Peds - Chapter 11: Caring for Children in Diverse Settings

The nurse is caring for a technology-dependent school-age child in his home. Which action best builds a trusting relationship? a) Changing the date and time of the child's physical therapy to fit the family schedule b) Discussing care and treatment with the parent and child together c) Talking with the brother of the child who feels ignored d) Encouraging the parents to join a support group

Discussing care and treatment with the parent and child together

The nurse is working in the pediatric unit of the hospital and is making observations about the safety issues related to the pediatric unit. Which of the following is the biggest concern related to safety of the hospitalized child? a) A variety of nursing staff and other hospital staff are in and out of the child's room during hospitalization, and close observation of the child by the staff is difficult. b) The child is out of the home environment they are used to without safety locks on doors and cabinets and things being placed in safe storage. c) The caregivers are in a high-stress situation and are unable to concentrate and pay attention to what the child is doing at all times. d) Taking a child in and out of bed, doing frequent checks and procedures, and caregivers sitting at the side of the bed leaves opportunity for the siderails to be left down.

Taking a child in and out of bed, doing frequent checks and procedures, and caregivers sitting at the side of the bed leaves opportunity for the siderails to be left down.

The nurse is preparing to admit a 4-year-old who will be having tympanostomy tubes placed in both ears. Which strategy is most likely to reduce the child's fears of the procedure? a) "Let me show you the operating room." b) "Don't worry, you will be asleep the whole time." c) "The doctor is going to insert tympanostomy tubes in your ears." d) "Let me show you how tiny these tubes are."

"Let me show you how tiny these tubes are."

The nurse is preparing a 5-year-old boy for surgery on his lower leg. His mother is helping him into the hospital gown and the boy fights removal of his underwear. What is the most appropriate nursing action? 1. Allow the mother to remove the underwear. 2. Tell the boy he is acting childishly. 3. Notify the OR that the underwear is on. 4. Allow the boy to keep his underwear on.

Allow the boy to keep his underwear on.

The nurse is caring for a preschooler who is hospitalized with a suspected blood disorder and receives an order to draw a blood sample. Which approach is best? a) "We need to put a little hole in your arm." b) "Why don't you sit on your mom's lap?" c) "I need to remove a little blood." d) "I need to take some blood."

"Why don't you sit on your mom's lap?"

The nurse is admitting a 14-year-old girl for a tonsillectomy and is preparing her for the procedure. Which of the following is the best statement or question? a) "Are you wondering about anything related to your tonsillectomy?" b) "Are you feeling scared about the surgery?" c) "Some of the sounds in the hospital can be scary." d) "I have your discharge instructions for you."

"Are you wondering about anything related to your tonsillectomy?"

A nurse is educating the parents on how to help their 10-year-old daughter deal with an extended hospital stay due to surgery, followed by traction. Which response indicates a need for further teaching? a) "We must prepare her in advance." b) "She will be sensitive to our concerns." c) "I should not tell her how long she will be here." d) "She will watch our reactions carefully."

"I should not tell her how long she will be here."

The nurse is documenting the child's intake. The child ate 4 cups of ice during this shift. How many cups of fluid did the child ingest? a) 1 cup of fluid b) ½ cup of fluid c) 4 cups of fluid d) 2 cups of fluid

2 cups of fluid

The nurse is caring for an 18-month-old boy hospitalized with a gastrointestinal disorder. The nurse knows that the child is at risk for separation anxiety. The nurse watches for behaviors that indicate the first phase of separation anxiety. For which behavior should the nurse watch? a) Crying and acting out b) Exhibiting apathy and withdrawing from others c) Loosing interest in play and food d) Embracing others who attempt to comfort him

Crying and acting out

The nurse is caring for a child who has been hospitalized for six days and whose caregivers are unable to stay with the child. The child cried most of the day for the first three days but now is quiet and seems to be accepting the hospitalization and being away from the caregivers. This behavior in the child is an example of which of the following stages of separation? a) Denial b) Protest c) Depression d) Despair

Despair

A 5-year-old boy is scheduled for hospitalization in 2 weeks. Which of the following is the best intervention to help ease the stress of hospitalization in this patient? a) Encourage the family to participate in the child-life program. b) Have his parents explain the situation. c) Arrange for the child to tour the hospital. d) Allow the child to talk to a friend who recently had the same procedure.

Encourage the family to participate in the child-life program.

A child is to undergo a tympanostomy tube placement in a freestanding outpatient surgery center. What is the major disadvantage associated with this location? 1. Increased risk for infection 2. Increased health care costs 3. Need to be transferred if overnight stay is required 4. Increased disruption of family functioning

Need to be transferred if overnight stay is required

The 10-year-old girl hospitalized for bladder surgery will be most stressed when nurses provide what care? a) Abdominal dressing change b) Perineal and indwelling catheter care c) Auscultation of breath and bowel sounds d) Change of the hospital gown

Perineal and indwelling catheter care

A 6 year old will be hospitalized for a surgical procedure. How can the nurse best ease the stress of hospitalization for this child? a) Tell the parents to bring toys for the child from home. b) Have another child talk with the child to be hospitalized. c) Prepare the child for hospitalization by explaining what to expect and showing him or her around the hospital. d) There is no way to adequately prepare a child for an impending hospitalization.

Prepare the child for hospitalization by explaining what to expect and showing him or her around the hospital.

The pediatric unit in the hospital is designed to be comfortable for the child and to make the child feel secure. Which of the following aspects of the pediatric unit would be most likely to support the child who is hospitalized? a) The hallways are painted with bright colors and characters familiar to children. b) Procedures and treatments are done in a room other than the child's hospital room. c) A playroom is available which is stocked toys and activities for a variety of ages of children. d) Staff members wear clothes that are a variety of colors, designs and patterns.

Procedures and treatments are done in a room other than the child's hospital room.

The nurse is providing home care for a 4-year-old girl with a chronic respiratory illness. What would be a case management activity? a) Teaching the grandmother how to do chest physiotherapy b) Assessing the cleanliness of the home c) Establishing eligibility for a Medicaid waiver d) Scheduling intravenous and respiratory therapy services needed by the child

Scheduling intravenous and respiratory therapy services needed by the child

A nurse is developing a preoperative plan of care for a 2-year-old. The nurse should pay particular attention to which of the child's age-related fears? a) Separation from friends b) Loss of control c) Separation from parents d) Loss of independence

Separation from parents

A nurse is preparing to start an intravenous (IV) line on a 5 year old. Where does the nurse understand the procedure should be performed so that the child's "safe place" will not be disrupted? a) The operating room b) The emergency department c) The treatment room d) The child's room

The treatment room

A nurse is using a doll to explain what will be done when starting an intravenous (IV) line on a 4 year old. What type of play is this considered? a) Parallel play b) Interactive play c) Play therapy d) Therapeutic play

Therapeutic play

The nurse is caring for a 7- year-old boy in a body cast. He is shy and seems fearful of the numerous personnel in and out of his room. How can the nurse help reduce his fear? a) Remind the boy he will be out of the hospital and going home soon. b) Write the name of his nurse on a board and identify all staff on each shift, every day. c) Tell him not to worry; explain that everyone is here to care for him. d) Encourage the boy's parents to stay with him at all times to reduce his fears.

Write the name of his nurse on a board and identify all staff on each shift, every day.

The nurse who wishes to be as supportive as possible to the hospitalized preschooler makes great effort to avoid threatening the 4-year-old's: a) verbal skills. b) food preferences. c) body integrity. d) creativity.

body integrity.

The nurse is talking with the parents of a hospitalized child who has three siblings at home being cared for by the grandparents. The main idea the nurse wants the parents to understand is that siblings may experience: a) jealousy toward their ill brother or sister. b) stress equal to that of the affected child. c) guilt, believing they caused their bother's or sister's illness. d) resentment toward the parents.

stress equal to that of the affected child.

The student nurse is assisting the more experienced pediatric nurse. Which statements by the student indicate further education is required? Select all that apply. a) "It would be easy to perform a straight catheterization while the baby is in his crib." b) "Could you give the nauseated child some medicine before it is time for him to start thinking about ordering lunch?" c) "I'm going to redress the child's IV site while she is in the playroom." d) "I told the child's mom to go ahead and bring in his blanket and stuffed animal." e) "I took our new teenaged child down to show him the playroom."

• "I'm going to redress the child's IV site while she is in the playroom." • "I took our new teenaged child down to show him the playroom." • "It would be easy to perform a straight catheterization while the baby is in his crib."

Question: The nurse is providing care for a hospitalized child. Rank the following phases in the order of occurrence based on the nurse's statements. 1 "Hi, my name is Cindy and I'm going to be your nurse for today." 2 "You handled that procedure so well! Would you like me to get Mr. Snuggles for you?" 3 "Would you like your medicine before or after your mom helps take a bath?" 4 "Let's sit over here and play a game of 'Go Fish'."

"Hi, my name is Cindy and I'm going to be your nurse for today." "Let's sit over here and play a game of 'Go Fish'." "Would you like your medicine before or after your mom helps take a bath?" "You handled that procedure so well! Would you like me to get Mr. Snuggles for you?"

The nurse is caring for a child hospitalized with complications from asthma. Which statement by the parents indicates a need for careful observation of the child's anxiety level? a) "My mother passed away here after surgery." b) "Our twins were born here 18 months ago." c) "My father undergoes kidney dialysis at this hospital." d) "We attended a 'living with asthma' class here."

"My mother passed away here after surgery."

A nurse is preparing to admit a child for a tonsillectomy. How should the nurse establish rapport? a) "Let's take a look at your tonsils." b) "Tell me about your cute stuffed dog you have." c) "Are you scared about having your tonsils out?" d) "Do you understand why you are here?"

"Tell me about your cute stuffed dog you have."

The nurse is working with a group of caregivers of children in a community setting. The topic of hospitalization and the effects of hospitalization on the child are being discussed. Which of the following statements made by the caregivers supports the most effective way for children to be educated about hospitals? a) "The school nurse set up posters and displays showing pictures of what the inside of a hospital looked like, and we made sure our daughter saw the display." b) "We are going to take our child to an open house at the hospital so she can see the pediatric unit." c) "My wife brought home several books about hospitalization and surgery, and she and I are reading them to our son." d) "Our next door neighbor was sick and died in the hospital. We explained to our son that usually babies are born and people get well in hospitals."

"We are going to take our child to an open house at the hospital so she can see the pediatric unit."

A mother in the outpatient setting is explaining how she plans to prepare her 5-year-old for hospital admission. What remark indicates the parent requires additional teaching? a) "We found several books for him at the library that talk about being in the hospital." b) "We have a date to visit pediatrics and tour their department." c) "We watched a program for kids on public television about being in the hospital." d) "We told him to use his manners and behave like a big, brave boy."

"We told him to use his manners and behave like a big, brave boy."

A 10-year-old child on a regular diet refuses to eat the food on her meal tray. She requests chicken nuggets, French fries, and ice cream. What is the best nursing action? 1. Ask that the child's desired foods be sent up from the kitchen. 2. Negotiate with the child to eat at least part of the food on the tray. 3. Remove a privilege. 4. Offer the child cereal and milk from stock on the nursing unit.

Ask that the child's desired foods be sent up from the kitchen.

The nurse is providing hair care for an African American 10-year-old girl hospitalized with a painful disorder. What should the nurse do first? a) Use commercial detangling solutions prior to brushing. b) Ask the girl and/or her family about any preferences in hair care or for usual procedures used. c) Condition the hair before shampooing. d) Dry the hair before combing.

Ask the girl and/or her family about any preferences in hair care or for usual procedures used.

The nurse is caring for a preoperative pediatric patient. Of the following, which would be best for the nurse to do with this patient? a) Explain how therapeutic plan can be used in preparing the child for surgery. b) Teach technical terminology to the caregivers so they will understand what is being said postoperatively. c) Determine how much the child knows and is capable of understanding. d) Keep the child away from any food or drinks to ensure the child is NPO.

Determine how much the child knows and is capable of understanding.

The nurse providing home care to a 2-year-old listens to the child's parents talk about how the child and family are adjusting to the child's current illness. Which of the following roles is the nurse participating in? 1. Case management 2. Child and family advocacy 3. Direct nursing care 4. Child and family education

Direct nursing care

A 5-year-old boy is scheduled for hospitalization in 2 weeks. Which of the following is the best intervention to help ease the stress of hospitalization in this patient? a) Have his parents explain the situation. b) Encourage the family to participate in the child-life program. c) Allow the child to talk to a friend who recently had the same procedure. d) Arrange for the child to tour the hospital.

Encourage the family to participate in the child-life program.

A nurse is admitting a 7 year old to the pediatric unit of the hospital. While the nurse is showing the child and parents the room and explaining where things are, the child becomes upset and frightened. What is the best action by the nurse? a) Keep on showing and explaining to the parents and do not include the child. b) Tell the child that there is nothing to be afraid of and that nobody will hurt the child during hospitalization. c) Ask the parents to leave the room while explaining procedures to the child. d) Go slowly with the acquaintance process.

Go slowly with the acquaintance process.

The school nurse is caring for an 8-year-old boy with asthma. What is most likely to be part of the child's Individualized Health Plan? a) Giving the child his prescribed asthma medications b) Storing the child's asthma inhaler in the health office c) Making a monthly report of the child's asthma episodes to his physician d) Helping the child modify his physical activity requirements

Helping the child modify his physical activity requirements

The nurse is caring for a 10-year-old boy who had an appendectomy 2 days ago. Prior to surgery he had expressed that he was worried that after the procedure he would hurt and have lots of pain. The nurse asks the child what his pain level is on a scale of 0 to 10, with 10 being the worst pain. He tells the nurse he has no pain. The most appropriate action by the nurse would be to a) Ask him to show you his pain level using the color pain scale. b) Explain to his caregiver that his pain level shows he is getting better quickly. c) Tell him to let you know if he begins to feel pain. d) Observe him for physical signs which might indicate pain.

Observe him for physical signs which might indicate pain.

A toddler needs to be transported to a far area of the hospital for noninvasive diagnostic testing. The nurse chooses to: a) Have the mother carry the child wrapped in a blanket. b) Use a wheeled cart with sides to provide for safety. c) Transport the child in his crib surrounded by his toys. d) Place the child on the mother's lap and push the two in a wheelchair.

Place the child on the mother's lap and push the two in a wheelchair.

When a child is hospitalized and must be away from the caregiver, the child goes through stages of response to the separation. The child who cries and refuses to let the nurse or anyone else comfort them and is continually looking out the door to see if the caregiver is returning is in which stage of separation? a) Anger b) Despair c) Denial d) Protest

Protest

A 3 year old who has just been admitted with pneumonia needs to have an intravenous (IV) line inserted for antibiotic therapy. Which of the following is the best nursing action? a) Tell the patient to stay with the mother in his room while the IV is inserted. b) Take the patient to the treatment room to have the IV inserted. c) Inform the patient's mother that she can stay in the room and hold the child while the IV is inserted. d) Tell the patient that it will feel like a bumble bee sting when inserted.

Take the patient to the treatment room to have the IV inserted.

A 5 year old scheduled for surgery in the morning wakes at 2 am and asks the nurse for something to eat and drink. What should the nurse tell this patient? a) That the patient is NPO for surgery b) That the patient cannot have anything until after surgery c) That the patient could aspirate if eating or drinking anything so close to surgery d) That not having food or drink before surgery will prevent an upset stomach

That not having food or drink before surgery will prevent an upset stomach

The nurse is caring for a 10-year-old child admitted for a surgical procedure to be done the next day. The nurse takes the child to a special area in the playroom and lets the child "start" an IV on a stuffed bear. Which of the following is this action an example of? a) Play therapy b) Positive reinforcement c) Therapeutic play d) Age-related activity

Therapeutic play

The nurse working on the pediatric unit is talking with the child-life specialist. The nurse asks the specialist what the technique is called in which activities are used to help the child have a better understanding of what will be happening to him or her in a specific situation. Which of the following best describes what the nurse is discussing? a) Cooperative play b) Therapeutic play c) Onlooker play d) Play therapy

Therapeutic play

A nurse getting ready to conduct preoperative teaching with a 9 year old realizes that the best method when teaching young patients is which of the following? a) Give all information to the parent. b) Give little information quickly. c) Use short sessions. d) Discuss everything at once.

Use short sessions.

A 6-year-old needs to cough and deep breathe following surgery. To accomplish this, the nurse will: a) instruct the parents to remind the child to cough and deep breathe every 2 hours. b) arrange for respiratory therapy to do coughing and deep breathing exercises with the child. c) teach the young school-ager to use an incentive spirometer. d) blow a pinwheel and bubbles with the child.

blow a pinwheel and bubbles with the child.

A 5-year-old patient whose mother is rooming-in during the child's hospitalization will benefit in which of the following areas? a) feelings of good health b) feelings of security c) feelings of isolation d) feelings of joy

feelings of security

On the first postoperative day, a 4 year old who was hospitalized for an emergency appendectomy has begun to cry relentlessly, will not let the nurse touch her, and keeps asking for her mother. The pediatric nurse is aware that this patient is in which stage of separation? a) grief b) despair c) protest d) denial

protest

The nurse is preparing a 4-year-old girl for a lumbar puncture. The child is extremely fearful and crying. The nurse needs to quickly gain the child's cooperation so the procedure can move forward as ordered. Which approach by the nurse should be used? a) Apply a mummy restraint. b) Explain to the child that she must calm down. c) Engage the mother in therapeutic hugging. d) Tell the child everyone is trying to help her.

Engage the mother in therapeutic hugging.

The nurse is educating the parents of a 7-year-old boy, scheduled for surgery, to help prepare the child for hospitalization. Which statement by the parents indicates a need for further teaching? a) "We should talk about going to the hospital and what it will be like coming home" b) "We should visit the hospital and go through the preadmission tour in advance" c) "It is best to wait and let him bring up the surgery or any questions he has" d) "It is a good idea to read stories about experiences with hospitals or surgery"

"It is best to wait and let him bring up the surgery or any questions he has"

The nurse is caring for a 14-year-old child who is scheduled to have surgery the next day. Which of the following would be most appropriate for the nurse to do to help prepare this child for surgery? a) Give the child a book to read which describes the people who are involved in the preoperative, surgical, and postoperative areas. b) Show the child models of the body that include the organs or parts of the body the child will be having surgery on. c) Explain to the caregivers while they are in the room with the child the reason the child will be kept NPO. d) Allow the child to use the equipment that will be seen in the operating room, such as masks, gowns, gloves.

Give the child a book to read which describes the people who are involved in the preoperative, surgical, and postoperative areas.

A 6-month-old infant requires restraint to prevent removal of his nasogastric tube. What is the priority nursing intervention? 1. Tie the restraint loosely to prevent skin breakdown. 2. Leave the baby unrestrained when directly observed. 3. Position the restrained infant prone to prevent aspiration. 4. Place the infant in a room near the nurses' station.

Leave the baby unrestrained when directly observed.

A young hospitalized patient is crying because his mother is going to work to take care of some important business but has promised to return in a few hours. What could the mother do to allay the child's fear that she will not return? a) Say that the patient can call her on her cell phone anytime. b) Promise him that she will return. c) Tell him that the nurse has her cell phone number and can call. d) Give him her scarf to keep for her.

Give him her scarf to keep for her

What will the nurse view as best maintaining normalcy in the life of a 10-year-old boy who is experiencing a lengthy hospitalization? a) Playing board games with the child life specialist b) Keeping up with his schoolwork c) Choosing the time of his bath or shower d) Watching daytime television e) Writing down his oral intake on the day and evening shifts

Keeping up with his schoolwork

A nurse is caring for an 18-month-old girl undergoing traction therapy in a rehabilitation unit. The nurse understands that the girl is in the second phase of separation anxiety when she observes what behavior? a) The girl acts extremely agitated. b) The girl ignores her. c) The toddler cries inconsolably. d) The child exhibits signs of anger. e) The toddler is quiet, looks sad, and is disinterested in playing.

The toddler is quiet, looks sad, and is disinterested in playing.

When 4-year-old Vernon's mother returns to room-in at the hospital with him after a 3-day trip back home, she is anxious and excited to hug him. When she leans over his bed to pick him up, he turns his back and scoots away. Which of the following statements made by the nurse would be an explanation for the child's reaction? a) "Now that he has seen that you have returned he will feel better, but you should leave the room for a few minutes to help him feel in control." b) "His distrust is abnormal. It may or may not go away in a day or two; we will just have to wait and see." c) "He is probably just tired from the many tests run while you were away." d) "His distrust is normal and may have lingering effects, but you should touch and soothe him as much as possible."

"His distrust is normal and may have lingering effects, but you should touch and soothe him as much as possible."

The nurse is providing teaching for the parents of an 8-year-old girl who has undergone surgery. The nurse emphasizes the importance of maintaining adequate hydration. Which response by the mother would indicate a need for further teaching? a) "Ice chips count as fluid intake. One cup of ice equals a half-cup of water." b) "I should offer her small amounts of fluid frequently." c) "I will remind her that she will need an IV if she does not drink." d) "Anything that melts at body temperature is counted as a fluid."

"I will remind her that she will need an IV if she does not drink."

The nurse is working with the caregivers of a child who is being discharged from a healthcare setting. Which of the following statements is most accurate regarding discharge planning? a) Arrangements should be make for the caregiver to have help with treatments that appear too complex for the caregiver to manage a few days after the child's discharge. b) A conference to review information and procedures with the family caregivers is important to do as part of discharge planning. c) Discharge planning should be just immediately prior to the child leaving the facility. d) Written instructions should be the basis of discharge information so they can be taken home with the child.

A conference to review information and procedures with the family caregivers is important to do as part of discharge planning.

Which of the following activities would be most beneficial in educating children regarding hospitals and hospitalization? a) In an organized group such as Boy or Girl Scouts, children take a tour around the city looking at where buildings such as the hospital, police station, and fire station are. b) A school nurse does a presentation to groups of school child about what it is like to be in the hospital. c) The caregivers take all of the children in the family to an open house at the hospital. d) The caregivers check out books and a DVD from the library explaining the admission process and hospitalization and the family watches it together.

The caregivers take all of the children in the family to an open house at the hospital.

An adolescent would benefit from being out of his hospital room. What can the nurse do to promote this? Select all that apply. a) Encourage the teen to investigate the playroom. b) Invite the adolescent to meet with other teens for lunch in a common space. c) Suggest the adolescent visit other areas within the hospital that are away from the pediatric unit. d) Challenge the adolescent to a video game in the recreation area.

• Invite the adolescent to meet with other teens for lunch in a common space. • Challenge the adolescent to a video game in the recreation area.

A 5-year-old boy is brought to the emergency room with a possible broken arm. His 18-year-old sister, who is also his primary caregiver, has come with him. The boy is relatively calm, but his sister is so upset she is nearly hysterical. The nurse notes that as her behaviors show more anxiety, the boy is getting more upset and his anxiety is also increasing. Which of the following would be best for the nurse to do in this situation? a) Tell the caregiver she will have to leave the room if she doesn't calm down. b) Ask his sister to calm down so that she can hold her brother's other hand while his cast is being put on. c) Ignore the caregiver's behavior. Tell the child that he is going to be fine and that his sister is just nervous. d) Reassure the child. Tell him you need to ask his sister some questions, and then gently remove his sister from the room.

Reassure the child. Tell him you need to ask his sister some questions, and then gently remove his sister from the room.

The nurse is providing home care for an 8-year-old girl who is dependent on a ventilator, and for her family. What is a part of case management for the child and family? a) Problem solving with the parents and child ways to get the child's homework when she is unable to attend school b) Teaching the parents how to do passive range of motion and active range of motion with their child c) Doing the complex sterile dressing changes the child requires d) Scheduling respite care of the child with a child care provider

Scheduling respite care of the child with a child care provider

A few days after discharge, the parent of an 8-year-old calls the pediatric clinic, concerned about the child's behavior now that she is home. The parent expresses that the child is treating her siblings badly and using language she knows she is not allowed to use. The parent asks the nurse for suggestions regarding how to handle this behavior. Which of the following statements would be most appropriate for the nurse to make to this parent? a) "Coming home is a difficult adjustment. Warn your daughter that you expect her to begin to behave better over the next few weeks." b) "Tell her you don't like her behavior and have her to stay in her room until she can be nicer to her siblings." c) "Children often feel guilty for the attention they've taken away from their siblings and act out as a way of earning the attention." d) "Respond to her behavior in a firm, loving, consistent way."

"Respond to her behavior in a firm, loving, consistent way."

The nurse is working with the caregivers and families of children who are hospitalized. Members of the group make the following statements. Which statement gives an indication of an issue that would likely be a major factor influencing the family's response to the child's illness? a) "We have really good insurance—it covered everything the last time she was in the hospital." b) "When my sister was in the hospital before, the nurse let me get up on her bed while she read me a story." c) "Sometimes I wonder if the reason she is sick is because I have so many responsibilities at work and at home." d) "My husband was so relieved when he heard that after the next surgery he will probably not need to have any more and will be fine."

"Sometimes I wonder if the reason she is sick is because I have so many responsibilities at work and at home."

The nurse has applied a restraint to the child's right wrist to prevent the child from pulling out an intravenous line. Which assessment findings ensure that there is proper circulation to the child's right arm? Select all that apply. a) Fingers are pink and warm bilaterally b) Radial pulses are easily palpable bilaterally c) Lungs are clear throughout d) Capillary refill is less than 2 seconds in upper extremities bilaterally e) Bowel sounds present in all four quadrants

• Fingers are pink and warm bilaterally • Radial pulses are easily palpable bilaterally • Capillary refill is less than 2 seconds in upper extremities bilaterally

The grandmother of a 1-year-old cancer patient comes to visit the child in the PICU. She sits in a chair near the child's bed but doesn't touch him. Which of the following actions by the nurse would be most appropriate? a) Respect their privacy and leave the room. b) Pick up the child so that the grandmother sees he can be touched. c) Ask the grandmother if she would like to talk to the child. d) Encourage the grandmother to rock the child in a rocking chair.

Encourage the grandmother to rock the child in a rocking chair.

The nurse has been assigned to care for a child who is on transmission-based precautions. This nurse has not cared for this child before. Which of the following actions would be the best way to help the child feel comfortable with the nurse? a) Remind the child that her caregivers will be in to visit soon. b) Let the child see his or her face before the mask is put on. c) Read to the child for a few minutes before starting care. d) Ask the previous nurse to introduce the new nurse.

Let the child see his or her face before the mask is put on.

A 15-year-old boy asks numerous questions about recovery from anesthesia and typical behaviors of someone awakening from sedation. The nurse interprets the concern of this teen to be: a) about his ability to control his own behavior. b) about a change in body image. c) adequacy of postsurgical pain control. d) anxiety related to the surgical procedure itself.

about his ability to control his own behavior.

A nurse is caring for a 6-year-old boy hospitalized due to an infection requiring intravenous antibiotic therapy. The child's motor activity is restricted and he is acting out, yelling, kicking, and screaming. How should the nurse respond to help promote positive coping? a) "Let me explain why you need to sit still." b) "Would you like to read or play video games?" c) "Do I need to call your parents?" d) "Your medicine is the only way you will get better."

"Would you like to read or play video games?"

A nurse caring for a 5 year old who had abdominal surgery yesterday is trying to teach the child how to take deep breaths. The best way that the nurse can accomplish this is by doing which of the following? a) teaching purse-lip breathing b) using a pinwheel c) using a flow meter d) using a spirometer

using a pinwheel

The nurse is preparing a postsurgical care plan for an infant girl located on a general hospital unit that only occasionally admits children. To ensure the infant's safety, what should the nurse include in the plan? a) Ask the family to stay with the infant at all times. b) Put the infant in a carrier and bring her to the nurses' station. c) Place the infant in a room close to the nurses' station. d) Place the infant in a room with an ambulatory adolescent.

Place the infant in a room close to the nurses' station.

The nurse caring for a 6-month-old infant can best reduce the stress of hospitalization by: a) supporting the parent in his or her presence and caregiving. b) keeping the infant warm and dry. c) providing opportunity for nonnutritive sucking. d) holding and rocking the infant.

supporting the parent in his or her presence and caregiving.