CH 31

What is the most accurate definition of the focus of pediatric nursing? 1 Rehabilitative nursing 2 Family-centered nursing 3 Patient advocate nursing 4 Patient-centered nursing

2 Family-centered nursing

Which fluids would the nurse tell the parents are acceptable for encouraging fluid intake in a child at home? Select all that apply. 1 Solid gelatin 2 Sports drinks 3 Sweetened tea 4 Sweetened cola 5 Flavored ice pops 6 Sweetened coffee

1 Solid gelatin 2 Sports drinks 3 Sweetened tea 5 Flavored ice pops

Which data collected on an 11-year-old wounded child would cause the nurse to suspect physical abuse? Select all that apply. 1 Afraid to go home 2 Drug addiction 3 Suicidal thoughts 4 Pain while voiding 5 Hiding the wound

1 Afraid to go home 3 Suicidal thoughts 5 Hiding the wound

Which point is most important for the nurse to address with parents about accident prevention for adolescents? 1 Wearing seat belts, teaching fire safety, and the need to inform parents of whereabouts 2 Teaching of traffic dangers, keeping sharp objects out of reach, and avoiding use of pillows 3 Teaching proper use of protective gear in sports, reviewing acceptable behavior in a moving car, and practicing fire drills 4 Education and review of basic first aid; setting consequences for substance abuse, especially drinking; and discussing the dangers of swimming alone

4 Education and review of basic first aid; setting consequences for substance abuse, especially drinking; and discussing the dangers of swimming alone

A nurse observes that a hospitalized child is not eating, is crying for the parents, and is uncooperative. The nurse recognizes that this behavior raises concerns about separation, loss of control, and fear of pain and bodily harm. A child of which age level would typically demonstrate these responses? 1 Infant 2 Toddler 3 Preschool 4 School age

2 Toddler

Which instruction will the nurse give to the parents of an uncircumcised infant at the time of discharge? 1 "Wash the infant's genitalia on alternate days." 2 "Apply powder regularly if the foreskin is retracted." 3 "Do not attempt to retract the foreskin of the penis." 4 "Apply ointment to reduce the bleeding at the site of retraction."

3 "Do not attempt to retract the foreskin of the penis."

Which statement by a student nurse indicates the need for additional teaching regarding the nutritional needs of a 6-month-old child? 1 "Use honey as sweetener in the child's diet." 2 "Feed directly using hands when teeth erupt." 3 "Feed new foods to the child at 1-week intervals." 4 "First feed fruit juice, then strained vegetables to the child."

1 "Use honey as sweetener in the child's diet."

The nurse is teaching new parents how to care for their infant. Which statement made by the nurse would promote healthy behavior in the infant? Select all that apply. 1 Speak the words clearly with the infant. 2 Play games like "peek-a-boo" with the infant. 3 Use baby talk to communicate with the infant. 4 Encourage the infant through nonverbal means. 5 Place the infant in a prone position after feeding.

1 Speak the words clearly with the infant. 2 Play games like "peek-a-boo" with the infant. 5 Place the infant in a prone position after feeding.

Which education aids would the nurse incorporate into the orientation program for children being admitted to the hospital? Select all that apply. 1 Tours 2 Movies 3 Video games 4 Sports figures 5 Puppet shows 6 Equipment handling

1 Tours 2 Movies 5 Puppet shows 6 Equipment handling

A school-aged child shows inappropriate fears, has difficulty speaking, and behaves differently in the presence of any stranger. Which signs would indicate to the nurse the possibility of emotional abuse or neglect? Select all that apply. 1 Unable to control urination 2 Experiencing sleep disturbances 3 Consistently hungry 4 Having improper eating habits 5 Maintaining poor personal hygiene

1 Unable to control urination 2 Experiencing sleep disturbances 4 Having improper eating habits

The nurse is preparing a diet plan for a 10-year-old child. How many calories does the nurse calculate for a child weighing 61.6 pounds? Record your answer using a whole number. _____ kcal

1960

A nurse preparing to give a child an intramuscular injection identifies which area on the thigh as the vastus lateralis muscle? 1 1 2 2 3 3 4 4

2 2

By which age are all of the primary teeth typically present in a child? 1 6 years old 2 3 years old 3 18 months old 4 12 months old

2 3 years old

Which nursing intervention is necessary for effective administration of eye ointment and eye drops in an infant? 1 Administer eye drops before sleep and eye ointment while asleep. 2 Administer eye ointment and eye drops simultaneously in both eyes. 3 Administer eye ointment 3 minutes after the administration of the eye drops. 4 Administer eye ointment and eye drops on alternate days at the same time.

3 Administer eye ointment 3 minutes after the administration of the eye drops.

Which contribution did Dr. Abraham Jacobi have to reducing the mortality rate of children in the United States? 1 Reduction in child labor 2 Promotion of child education 3 Establishment of milk stations 4 Establishment of community nursing services

3 Establishment of milk stations

Which suspicious finding would indicate possible physical abuse in a child? 1 Torn underclothing 2 Poor personal hygiene 3 Marks of symmetric burns 4 Anxiety and hyperalertness

3 Marks of symmetric burns

A child has nausea due to the intake of oral medication. Which advice does the nurse give to the child's mother to reduce nausea? 1 "Mix the drug in the milk and administer it to the child." 2 "Give the child an ice cube to suck after administering the drug." 3 "Ask the child to swallow the medicine quickly and drink water." 4 "Give the child a carbonated drink immediately after the medication."

4 "Give the child a carbonated drink immediately after the medication."

Which statement by the licensed practical/vocational nurse (LPN/LVN) will best prepare the child for an intramuscular (IM) injection? 1 "This shot will hurt; you're a big girl, so don't cry." 2 "I am going to give you a shot. It will feel like a mosquito bite and will burn for a short time afterward." 3 "The doctor says you need a shot of medicine to get better because you keep spitting out the other medicine." 4 "Other kids tell me different things about how this feels. Some say it feels like a cat scratch. Will you tell me how it felt to you after we are done?"

4 "Other kids tell me different things about how this feels. Some say it feels like a cat scratch. Will you tell me how it felt to you after we are done?"

Which needs, if not supplied, are indicators of physical neglect of a child? Select all that apply. 1 Food 2 Shelter 3 Clothing 4 Affection 5 Attention 6 Health care

Food 2 Shelter 3 Clothing 6 Health care

Which behavior indicates that a 3-year-old child is cooperative during the examination procedure? 1 Smiles at the nurse 2 Sits on the parent's lap 3 Doesn't look at the nurse 4 Rejects the offered equipment

1 Smiles at the nurse

Which cause of deaths and disabilities in children is the most common? 1 Disease 2 Injuries 3 Carelessness 4 Risk-taking activities

2 Injuries

Which measurement does the nurse take to assess a 3-year-old child's growth? 1 Head circumference 2 Length in supine position 3 Height in supine position 4 Height in upright position

4 Height in upright position

Which muscle is the most suitable site for administration of the hepatitis B vaccine for a 2-year-old child? 1 Deltoid 2 Dorsogluteal 3 Biceps brachii 4 Vastus intermedius

1 Deltoid

Which strategies would the pediatric nurse use to communicate with children? Select all that apply. 1 Always offer children a choice to allow them control of their situation. 2 Use a calm, unhurried voice in a positive way to give directions or information. 3 Address all communication to the parent and ask the parent to give the information to the child. 4 As a general guide, use sentences whose sum of words is equal to the child's age in years plus one. 5 Avoid phrases that may be misinterpreted or provide more information than the child can understand.

1 Always offer children a choice to allow them control of their situation. 2 Use a calm, unhurried voice in a positive way to give directions or information. 4 As a general guide, use sentences whose sum of words is equal to the child's age in years plus one. 5 Avoid phrases that may be misinterpreted or provide more information than the child can understand.

Which effective diagnostic tools would the nurse use to recognize a child who has been abused or neglected? 1 Physical examination and interview 2 Patient history and physical assessment 3 Patient history and physical examination 4 Patient complaint and physical assessment

3 Patient history and physical examination

The nurse is caring for a 3-year-old child who has pain during venipuncture. Which nursing interventions would provide relief to the child? Select all that apply. 1 Play a music tape at high volume. 2 Administer an opioid drug for pain. 3 Rock the child at frequent intervals. 4 Ask the parent to stay with the child. 5 Administer an analgesic drug for pain.

3 Rock the child at frequent intervals. 4 Ask the parent to stay with the child. 5 Administer an analgesic drug for pain.

The nurse finds the urine of a 1-year-old infant is colorless and odorless. The nurse also finds that the urine has a specific gravity of approximately 1.020, and the infant passes urine approximately 22 mL/hr. Which conclusion would the nurse make from these findings about the infant? 1 Prone to dehydration 2 At risk of renal disease 3 Increased urine output 4 Normal kidney functioning

4 Normal kidney functioning

Because pain is often underestimated in children, how will the nurse best assess a child's pain? 1 Observe the child's activity. 2 Observe the child's facial expressions. 3 Monitor vital signs for elevated pulse or blood pressure. 4 Use accepted pain assessment tools, such as the Wong-Baker FACES scale.

4 Use accepted pain assessment tools, such as the Wong-Baker FACES scale.

Which amenities should the nurse plan to include in the room preparation for a physical assessment of a child? Select all that apply. 1 A comfortably warm temperature 2 A well-lit room, decorated with neutral colors 3 Equipment laid out so that easy access is possible 4 Toys, dolls, and games available as rewards for a cooperative child 5 Privacy provided, especially for adolescents and school-aged children 6 Comfortable furniture for children and others who may wish to be there

1 A comfortably warm temperature 2 A well-lit room, decorated with neutral colors 4 Toys, dolls, and games available as rewards for a cooperative child 5 Privacy provided, especially for adolescents and school-aged children

Which stress points are common for a child who is going to undergo surgery? Select all that apply. 1 Admission 2 Blood tests 3 The morning of surgery 4 Injection of postoperative medications 5 Return from the postanesthesia care unit (PACU) 6 Just before and during transport to the operating room (OR)

1 Admission 2 Blood tests 5 Return from the postanesthesia care unit (PACU) 6 Just before and during transport to the operating room (OR)

The licensed practical/vocational nurse (LPN/LVN) enters and observes an object in a Vietnamese mother's hand and bright red welts on her toddler's skin. Which nursing intervention is appropriate? 1 Ask the parent to explain what is occurring. 2 Immediately notify the registered nurse (RN) and report the observations. 3 Quickly approach the parents and ask them to leave the room. 4 Immediately notify social services about the possibility of child abuse.

1 Ask the parent to explain what is occurring.

The nurse screening for the presence of child abuse collects data in which categories? 1 Emotional, sexual, and physical 2 Physical, intellectual, and sexual 3 Emotional, sexual, and psychological 4 Physical, psychological, and psychosexual

1 Emotional, sexual, and physical

Which major stressors might a hospitalized child experience? Select all that apply. 1 Pain 2 Bodily trauma 3 Loss of control 4 Hospital gowns 5 Unusual medications 6 Unfamiliar environment

1 Pain 2 Bodily trauma 3 Loss of control 6 Unfamiliar environment

Which action would the nurse anticipate from the health care provider to remove wax from the child's ear? 1 Prescribe wax softeners for the child to soften the cerumen for easy removal. 2 Advise the mother to gently clean both the inner and outer portion of the ear canal. 3 Advise the mother to remove the cerumen by inserting cotton swabs in the ear canal. 4 Suggest the mother instill mineral oil after rinsing the external canal with an ear syringe.

1 Prescribe wax softeners for the child to soften the cerumen for easy removal.

Which qualities are desirable in a competent pediatric nurse? Select all that apply. 1 Enjoys working with children 2 Teaches parents about childcare 3 Explains healthy habits to the child 4 Discusses the severity of the condition 5 Takes complete responsibility for the child

1 Enjoys working with children 2 Teaches parents about childcare 3 Explains healthy habits to the child

Which finding would the nurse report as a concern of possible spina bifida in a newborn? 1 Hair on the sacrum 2 Convex-shaped nails 3 C-shaped spinal cord 4 Heart rate of 120 beats/min

1 Hair on the sacrum

The nurse has only an undersized cuff to check an infant's blood pressure. Which nursing intervention would be best in this situation? 1 Measure with an undersized cuff. 2 Measure the blood pressure in the calf. 3 Advise the parents to visit the next day. 4 Report to the health care provider.

2 Measure the blood pressure in the calf.

Which visual acuity is typical of a newborn? 1 20/22 2 20/100 3 20/400 4 20/200

3 20/400

Which characteristics of a health care provider would be most receptive by an adolescent? Select all that apply. 1 Warmth 2 Competence 3 Professionalism 4 Computer literacy 5 Ability to communicate 6 Straightforwardness and honesty

1 Warmth 2 Competence 5 Ability to communicate 6 Straightforwardness and honesty

Which action of a mother indicates effective learning regarding prevention of accidents and injuries to her baby? 1 Drinking hot tea holding the baby 2 Checking the bath water temperature 3 Allowing the baby to sleep on its stomach 4 Tucking blankets in to cover the baby

2 Checking the bath water temperature

An off-duty licensed practical/vocational nurse (LPN/LVN) recognizes cigarette burns on a child. Which response would be best as a health care professional? 1 Hand the mother a brochure on managing stress. 2 Notify the appropriate agency that that there is reason to believe a child has been abused. 3 Ignore the observations because the LPN/LVN is off duty as a nurse and there is nothing that can be done. 4 Assess for signs and symptoms of infection, and refer the child's mother to a health care provider.

2 Notify the appropriate agency that that there is reason to believe a child has been abused.

Which statements are true regarding oxygen therapy for an 18-month-old child? Select all that apply. 1 The child should be encouraged to cry because crying ensures the child has an adequate oxygen supply. 2 A nasal cannula is an effective oxygen delivery device even if the child breathes through the mouth. 3 Maintaining cannula placement may be difficult because the child is able to remove it from the nares. 4 Oxygen flow by nasal cannula allows constant oxygen delivery even while eating and talking, because the mouth remains unobstructed. 5 To assess adequate oxygenation, the nurse checks cannula placement and oxygen saturation using a pulse oximeter every 2 hours and as needed (PRN).

3 Maintaining cannula placement may be difficult because the child is able to remove it from the nares. 4 Oxygen flow by nasal cannula allows constant oxygen delivery even while eating and talking, because the mouth remains unobstructed. 5 To assess adequate oxygenation, the nurse checks cannula placement and oxygen saturation using a pulse oximeter every 2 hours and as needed (PRN).

While auscultating the breath sounds of a child, which actions by the nurse are appropriate? Select all that apply. 1 Talk to the child to reduce stress. 2 Avoid placing stethoscope on a bare chest. 3 Warm the stethoscope before placing it on the child's body. 4 Apply pressure on the chest piece to hear the breath sounds. 5 Check for moderate room temperatures before placing the chest piece.

3 Warm the stethoscope before placing it on the child's body. 4 Apply pressure on the chest piece to hear the breath sounds. 5 Check for moderate room temperatures before placing the chest piece.

Which measurement of body temperature is insensitive in detecting fever in a 2-year-old patient? 1 Oral site 2 Rectal site 3 Axillary site 4 Tympanic membrane

4 Tympanic membrane

Which statements does the nurse include in the teaching plan about measures parents can take to prevent dental caries in their infants? Select all that apply. 1 Avoid snacks containing a high-fiber content. 2 Give a bottle of milk daily before going to bed. 3 Give water, if the child needs a bottle at bedtime. 4 Avoid snacks containing high concentrated sugars. 5 Give a teaspoon full of honey daily before going to bed.

3 Give water, if the child needs a bottle at bedtime. 4 Avoid snacks containing high concentrated sugars

Why would the nurse keep the fingers free from the chest piece while auscultating breath sounds? 1 To clearly hear the sounds 2 To compare different sounds 3 To avoid false resembling sounds 4 To prevent interference from outside sounds

3 To avoid false resembling sounds

Which intramuscular injection site would the nurse use in a 12-month-old child? 1 Deltoid 2 Gluteus medius 3 Vastus lateralis 4 Rectus femoris

3 Vastus lateralis

Which muscle is the most appropriate site to administer an intramuscular (IM) injection in a 3-month-old child? 1 Deltoid 2 Dorsogluteal 3 Vastus lateralis 4 Rectus femoral

3 Vastus lateralis

The nurse knows that paleness (pallor) may be a sign of which potential conditions? Select all that apply. 1 Shock 2 Edema 3 Erythema 4 Hypertension 5 Chronic disease 6 Potential anemia

1 Shock 2 Edema 5 Chronic disease 6 Potential anemia

A mother tells the nurse, "I feed my infant with cow's milk, because breast milk is not sufficient." Which data would the nurse collect in the infant? 1 Urinary output 2 Blood pressure 3 Lesions on the skin near the anus 4 Yellow discoloration of the nails

1 Urinary output

Which factor is a major influence on the child's growth? 1 Activity level 2 Nutritional intake 3 Parental influence 4 Sibling and peer influence

2 Nutritional intake

Which technique would be best to check placement of the feeding tube before initiating a gavage feeding? 1 Aspirate for stomach contents per policy and procedure. 2 Contact the radiology department for an x-ray examination to confirm proper placement. 3 Aspirate for stomach contents and then inject air into the feeding tube while listening for gurgling sounds per policy and procedure. 4 Inject a small amount of air through a syringe into the feeding tube while simultaneously listening with a stethoscope over the stomach area for the sound of gurgling.

3 Aspirate for stomach contents and then inject air into the feeding tube while listening for gurgling sounds per policy and procedure.

The hospital environment can be frightening and traumatic for children. How can the nurse help alleviate these stressors? 1 Keep nurse time with the child at a minimum by performing tasks and procedures as quickly as possible. 2 Keep the television on at all times while the child is in the hospital to distract the child and muffle unfamiliar noises. 3 Adhere to strict visiting hours as parents visit, because the child feeds off of parental anxieties, leading to more crying. 4 During preadmission, offer the parents and child a tour of the pediatric unit and invite the parents to room in with the child during hospitalization.

4 During preadmission, offer the parents and child a tour of the pediatric unit and invite the parents to room in with the child during hospitalization.

The nurse is teaching the parents of a 4-year-old child about measures to take to prevent accidents. Which response of the parents indicates the need for further teaching? 1 "I should use a car seat or seat belt in the car." 2 "I should not leave the child alone in the bathtub." 3 "I should avoid keeping loaded firearms in the house." 4 "I should permit the child to play on the sidewalks of the road."

4 "I should permit the child to play on the sidewalks of the road."

Which patient demonstrates an abnormal growth pattern that should be reported to the pediatrician? 1 1-year-old child who has tripled the birth weight 2 12-year-old adolescent who has a sudden increase in height 3 7-year-old child who has a gradual increase in weight and height 4 5-year-old child who has a widely disparate height-to-weight ratio

4 5-year-old child who has a widely disparate height-to-weight ratio

Which ability is the most important for a nurse to have to enjoy working in pediatrics? 1 Ability to perform correct nursing diagnoses 2 Ability to communicate with children and families 3 Ability to identify stressors and provide care to family members 4 Ability to recognize and appreciate the uniqueness of each child

4 Ability to recognize and appreciate the uniqueness of each child

The nurse is a bathing an infant who has an intact umbilical cord. Which procedure should the nurse follow? 1 Clean the area around the cord with water. 2 Use a cotton-tipped applicator to clean the ears. 3 Use mild soap to clean the area around the eyes. 4 Clean the face and dry it before proceeding to other parts.

4 Clean the face and dry it before proceeding to other parts.

Which statement is true about orthopedic injuries in the pediatric patient? 1 Bone fractures tend to heal most quickly in the pediatric population. 2 Many bone fractures will heal without treatment in pediatric population. 3 It is extremely easy for a pediatric patient to break bones before age 10 years. 4 Providing calcium supplements for pediatric patients will decrease their risk for breaks.

1 Bone fractures tend to heal most quickly in the pediatric population.

Which methods will help encourage a child's acceptance of an oral medication? Select all that apply. 1 Have the child drink the medication through a straw. 2 Have the child ingest the medication mixed with milk. 3 Have the child suck an ice cube before ingesting the drug. 4 Have the child ingest the drug after mixing with ice cream. 5 Have the child pinch the nose and then drink the medication. 6 Have the child lie on the back while the medication is administered.

1 Have the child drink the medication through a straw. 3 Have the child suck an ice cube before ingesting the drug. 4 Have the child ingest the drug after mixing with ice cream. 5 Have the child pinch the nose and then drink the medication.

A nurse is preparing to perform a pediatric physical assessment of a 3-year old child. Which behaviors signal the nurse that the child is ready to cooperate? Select all that apply. 1 Talking to the nurse 2 Making eye contact 3 Sitting on parent's lap 4 Allowing physical touching 5 Accepting offered equipment 6 Accepting a doll from the nurse

1 Talking to the nurse 2 Making eye contact 4 Allowing physical touching 5 Accepting offered equipment

How does the nurse best describe to the nursing student the term separation anxiety as it pertains to hospitalized children? 1 Homesickness 2 Isolation from parents and family 3 Desire to bond with hospital caregivers 4 Fear of losing support from friends and peers

2 Isolation from parents and family

How many words is the 2-year-old child likely to know? 1 About 25 to 50 2 More than 250 3 More than 150 4 More than 500

2 More than 250

Which action by a student nurse when measuring the weight of a 5-year-old child would need correcting? 1 The student nurse gives the child a gown. 2 The student nurse records the intravenous attachment. 3 The student nurse uses a different scale to weigh every day. 4 The student nurse records the nasogastric tube attachment.

3 The student nurse uses a different scale to weigh every day.

Which nursing actions are important to ensure the safety of an obese small child who is to receive an intramuscular (IM) injection? Select all that apply. 1 Administer the medication into the dorsogluteal muscle. 2 Administer the medication into the vastus lateralis muscle. 3 Inject the medication quickly but remove the needle slowly. 4 Administer the medication with the child in the upright position. 5 Displace the subcutaneous tissue by spreading the skin with the fingers.

2 Administer the medication into the vastus lateralis muscle. 5 Displace the subcutaneous tissue by spreading the skin with the fingers.