341 Ch 1

Which child represents an increasingly common pediatric medical scenario currently present in the United States? 4-year-old girl diagnosed with non-Hodgkin lymphoma 13-year-old boy admitted with a fall-induced fractured femur 5-hour-old neonate diagnosed with Tetralogy of Fallot 9-year-old girl diagnosed with type 2 diabetes

9-year-old girl diagnosed with type 2 diabetes

A nurse is providing care to a child and family recently admitted to the hospital. The nurse would anticipate the need to obtain specialized informed consent in which situation? Select all that apply. Before photographing the child On admission to the facility After applying restraints Before a bone marrow aspiration Prior to radiation therapy

Before photographing the child Before a bone marrow aspiration Prior to radiation therapy

The nurse is providing education to the parents of a school-aged child. Which information would the nurse include in the teaching plan? Verbal directions regarding gates at the top and bottom of the stairs Teaching about the signs and symptoms of sexually transmitted infections Discussion of the importance of proper use and fit of a helmet for bike riding Information about and encouragement to avoid the dangers of distracted driving

Discussion of the importance of proper use and fit of a helmet for bike riding

Morbidity rates among children are most highly associated with which cause? Environmental factors Firearms at home School violence Suicide and homicide

Environmental factors

The home health nurse is visiting a child with chronic medical needs, including home oxygen and nebulizers. During the visit, the parents indicate the primary income earner recently was laid off work and the family has lost their insurance benefits. What action would the nurse take next? Refer the family to a case manager or social worker to assist in getting them resources Ask the health care provider to prescribe the most affordable or generic form of the medications Encourage the family to seek the advice of their spiritual or religious advisor Offer the name and contact number of a support group for parents of ill children

Refer the family to a case manager or social worker to assist in getting them resources

The nurse is advised in the change of shift report that a child on the unit is considered a "mature minor". What criteria must this child meet to be considered in this role? The child's parents must approve of the child being considered a "mature minor". The child must have the maturity to understand the information provided related to his condition and planned course of treatment. Signing any forms of consent by a mature minor must be witnessed by a court appointed advocate of the child. The child must be at least 16 years of age.

The child must have the maturity to understand the information provided related to his condition and planned course of treatment.

During the weekly team meetings, the physician and case manager discuss the client's planned assent. What activity should the nurse most anticipate? The client will be moving toward legal emancipation. The client will be discharged to home in the coming days. The client will begin to have increasing amounts of time spent unsupervised. The client will have a conference with the physician about the planned course of care and treatment.

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

The nurse is reviewing a client's chart. The nurse notes that "AND" is documented in the area outlining treatment options. What will this this entail? The notation of "AND" indicates that no resuscitation efforts will be performed for the client. "AND" refers to the absence of a noted health care directive for the client. AND refers to the plans to "Allow Narcotic Delivery" to the client. The abbreviation "AND" indicates that inclusion of the plans of the family in addition to those outlined by the primary care physician.

The notation of "AND" indicates that no resuscitation efforts will be performed for the client. "AND" is used to denote "allow natural death". This is a form of do not resuscitate.

What was the primary goal for the establishment of the Children's Bureau? The improvement of parenting behaviors To improve the standards of health care To promote prenatal care To reduce prematurity

To improve the standards of health care

The nurse is working with the parents of an infant and a toddler in the clinical setting. What statement by the parent would alert the nurse to assess the children further? "We have to hire babysitters sometimes because our parents are not able to help babysit." "We enjoy taking walks in the park and playing outside as much as possible." "We have baby gates installed at the top and bottom of our stairs in our home." "We live in an old house, and we are planning to renovate it when the kids are older."

"We live in an old house, and we are planning to renovate it when the kids are older."

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

Showing the mother how to teach hand washing to her child

A student nurse shares an interest in pediatric nursing. When discussing her thoughts about pediatric nursing, which statements are consistent with the philosophies of pediatric nursing care? Select all that apply. "I believe the family should be included in all aspects of the plan of care and treatment." "I think the parents must be the director of the client's care until adulthood." "Until they are teens, kids should have a limited amount of decision making in their care." "The child should be included as much as possible in the plan of care." "Since health care can be scary for a child, it's important to make them feel secure."

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

The student nurse is preparing a presentation on Lillian Wald's contributions to nursing. After presenting information on the Henry Street Settlement House, which comments by the audience indicates understanding of the material presented? Select all that apply. "Psychiatric nursing of children was a major component of the Henry Street Settlement House." "Lillian Wald helped initiate public health nursing through the Henry Street Settlement House." "A lot of financially poor families were helped by the Henry Street Settlement House." "Many children were helped by the Henry Street Settlement House by educating mothers about proper health care of their children." "The Henry Street Settlement House was a major factor in the education of nurses."

"Lillian Wald helped initiate public health nursing through the Henry Street Settlement House." "A lot of financially poor families were helped by the Henry Street Settlement House." "Many children were helped by the Henry Street Settlement House by educating mothers about proper health care of their children." "The Henry Street Settlement House was a major factor in the education of nurses."

The parents of a child receiving chemotherapy for leukemia notice "certified pediatric hematology/oncology nurse" on the nurse's name badge. The parents ask the nurse about this. What is the best response by the nurse? "Many of us that work the oncology unit have this certification." "We receive a pay increase if we earn this certification." "This certifies that I have specialized in the field of oncology/hematology care of children." "The hospital requires that we have this certification if we will be administering chemotherapy."

"This certifies that I have specialized in the field of oncology/hematology care of children."

The nurse is caring for a child who underwent an appendectomy 12 hours ago. The child has reported incisional pain. When the nurse attempts to administer the prescribed analgesic the child's mother declines the medication. What initial action by the nurse is most appropriate? Contact the nursing supervisor. Contact the physician. Document the refusal of the medication and continue to observe the child. Ask the child's mother to elaborate on her concerns about the medication.

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

A nurse is reviewing the medical record of a 3-year-old child who is brought to the clinic for an evaluation. The nurse notes that the child is participating in a community Early Head Start program. The nurse understands that this program focuses on which aspect? Coverage by Medicaid Child development Services for handicapped children Health insurance

Child development

A student nurse raises questions about the value of evidence-based practice. What information should be contained in the response provided? Select all that apply. Client outcomes are improved with evidence-based practice. Evidence-based practice seeks to promote increased variation in the care delivered to clients. Evidence-based practice is a clinical decision-making approach to providing nursing care. Instructors of nursing and researchers are the most responsible parties for ensuring evidence-based practice. The quest for practice improvement is the responsibility for all nurses.

Client outcomes are improved with evidence-based practice. Evidence-based practice is a clinical decision-making approach to providing nursing care. The quest for practice improvement is the responsibility for all nurses.

After unintentional injuries, what is the leading cause of childhood mortality for children ages 1 to 4 years? Congenital malformations Pediatric cancer Cardiac septal defects Intentional injuries

Congenital malformations

A child with a chronic illness is being discharged home. The nurse manager arranges for home care for the child. The nurse manager follows up with a phone call to check on the child's progress 1 week after discharge. Which concept best defines these actions? Advocacy care Continuity of care Culturally competent care Family-centered care

Continuity of care

Following the discharge of a child who has a chronic health condition from the hospital, the nurse case manager follows up with a visit to the home and meets with the family and child. This visit best represents which philosophy of pediatric nursing? Risk-reduction potential care Atraumatic therapeutic care Evidence-based nursing care Family-centered care

Family-centered care

A 3-year-old child is being prepared for a lumbar puncture and the parents are being asked to provide consent. Which activity would be the nurse's responsibility during this process? Select all that apply. Describing the procedure in detail Ensuring the form is signed by the parents Witnessing the parents signing the form Explaining the risk and benefits of the procedure Checking the parents' understanding of the procedure

Ensuring the form is signed by the parents Witnessing the parents signing the form Checking the parents' understanding of the procedure

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

Facilitating return to school by working with the school nurse

What is a current trend in child health care? Health promotion rather than health restoration is stressed. Children are hospitalized for observation more than previously. Nursing roles are decreasing because of the increasing role of families. Child health care is moving out of regional centers.

Health promotion rather than health restoration is stressed.

The nurse is applying the nursing process to the care of a 5-year-old child who has been diagnosed with asthma. Which action should the nurse perform first? Interview the child and the caregivers to determine the most common causes of the child's symptoms Collaborate with the child and the caregivers to determine their specific, desired outcomes for care Teach the child and the caregivers basic strategies for preventing and managing asthma symptoms Identify the nursing diagnoses that are most commonly associated with childhood asthma

Interview the child and the caregivers to determine the most common causes of the child's symptoms

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

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

The nurse is caring for a 2-year-old boy who needs a lumbar puncture. His mother is present. What would prevent informed consent from being obtained? Determining the mother cannot read the form Learning the mother is not the custodial parent Finding out the mother is younger than 18 years of age Establishing the mother was never married

Learning the mother is not the custodial parent

In 2007 the World Factbook published statistics that showed the United States still lagged behind other industrialized nations in the incidence of infant mortality. What is one reason that the United States has a higher infant mortality rate than other countries? Low adolescent delivery rates Low birth weight Home deliveries Early prenatal care

Low birth weight

The nurse is assessing a 9-year-old boy with pneumonia. Which finding is a factor for this child's morbidity? Medical records reveal a history of asthma Child's height and weight plot at the 50th percentile on the growth chart Child's white blood cell (WBC) count is within normal limits Child is active in a Boy Scout troop

Medical records reveal a history of asthma

The parent of an 11-year-old girl with an inoperable brain tumor confides to the nurse that her daughter's physician is "pushing them" to convince their daughter to participate in a controversial treatment that has a high risk for side effects. She further states that she told him twice that they were not interested. What would be the nurse's best response to this situation? Tell the doctor that the procedure is not in the best interests of this girl and ask him to respect the rights of the family. Tell the parents to state in writing that they will not participate in the treatment and give the letter to their physician. Meet with the physician and disclose the concerns of the family; refer the case to the institutional ethics committee if not resolved. Reassure the family that the doctor is acting in their best interests and they should reconsider the treatment.

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

A 17-year-old has been diagnosed with HIV. When developing the plan of care, which initial action should be included? Contact the CDC. Obtain a listing of the child's sexual contacts. Notify the local health department of the individual's HIV status. Notify the child's sexual contacts.

Notify the local health department of the individual's HIV status.

A nurse is caring for a child. Which individual would the nurse identify as being primarily responsible for initiating and coordinating health care? Social worker Parents Community Case manager

Parents Parents and guardians have the primary responsibility for initiating and coordinating services rendered by health professionals. A social worker or case manager may be involved but are not primarily responsible for the child's care. The community provides programs to promote and support children's health.

The nurse reviews the medical record of a child with a Wilms tumor and notes the child has a do not attempt resuscitation (DNAR) prescription from the primary health care provider. During assessment, the nurse notes the child is not breathing, pulse is 20 beats/minute, and is unresponsive. Which action by the nurse is appropriate? Perform sternal rub Perform cardiopulmonary resuscitation Measure the child's urine output Support the child and family members

Support the child and family members

To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups? Teach injury prevention and proper safety practices. Advocate for more research into control of environmental toxins. Provide guidance regarding proper nutrition. Help integrate exercise practices and programs into the lifestyles of individuals and communities.

Teach injury prevention and proper safety practices.

Consent for urgent treatment is needed for a minor. The parents are unable to be at the hospital. What action by the nurse constitutes informed consent? Treating the minor and obtaining written informed consent when the parent arrives Explaining the needed treatment to the minor and documenting this action Contacting the institution's attorney to provide and document consent Telephone consent with two witnesses listening simultaneously

Telephone consent with two witnesses listening simultaneously

The nurse is working in a pediatric facility whose mission statement strongly emphasizes providing family-centered care. What nursing intervention best exemplifies this facility's belief? The nurse plans a meeting with the parents, child, and case worker to discuss care alternatives for the child The nurse asks the child to describe his relationship with his parents The nurse questions the competency of care provided by a single father to his child The nurse assesses the interaction between a child and his parents when the parents visit

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

A child with a serious health condition has been hospitalized to undergo treatments. After a week of treatment the physicians have determined that the child has only weeks to live. What is the most likely initial course of action the nurse can anticipate? The parents will be asked to sign the do not resuscitate paperwork. "Do not resuscitate" orders should be obtained from the physician. A referral to the hospital's ethics committee will be initiated. The physician will confer with the parents to outline the severity of the child's condition.

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

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

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

A nurse is preparing a presentation for a local parent group. The group consists of parents with children younger than 4 years of age. As part of the presentation, the nurse plans to include teaching about preventing deaths in this age group. The nurse would most likely focus on prevention activities primarily related to which area? Heart disease Unintentional injuries Respiratory infections Cancer

Unintentional injuries

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

WIC The special supplemental nutrition program for women, infants, and children (WIC) provides services to supply nutritional food to low-income women and their children. SCHIP or CHIP provides health insurance to newborns and children in low-income families who do not otherwise qualify for Medicaid and are uninsured. The Early Childhood Intervention (ECI) program, sponsored by Easter Seals, is available for the child with disabilities or developmental delays.

The nurse provides soy milk and fresh vegetables to a pregnant woman who is single, and the mother of a toddler. Which federal program is the nurse implementing? Maternity & Infancy (Sheppard-Towner) Act WIC Food Package Revised Expansion of Lunch & Nutrition Act No Child Left Behind Act

WIC Food Package Revised

Which nursing activity requires the pediatric nurse to implement the ethical principle of nonmaleficence? Weighing the potential harm caused by a child's chemotherapy with its potential benefits Encouraging an adolescent client to take ownership of her health status independent of her parents Mediating between a father, who wants his infant circumcised, and the mother who is opposed Providing empathic, holistic care to a family who has just learned that their child's prognosis is poor

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

An important role of the nurse caring for children and their families is that of child advocate. Which intervention best reflects this role? Teaching parents the proper way to administer insulin to their child Accurately documenting and reporting client conditions Administering medications to clients on a timely basis Working to change agency policy to better serve families

Working to change agency policy to better serve families

Pediatric nurses are developing more home care and community-based services for children with chronic illnesses because: uninsured families can access these services. increasing numbers of children live with chronic disabilities due to advances in health care that allow children with formerly fatal diseases to survive. disability and chronic illness have increased with the appearance of more genetic abnormalities. more disabilities are occurring in children because many women are delaying pregnancy and giving birth to babies later in life. there are fewer positions for nurses in institutions providing acute care.

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