OB Chapter 26; 21st Century Pediatric Nursing

A patient is put on a ventilator in the intensive care unit of a tertiary hospital for long-term care. While caring for the patient, the nurse continuously assesses the health status of the patient. How does this intervention affect the patient's outcome? It prevents: a. pneumonia. b. lung cancer. c. cystic fibrosis. d. pulmonary edema.

A; pneumonia.

Nurses play an important role in current issues and trends in health care. What is a current trend in pediatric nursing and health care today? a. The patient is the unit of care for the health care provider. b. Discharge planning begins when the physician writes the order. c. Health promotion resources enable children to achieve their full potential. d. The focus of pediatric health care is trending toward acute hospital care.

C; Health promotion resources enable children to achieve their full potential.

Which statement is most descriptive of pediatric family-centered care? a. It reduces the effect of cultural diversity on the family b. It encourages family dependence on the health care system c. It recognizes that the family is the constant in the child's life d. It avoids expecting families to be part of the decision-making process

C; It recognizes that the family is the constant in a child's life

The leading cause of death from unintentional injuries in children is: a. Poisoning b. Drowning c. Motor vehicle-related fatalities d. Fire and burn related fatalities

C; Motor vehicle-related fatalities

Which action by the nurse demonstrates use of evidence-based practice (EBP)? a. Gathering equipment for a procedure b. Documenting changes in a patients status c. Questioning the use of daily central line dressing changes d. Clarifying a physicians prescription for morphine

C; Questioning the use of daily central line dressing changes

To establish evidence-based practice, the nurse has to collect high-quality evidence from various sources. Where does the nurse find the best quality of evidence? a. Observational studies b. Hospital patient records c. Randomized clinical trials d. Direct interview with patients

C; Randomized clinical trials

The pediatric nurse works efficiently in providing nursing care to an acutely ill child. After discharge, parents of the child ask the nurse to visit their home for dinner. What should the nurse do? a. Accept it; otherwise it may adversely affect the good relationship. b. Tell them to schedule it later as it is a busy day in hospital. c. Reject it courteously and thank them for the invitation. d. Ask them to invite other staff who were involved in the care as well.

C; Reject it courteously and thank them for the invitation.

The nurse is caring for a patient who is on long-term catheterization. According to the National Quality Forum, what should the nurse assess in this patient? a. Oxygen saturation using arterial or venous blood b. Monitoring of respiratory rate while in a sitting position c. Signs and symptoms of a urinary tract infection d. Abnormal changes in the electrocardiogram (ECG)

C; Signs and symptoms of a urinary tract infection

The major cause of death for children older than 1 year is: a. Cancer b. Infection c. Unintentional injuries d. Congenital abnormalities

C; Unintentional injuries

The signs and symptoms in a nursing diagnosis describe: a. projected changes in an individual's health status, clinical conditions, or behavior. b. an individual's response to health pattern deficits in the child, family, or community. c. a cluster of cues and/or defining characteristics that are derived from patient assessment and indicate actual health problems. d. physiologic, situational, and maturational factors that cause the problem or influence its development.

C; a cluster of cues and/or defining characteristics that are derived from patient assessment and indicate actual health problems.

A clinic nurse is planning a teaching session about childhood obesity prevention for parents of school-age children. The nurse should include which associated risk of obesity in the teaching plan? a. Type 1 diabetes b. Respiratory disease c. Celiac disease d. Type 2 diabetes

D; Type 2 diabetes

Infant mortality for infants in the United States less than 1 year of age: a. has dramatically increased. b. is the same as it is in developing countries. c. is the same as the rate in Japan. d. has decreased over the past few years.

D; has decreased over the past few years.

Evidence-based practice, a current health care trend, is best described as: a. gathering evidence of mortality and morbidity in children. b. meeting physical and psychosocial needs of the child and family in all areas of practice. c. using a professional code of ethics as a means for professional self-regulation. d. questioning why something is effective and whether there is a better approach.

D; questioning why something is effective and whether there is a better approach.

Mortality rates are calculated from a: a. survey of physicians. b. sample of hospital records. c. registry of all deaths. d. sample of death certificates.

D; sample of death certificates

From a worldwide perspective, infant mortality in the United States: a. Is the highest of the other developed nations. b. Lags behind five other developed nations. c. Is the lowest infant death rate of developed nations. d. Lags behind most other developed nations.

a; is the highest of other developed nations

The senior nurse instructed the student nurse to check the website, www.ndvh.org. Information about which topic will the student nurse find on this website? a. Domestic violence b. Malnourishment c. Infant mortality rate d. Hospital administration

1; Domestic violence

The pediatric nurse is working on a project to contribute to research and evidence-based practice. What should the nurse do when caring for patients of different age groups? Arrange the following steps in the correct order. 1.Develop a care plan. 2.Evaluate the effectiveness of intervention. 3.Collect information. 4.Identify specific questions.

4, 3, 1, 2

The nurse has to follow a method of problem identification and problem solving. Arrange the steps of the nursing process model in an appropriate order. 1.Planning 2.Evaluation 3.Diagnosis 4.Assessment 5.Implementation

4, 3, 1, 5 ,2

An example of atraumatic care would be to: a. eliminate or minimize distress experienced by a child in a health care setting. b. restrict visiting hours to adults only. c. perform invasive procedures only in the treatment room. d. permit only traditional clinical practices.

A; eliminate or minimize distress experienced by a child in a health care setting.

Two basic concepts in the philosophy of family-centered pediatric nursing care are: a. enabling and empowerment. b. empowerment and bias. c. enabling and curing. d. empowerment and self-control.

A; enabling and empowerment

The nurse is instructing the parents of a 6-month-old child about the dietary requirements and factors that may influence the eating habits of the child. Which statement made by the nurse is appropriate? Select all that apply. a. "Culture will have some influence on children's eating habits." b. "Cholesterol is required for the synthesis of neurons in child's brain." c. "During adolescence, children tend to make food choices for sociability." d. "First 3 years of life are crucial in establishing eating habits of children." e. "Cholesterol content is high in nuts and vegetable oils so use them sparingly."

A, B, C, D

The pediatric nurse is providing first aid to a child. The child sustained minor injuries while playing on the ground, and has severe pain in the knee joint. Which of the nursing interventions in the care of the child come under atraumatic care? Select all that apply. a. Controlling pain b. Allowing the child's privacy c. Respecting cultural differences d. Fostering the parent-child relationship e. Giving vaccination for preventing tetanus

A, B, C, D

The nurse is assessing a school-age child. The child stays with a parent who is recently divorced and has a meager income. The child does not like to mingle with other students at school. The child's performance is poor in studies and is cruel toward pets at home. Which factors in the child could most likely lead to pediatric social illness? Select all that apply. a. Poverty b. Pet cruelty c. Single parent d. Going to school e. Behavior with others

A, B, C, E

15. The nursing process is a method of problem identification and problem solving that describes what the nurse actually does. The five steps include (Select all that apply): a. Assessment b. Diagnosis c. Planning d. Documentation e. Implementation f. Evaluation

A, B, C, E, F

A 9-month-old child has been treated after a choking incident. Which advice does the nurse give to the parents to prevent further incidents? Select all that apply. a. "Never leave your child unattended." b. "Your child is too young to be allowed to eat solid food." c. "Make sure all cabinets, drawers, and containers are childproof." d. "Marbles and LEGOs are not appropriate toys for children at that age." e. "Allowing your child to crawl on the floor increases the risk for injury."

A, C, D

Parents inform the nurse that they had noticed some needle injuries on their child's left elbow and some syringes and needles in the child's school bag. What should the nurse suggest to the child's parent? Select all that apply. a. Encourage the child to participate in scouts. b. Discourage the child from participating in sports due to injury. c. Encourage the child to participate in church activities. d. Provide first aid to the child and apply bandage to elbow. e. Educate the parent and children about the ill effects of drugs.

A, C, E

Which actions of the nurse indicate that the nurse is providing atraumatic care to the patient who is admitted in the intensive care unit and his or her family? Select all that apply. a. The nurse patiently listens to the parent's concerns. b. The nurse spends off-duty time playing with the child. c. The nurse allows a parent to stay with the child at all times. d. The nurse gives the appropriate pain medications to the child. e. The nurse explains the treatment given to the child to the parents

A, D, E

A nurse is planning a class on accident prevention for parents of toddlers. Which safety topic is the priority for this class? a. Appropriate use of car seat restraints b. Safety crossing the street c. Helmet use when riding a bicycle d. Poison control numbers

A; Appropriate use of car seat restraints

Which of the following is descriptive of deaths caused by unintentional injuries? a. More deaths occur in males. b. More deaths occur in females. c. The pattern of deaths varies widely in Western societies. d. The pattern of deaths does not vary according to age and sex.

A; More deaths occur in males

The nurse is teaching a pregnant woman to eat a nutritious diet and to attend regular antenatal health check-ups for the assessment of fetal well-being. The primary purpose of this nursing intervention is to reduce the neonatal mortality rate due to: a. birth weight less than 2.5g. b. gestational diabetes in mother. c. birth weight of more than 3.5 g. d. febrile convulsions in neonate

A; birth weight less than 2.5g

The pediatric nurse has recorded the birth weight, head circumference, axillary temperature, and crown to rump length of a newborn baby. What does the nurse consider while assessing the risk for mortality in this infant? a. Measure head circumference on alternate weeks. b. Use the birth weight for the assessment of infant mortality rate. c. Prefer rectal temperature to axillary temperature in the new born. d. Crown to rump length is the best indicator of infant mortality rate

B; Use the birth weight for the assessment of infant mortality rate.

The nurse finds that a child spends several hours each day playing video games and lives in a home environment with limited access to safe playgrounds and parks. What health risks does the nurse expect based on these findings? Select all that apply. a. Tooth decay b. Hypertension c. Diabetes d. Growth delays e. Hypercholesterolemia

B, C, E

Which behaviors by the nurse indicate a therapeutic relationship with children and families? (Select all that apply.) a. Spending off-duty time with children and families b. Asking questions if families are not participating in the care c. Clarifying information for families d. Buying toys for a hospitalized child e. Learning about the family's religious preference

B, C, E

Which statement best describes the process of critical thinking? a. It is a simple developmental process b. It is purposeful and goal directed c. It is based on deliberate and irrational thought d. It assists individuals in guessing what is most appropriate

B. It is purposeful and goal directed

Which of the following objectives would not be considered a priority area for Healthy People 2020? a. Improving nutritional and infant health b. Technologic advances to treat neonates c. Reducing violent and abusive behavior d. Vaccinating 90% of 2-year-olds

B. Technologic advances to treat neonates

The nurse who works in a pediatric ward wants to explore his/her own ability to develop a therapeutic relationship with children and their families. The nurse does a self-assessment to evaluate the care giving style by using an assessment questionnaire. In the questionnaire the nurse answers "yes" to a question, which indicates a positive action. What was the question to which the nurse answered as "yes"? a. "Do you control visitor access to children by using excuses?" b. "Do you periodically interview children to determine their current issues?" c. "Do you become critical when parents do not visit their children?" d. "Does the senior nurse appreciate you for being close to the child?"

B; "Do you periodically interview children to determine their current issues?"

The type of injury a child is especially susceptible to at a specific age is most closely related to: a. Physical health of the child b. Developmental level of the child c. Educational level of the child d. Number of responsible adults in the home

B; Developmental level of the child

In addition to injuries, the leading causes of death in adolescents ages 15 to 19 years are: a. Suicide, cancer. b. Homicide, suicide c. Homicide, heart disease. d. Drowning, cancer.

B; Homicide, suicide

Which statement regarding childhood morbidity is the most accurate? a. Morbidity does not vary with age b. Morbidity is not distributed randomly c. Little can be done to improve morbidity d. Unintentional injuries do not have an effect on morbidity

B; Morbidity is not distributed randomly

The nurse is preparing staff in-service education about atraumatic care for pediatric patients. Which intervention should the nurse include? a. Prepare the child for separation from parents during hospitalization by reviewing a video. b. Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal. c. Help the child accept the loss of control associated with hospitalization. d. Help the child accept pain that is connected with a treatment or procedure.

B; Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal.

What important information should the nurse include when teaching the parents of an adolescent about nutrition? a. Adolescents are usually mature enough to make healthy food choices. b. Resources are available to assist lower income families to obtain enough protein. c. Behavior problems in this age group are not related to nutritional deficiencies. d. Parental influence has the greatest impact on food choices at this age.

B; Resources are available to assist lover income families to obtain enough protein.

The parent of a newborn child asks the nurse the importance of breastfeeding. What should the nurse tell the parent? Select all that apply. a. Breast milk is not rich in micro-nutrients. b. Breast milk is not recommended for infants with fever. c. Enzymes in breast milk are helpful in the digestion of milk. d. Immunoglobulins in milk can prevent infections and diseases. e. Breastfeeding can decrease infant mortality and morbidity.

C, D, E

The nurse is evaluating the quality of evidence of research found in the field of infectious diseases in infants. The nurse found unusually strong evidence from unbiased observational studies. What grade should be given to this research according to the GRADE criteria? a. Low b. High c. Very low d. Moderate

D; Moderate

The role of the pediatric nurse is influenced by trends in health care. The greatest trend in health care is: a. primary focus on treatment of disease or disability. b. national health care planning on a distributive or episodic basis. c. accountability to professional codes and international standards. d. shift of focus to prevention of illness and maintenance of health.

D; Shift of focus to prevention of illness and maintenance of health

Which is now referred to as the "new morbidity"? a. Limitations in the major activities of daily living b. Unintentional injuries that cause chronic health problems c. Discoveries of new therapies to treat health problems d. Behavioral, social, and educational problems that alter health

D; Behavioral, social and educational problems that alter health

Which of the following statements about injuries in childhood is false? a. Male deaths outnumber female deaths. b. After 1 year of age, death rates in children are less than for infants. c. Children ages 5 to 14 years have the lowest rate of death. d. Caucasians have more deaths for all ages than Hispanics.

D; Caucasians have more deaths for all ages than Hispanics

The community nurse has conducted a survey on the frequency of occurrences of various diseases and health problems such as acne, headache, diarrhea, and upper respiratory tract infections (URTI) in children. What trend would the nurse most likely notice from the survey? The frequency of: a. Acne decreases with age b. URTI increases with age c. Diarrhea increases with age d. Headaches increases with age

D; Headaches increases with age