the form of praise and celebration, along with rewards and incentives such as treats, stickers, and new underwear.

Ch9 The nurse in a pediatric clinic is performing a routine assessment on a preschool child. The nurse plans to evaluate some of the child's growth and development by interacting directly with the child. Which level of language does the nurse expect if the child is 4 years of age? Page 174 1. States full name and address without prompting 2. Appropriately converses using two to three sentences 3. Answers questions consistently with a "yes" or "no" 4. Speaks clearly enough to be understood

2 A preschooler 4 years of age is expected to speak in sentences consisting of 4 to 5 words. A toddler is expected to converse using two to three sentences; the expectation is the same for a preschooler 4 years of age.

Ch11 During admission of an adolescent to the hospital for an acute illness, the nurse asks about the use of complementary and alternative medicine (CAM). In which manner does the nurse approach the topic to obtain an accurate answer? Page 211 1. Tells the adolescent that unreported CAM is a major cause of complications 2. Asks the adolescent what kind of CAM is used in the home and among friends 3. Informs the adolescent that CAM must be completely avoided when hospitalized 4. States that CAM is actually a primitive type of modern medication therapy

2 Adolescents are often reluctant to discuss their use of CAM. Start out by asking the adolescent about family and peer use of CAM. If the adolescent reports use by a close family member or peer, then the adolescent is most likely also using CAM. The nurse can use therapeutic communication skills to acquire additional information.

Ch11 The parents of an adolescent are distressed about the psychological changes in their child. Which example does the nurse validate as being a source of concern? Page 200 1. Constantly compares their body with others 2. Comfortable with doing what the crowd does 3. Regularly tests family limits and rules 4. Presents self in a constantly changing personae

2 Because impulsiveness and a sense of invincibility are common characteristics of the adolescent, the nurse will validate the parents' concern when the adolescent is comfortable doing what the crowd does

Ch9 The nurse is evaluating the motor development of a preschooler at age 5 years. Which assessment finding is essential for the child to be considered ready for kindergarten? Page 174 1. Dresses independently 2. Uses the toilet without assistance 3. Draws stick figures with two or more body parts 4. Throws overhand and catches a bounced ball

2 Before entering preschool, the preschooler needs to be able to use the toilet without assistance

Ch7 The nurse in a pediatric clinic is checking the developmental milestones for a 3-year-old patient. Which finding causes the nurse to perform additional assessments? Page 108 1.The patient's tee shirt is on backward. 2.The patient loses balance when kicking a ball. 3.The patient draws a circle that is closed but oblong. 4.The patient jumps with both feet about 2 inches high.

2 Between the ages of 2 to 3 years, a toddler should be able to kick a ball. The fact that the patient loses balance when attempting this skill may require additional assessment.

Ch7 The pediatric nurse is providing care for a 14-year-old female patient. After the patient's parents leave the hospital, the patient begins to cry. The nurse explores the patient's feelings using therapeutic communication. Which information causes the nurse to report suspected sexual abuse? Page 117 1. The patient is frequently denied access to needed health care. 2. The patient reports frequent episodes of genital irritation. 3. The patient admits to multiple incidences of skipping school. 4. The patient states that an older brother frequently "hurts" her.

2 Frequent episodes of genital irritation is indicative of possible sexual abuse and should be reported as such.

Ch11 The nurse in an acute pediatric care setting is providing care for a 15-year-old patient. The patient is recovering from abdominal surgery. Which nursing intervention is appropriate for this patient? Page 209 1. Offer to play a video game with the patient. 2. Ask if the patient wants to learn how to care for the incision. 3. Tell the patient that intramuscular (IM) injections will feel like a small pinch. 4. Discourage long visits by peers by reinforcing the need for rest.

2 It is appropriate for the nurse to encourage the adolescent's active participation in meeting health-care needs. Because the patient may be involved in wound care after discharge, this is a prime time for the nurse to provide appropriate patient education.

Ch9 A nurse is teaching a group of mothers about the signs and symptoms of respiratory distress. Which statement by the parent indicates the teaching is understood? Page 184 1. "Nasal flaring is normal since my son has asthma." 2. "Retractions are when I can see my son's ribs when takes a breath in." 3. "Tachypnea is when my son's breathing is much slower than normal." 4. "Tripod position is when my son's shoulders are up, and his head is down."

2 Retractions are the ability to see ribs during inhalation.

Ch9 The nurse in a pediatric office is performing physical assessments on multiple patients. Which patient will the nurse specifically report to the health-care provider because of physical assessment findings? Page 175 1. The 4-year-old patient with a blood pressure of 110/75 mm Hg, pulse of 98 beats/min 2. The 3-year-old patient with a history of prematurely closed fontanels who has a headache 3.The 2-year-old patient with asthma who exhibits abdominal breathing at 26 breaths/min 4.The 3-year-old patient with a soiled diaper, at the 70th percentile of weight and height

2 The 3-year-old patient with a history of prematurely closed fontanels has a condition that will affect the growth of the head. The presence of a headache is an indicator of possible increased intracranial pressure. Because there is a potential for brain damage, the nurse will report this finding specifically (and immediately) to the health-care provider.

Ch7 The nurse works in an elementary school with students ranging from 6 to 11 years of age. The nurse uses knowledge related to Freud's psychosocial theory to identify which behavior in this pediatric population? Page 111 1. Oedipal or Electra conflicts 2. Energy focused on socialization 3. Curiosity about anatomical differences 4. Mild struggles with sexuality

2 The energy focus is on socialization and increasing problem-solving abilities.

Ch11 The nurse is preparing to perform a routine physical examination on a female who is 15 years of age. The patient states, "I am anxious about having my private parts examined." Which statement does the nurse make? Page 202 1. "Slow breaths and relaxation will manage the pain." 2. "I will only briefly examine your external genitalia." 3. "Pelvic exams are recommended after your periods begin." 4. "The instruments are small and the examination is brief."

2 The first gynecological examination should occur between ages 13 and 15 years for external examination only; pelvic examinations are performed on an adolescent when problems arise such as pain or abnormal bleeding

Ch8 The nurse in the neonatal care unit notices that a term neonate has a respiratory rate of 66 breaths/min and exhibits pallor and lethargy. Which action does the nurse take immediately? Page 125 1. Unwraps the neonate and assesses for the presence of hypotonia. 2. Wraps the neonate in an additional blanket and puts a knitted cap on the neonate. 3. Takes the neonate to the mother and assesses sucking reflex during a feeding. 4. Contacts the neonate's health-care provider and seeks permission to take a rectal temperature.

2 The initial assessment findings of the neonate are indicative of cold stress. Immediately, the nurse needs to take actions that will conserve body temperature. A knitted cap will cover the largest exposed area for heat loss; wrapping an additional blanket around the neonate will preserve heat.

Ch7 The nurse in a pediatric clinic is performing an assessment on an infant in the presence of both parents. The parents are short and moderately overweight. One parent states, "We are going to do everything we can to raise a strong, tall, athletic child." How does the nurse respond? Page 115 1. Provides materials about healthy diets and lifestyles for families 2. Shares the impact of genetics on environmental conditions 3. Suggests to the parents how to alter their lifestyles 4. Recognizes the parents for having positive attitudes and goals

2 The nurse is aware that nature involves the traits, capacities, and limitations that a person inherits from parents at conception. Genetically, the infant may not become tall due to any nurturing behaviors; however, the infant can be strong and athletic because of nurturing.

Ch8 The nurse in a pediatric clinic is frequently required to administer medications to infants. Which approach will the nurse take when administering an immunization injection? Page 158 1. Use a 1-inch needle with a maximum of 1.5 mL of fluid. 2. Keep the infant on the caregiver's lap and use distraction. 3. Explain the medication and the purpose in simple terms to the infant. 4. Immediately comfort the infant with cuddling and patting.

2 The nurse should approach the infant slowly and at eye level. Handle the infant gently, keep the infant on the caregiver's lap, and use distraction to decrease anxiety

Ch10 A school-aged child is being treated for an overdose of cough medicine administered by the parent. The child is 12 years of age and weighs 98 pounds. The label on the bottle states not to give the medication to children younger than 6 years, and provides a dosing chart that indicates an adult dose for children over 50 kg. For which reason does the nurse suspect the overdose occurred? Page 192 1. The cough continued after being medicated. 2. The parent misunderstood weight parameters. 3. The parent measured with a household spoon. 4. The parent attempted to induce sleep in the child.

2 The nurse suspects that the parent misunderstood the weight parameters for the medication. The parent may have thought 50 kg was another way of indicating 50 pounds and given the child an adult dose. Multiple doses caused an overdose

Ch9 The nurse is asking a parent of a toddler at age 18 months if there are any particular parenting challenges at this time. Which advice will the nurse offer if the parent shares issues with separation anxiety? 1. The parent needs to just leave quickly and ignore the toddler's protests. 2. The parent needs to keep reassuring the toddler that the parent will return. 3. The toddler is to be left only with family members until the fear subsides. 4. The parent needs to plan leaving times to coincide with the toddler's naps.

2 The nurse will advise the parent to repeatedly reassure the toddler that the parent will be back. After the toddler is reassured, the parent needs to leave quickly

Ch8 The nurse is providing care for a newborn who was delivered at 34 weeks' gestation. The nurse understands the newborn is a greater risk for death or chronic care needs. Which recommendation does the nurse make to the parent to prevent the newborn from developing a common complication? Page 164 1. Strictly limit the newborn's exposure to persons outside the family for 6 months. 2. Start a series of palivizumab prophylaxis immunization as advised by the pediatrician. 3. Strongly express the need for more frequent pediatric visits to prevent complications. 4. Reinforce not allowing the premature newborn to cry for more than 10 minutes.

2 The prevention for respiratory syncytial virus (RSV; a common complication for premature neonates) is palivizumab (Synagis) prophylaxis immunization; there are significant benefits to premature infants and infants who are less than 35 weeks. Palivizumab is given in no more than five monthly doses during RSV season (late October to late January).

Ch8 The nurse in a community pediatric clinic screens for conditions that cause concern for possible infant abuse or neglect. Which situation will prompt the nurse to recommend parenting education? Page 167 1. The stay-at-home mother of four children (ages 4 to 16 years) who is bringing home a newborn 2. The teenage couple with a newborn who live apart, but the father babysits during the day so the mother can attend school 3. The newly relocated couple with a young infant who are now 12 hours away from family and friends 4. The parents of an infant who live apart because the father of the infant is married and has a family with his spouse

2 The teenage couple with a newborn will cause the nurse the greatest concern about infant abuse or neglect. Because the couple live apart, the father is not exposed to the infant except when he is babysitting; unfamiliarity with the infant's behaviors or needs can lead to neglect. Frustration related to a lack of knowledge and/or immaturity places the infant at risk for abuse. The nurse needs to strongly recommend a program such as daddy boot camp to this couple.

Ch10 The nurse is invited to present a program on child safety to parents of school-age children in the fourth and fifth grades. Considering the age, which information does the nurse include in the teaching plan? Page 193 1. Immunization schedule 2. Head injury prevention 3. Age-appropriate toys 4. Symptoms of illnesses

2 Unintentional injury, including head injury, is the leading cause of death in this age group. Studies show that parents' knowledge of head injuries is limited. This information and the ages of the children makes this an important topic for the nurse to cover

Ch8 The nurse is providing care for a hospitalized infant who is 4 months of age. While making a plan of care for the patient, which interventions specific to the patient's age will the nurse include? Select any that apply. Page 160 1. Encourage caregivers to go home to rest and sleep. 2. Suggest a favorite or comfort item be brought from home. 3. Plan for invasive procedures to be performed in a treatment room. 4. Monitor the infant for behaviors and cues indicating separation anxiety. 5. Educate caregivers to leave the side rails of the crib down during the day.

2,3 Even at 4 months, a familiar item from home provides comfort to the infant. The caregiver needs to bring a favorite toy or blanket. (3) The nurse will make arrangements in the plan of care to perform all painful or invasive procedures in a treatment room. Performing such procedures at the crib site will create anxiety for the infant whenever the nurse approaches.

Ch11 Nurses in pediatric emergency departments attend an educational program about identifying victims of human trafficking. Which characteristics have the nurses learned to identify? Select all that apply. Page 212 1. Women 2. Age less than 18 years 3. Frequent urinary tract infections (UTIs) and STIs 4. Minors who are pregnant 5. Appearing relaxed and calm

2,3,4 About 25% of human trafficking victims are minors. The average age is 12 to 14 years (2), Poor health conditions among this population include STIs; urinary tract infections; multiple pregnancies, abortions, and/or miscarriages; injuries, skin conditions, burns, dental disease, malnutrition, and mental health issues with depression, anxiety, post-traumatic stress disorder (PTSD) and suicide attempts (3), Many young women will have had multiple pregnancies, abortions, and miscarriages (4)

Ch7 Erickson's psychosocial development theory proposes that the school-aged child between ages 6 and 12 years is in the stage of industry vs. inferiority. Based on this theory, how will the pediatric nurse design activities as part of a diversional program for children who are in a long-term medical facility? Select all that apply. Page 113 1. Identify adequate activities suited for solitary play. 2. Provide activities that involve more than one person. 3. Allow participation in simple tasks on the unit of care. 4. Designate methods of recognition for completed tasks. 5. Set guidelines and policies that are clear and enforceable.

2,3,4,5 The school-aged child enjoys working in groups and forming social relationships. (3) Developing a sense of industry provides the child with purpose and confidence in being successful; participation in small tasks will fulfill this need. (4) If a child is unable to be successful, this can result in a sense of inferiority. Success needs to be recognized and rewarded. (5) The school-aged child in this stage follows the rules and likes order.

Ch10 A 13-year-old student has cerebral palsy but is able to communicate well with others. The parents support their child being mainstreamed into a school setting even though self-care is limited. The school nurse likely needs to arrange for which type of care for this student? Select all that apply. Page 197 1. Tracheostomy suctioning 2. Elimination/personal hygiene assistance 3. Colostomy management 4. Oral or enteral feedings 5. Medication administration

2,4 Patients with cerebral palsy may have urine and fecal incontinence. This student will need assistance with toileting, personal hygiene, or urinary catheter care. (4) Due to limited self-care, the student is likely to need assistance with either oral or enteral feedings.

Ch4 A 17-year-old pediatric patient is admitted for a fractured femur. The patient exhibits signs of being withdrawn and emotional throughout the day. During reassessment by the nurse, which approaches will reveal spiritual distress? Select all that apply. Page 62 1. Asking the patient about pain level using a scale of 0 to 10 2. Inquiring about the meaning of the fracture and hospitalization to the patient 3. Observing for and explaining the meaning of swelling and erythema of the leg 4. Performing an assessment of the patient's behaviors using the FICA scale 5. Discussing the patient's previous methods of handling distress with the parents

2,4 The nurse needs to explore the patient's feelings about the fracture and the resulting hospitalization. It is important to identify manifestations of anger, guilt, or depression related to the patient's condition. (4) The FICA scale stands for faith, importance, community, and address. The four components of the tool provide the nurse with baseline patient data that can be used to individualize care. Assessment with this tool reveals spirituality and spiritual concerns.

Ch8 The nurse is providing counseling to the caregivers of a 4-year-old child who was born with a genetic condition that interferes with physical and psychosocial development. The child has had multiple hospitalizations for illnesses and infections related to the genetic condition. For which reasons will the nurse suggest the caregivers consider placement in a pediatric medical home? Select all that apply. Page 159 1. The caregivers will be relieved of care needed for 24 hours every day. 2. The home is set up to provide pediatric care from birth to adulthood. 3. The child's medical history indicates health risks related to family care. 4. The model is designed to reflect care standards suggested by pediatricians. 5. Care is coordinated by an interdisciplinary team that includes the caregivers.

2,4,5 The pediatrician-designed model of the pediatric medical home involves providing care to patients from birth to adulthood. (4) The AAP developed the pediatric medical home model to deliver primary care to the child and family in a coordinated and comprehensive approach. (5) A medical home integrates and coordinates care through interdisciplinary coordination with the child, family, primary health-care providers, specialists, hospitals, health-care systems, public health, and the community.

Ch7 The nurse is performing a clinic assessment on a 1-month-old new patient. During the interview, the mother shares personal information. Which comments will cause the nurse concern about growth and development? Select all that apply. Page 116 1. "I was anemic during pregnancy and still take iron pills." 2. "Fat people are gross; I only gained 16 pounds during pregnancy." 3. "I don't think I even had a single cold during my pregnancy." 4. "During my pregnancy I never even took care of the cat." 5. "I really decreased my smoking habit during my pregnancy."

2,5 The nurse is concerned by this comment on two levels. Poor nutrition in the mother can lead to low-birthweight babies, as well as slow development, compromised neurological performance, and impaired immune status. The mother's attitude about "fat people" may carry over through the lifetime of the infant and cause insufficient nutrition for growth and development and/or psychosocial issues. (5) Maternal smoking can result in infants with low birth weight and/or congenital anomalies such as cleft lip and cleft palate. The nurse needs to provide teaching about the effects of smoking during pregnancy, especially if another pregnancy is planned.

Ch 9 The nurse in a pediatric clinic is assessing the motor development of a 2-year-old patient. The nurse reviews the toddler's last assessment results prior to determining changes. Which new development does the nurse expect to find during assessment? Page 174 1. Draws squares, circles, and triangles 2. Throws objects overhand 3. Can turn doorknobs 4. Climbs stairs without assistance

3 A 2-year-old is expected to be able to turn doorknobs.

Ch9 The nurse is involved in a clinic screening for the kindergarten readiness of preschoolers. Primarily the children being screened are between the ages of 4 and 5 years. Which child does the nurse recognize as being ready to attend school? Page 175 1. The 4-year-old who points correctly to three different colors and voices reluctance to start school. 2. The 5-year-old who is unhappy about being told there is a 5-minute wait and then refuses to count. 3. The 4-year-old who counts to 10, recalls part of a story, and asks questions about the screening. 4. The 5-year-old who insists a parent stay with him, counts to 10, knows five colors, and recalls a story.

3 A 4-year-old who can count to 10, recall part of a story, and asks questions about the screening exhibits a readiness for school.

Ch10 The nurse is preparing to administer medications to school-aged patients. The nurse is aware the pediatric patient doses are different than medication doses for adults. Which factor does the nurse apply to administering pediatric medications? Page 192 1. Children's bodies are smaller and need half of the adult dose. 2. The metabolic rate of a child is slower and can cause overdosing. 3. Doses of medications are ordered according to the child's weight. 4. The first dosage consideration is based on the age of the child.

3 Basing medication dosage on weight gives an accurate and safe dose for each patient.

Ch8 The nurse is assessing an infant at 1 month of age. At birth the infant weighed 7 pounds 10 ounces. Which is the minimum weight the nurse will expect during this assessment? Page 148 1. 8 pounds 2 ounces 2. 8 pounds 10 ounces 3. 8 pounds 14 ounces 4. 9 pounds 6 ounces

3 Birth to 1 month, the infant is expected to gain a minimum of 5 ounces weekly. The minimum expected weight for the infant weighing 7 pounds 10 ounces at birth is 8 pounds 14 ounces.

Ch11 The nurse in a pediatric clinic is assessing a female adolescent who is 15 years of age. When the nurse performs a sexuality assessment, the patient states, "I have never had anything but safe sex." Which approach does the nurse take next? Page 208 1. Provide birth-control options. 2. Ascertain the number of sex partners. 3. Ask the patient to define "safe sex." 4. Inquire about treatment of a sexually transmitted infection (STI).

3 Given the patient's comment about having only safe sex, the nurse needs to determine the patient's definition of the term. Engagement in oral/anal sex is often considered "safe" by adolescents. If this defines the patient's sexual practice, the nurse needs to educate the patient about risks such as acquiring STIs via oral and anal routes.

Ch10 The nurses in a local health department are scheduled to perform screenings at a public elementary school. Which printed information will the nurses most likely send home with the students after the screening? Page 190 1. Importance of keeping immunizations up to date 2. Procedure for handwashing to prevent illnesses 3. Methods of treating and avoiding lice infestation 4. Proper way to cover up when coughing or sneezing

3 Infestations of head lice are prevalent among school-age children. The health department nurses will perform on-site screenings for the presence of the problem. Infected students will receive notifications about positive identification. All students will receive printed material about the treatment and prevention of lice infestation

Ch10 The nurse is gathering assessment data on a child who is 8 years of age and newly diagnosed with type 1 diabetes mellitus. The caregiver shares a reluctance to allow the child to return to school because the child's glucose levels need to be checked several times daily. Which information is most important for the nurse to share? Page 197 1. The caregiver may consider personally attending school with the child. 2. The child's medical condition is manageable in school and other places. 3. The school nurse can care for the special needs of children in school. 4. The caregiver is interrupting psychosocial development in the child.

3 Most children can be cared for at school by a school nurse. Medications for asthma and diabetes are commonly administered by the school nurse. This information will be most beneficial to both the child and the caregiver.

Ch7 The nurse is visiting the home of a new mother and a 2-month-old infant. The nurse notices the infant vigorously sucking on the fist and whining but not crying. The mother validates that the behavior is common. Which information does the nurse need to obtain from the mother? Page 111 1. If the mother is breast or bottle feeding 2. How long the infant sleeps at night 3. What type of feeding schedule is followed 4. If the infant draws up the legs when crying

3 Normal development requires not depriving oral gratification, such as weaning too soon or a rigid feeding schedule. Because of the infant's vigorous fist sucking, the nurse needs to ascertain what type of feeding schedule is being followed.

Ch7 The nurse is performing a development assessment on a 3-month-old infant who was 6 weeks premature. The nurse states the infant's development is normal. The parent expresses that the baby seems behind what other babies the same age are doing. Which information does the nurse share to provide reassurance to the parent? Page 116 1. The infant will catch up developmentally by age 1 year. 2. Developmental milestones vary from infant to infant. 3. The infant's age is adjusted because of prematurity. 4. Each infant is an individual with unique development.

3 Premature infants can experience delayed growth and development and are thus expected to reach developmental milestones at the same age they would have reached them if born at normal gestational age. Age is adjusted for assessments: subtract the weeks/months that the infant was born prematurely from the current chronological age.

Ch9 A parent has brought a toddler to a new pediatric clinic for a routine visit. The nurse will obtain a health history from the parent. Which information is most important for the nurse to gather? Page 175 1. Chief complaint 2. Family medical history 3. Toddler medical history 4. Social history

3 The most important health history information is the toddler's medical history, which will include childhood illnesses, hospitalizations, surgeries, immunizations, and results of vision/hearing/developmental screens.

Ch9 The nurse finishes a series of parenting classes on the topic of tantrums and discipline. Which comment by an attending parent causes the nurse concern? Page 181 1. "We have learned to ignore her and she stops." 2. "I will give a snack and a nap if he is that grumpy." 3. "He plays and then suddenly screams for no reason." 4. "She is learning that a tantrum means a time-out alone."

3 The nurse is aware that some tantrum triggers may indicate a problem related to mental, physical, or emotional issues. The child that is playing and suddenly screams for no reason will cause the nurse concern.

Ch7 The school nurse in a high school setting expresses concern to school administration regarding the increase in student complaints about bullying, physical violence, and rejection. Which concern related to psychosocial development does the nurse share as being most important? Page 114 1. Students are preoccupied with how they are seen in the eyes of others. 2. Students who are bullied will develop issues related to sexual orientation. 3. Students may be unable to provide a meaningful definition of self. 4. Students who are aggressive will develop a strong sense of guilt as adults.

3 The nurse's concern is focused on the possibility the students involved in any aspect of bullying, physical violence, and rejection will be unable to provide a meaningful definition of self, which places them at risk for role confusion in one or more roles throughout life.

Ch8 A neonate is delivered 3 weeks before the due date. The nurse performs assessment of gestational age by using the Ballard maturational scoring tool. Which assessment result indicates a premature infant? Page 144 1. A rating of the highest scores for physical maturity and neuromuscular activity 2. A rating of the lowest scores for physical maturity and neuromuscular activity 3. A rating of the lowest scores based on weight, length, and head circumference 4. A rating of the highest scores based on weight, length, and head circumference

3 The scores for the assessments are plotted on a graph to provide a gestational age based on weight, length, and head circumference to determine whether the neonate is appropriate for gestational age. Term neonates have higher scores than premature neonates. Premature neonates have lower scores; being born at 37 weeks' gestation does indicate prematurity

Ch11 The nurse working in the emergency department of a pediatric care facility is receiving an adolescent patient with a gunshot wound to the head. The patient is unconscious but exhibiting signs of life-threatening deterioration. Which action does the nurse take? Page 209 1. Keep attempting to reach the parents. 2. Determine whether the patient is emancipated. 3. Prepare the patient for surgery. 4. Call the facility's legal advisor.

3 Under the Emergency Medical Treatment and Active Labor Act of 1986, adolescents who require emergency care may be treated regardless of whether caregiver consent has been obtained. The nurse will prepare the patient for surgery

Ch8 The nurse in a pediatric clinic is preparing to assess an infant at the age of 9 months. The nurse is aware that this well-baby checkup will involve assessment for developmental delays or disabilities. Which finding causes the nurse to suspect a developmental delay? Page 148 1. Displays sucking reflex when presented with bottle or pacifier 2. Cries and reaches for the parent when placed on the examination table 3. Loses interest in a toy that is dropped out of sight by the nurse 4. Waves or shakes the head in response to verbal cues "bye-bye" and "no"

3 When a 9-month-old infant loses interest in an object that is dropped out of sight by the nurse, the nurse is concerned by a possible developmental delay. At 9 months of age the infant is expected to know where to look for an object that has been dropped

Ch11 The nurse is gathering health data on an adolescent who is 16 years of age. Which comment by the adolescent will cause the nurse to seek additional information? Page 200 1. "I have to be the clumsiest kid in the world. Always tripping over my own feet." 2. "Some days I just hate school. I want to get out and on to a job or college." 3. "I try to keep my distance from a kid in my class who coughs all day long." 4. "I know that I have always been a skinny kid, but wish I could gain weight."

3 When the adolescent expresses trying to stay away from someone who is constantly coughing, the nurse seeks additional information and may recommend TB testing for the patient.

Ch11 An adolescent who is 12 years of age is a year into treatment for a malignant brain tumor. For which psychosocial and spiritual care will the nurse plan? Select all that apply. 1. Remind the patient that achieving a vocation/career is not likely. Page 210 2. Encourage parents to remain hopeful about the adolescent's future. 3. Promote self-esteem and confidence with praise for accomplishments. 4. Assess the patient for indications of fear from facing a premature death. 5. Use developmental age because there may be some developmental delays.

3,4,5 The nurse needs to allow for the adolescent's completion of tasks as able. Then, the nurse needs to promote self-esteem and confidence with sincere praise of accomplishments (3), The possibility of a premature death can be especially difficult for an adolescent patient. The nurse needs to assess for fear of facing their own premature death (4), The nurse needs to use developmental rather than chronological age when caring for chronically ill adolescents, because there may be some developmental delays (5)

Ch10 The nurse in a pediatric clinic is preparing to assess an older school-aged child. Which behavior by the child prompts the nurse to ask if the parent should leave the room? Select all that apply. Page 191 1. Acknowledges that the parent is aware of adolescent's sexual activity 2. Refers some of the nurse's questions about health history to the parent 3. Makes attempts to keep their body covered during physical assessment 4. Looks tense and anxious when asked about body functions and changes 5. Does not respond to questions relating to thoughts, feelings, and opinions

3,4,5 When the nurse notices the adolescent's attempts to keep his or her body covered, the nurse should inquire if the patient wants the parent to leave the room. (4) When the adolescent looks tense and anxious at any time during the examination, the nurse should inquire if the patient wants the parent to leave the room. (5) When the nurse notices the adolescent's lack of response to questions related to thoughts, feelings, and opinions, the nurse should ask if the patient wants the parent to leave the room.

Ch10 The nurse is making a home visit for a child who is 9 years of age and currently unable to attend school because of an illness causing immunosuppression. The child seems depressed and tells the nurse, "I miss my friends and all the fun we had." Which interventions will the nurse add to the plan of care to meet the child's psychosocial needs? Select all that apply. Page 197 1. Have the parents take videos of friends for the child to view. 2. Allow friends to visit from the doorway of the child's room. 3. Provide instructions on how to visit friends on a computer. 4. Suggest that the child and friends send letters to each other. 5. Ask parents to arrange daily time for telephone visiting with friends.

3,5 School-age children are very technology savvy and most of them have access to computers. Providing instructions about how the child and friends can visit safely in current time will help meet the child's psychosocial needs. (5) Verbal communication is a good way to help the isolated child keep in touch with friends. Daily telephone conversations will help meet the child's psychosocial needs

Ch10 The emergency department nurse manager receives a call that a school-age patient will be arriving shortly. The nurse is instructed to have a chaplain and social worker available for the family. The nurse manager is likely to anticipate which possible conditions of the arriving patient? Select all that apply. Page 195 1. Pneumonia 2. Terminal cancer 3. Car accident 4. Child abuse 5. Sports injury

3,5 The nurse is aware that unintentional injuries and cancer are the leading causes of death for children between the ages of 5 to 14 years. A car accident can be a source of serious body and head injuries, prompting the need for a chaplain and the services of a social worker. (5) School-age children are at risk for unintentional injuries; sports are activities that can result in injuries requiring emergency medical attention. The request for a chaplain and social worker may be indicative of serious injury.

Ch10 The school nurse is presenting information on the importance of exercise to children in the fifth and sixth grades of school. Which reason does the nurse cite as being the best reason for being physically active? Page 194 1. Sports provide an opportunity to bond with peers. 2. Normal childhood activities make exercise fun. 3. Physical activity needs to replace technology hours. 4. Early exercise will carry over as good habits for adults.

4 As with nutrition, early education and experience with exercise can help to form good habits that can last a lifetime. This is the best reason for the nurse to promote physical activity, along with proven health benefits.

Ch7 The caregiver of a 9-month-old infant asks the nurse about what toys are age appropriate. Using Piaget's theory of development, which toy does the nurse recommend? Page 110 1. Building blocks 2. Colorful mobiles 3. Picture books 4. Musical rattles

4 At 8 months, the infant should be in Piaget's stage 4: coordination of secondary schemata. To achieve a desired effect, the infant will repeat an action, such as repeatedly shaking a rattle to make sounds. The nurse will recommend a variety of rattles as appropriate toys for this patient.

Ch10 The nurse in a pediatric office is preparing to remove stitches from an 8-year-old child's arm. Which approach by the nurse before the procedure is most effective? Page 193 1. Provide information in advance of how the procedure is performed. 2. Tell the patient, "I will be back in 15 minutes to take out your stitches." 3. Have a coworker in the room to assist if the patient becomes uncooperative. 4. Bring the instruments to the room and announce, "Let's get those stitches out."

4 If a procedure must be performed, have the instruments ready and inform the child immediately before the procedure. The action will keep the patient from becoming more anxious. The nurse needs to use a friendly and calm manner to help reduce patient stress.

Ch11 A nurse is teaching a group of overweight adolescents about healthy lifestyle choices. Which statement by an adolescent indicates that more teaching is needed? Page 208 1. "I should eat foods high in fiber and low in fat." 2. "I should eat at the table instead of in front of the television." 3. "I should eat a balanced meal instead of taking dietary supplements." 4. "I should get 30 minutes or more of moderate-intensity activity daily."

4 It is recommended to get 60 minutes or more of moderate intensity activity daily. This adolescent requires further teaching.

Ch8 During a parenting class, a father states, "My wife cannot hold the baby without singing a lullaby, even in public. It's kind of embarrassing for me." Which opinion does the nurse share with the group after researching the topic? Page 164 1. Caregivers sometimes sing for their own attention and benefit. 2. The father can walk away from public places if the mother sings. 3. The mother needs to find another way of comforting her baby. 4. Singing of lullabies by caregivers has a calming effect on infants.

4 Research indicates music has been shown to stimulate neurological growth and development, to calm, and to improve sleeping patterns in infants. This is an appropriate research finding to present to parents.

Ch8 The nurse is providing care for a neonate who is identified as being at risk for neonatal abstinence syndrome. Which assessment finding causes the nurse to expect pharmacological interventions for this neonate? Page 122 1. Central and autonomic nervous system irritability and dysfunction are present. 2. There is evidence of opioids in the neonate's meconium. 3. Symptoms are not alleviated with swaddling, comforting, and feeding. 4. The Finnegan neonatal abstinence score is 10 at 3 hours after birth.

4 The Finnegan neonatal abstinence score of 10 at 3 hours after birth is the strongest indicator of the need for pharmacological interventions for this neonate. Pharmacological interventions are with morphine sulfate or methadone adjusted based appropriately for scores greater than 8.

Ch11 The nurse is providing care for an adolescent patient who is hospitalized following a grand mal seizure. The condition has existed for 5 years and resulted in multiple hospitalizations. Which nursing intervention is appropriate for this client? Page 210 1. Ask the patient and family to consider homeschooling. 2. Arrange for home care and regular nursing visitations. 3. Explain methods to minimize the chronic medical events. 4. Refer patient and family to applicable Internet resources.

4 The adolescent patient is likely to have an interest and the ability to do research on the Internet. To promote understanding through valid and applicable resources, the nurse needs to refer the patient and family to reliable Web sites.

Ch9 The nurse is gathering assessment information from the parent of a 5-year-old child. The parent states, "I am very frustrated. She insists on doing things alone even if it is a struggle to do it right, and gets angry if I redo the task." Which information will the nurse share with the parent to promote greater understanding? Page 175 1. Assure the parent that the child will become more compliant as she matures. 2. Suggest how the parent can critique the child's actions without hurting feelings. 3. Encourage the parent to set aside time each week to teach the child the correct way to do things. 4. Explain the child's interest in new things, the need to be independent, and pride in her abilities.

4 The behavior of this preschooler reflects the milestones related to social and emotional development. The nurse should explain behaviors in a positive way and encourage the parent to support expected growth and development

Ch11 The nurse is preparing to perform a physical examination of an adolescent who is 13 years of age. Which action by the nurse will decrease the adolescent's anxiety during the examination? Page 201 1. Teaching the anatomical names of body parts 2. Verbalizing findings of physical abnormalities 3. Referring patient concerns to the physician 4. Telling the patient what to expect and why

4 The most effective way to decrease an adolescent's anxiety about a physical examination is to inform the adolescent of the nurse's actions and explain the rationales

Ch10 The nurse is examining a 10-year-old child brought to the clinic because of episodes of shortness of breath, headaches, and stomach upset. The nurse notices bruises in various stages of resolution on the upper arms and upper legs. Which additional information is most important for the nurse to obtain? Page 189 1. Ask about the duration of the presenting symptoms. 2. Ascertain if there is a change in school performance. 3. Ascertain whether there has been a change in mood or behavior 4. Seek information about the cause of the bruises.

4 The most important information for the nurse to obtain is the source of the bruising. The child may have a valid explanation, or the explanation may increase the nurse's concern. The nurse will evaluate the child's response and act accordingly.

Ch9 The nurse works in the pediatric unit of a hospital and is currently providing care for a 1-year-old patient. Which action by the nurse is most important for maintaining the safety of this patient? Page 177 1. Question about the presence of smoke and carbon monoxide detectors in the home. 2. Check the temperatures of water, food, and drinks to prevent burns. 3. Provide caregiver education on basic home, outdoor play, and car safety measures. 4. Regularly check equipment in the crib environment for potential safety hazards.

4 The nurse in an acute care setting is most focused on safety during the hospitalization of a pediatric patient. The nurse needs to check equipment regularly, with special attention to wire and cord placement to minimize entanglement, suction availability at crib side, and minimal equipment and crib attachments to decrease choking and suffocation hazards.

Ch7 The nurse is teaching a parenting class being held in a community clinic. The nurse is focusing on behaviors that will assist in increasing the number of children who score well in kindergarten readiness screening. Which comment by a parent indicates the need for additional information? Page 115 1. "I am not athletic, but the kids would love an outdoor play area." 2. "Practicing counting with the kids while traveling is a good idea." 3. "I like the suggestion to label basic items for word recognition." 4. "In our family we watch TV; books are a waste of money."

4 The nurse needs to provide additional information to the parent who thinks books are a waste of money. The parent needs to be aware of community agencies that will supply books to children and of programs that provide reading/story times

Ch3 The nurse is assessing a pediatric patient in the emergency room for injuries sustained from a fall. The nurse asks the parents how the child was injured. Which response by the parent uses the most productive communication pattern? Page 36 1."My partner forgot to check the baby gate like I asked." 2."I am the only one who checks the baby gate all the time." 3."It's typical. My partner just doesn't follow directions." 4."I forgot the check the baby gate when I came home."

4 This is a direct and clear message stating that the baby gate was not latched without displacing the blame

Ch11 A 13-year-old patient is being seen for an annual exam. During the exam, the nurse screens for depression and suicidal ideation. Which response by the client is of greatest concern? Page 209 1. "Sometimes I feel sad or down, especially when I'm stressed out." 2. "Some nights I have trouble falling asleep, but once asleep, I stay asleep." 3. "I have been staying home a lot. I started a new school this year and don't really know anyone." 4. "A lot of the time, I think everyone would be better off if I'd never been born."

4 This statement indicates the child may be thinking about suicide or self-harm. This is the greatest concern and requires immediate follow-up.

Ch10 The nurse is visiting the home of a family who is providing care for a school-age child with profound disabilities. The nurse notes that the primary caregiver looks tired and thin. The caregiver admits to feeling overwhelmed and then guilty about negative feelings. Which intervention by the nurse is most helpful? Page 197 1. Arrange for a counselor to meet with the family and assess for well-being. 2. Suggest a means of child management so the parents can plan a short getaway. 3. Provide literature about extended-care facilities where the child can be cared for. 4. Recommend the caregiver to a support group where feelings can be shared.

4 To combat the effects of caregiver fatigue, caregivers must have a good support network and ability to participate in activities that promote stress relief. The nurse's recommendation for a support group is the best intervention to address the caregiver's immediate needs.

Ch9 The nurse is evaluating the language skills of a 2-year-old patient. Which assessment finding causes the nurse to suspect a developmental delay? Page 174 1. States, "Want mommy!" 2. Points to objects named by the nurse 3. Converses using two short sentences 4. Repeats sounds but not words said by the nurse

4 Toddlers like to repeat words that are overheard. The expectation is for the toddler at 2 years of age to repeat a single word spoken by the nurse. The inability to perform this action may cause the nurse to suspect a developmental delay or a hearing defect.

all done, u got this

bitch

Ch5 A 2-year-old has recently been diagnosed with a terminal type of cancer but is not experiencing any severe symptoms of the illness at this time. The mother of the patient is depressed and feels guilt over the illness. She admits to mentally planning the funeral and expecting to be devastated. The nurse identifies the mother as experiencing which stage of grief? Page 71 1.Anticipatory 2.Anger 3.Denial 4.Bargaining

1 Anticipatory grief occurs before the stages of grief and is common in infant and pediatric death when the family of a patient with a terminal diagnosis prepares for death before the dying process.

Ch5 The pediatric hospice nurse is presenting information to a group of nursing students regarding organ donation. Which statement made by the nursing student indicates a need for further education? Page 72 1."Pediatric organs can only be transplanted into pediatric recipients." 2."The donor's organs must be undamaged by trauma, disease, or medications." 3."The family will be approached by an organ donation team." 4."Organ procurement is done at the donor's facility."

1 -Pediatric organs can be transplanted into adults and pediatric recipients.

Ch2 The nurse is preparing an 8-year-old patient for a cancer protocol that has a significant amount of risk. The parents have provided informed consent for this trial, but the patient has refused to partake in this research. What is the most appropriate course of action for this situation? Page 23 1.Treatment is carried forth, despite the patient's dissent. 2.Treatment must be delayed until the parents and patient agree. 3.Treatment is delayed for review by the ethics committee. 4.Treatment is canceled until the patient assents.

1 Although the patient has refused, the parents have provided permission for the care of the patient.

Ch5 The nurse is presenting information to pregnant couples about the "safe to sleep" campaign to prevent sudden infant death syndrome (SIDS). One attendee states, "Babies sleep best on their bellies. What difference does position make?" Which answer by the nurse is best? Page 66 1."Positioning on the back opens the airway fully." 2."Sleeping face down increases the risk of aspiration." 3."The most dangerous time is 2 to 4 months of age." 4."Of greater importance is not using blankets."

1 The nurse should always educate parents to put their infants on their backs to sleep to help prevent SIDS by keeping the airway fully open.

Ch5 The hospice nurse is providing care for a 12-year-old patient who is receiving end-of-life care Parents and younger siblings are at the bedside and involved with patient care. Which comment by the nurse exemplifies appropriate communication? Page 67 1."Please let me know if you have pain so that I can make you more comfortable." 2."Do not be sad; know your son is going to heaven and all of you will be together in the future." 3."Your brother is suffering, and you need to be strong and brave for him now." 4."I understand you will be ready to move away from this life and on to the next."

1 End-of-life communication with the patient needs to be compassionate and developmentally appropriate. The nurse needs to communicate a caring attitude about the patient's pain and comfort status. This comment is appropriate.

Ch1 Which of the following continuing education courses would best enhance the pediatric nurse's practice in relationship to current trends? Page 8 1.Evidence-based practice on improving antibiotic adherence with education to the family unit 2.Evidence-based practice on proper administration of antibiotics for children with autoimmune diseases 3.How to enhance communication with children in regards to adherence to antibiotic use 4.How to decrease instances of exacerbation of infections of children with autoimmune diseases with antibiotics

1 Evidence-based practice may facilitate medication adherence if provided to the family unit. This may help prevent future antibiotic-resistant diseases.

Ch4 The nurse is admitting a 15-year-old, who recently immigrated to this country with their family, for abdominal pain lasting 3 days. The accompanying parent reports that the patient is exhibiting intense pain, vomiting, and diarrhea. The nurse notes that the patient places their pain level at 3 on a scale of 0 to 10. Which conclusion does the nurse draw regarding the discrepancy in the level of pain? Page 60 1.The patient's response may be related to cultural expectations. 2.The patient is angry that the parent insisted on seeking medical treatment. 3.The parent's fear of serious illness is causing an exaggeration of symptoms. 4.The parent wants to make sure the child gets immediate medical care.

1 Individuals will act and respond as they have been taught to act and respond. Children may "pretend" by responding in an "acceptable" way rather than one that accurately communicates their feelings and/or condition

Ch4 During orientation, the new nurse on a pediatric unit is informed that Leininger's Cultural Care Theory is implemented because of a large multicultural population at the facility. Which aspect of Leininger's theory best defines the theory's impact on nursing care? Page 57 1.Transcultural nursing occurs when the nurse incorporates the patient's culture into the care provided. 2.The theory considers the complexity and interrelatedness of an individual within an environment and the community to which they belong to be unimportant in providing culturally competent nursing care. 3.The theory helps explain how practices handed down from generations can improve an individual's health today. 4.Leininger's theory has been able to capture and articulate how culture affects health in developed nations.

1 Leininger's theory best defines the impact on nursing as when transcultural nursing occurs, because the nurse incorporates the patient's culture into the care provided.

Ch1 The pediatric nurse desires to expand his or her career options to become the hospital's nurse educator of pediatrics. Which of the following is necessary for this nurse to achieve this career goal? Page 7 1.The nurse is recommended to earn a minimum of a master's degree in nursing. 2.The nurse must earn a minimum of a doctorate degree in nursing. 3.The nurse must implement and develop research in nursing practice. 4.The nurse must implement a plan to obtain certification in pediatrics.

1 Pediatric nurses with master's degree preparation are often employed as nurse educators. Many academic settings require nursing instructors to have a nursing doctorate or be actively working to obtain a doctorate.

Ch1 The medical-surgical float nurse is assigned to the pediatric unit for the first time and states that the skills are "the same as general nursing since children are little adults with smaller bodies." What component of pediatric nursing contraindicates this statement? Page 3 1. Pediatric nursing involves care based on the developmental level of the patient. 2. Pediatric nursing involves the patient's family in the plan of care. 3. Pediatric nursing in based on prevention of infectious diseases. 4. Pediatric nursing involves cultural sensitivity in patient care.

1 Pediatric nursing involves not only general nursing care and planning but also the developmental level of the patient. The history of pediatric nursing describes how the role has evolved into a specialty

Ch1 The pediatric nurse is developing interventions for a school-aged child based on the nursing diagnosis of imbalanced nutrition related to a body mass index (BMI) of 37 and poor food choices as evidenced by patient's mother's food diary for the family and child's statements of food preferences. Which of the following would be an appropriate nursing intervention? Page 8 1.Provide the child and family with information from https://www.MyPlate.gov for healthy food options. 2.Increase the child's activity by incorporating the child's friends into a plan of healthy exercise options. 3.Explain the importance of balancing diet and exercise to prevent obesity to the child and family. 4.Provide information on the increased risk for potential disease processes such as diabetes and hypertension.

1 Providing information on a reliable resource for both the child and family may facilitate adherence and comprehension

Ch2 Which of the following behaviors serves as an example of the nurse directly upholding the American Nurses Association's (ANA's) Code of Ethics for Nurses? Page 13 1.The nursing union develops a safe patient-to-nurse ratio. 2.The nurse joins a professional specialty organization. 3.The nurse maintains sterile technique during procedures. 4.The nurse develops a plan of care for a community-wide illness.

1 Provisions 5 and 6 of the ANA code describe how the nurse establishes and improves health-care environments and conditions of employment conducive to quality of health care.

Ch5 The nurse assesses the pain level of a school-age patient who is receiving end-of-life care and determines a need for pain medication. The health-care provider has prescribed morphine sulfate to be administered either orally or rectally. For which reason will the nurse decide to administer the medication orally? Page 69 1.To prevent the patient from being embarrassed by rectal administration 2.To ensure the pain medication is absorbed as quickly as possible 3.To avoid stimulation of rectal spasms during insertion of the medication 4.To decrease the risk of respiratory suppression

1 The administration of medication rectally is likely to cause a school-age client to be embarrassed. When possible, the nurse will prevent psychosocial discomfort as well as physical discomfort.

Ch3 The nurse is providing care to a 4-year-old child who is recovering from an orthopedic injury in the hospital. The nurse notes there are two siblings who are ages 6 years and 1 year. The father is the primary caregiver, and the mother is the primary wage earner. During the assessment, the nurse notes that the 6-year-old seems to be the primary nurturer of the 1-year-old, while the father tends to the 4-year-old, and the mother talks on her cell phone. Which nursing diagnosis is appropriate for this family? Page 47 1.Compromised family coping r/t insufficient reciprocal support between the parents as evidenced by family behavior during hospital visits. 2.Risk for delayed development r/t lack of parental involvement as evidenced by family behavior, mother and siblings not interacting. 3.Ineffective family health management r/t family conflict as evidenced by mother's inability to interact with the child during hospitalization. 4.Interrupted family processes r/t hospitalized child as evidenced by lack of full family interactions during hospitalization.

1 The lack of interaction may be the family dynamics, or it can be the result of the crisis of hospitalization

Ch5 The nurse is providing end-of-life care to a pediatric patient and family. The nurse understands the need for communicating with the multidisciplinary care team regarding the patient and family needs. For which reason is multidisciplinary communication with the patient's nurse so important? Page 67 1.The nurse has the most contact with the patient and family and acts as an advocate and voice for their care. 2.The multidisciplinary team relies on the nurse to provide appropriate education to the patient and family during end-of-life care. 3.As the sole communicator, the nurse can make sure that all members of the multidisciplinary team are equally informed. 4.The patient and family can communicate with the nurse with whom they have built a trusting relationship.

1 The nurse has the most contact with the patient and family and acts as an advocate and voice for their care. The nurse can determine effectively which member of the multidisciplinary team should be contacted to provide the best care.

Ch5 The pediatric nurse is providing care for a terminally ill patient who is 17 years of age. The patient has been resistant to aggressive chemotherapy because of undesirable side effects. The patient states, "I have finally convinced my parents to sign a DNR (do not resuscitate) order. It is my life, and I should be able to decide how I want to live." Which legal consideration causes the nurse greatest concern? Page 73 1. A DNR order can be reversed at any time by the legal guardians. 2. The primary health-care provider can deny a DNR if the patient is a minor. 3. The patient does not understand all aspects of the DNR order. 4. A DNR can be written to provide partial life-sustaining interventions.

1 The nurse is aware that the patient is a minor and only legal guardians can determine a minor's DNR status. The patient's sense of satisfaction is the nurse's greatest concern, because legal guardians can reverse a DNR decision at any time.

Ch1 Which of the following tasks is associated with the pediatric medical home care model of pediatric nursing? Page 6 1.The nurse refers the family to a childhood cancer support group prior to discharge from the hospital. 2.The nurse includes a simple explanation of the procedure to the child based on the child's developmental level. 3.The nurse includes the family's cultural celebrations and observations while providing care to the child. 4.The nurse develops the plan of care with the child and family as the focal point of the interventions.

1 The pediatric medical home care model coordinates care and includes referrals for community services for nonmedical needs.

Ch3 The nurse is providing care to a 10-year-old patient hospitalized for multiple injuries from a motor vehicle crash. Which nursing intervention is appropriate for communication with this child? Page 51 1.Include the child in some decisions regarding care, such as choosing food from the hospital menu. 2.Offer the child a chance to play with the medical instruments when possible. 3.Communicate primarily to the parents regarding treatments and the child's progress. 4.Recognize that behavior may fluctuate between adult and childlike during hospitalization.

1 The school-aged child may lose control during hospitalization. Giving the child choices can facilitate empowerment and decrease fear and anxiety.

Ch3 The nurse is assessing preschool twins during a well-child visit in the family clinic. Which action by the parents would indicate a healthy transition for the family per Duvall's family development theory? Page 44 1.The parents state that they have maintained scheduled play dates to help the children socialize. 2.The parents have maintained the children's well-child examinations and immunizations. 3.The parents have compiled a list of goals and request suggested interventions. 4.The parents and children appear to interact well and display nurturing and affection.

1 This is an example of Duvall's family development theory during the preschool stage. The family is preparing the children for entry into school by socializing them.

Ch3 The nurse is providing care to a 17-year-old patient in the family practice clinic. The patient reports concern for the parents, as she is the last one of the four children to leave the home. She is concerned that her parents may "fall apart" when she leaves for college in the fall. What is the best response from the nurse based on the family systems theory? Page 43 1."Although changes that occur in one family member's life affects the entire family, keep in mind that your family is dynamic." 2."Each member of the family has to differentiate themselves, whether good or bad, to influence family relationships." 3."Although this may put a strain on their relationship, a healthy family recognizes the need love and growth." 4."Although the family is growing apart, this is a time for your parents to refocus on extended family relationships."

1 This is an example of how changes in one family member's life affect the entire family and that the family is dynamic.

Ch1 The nurse recognizes the needs of professional development to provide safe and effective care to the pediatric population by attending which of the following courses? Page 8 1.Procedure with rationale to administer human papilloma vaccine to the middle school population 2.Study review of the incidence of bullying and intimidation in the elementary school population 3.Demographic study of the U.S. population with regard to cultural diversity and practices 4.How to provide individual health care education for the children without parental interference

1 This is an example of shifting the focus of medical/nursing care from disease treatment to disease prevention

Ch2 The nurse recognizes that the ANA characterizes which fundamental nursing practice within the Pediatric Nursing Standards of Practice and Professional Performance for Nurses? Page 14 1.Nursing utilizes evidence-based practice for the rationale of interventions. 2.Nursing complies with the health-care provider orders to maintain scope of practice. 3.Nursing maintains the institutional review boards (IRBs) that monitor care. 4.Nursing facilitates the rules of laws within the health-care continuum.

1 This is an example of the recognition of the Pediatric Nursing Standards of Practice and Professional Performance as a living document that changes with scientific knowledge. Standard #5 states, "The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue person and professional growth." Additionally, standard #7 states, "The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development."

Ch3 The nurse is providing care to a pediatric patient in the mental health facility. The nurse asks the patient to draw a picture of her family. What is the function of this activity? Page 46 1.This drawing depicts the child's perspective of the family unit. 2.This drawing provides an outlet from the therapy sessions. 3.This activity is a tool to facilitate communication via play. 4.This activity develops problem-solving skills for the child.

1 This provides an opportunity for others to view the child's perspective of the family and can reflect the family's health and areas of distress

Ch2 The nurse is providing discharge teaching to the family of a hospitalized 9-year-old patient recently diagnosed with asthma. The family states that they feel overwhelmed with the treatment plans and cannot perform the necessary nebulizer treatments. Which nursing intervention best reflects the professional performance aspect of pediatric nursing standards? Page 14 1.The nurse arranges for a home-care respiratory therapy consultation to teach the family proper techniques in the home setting. 2.The nurse contacts the health-care provider to delay the patient's discharge from the hospital until the family is able to perform treatments. 3.The nurse collects comprehensive data pertinent to the patient's situation by reviewing the home situation. 4.The nurse evaluates progress toward the attainment of outcomes by having the family perform return demonstrations.

1 This would involve communication with the family regarding their concerns. The nurse will collaborate with the respiratory therapist to arrange a home visit for further teaching. The nurse considers the overall safety of the patient and family by using available resources to deliver home care. The nurse is being an active advocate for the patient and family by providing more resources and coordinating help at home.

Ch2 The nurse is providing care to a hospitalized pediatric patient, and the patient is refusing all pain medication despite signs of obvious distress. The patient tells the nurse, "All you nurses lied, and the shots hurt." What is the most appropriate nursing measure at this time? Page 27 1.Provide the medication in a cup of juice. 2.Have the parents administer the medication. 3.Explain not all medications are shots. 4.Admit to the patient that the shots hurt but explain they help.

4 Telling the truth may help rebuild the lost trust. "In general, children prefer the truth and may develop distrust for health-care providers

Ch4 A nurse is caring for an infant from a different culture than their own. The mother allows the infant to continue to cry without assessing for a cause of the distress. The nurse is disturbed about this parenting. Which is the best action for the nurse to take initially? Page 55 1.Ask the mother to share what she believes about infant crying. 2.Teach the mother that infants cry for a reason that needs to be identified. 3.Consult with the child-life specialist about the appropriateness of mother's behavior. 4.Become a role model by demonstrating proper care of the infant to the mother.

1 To provide care that is culturally competent, nurses must be aware of and identify the belief systems of clients and caregivers. The initial action by the nurse is to ascertain the mother's belief related to infant crying. Understanding and respect for cultures is fundamental to cultural competence.

Ch2 The nurse is providing care to a toddler recently diagnosed with asthma. The parents have become verbally aggressive with staff and have challenged many of the unit rules. Which of the following may have contributed to the family's challenging behavior? Select all that apply. Page 16 1.The parents are both working professionals in leadership roles and fear loss of control. 2.The family has researched asthma on the Internet and does not agree with the treatment protocol. 3.The staff members have maintained therapeutic communication with the patient and family. 4.The nurse has developed a mutual set of goals and interventions with the family. 5.The staff members have provided a medically trained translator to promote understanding in care.

1,2 Family members who have a background in leadership may fear loss of control over their child and lash out at the staff. (2) If the family is in possession of inadequate information or misinformation, they may lash out or challenge the treatment protocol

Ch4 The nurse is aware that pediatric patients and their families have cultural needs and influences during periods of hospitalization. Which cultural elements does the nurse specifically provide for the hospitalized patient? Select all that apply. Page 58 1. Follow the schedules for meals and sleep times observed at home. 2. Encourage visitations and play times with the patient's siblings. 3. Provide a private and suitable place for caregiver hygiene and meals. 4. Set scheduled times for parents to have uninterrupted access to the patient. 5. Promote staff acceptance to parenteral input to the patient's plan of care.

1,2 It is important for the hospitalized pediatric patient to maintain some level of normalcy, which can be provided when cultural patterns are maintained. Good examples are following home schedules for meals and sleep times. (2) The pediatric patient's cultural environment includes play time with siblings. The nurse can meet this cultural need by encouraging sibling visitations and play times.

Ch4 The nurse provides care in a pediatric health-care facility with a culturally diverse patient population. In which manner will the nurse promote effective and culturally considerate communication with patients? Select all that apply. Page 58 1. Communicate in a language understood by the patient and family. 2. Identify the person responsible for making the patient's medical decisions. 3. Utilize opportunities to learn about interacting with diverse cultures. 4. Identify patient's/family's perception about the cause of physical illness. 5. Learn about and practice culturally correct nonverbal communication.

1,2,3,4,5 The nurse needs to communicate in a language understood by the patient and family, which may include the use of an interpreter and/or written materials in the appropriate language. (2) When caring for the culturally diverse pediatric patient, the nurse needs to determine who will make the patient's medical decisions. (3) When working in a health-care facility that cares for culturally diverse patients, the nurse has a responsibility to learn about interacting with diverse cultures. (4) It is important for the nurse to identify the patient's/family's perception about the cause of physical illness. This information will reveal cultural reactions to medical treatment and illness prevention. (5) It is essential for the nurse to be aware that silence, eye contact, and personal space can mean different things in different cultures.

Ch4 The charge nurse on a pediatric unit is aware that the nurses do not demonstrate culturally competent care. Which actions does the charge nurse implement to help the nurses develop this competency? Select all that apply. Page 57 1. Arrange for classes to learn about culturally competent care. 2. Identify the cultural groups most frequently served by the facility. 3. Share the reasons why nurses need to be culturally competent. 4. Teach nurses that their own cultures and beliefs are to be eliminated. 5. Provide cultural assessment tools for the unit nurses to use.

1,2,3,5 Education to maintain current knowledge and understand new and evolving practices in culturally competent care will improve nursing care. (2) It is essential to identify cultural groups predominant in the organization's practice and to examine the beliefs and values of these cultures that may affect care. (3) Staff members are expected to strive for cultural competency and effectiveness in interactions with individuals of different cultures. (5) Provision of theory and tools are necessary to perform culturally competent care for all children and their caregivers.

Ch2 Which of the following are examples of a nurse adhering to the pediatric standards of practice? Select all that apply. Page 14 1.The nurse educates the parents on how to administer insulin to their 9-year-old child. 2.The nurse asks the 3-year-old child to describe their level of pain with a FACES Scale or Oucher Scale. 3.The nurse refuses to divulge medical information to the parents of a pregnant adolescent. 4.The nurse provides extra free supplies to the family of an underinsured ill child. 5.The nurse uses evidence-based practice to maintain competency of new practices.

1,2,3,5 Teaching parents how to administer insulin relates to advocacy and empowerment for the patient and family. (2) Using these established tools to assess a patient's pain level is an example of effective communication. (3) This action ensures the privacy of the patient. Although the parents may be financially responsible for the adolescent, they are not entitled to the child's medical information without the patient's express permission. (5) Per the ANA and pediatric standards of care, the nurse must maintain competency in current standards of care.

Ch1 The nurse is developing a health fair for children aged 5 and 6 years. Which of the following would be appropriate topics for this population based on current trends? Select all that apply. Page 7-8 1. How to deal with bullying on the Internet 2.How to prevent the flu with hand washing 3.How to choose and eat healthy foods 4.How to recognize suicidal thoughts 5.Ways to stay active and stay healthy

1,2,3,5 There is a trend of bullying on the Internet that can influence a child's overall health. (2) Young children are able to use gross motor skills and some reasoning for proper hand washing. (3) This may empower the child to eat healthy items to prevent obesity and the associated disease processes. (5) This may empower the child to eat healthy items to prevent obesity and the associated disease processes.

Ch5 The parents of a dying child have decided to withdraw medical treatment and allow their child to die peacefully. Which nursing actions will occur after the withdrawal is implemented? Select all that apply. Page 71 1. Monitoring equipment is turned off. 2. All invasive lines are disconnected. 3. Periodic validation is sought from the family regarding the decision to end care. 4. A comfortable, peaceful environment is created for the patient and family. 5. The family is provided with undisturbed privacy.

1,2,4,5 Monitoring equipment is turned off; when operating, the equipment can be a disturbing distraction. (2) Invasive lines and equipment are removed to present the patient with an appearance as normal as possible. (4) The patient's linens can be changed or straightened, lights can be dimmed, and the patient placed in a comfortable position. Chairs and other desired accommodations are provided for the family. (5) To ensure uninterrupted privacy, the door should be closed and the family left undisturbed unless they seek assistance.

Ch4 The nurse in a pediatric clinic is concerned about health-care disparities among the patient population. Which patient or family comment indicates the presence of health disparities related to culture? Select all that apply. Page 57 1. "I didn't bring my child sooner because I have a limited income." 2. "I tried all the remedies my mother used, but he just got sicker." 3. "My mother does not speak English and will need an interpreter." 4. "I felt certain that you would see my child who is now an adolescent." 5. "We took a bus and transferred twice to get our sick child here."

1,2,5 Socioeconomic status can be a cause of health-care disparity; parents may be reluctant to seek medical care if the family income is limited or there is a lack of health-care insurance. (2) Cultural background can contribute to health-care disparity. Some ethnic groups are likely to try "home" remedies before seeking professional health care. (5) This comment is related to geographic location, which is a contributor to health-care disparity.

Ch5 The nurse is providing end-of-life education to parents of a child diagnosed with a terminal illness. Which topics of education are important for the nurse to provide? Select all that apply. Page 71 1. How the progression of the disease will affect their child 2. The physical changes that will occur during the dying process 3. Funeral homes that can be contacted before death 4. How pain management can interfere with communication 5. What to expect after death including how the child will look

1,2,5 The nurse needs to cover the topic of how the progression of the disease will affect their child. This information will help the parents to distinguish between expected and unexpected changes (2) The nurse needs to cover the topic of the physical changes that will occur during the dying process. Some topics will include skin alterations, breathing alterations, altered consciousness, and changes in verbalization. (5) . The nurse needs to cover the topic of what to expect after death. Some families are concerned that the physical appearance is grossly altered. The parents also need to know about how the body will be cared for and about making funeral arrangements

Ch1 The nurse must obtain data for a routine assessment of the 8-month-old patient. Which of the following are part of that assessment? Select all that apply. Page 3 1.Measure the head circumference and record results. 2.Enter length and weight in the growth chart. 3.Assess bilateral hand grasp strength and function. 4.Input the Tanner scale results in the chart. 5.List most recent immunizations in the chart.

1,2,5 The pediatric nurse monitors growth and development, including physical maturation. (2) The pediatric nurse monitors growth and development, including physical maturation. (5) The pediatric nurse assessment includes listing of required immunizations in preparation for administering the appropriate ones.

Ch1 The pediatric nurse is providing care to a 5-year-old patient for speech impediments that were caused by repeated incidences of otitis media. Which of the following is an example of current issues regarding this type of medical problem? Select all that apply. Page 8 1.Increased admissions based on environmental risk factors, such as smoking 2.Increased admissions based on knowledge deficits due to language barriers 3.Increased awareness of childhood health issues from social media and Internet 4.Shift in the focus of medical care from disease treatment to disease prevention 5.Deficient knowledge that has negatively impacted the adherence to the antibiotic regimen

1,2,5 Trends in pediatric nursing practice have been affected by environmental risk factors. (2) Language barriers directly affect adherence and understanding of the care. When the family-centered care model is used in pediatric nursing, if there is a deficit in communication, care can be negatively impacted. (5) Deficit knowledge directly affects adherence and understanding of the care.

Ch4 The nurse is conducting a health assessment on a 10-year-old who has rows of round bruises on his arms and back. The bruises appear to have occurred at the same time. The child states that their family practices "folk-medicine." The nurse is familiar with alternative medicine but should evaluate the patient by asking which questions? Select all that apply. Page 61 1. "Have you fallen or injured yourself recently?" 2. "How often do you feel hungry?" 3. "What does your family do to heal illness?" 4. "Are you playing any sports in school?" 5. "Has anyone hit you or otherwise hurt you?"

1,3,5 Being familiar with alternative medicine may cause the nurse to suspect the bruising is a treatment. However, this is an appropriate early question to rule out accidental injury. (3) . It is essential to know about specific cultural practices regarding health, as well as definitions of and beliefs about health and illness. The nurse needs to validate the use of alternative medicine as a source of the bruising. (5) Life experiences such as immigration and refugee status may include a history of violence, oppression, and trauma. Even though the nurse suspects bruising from alternative medicine, trauma still needs to be specifically ruled out.

Ch5 The nurse works on a pediatric unit that allows parents to remain in the room if the patient is coded. The nurse is aware that having persons in the room other than medical personnel can present safety issues. Which concerns are important to address? Select all that apply. Page 72 1. The possibility of an accidental shock during cardiac shock delivery 2. The possibility of accidental contamination of sterile fields and procedures 3. The possibility of medical staff being blocked from access to the patient 4. The possibility of medical staff being interrupted by emotional verbalization 5. The possibility of overcrowding interfering with needed medical equipment

1,3,5 It is important for the nurse to be concerned about the safety of the family. The concern about family members not touching the bed or medical equipment during cardiac shock delivery will need to be addressed. (3) For the safety of all involved, it is important to ensure that family members are not in the way of medical staff or interfere with treatment. (5) For the safety of all involved, it is important to ensure that family members are not in the way of medical equipment.

Ch2 Which of the following nursing actions is an example of a function of the Code of Ethics for Nurses directly relating to the health-care environment? Select all that apply. Page 13 1.The nurse cowrote a policy on nurse:patient ratio for the unit. 2.The nurse includes the extended family in discharge instructions. 3.The nurse joined a local professional organization that shapes community policy. 4.The nurse enrolled in a basic American Sign Language course. 5.The nurse joins the safety and infection control committees.

1,3,5 This is provision #6, which states the nurse participates in improving health-care environments and conditions of employment. (3) This could indirectly influence the workplace environment by shaping social policy. This relates to provision #9. (5) This relates to provision #8, which states that the nurse will collaborate with other health professionals to meet health needs of the facility and community. An example is how the two patient-identifier practice was started by a group of concerned nurses.

Ch1 The school nurse is providing care to the student population in the urban elementary school. The nurse notes that the children do not feel safe playing outside during recess due to the recent violent incidents in the surrounding area. What are some disease processes that the nurse may notice due to this inactivity? Select all that apply. Page 8 1.The general population is at higher risk for obesity. 2.The students are at higher risk for increased bullying. 3.The students are at a higher risk for learning disabilities. 4.The students are at higher risk for diabetes mellitus. 5.The students are at higher risk for earlier onset of puberty.

1,4 Inactivity increases the incidences of obesity. (4) Along with obesity, inactivity may increase the likelihood of diabetes mellitus.

Ch4 The new nurse on the pediatric unit asks not to be assigned a child whose family is from the Middle East. Which personal questions does the nurse manager suggest the nurse contemplate as a method to develop self-awareness related to cultural differences? Select all that apply. Page 56 1.What have been my experiences with those of different cultures? 2.Is my unacceptance related to political differences between countries? 3.Am I attempting to not reject the culture of my family and my upbringing? 4.Are there conflicting values between the patient/family and myself? 5.Why do I feel so guilty and ashamed for not accepting a different culture?

1,4 The nurse manager should suggest the nurse explore the nurse's experiences with those of different cultures. The nurse should explore if those experiences were either positive or negative. (4) To understand personal feelings, the nurse should ask if there are conflicting values between the patient/family and the nurse. The answer to this question will help the nurse recognize differences and work toward resolution.

Ch3 The nurse is providing care to an 11-month-old child who is hospitalized with pneumonia. Which nursing interventions are appropriate for this child? Select all that apply. Page 49 1.Communicate primarily with parents regarding treatment. 2.Allow the child to tour the facility before treatments. 3.Use simple terminology when talking to the child. 4.Use a singsong wide-eyed approach to interact. 5.Promote a sense of security with use of gentle touch.

1,4,5 This would provide family-centered care and note the parent's role in the child's life and well-being. (4) This can gain the infant's attention. (5) This would promote a sense of comfort for the child.

Ch4 The nurse is providing care for a child of a family who are migrant workers. According to Dr. Madeleine Leininger's Cultural Care Theory, which component of the theory is key for providing culturally competent nursing care? Page 57 1.Gaining the trust of patients/families of the culture 2.Capturing and articulating how culture impacts health 3.Understanding the environment created by migration 4.Learning the culture practices embraced by the patient/family

2 A key component of Dr. Leininger's theory is the ability to capture and articulate how culture affects health. The theory helps explain how practices handed down from generations can impact an individual's health today.

Ch1 The culturally sensitive pediatric nurse is aware of the racial makeup of the U.S. population. Which of the following reflects the demographics of the U.S. pediatric population in 2018, based on U.S. Census Bureau data? Page 5 1. The American Indian and Alaska Native population represent one-fifth of the pediatric population. 2. About half of the children fall in the category of something other than White non-Hispanic. 3. The population of Asian children decreased from 2015 to 2018. 4. There was no change in the population of Non-Hispanic children who represent two or more races between 2015 and 2018.

2 About 50% of the children aged 0 to 17 in 2018 were White non-Hispanic.

Ch2 The nurse is providing care to an adolescent patient with cystic fibrosis in the acute-care setting. The patient tells the nurse, "You are my favorite because you always listen to me, not like the other nurse who hates me." Which response by the nurse is most appropriate? Page 15 1."I will report the other nurse immediately, and you won't have to see her again." 2."If you have any concerns, I can ask the charge nurse to talk to you, but we all work as a team." 3."That's nice of you to say. I will try hard to keep you happy while here as my patient." 4."I understand. She has been reported by the other staff members for playing favorites."

2 Acknowledgment of the patient's statement and referring the matter to a neutral party may prevent splitting of the staff members. This can avert adversarial responses from the patient

Ch4 The nurse is completing the admission process for a pediatric patient by obtaining information related to the patient's culture. Which area of assessment is most important if the patient is an infant? Page 61 1.The religious beliefs of the patient's family 2.The family's perception of the current health status 3.The patient's food preferences 4.The typical daily schedule followed by family and patient

2 Because of the age of the patient, the most important area of cultural assessment is the family's perception of the current health status. The nurse will need to know if the medical condition or treatments are impacted by cultural beliefs or practices

Ch3 The nurse is providing discharge instructions to the family of a 14-year-old patient who was treated for an exacerbation of a chronic illness. The nurse recognizes that this will add stress to the family unit and has developed a plan of care based on the family-centered care model. Which intervention best addresses the crisis experienced by the family unit at this time? Page 52 1.Encourage the patient to contact friends from school for visits. 2.Discuss treatment options and alternatives with the family. 3.Provide privacy to discuss their options independently of staff. 4.Request clergy to counsel the family prior to discharge.

2 By providing resources and options, the family may feel empowered.

Ch4 The nurse is preparing to provide care to a child from a culture that is unfamiliar to the nurse. Which action by the nurse is most effective in providing culturally competent care? Page 55 1.Researching the culture on the Internet 2.Recognizing that each person and family is unique 3.Seeking advice from a coworker from the same culture 4.Determining which family member is the decision maker

2 Each family and individual is unique, and family groups and/or family members of the same culture may apply and interpret their culture in different ways. The nurse needs to specifically assess the patient and family for cultural beliefs.

Ch5 The nurses on a unit that cares for terminal pediatric patients wish to implement a change in facility policy to allow parents/guardians to remain during a patient code. Which is the most powerful reason that nurses can present to administration? Page 72 1. Family-centered care can be continued during a very stressful situation. 2. The family knows everything possible was done to save the patient. 3. The family experiences greater communication and decreased confusion. 4. Family may desire to stay during specific interventions that seem inappropriate.

2 Having family stay during a code can be positive because the family knows everything possible was done to save the patient. This is the most powerful reason for the nurses to present to administration

Ch2 .The nurse is assessing an adolescent patient in the emergency department with a suspected intentional overdose. After given treatment, the patient refuses to give her parent's contact information and states, "It is none of their business." What is the nurse's best response? Page 20 1."Now that you are safe, let me help you develop a plan to prevent a recurrence." 2."I'm sorry, but I'm obligated to tell them. Let me help you develop a plan for their possible responses." 3."Although most of your health care is confidential, we are obligated to notify them." 4."I think you should tell them, but we will honor your confidentiality and not disclose the reason for your visit."

2 Health-care professionals who have a reasonable concern that a patient may harm themselves are required by law to break confidentiality. The child should be given the option to participate in telling the parents, but ultimately the health-care provider is mandated to report the patient's self

Ch3 The nurse is attempting to provide education to the family of a newborn in the home-care setting. Which nursing intervention will assess comprehension of the communication with the family? Page 37 1.The nurse identifies the primary caregiver of the infant for instructions and asks for privacy with the individual. 2.The nurse provides both written and verbal instructions and asks for a return demonstration. 3.The nurse provides descriptions of signs and symptoms to report to the primary care provider. 4.The nurse requests to see their calendar with approximate dates for immunizations.

2 If the caregivers are given both written and verbal instructions, it may enhance their understanding. If the caregiver is able to provide a return demonstration, it shows some comprehension of the task.

Ch5 With endorsement from the family, the health-care provider initiates hospice care for an adolescent patient who is terminally ill. For which statement by the family members about hospice care will the nurse provide additional information? Page 67 1."Our child will have a graceful, natural death." 2."Our child will die in the hospital." 3."Compassionate care will be focused on our child's comfort." 4."Our family can be involved in care as much as desired."

2 If the family anticipates that the patient will die in the hospital, the nurse can provide additional information that hospice care can also take place in the patient's home with visiting nurses and care aides. Some hospice groups have an independent facility.

Ch1 A nurse is providing relationship-based care to a pediatric patient. Which of the following is a challenge the nurse is likely to encounter while using this model of care? Page 7 1.Maintaining a sterile field for a procedure with a restless toddler 2.Communicating with the blended family on regular basis 3.Treating children with antibiotic-resistant illnesses 4.Caring for a larger number of children with autism spectrum disorders and childhood depression

2 Maintaining communication with families and caregivers has become more challenging due to the dynamics of current families

Ch3 A nurse is providing care to an adolescent patient. Which statement by the nurse is most likely to enhance communication with the patient? Page 51 1."Are you participating in any risky behaviors?" 2."What concerns do you have about your health?" 3."Are you taking your medication as prescribed?" 4."Is there a reason why you waited so long to come in?"

2 Nurses should encourage adolescent patients to express their feelings and concerns, and they should use open-ended questions to do so.

Ch1 The nurse has provided a presentation to middle school children about nursing as a career. One of the children stated that he wanted to be a pediatric nurse, because he wants to take care of babies and little "kids." What would be an appropriate response to this middle school-aged child? Page 3 1. "Nursing is a general practice; all nurses must know how to take care of all ages of patients." 2. "As a pediatric nurse, you would get to care for babies and little kids as well as children through their teenage years." 3. "What you are describing is actually a neonatal nurse. Neonatal nurses work with newborn babies, toddlers, and preschool-age children." 4. "Being a pediatric nurse requires a master's degree, so be sure to work hard in school!"

2 Pediatric nursing care requires the nurse to use assessment and evaluation tools that are unique to infants, children, and adolescent populations, not just babies and young children

Ch5 The nurse works in a pediatric hospice unit in an acute care facility. The nurse is currently providing care to an infant. Which assessment tool does the nurse use to identify the infant's level of pain? Page 69 1.FACES Pain Scale 2.FLACC (faces, legs, activity, cry, consolability) Scale 3.Visual Analogy Scale (VAS) 4.Neonatal and Infant Pain Scale (NIPS)

2 The FLACC Scale is used for newborn to 7 years. This assesses the patient's facial expression, leg positioning and flexion, activity level, crying level, and consolability. This is the appropriate scale for this patient.

Ch2The emergency department nurse is providing care to a 5-year-old child with a repeated exacerbation of otitis media. When it becomes apparent that the parents smoke and refuse to prevent the child's exposure to secondhand smoke, the nurse voices frustration to the family that they are causing the child's otitis media. Which of the provisions of the ANA Code of Ethics for Nurses has the nurse failed to follow? Page 13 1.The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient. 2.The nurse practices with compassion and respect for dignity, unrestricted by the nature of health problems. 3.The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient. 4.The patient's right to self-determination must be upheld, justified only when justified by law.

2 The nurse failed to practice with compassion and respect for the dignity of the patient (and family).

Ch3 The nurse assesses a toddler with an apparent ear infection in the emergency department and finds that the child is not up to date on immunizations or well-baby checkups. On further investigation, the nurse discovers that the family is uninsured and undocumented immigrants. What are the most likely barriers to effective communication at this time? Page 37 1.The insurance status affects many health-care practices such as immunizations. 2.The possible language issue may affect the family's comprehension of instructions. 3.The family may have barriers to transportation, employment, or knowledge. 4.The family may not have a primary care provider and relies on emergency care.

2 There may be a language issue, which can affect comprehension of the instructions. A medical interpreter may be required.

Ch2 The nurse understands that the nursing profession has standards of care that promote the covenant between patient and nurse. Which of the following is an example of this covenant? Page 14-15 1.The nurse adheres to strict guidelines regarding medication administration and procedures. 2.The nurse develops a care plan with mutually developed goals and interventions with the patient. 3.The nurse attends continuing education courses to maintain competency in skills. 4.The nurse considers each patient's cultural practices without bias or judgment.

2 This develops a level of trust and empathy between the patient and nurse (keyword: mutual goal and interventions).

Ch1 Which statement best describes the common core concepts of the different models of pediatric nursing? Page 5 1.All models focus on the open communication between the child and nurse. 2.All models focus on importance of family relationship to the child. 3.All models focus on safeguarding the child's dignity during care. 4.All models focus on coordination of care needs that arise during illness.

2 This is a common core concept in family-centered care, relationship-based care, and pediatric medical home care.

Ch2 The nurse is providing care to a hospitalized 1-year-old patient. The nurse locks the exits per protocol to prevent the removal of the child from the unit. The grandparents become angry about this, because they want to take the infant outside for "some fresh air." What is the appropriate measure that the staff takes to promote patient safety at this time? Page 26 1.Explain that the child is not to leave the floor without express permission from the parents. 2.Explain to the grandparents that this is a measure to prevent abduction of the patient. 3.Permit the grandparents to take the child after they sign a waiver for any possible injuries incurred off the unit. 4.Permit the grandparents a limited amount of time off the unit, due to treatment schedules.

2 This is a standard safety measure to prevent abduction by noncustodians.

Ch2 The nurse is providing care to a child in the home-care setting. The nurse often provides the mother with advice that varies from how to perform the child's medical care to marital advice. The nurse has stated that this is their favorite patient and has made this child's home the last stop of their shift to use her free time for visits. What is the relationship status between the nurse and family? Page 15 1.This is a therapeutic relationship based on family-centered care, with a focus on empathy. 2.This is not a therapeutic relationship, as the nurse has become enmeshed within the family. 3.This is a therapeutic relationship, with the nurse focusing on the well-being of the whole family. 4.This is not a therapeutic relationship, as the nurse has not included the whole family in the care.

2 This nurse has become enmeshed with the family without regard for professional boundaries

Ch4 The nurse is providing care for a pediatric patient whose family is from another culture. Which action is best when the nurse notices the patient is eating poorly at meals and rejecting snacks? Page 58 1.Ask the family members to share the types of foods preferred by the patient. 2.Encourage the family to prepare and bring favorite foods to the patient. 3.Offer the patient a variety of healthy and nutritious foods every 2 hours. 4.Contact the health-care provider and ask that dietary supplements be ordered.

2 Unless the patient has dietary restrictions, the most effective action by the nurse is to encourage the family to prepare and bring the patient's favorite foods to the hospital. Dietary preferences are part of an individual's culture and adequate nutrition is important.

Ch5 A 16-year-old patient is approaching the terminal stage of a brain tumor. The nurse notices the patient is calling friends and making plans for a social gathering several months away. When friends are present the patient assures them of a full recovery because of a new doctor. The nurse recognizes the patient is experiencing which stage of grief? Page 70 1. Acceptance 2. Denial 3. Anger 4. Bargaining

2 Unwillingness to accept the diagnosis and lack of trust in medical staff are indicative of denial.

Ch1 Which of the following examples accurately represent the unique role of the pediatric nurse? Select all that apply. Page 6 1.The nurse developed an intervention that correlated with the patient's particular cultural practice. 2.The nurse shared information on the progress and interventions with the family and patient. 3.The nurse engaged in one-to-one conversations with the family members as well as the patient. 4.The nurse requested the family to leave during invasive procedures to maintain privacy. 5.The nurse developed interventions based on the knowledge of human growth and development.

2,3,5 The family-centered care model of pediatric nursing incorporates the family in the plan of care as the focal point of the child's well-being. (3) The family-centered care model of pediatric nursing incorporates the family in the plan of care as the focal point of the child's well-being. (5) The pediatric nurse must be mindful of the growth and development of the pediatric patient.

Ch5 A pediatric patient with a terminal disease is placed in hospice care. In addition to basic patient care, which other services provided by a multidisciplinary team will meet the needs of the patient? Select all that apply. Page 68 1. Social work 2. Child-life specialist 3. Community programs 4. Physician 5. Grief counselor

2,4 The child-life specialist provides age- and developmentally appropriate toys and environment for patient. (4) The physician leads medical care and orders medications and interventions while providing the patient and family with education regarding the diagnosis.

Ch 2 Which of the following interventions are examples of a family-focused strategy? Select all that apply. Page 16-17 1.Coordinating care with other departments to lessen sleep disruptions 2.Providing storage and prep of meals from home for family members 3.Stipulating unilateral visiting rules for all patients and their families 4.Involving the parents in nursing change of shift reports and care plans 5.Providing dedicated family space with basic needs for rooming in parents

2,4,5 Meal storage and prep for meals at home will help decrease the discomfort for the family members of the patient. This is a culturally sensitive intervention as well. (4) This is family focused, because it involves the parents in the care of the child. (5) Providing a dedicated family space for rooming-in parents will ease the discomfort incurred from the hospital stay. There are "Ronald McDonald Family Rooms" in many facilities.

Ch3 The nurse is assessing an infant during a well-baby visit in the family practice clinic. During this assessment, the nurse asks the mother several routine questions regarding the infant's progress and notes that the mother nods her head but is looking at her cell phone. Which response by the nurse is most appropriate in this situation? Page 35 1.Continue the assessment and note the mother's disinterest in the infant's chart. 2.Continue to ask the questions repeatedly until an acceptable answer is provided. 3.Ask the mother if she could please put the phone down and discuss her infant's progress. 4.Contact the facility's social worker for a referral to child protective services for an in-home visit.

3 Attempting to interact with the mother is imperative, as she is the primary source of information

Ch1 The nurse is developing interventions for a transgender adolescent based on the nursing diagnosis decreased self-esteem related to transgender identity as evidenced by statements of feeling "worthless, different, and alone." What would be the most appropriate intervention based on the diagnosis? Page 8 1.Give positive feedback on personal choices as appropriate. 2.Provide gender-affirming care to transgender youth. 3.Provide information on support groups for patient and family. 4.Assess risk factors for depression and suicidal thoughts.

3 By locating support for both the patient and family, the patient may feel less isolated and develop coping skills from peers

Ch3 The nurse is performing a functional family assessment of a chronically ill pediatric patient. In what way can the nurse enhance communication with the family? Page 47 1.Identify the leader of the family and provide options for respite care. 2.Assess for abuse and report suspected abuse to the authorities. 3.Complete a family APGAR questionnaire and share the results. 4.Educate the family on resources in the community to help with care.

3 Assessing the family regarding the family dynamics and ability to cope with crises enhances communication with the family.

Ch1 The pediatric nurse begins a research project on 8-year-old patients with the medical diagnosis of pediatric acute-onset neuropsychiatric syndrome (PANS). The family has consented to the research, but as the nurse begins to administer the intervention, the patient refuses to cooperate. What is the appropriate response to this refusal? Page 7 1.The nurse should discuss with the family the options of performing the intervention without the child's knowledge. 2.The nurse should explain to the child that this is necessary and promise a reward at the end of the research project. 3.The nurse should refuse to perform the intervention until the child consents to the intervention and project. 4.The nurse should discuss the pros and cons of the research project with the child and focus on the outcomes.

3 Children aged 7 years and older can assent or dissent to be in a clinical trial.

Ch5 The nurse works on a pediatric unit where patients are on life support. Frequently, death is delayed for the benefit of organ donation and procurement. Which protocols for organ donation and procurement does the nurse always need to follow? Select all that apply. Page 73 1. The nurse approaches the family of a patient who is a viable candidate. 2. The best matched pediatric patients on the transplant list are notified. 3. The consent for organ donation can be given only by legal guardians. 4. The facility pediatric surgical team will procure the organs for transplant. 5. The parents only can accompany the patient to the operating room.

3 Consent is needed from the legal guardians for organ donation

Ch5 The nurse is providing care for a pediatric patient and family during the time when death of the patient seems imminent. The family is of Native American culture and has summoned tribal members to come and chant and pray at the bedside. Which behavior by the nurse is culturally correct? Page 69 1.Move the patient, family, and tribal members to an isolated location. 2.Ask the family to respect other patients by keeping the volume of chanting low. 3.Ask if the family has any additional needs, close the door, and provide privacy. 4.Call the nursing supervisor and ask for assistance in managing the situation.

3 Cultural considerations for pediatric end of life include respecting the cultural beliefs of the family and patient. Providing culturally competent care requires the nurse to incorporate the cultural beliefs of the family and patient into daily care. The spiritual needs of family and patient require the nurse to incorporate the spiritual beliefs of the family and patient into daily care.

Ch3 .In an acute care setting, the pediatric nurse is providing care to a 4-year-old patient with an exacerbation of cystic fibrosis. The nurse notes that there is little interaction between the patient and the older siblings when they visit. The siblings often seek to divert the staff's attention during their visits. What is the most appropriate nursing intervention at this time? Page 42 1.Ask the parents to leave the siblings at home to avoid disruptions. 2.Interact with the siblings and show them the playroom during visits. 3.Encourage the siblings to visit and bring familiar objects to the hospital. 4.Develop a plan to include the siblings in age-appropriate care of the patient.

3 Encouraging the siblings to bring a familiar object with them when they visit can increase their comfort level and encourage family-centered care.

Ch3 The emergency department nurse is providing care to a 3-year-old child who has suffered a major accident. The parents ask the nurse, "Is our child going to be okay?" What is the most effective communication response at this time? Page 37 1."Your child has suffered a severe laceration to the spinal cord and may have terminal paralysis." 2."Your child is being assessed at this time. I am confident the physician will resolve the problem." 3."Your child has suffered a major injury; let me give you some privacy. May I call the chaplain just to be with you?" 4."Your child has suffered a major injury. Please wait here while we finish assessing the injuries."

3 Give the family time and provide support during this time, from either clergy or social workers.

Ch3 The nurse is assessing the psychosocial needs of a family that has a chronically ill child. During the interview process, the nurse notes that the grandmother answers for all the family members. What nursing intervention is most appropriate at this time? Page 37 1.Ask the grandmother if a medical translator is necessary. 2.Continue with the interview and document the findings. 3.Identify the grandmother as the primary source of information. 4.Ask the grandmother to leave the room for privacy.

3 It is important to identify the roles within the family to facilitate a healthy relationship and dynamics.

Ch4 A child who is 10 years of age is brought to the clinic with symptoms of a serious lower respiratory infection. The attending adult self-identifies as a grandparent. The child states the grandparent is the only family of the patient. Which is the most important information for the nurse to acquire prior to treatment? Page 61 1.How to reach one of the patient's parents 2.Which other family members live with the patient 3.If the grandparent has legal custody of the patient 4.What caused the grandparent to seek medical care

3 It is most important for the nurse to acquire information regarding whether the grandparent is the legal guardian of the patient. Only a legal guardian can give consent for treatment of a pediatric patient.

Ch2 Which of the following statements serves as an example of the nurse directly upholding the ANA Pediatric Nursing: Scope and Standards of Practice? Page 14-15 1.The nursing union develops a safe patient-to-nurse ratio. 2.The nurse uses disengagement to remain in difficult situations with the patient. 3.The nurse maintains therapeutic relationships with the family and patient. 4.The nurse develops a plan of care for a community-wide illness.

3 It is required for therapeutic relationships to be at the core of pediatric nursing care for the Pediatric Nursing: Scope and Standards of Practice.

Ch5 The nurse is providing care for a pediatric patient who is 11 years of age. The patient is diagnosed with an aggressive form of cancer and is scheduled to begin chemotherapy. The patient tells the nurse, "I think I am going to die, but I also think I will get much sicker first." Which communication by the nurse is most appropriate for this patient? Page 71 1. Explain to the patient the importance of maintaining a hopeful outlook. 2. Encourage the patient to ask the doctor to explain what is going to happen. 3. Use basic terms to explain the disease progression and side effects of treatment. 4. Provide information about the different options that can be considered for the patient.

3 Nursing education to the pediatric patient in this scenario should include age-appropriate information about the disease and treatment.

Ch5 The coroner is informed of the unexpected death of an infant at 3 months of age. The infant died during the night in the home of the parents. Which expectation does the nurse have regarding follow-up to the infant's death? Page 73 1. The hospital will pay for an autopsy if requested by the health-care provider. 2. The coroner's office will not charge the parents if they request an autopsy. 3. The coroner can legally request an autopsy without the parent's consent. 4. The parents must give consent before an autopsy is performed for any reason.

3 The coroner has the legal right to request an autopsy in any suspicious or unexpected death and does not need consent of the family if it is considered legally necessary.

Ch2 The nurse is providing care to the mechanically ventilated 4-year-old patient who is believed to be the victim of abuse from the parents. The parents refuse to permit removal of the ventilator. The nurse believes this is because the parents are afraid that they will be charged with murder if the child dies. What is the recourse for the health-care team in this ethical dilemma? Page 21 1.Provide the treatment even in the face of undue burden of resources. 2.Provide the parents with their financial burden of this care. 3.Provide information to the courts for legal involvement. 4.Provide support to the parents even if the team would choose differently.

3 The parents are putting their self-interests ahead of the interests of the child and there is a clear conflict of interest. In this case, the parent's decision-making rights may be challenged legally

Ch4 The director of nursing (DON), who is responsible for planning the needs of a pediatric unit, focuses on demographics for the pediatric population. Based on federal statistics for 2020, which action does the DON prioritize for culturally sensitive care? Select all that apply. Page 57 1. Suggest for increased availability of educational literature in Chinese. 2. Plan to acquire more interpreters to serve the French population. 3. Determine whether local demographic changes reflect national demographic changes. 4. Plan to acquire more social workers to serve the Catholic population. 5. Obtain literature that is presented in both English and Spanish.

3,5 Children in Brief: Key National Indicators of Well-Being, 2020 (Federal Interagency Forum on Child and Family Statistics, n.d.). will help guide the DON's actions regarding providing culturally competent care. Local demographics may be very different and should be taken into consideration when planning culturally competent care. (5) The white non-Hispanic and Hispanic pediatric populations in the United States account for 75.8% of the total pediatric population in 2020.

Ch4 The nurse is making a home visit for a patient and family who are from a different culture than the nurse. Which assessment findings during the visit cause the nurse concern? Select all that apply. Page 62 1. The family home currently houses three generations of the family. 2. The household income is supplemented by government programs. 3. The home was built before 1945 and exhibits a lack of physical updates. 4. The children are accompanied by an adult to a playground. 5. The family lives 5 miles from a pediatric health-care facility.

3,5 The fact that the home was built in 1945 and lacks evidence of physical updates is a cause for concern by the nurse. Of specific concern is the risk of lead-based paints, outdated electrical service, and/or deterioration leading to accidents. (5) The fact that the family lives 5 miles from a pediatric health-care facility is a concern to the nurse. The nurse needs to carefully explore the family's access to health care and available transportation.

Ch3 The nurse is assessing a newborn who has been brought to the family clinic for her first well-child visit. The nurse accidentally drops a metal pan on the floor near the child. The child is startled, but the mother does not react. What is the most appropriate intervention at this time? Page 38 1.Speak loudly and clearly to mother to enhance comprehension. 2.Read the infant's chart to verify how to communicate. 3.Continue with the assessment and document the findings. 4.Ask the mother if she needs an interpreter to communicate.

4 According to the Americans with Disabilities Act (ADA), health-care providers have a duty to ensure that communication is effective.

Ch2 The nurse is preparing a 13-year-old patient for a full physical examination by the primary care provider (PCP). The patient asks that her mother leave the room because of the sensitive nature of the examination. What is the best course of action to be taken by the nurse to protect the interested parties? Page 20 1.Ask the mother to leave the room, and allow the patient to discuss her concerns privately with the PCP. 2.Allow the mother to stay in the room, and explain that she has the right to witness any care provided by the PCP. 3.Act as a chaperone and remain with the patient and mother in the room during the full examination. 4.Reassure the mother that the nurse will remain as a chaperone while she leaves the room.

4 Due to the sensitive nature of the examination, there should be a qualified chaperone to protect both the patient and practitioner

Ch1 The school nurse is developing a teaching session for the population of children in a middle school. The nurse has determined that the greatest need for the overall health of the children is promotion of healthy foods. Which of the following interventions is most likely to be effective? Page 8 1.Remove all unhealthy snacks from the vending machines. 2.Have a poster contest on healthy eating options. 3.Survey the student population during lunch breaks. 4.Engage the students in healthy choices with cooking lessons.

4 Engaging the students in healthy options would promote active learning and new skills

Ch1 The nurse at a family clinic is providing care to an adolescent patient diagnosed with diabetes. The patient has verbalized discomfort with the feelings of isolation when unable to drink alcohol with their friends. Which of the following would be the most appropriate response to this statement? Page 9 1. "Drinking alcohol is not only illegal but dangerous for your blood sugar control and overall well-being." 2. "You can still drink alcohol, in moderation, if you control the sugar spike with more insulin." 3. "Prepare for alcohol intake with more water and less carbohydrates before drinking to slow sugar spikes." 4."It is understandable that you want to be included, but perhaps we can work out a plan on how to work through those situations."

4 Helping the adolescent develop anticipatory guidance facilitates independence and healthy responses to peer pressure

Ch3 The nurse is assessing the family of a pediatric patient in the home-care setting. Which of the following family APGAR (adaptation, partnership, growth, affection, resolve) findings best correlates with the nursing diagnosis of caregiver role strain? Page 47 1.They have recently moved to the area and have not been able to form relationships within the community. 2.They show affection to each other and are able to devote time to other family members. 3.They have formed a partnership to carry forth the usual household responsibilities and support each other. 4.The mother provides primary care for the ill child and household while the father works two jobs to provide financial support.

4 It appears that both parents are strained with their responsibilities, the mother with primary care of the child, and the father's employment status.

Ch4 .The nurse works in a neighborhood pediatric clinic that serves a multicultural population. The nurse uses the Giger and Davidhizar Transcultural Assessment Model. Which of the six aspects is most helpful when performing pediatric assessments? Page 61 1.Acceptance of social organizations of which the patient and family are members 2.Awareness of personal space between the individuals who are communicating 3.Recognition of communication and how thoughts and feelings are expressed 4.Knowledge of biological variations, such as appropriate weight and development

4 Knowledge of biological variations, such as appropriate weight and development, is the most important aspect of this model during pediatric physical assessments because of the broad physical differences in children from different cultures.

Ch2 The home-care nurse is assessing the home environment for the pediatric patient. The nurse notes that the family is unable to perform some of the physical therapy exercises safely. What is the most appropriate initial nursing action? Page 14 1.Consult with the physical therapist to arrange more educational sessions. 2.Consult with the health-care provider for admission to a rehabilitation center. 3.Assess the exercises per the worksheet provided by the physical therapist. 4.Assess the family's understanding of how to safely complete the physical therapy exercises.

4 The appropriate initial nursing intervention is to assess the family's understanding of the problem

Ch3 The nurse is providing care to a 6-year-old child who is recovering from an infection after a round of chemotherapy in the hospital. The parents appear overwhelmed with the situation of wanting "quality time" and voice guilt over missing the healthy children's school functions when at the hospital. Which is an appropriate nursing goal for this family? Page 52 1.The family will demonstrate knowledge of the regimen and prevent further infections. 2.The family will meet and seek counseling for each family member prior to the patient's discharge to home. 3.The family will acknowledge the range of emotions during the child's hospitalization. 4.The family will meet with the social worker to coordinate community resources to facilitate the transition to home.

4 The family may not be aware of the available resources to their new community. They will need help in locating resources to facilitate the transition from the hospital to the home.

Ch2 The nurse is assessing an adolescent patient in the emergency department after she was attacked at a party. The patient refuses to give her parent's contact information and states, "They will kill me when they find out that I went to the party." What is the nurse's best response? Page 4 1."They will understand. Let me call them to at least get the insurance information." 2."Since you are a minor, we need their consent to legally treat you." 3."We will treat you, and your parents do not have to know that you are here." 4."I need to contact the social worker, as we have a duty to report this attack to your family and the authorities."

4 The nurse has an obligation as a mandated reporter to notify the appropriate authorities. Often the social worker will file a report. The nurse must verify that the patient's record contains documentation of this report.

Ch4 The nurse is considering taking classes to learn another language besides English. Which factor has the greatest impact on the nurse deciding which language to study? Page 57 1.The current cultural makeup of the area around the facility 2.The availability of foreign language classes within travel distance 3.The languages that are currently covered by professional interpreters 4.The 2020 projected ethnicity breakdown in the United States

4 The nurse needs to consult valid resources when determining which language is best to learn. An appropriate resource is the projection for America's children in 2020. Data are from Children in Brief: Key National Indicators of Well-Being, 2020 (Federal Interagency Forum on Child and Family Statistics

Ch5 The parents of a toddler, diagnosed to be in the end stage of a terminal illness, are concerned about how to manage pain without the sedation effects of pain medications. Which suggestion by the nurse is likely to meet the needs of both the parents and the patient? Page 68 1.Encourage the parents to bring favorite toys and books. 2.Initiate playtime in the playroom with other patients. 3.Provide age-appropriate videos for patient distraction. 4.Suggest a parent hold the patient and perform gentle massage.

4 The parents have expressed a desire for pain management without the sedation effects of pain medication. The unspoken need of the parents is to have the ability to interact with their child and still achieve pain management. When the nurse suggests that a parent hold the patient and perform gentle massage, the needs of both the patient and parents are being met; the suggested actions will promote relaxation and potentially decrease pain.