Pediatrics Chapter 1

A nurse is talking with the parents of a child who is participating in a research study evaluating drug therapy. Which statement by the parents indicates that the principle of beneficence is being addressed?

"There is some risk that the medication could cause him to have seizures."

A nurse is determining whether or not informed consent has been obtained from the family of a child who is going to have abdominal surgery. Which statement by the family would lead the nurse to suspect that informed consent is lacking?

"We had to sign the form right away so the surgery could get scheduled."

A nurse is working as part of a research team evaluating children for participation in a research study. The nurse demonstrates respect for persons when the nurse obtains assent from children over which age?

7

A terminally ill 15-year-old tells the nurse that she wants to stop all treatments and go home despite her parents' directives to provide extraordinary means to keep their child alive. What is the best resource available to this nurse to help solve this dilemma?

An institutional ethics committee

The nurse is caring for a 14-year-old boy with a debilitating illness who wants to attend school. Which of the following interventions addresses the child's physical health but not his quality of life?

Assessing the child's daily oxygen supplement needs

The school nurse is caring for several children who witnessed an accident in which an 8-year-old girl was struck by a car on the way to school. Which of the following is the most important first step in developing the nursing care plan for these children?

Determining whether the children were traumatized by the accident

The parents of a 12-year-old child preparing to undergo surgery explain to the nurse that their religious beliefs do not allow for blood transfusions. What initial action by the nurse is most appropriate?

Document the parents' requests.

A 16-year-old child is admitted to the hospital for treatment after a motor vehicle crash. Review of the child's record reveals that she has the legal right to consent to and make decisions for treatment. What is the term for this client's status?

Emancipated minor

Morbidity rates among children are most highly associated with which cause?

Environmental factors

The nurse is caring for a 16-year-old boy with injuries from a car accident. Which of the following activities describes the nurse's manager role?

Facilitating return to school by working with the school nurse

In order to advocate for children and families, the nurse must first acknowledge that the basic system in which health behavior and care are organized, secured, and performed is the:

Family

Which of the following would be a current trend that is influencing child care?

Greater use of alternative treatment modalities

Which of the following is NOT a trend in child health care today?

Health restoration is stressed over health promotion.

The nurse is caring for a 7-year-old boy with cystic fibrosis whose parents are intensely interested in all aspects of his condition and care. Which of the following is the most effective way of advocating for this child and family?

Helping parents access the area's multidisciplinary cystic fibrosis clinic

The 5-year-old in the emergency room is having glass removed from a wound. Which action constitutes ethical behavior by the nurse?

Holding he child's hand in order to facilitate removal of the glass

When describing the State Children's Health Insurance Program (SCHIP) to a group of families, which of the following would the nurse include?

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

The nurse is updating the records of a 10-year-old girl who had her appendix removed. Which action could jeopardize the privacy of the child's medical records?

Letting another nurse use the nurse's log-in session

The nurse is caring for a 7-year-old boy with cystic fibrosis whose parents are intensely interested in all aspects of the child's condition and care. Which of the following interventions is least important for empowering these health care consumers?

Locating the best deal on a high frequency chest compression vest

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 birth weight

The parent of an 11-year-old female patient 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?

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

Morbidity data indicate that support is needed from pediatric nursing groups to establish improved and additional services for children with what health issues?

Mental health and behavioral disorders

A nurse is caring for a child. Which individual would the nurse identify as being primarily responsible for initiating and coordinating healthcare?

Parents

A nurse is reviewing the medical record of a terminally ill child who has a DNAR order. The nurse interprets this as refraining from which of the following?

Performing cardiopulmonary resuscitation

The pediatric nurse knows that the state of children's health in the United States is evaluated by specific determinants and measures of health status. These determinants include:

Race and ethnicity

The nurse is focusing on health promotion for a 6-year-old girl. Which of the following interventions best supports Healthy People goals?

Recommending a helmet for biking

The nurse is talking with the mother of a 2-year-old girl during a scheduled visit. Which of the following teaching subjects least supports the emphasis on preventive care?

Reminding that child will imitate parents

The nurse is talking with the mother of a 2-year-old girl during a scheduled visit. Which of the following teaching subjects best supports the emphasis on preventive care?

Showing the mother how to teach hand washing to her child

The nurse is caring for a 5-year-old girl with meningitis. Which of the following may be considered ethical behavior?

Starting intravenous fluids even though the child protests

To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups?

Teach injury prevention and proper safety practices.

A group of students are reviewing information about Medicaid. The students demonstrate a need for additional study when they identify which of the following?

The federal government is responsible for administering it.

After teaching a group of nursing students about major threats to children's health, the instructor determines that the teaching was successful when the students state which of the following?

The prevalence of chronic disease is increasing.

The nurse dealing with global populations knows that the health of individuals in North America continues to improve, but much room for improvement remains. Which one of the following statements accurately reflects the state of health in North America?

The prevalence of chronic diseases is increasing.

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?

This nurse has not met the standard of care that constitutes adequate nursing practice identified in Pediatric Nursing: Scope of Standards and Practice.

Your patient is a 1-year-old girl from a low-income family presenting with a vitamin D deficiency and anemia. What assistance program do you recommend to the child's young mother?

WIC

Nurses can help to decrease the United States' mortality rate by advocating for improved access to healthcare for which ethnic groups in particular?

• African-Americans • American Indians and Native Alaskans • Puerto Rican-Americans

A group of students are reviewing information about the Education for All Handicapped Children Act and its amendments. The students demonstrate understanding of this information when they identify which of the following as a service that may be provided? Select all that apply.

• Speech therapy • Infant stimulation • Psychological services • Special education

The parents of a 9-year-old agree to allow their child to participate in a research project involving drug trials for a new drug for attention deficit hyperactivity disorder. Which of the following rights of the child are related to beneficence?

• The parents and child are told the physical and nonphysical risks associated with the research. • The parents and child are informed of the possible adverse effects of the research. • The parents and child are told of the direct and indirect benefits of participation.

A nurse is faced with an ethical conflict involving the care of a child. The child's parents disagree with the physician about the use of a feeding tube. The nurse sees the benefits and limitations of both parties' views. Which of the following would be most appropriate?

Take the issue to the Institutional Ethics Committee for advice.

A family that makes too much money to qualify for Medicaid, but who cannot afford to purchase health insurance, should be referred to the Children's Health Insurance Program (CHIP).

True

An important role of the nurse caring for children and their families is that of child advocate. Which one of the following interventions best reflects this role?

Working to change agency policy to better serve families

The nurse knows that children can give assent (agree) to participate in research. At what intellectual age does the American Academy of Pediatrics suggest minors may first do this?

7 years

Pediatric nurses are developing more home care and community-based services for children with chronic illnesses because:

Increasing numbers of children live with chronic disabilities due to advances in healthcare that allow children with formerly fatal diseases to survive

The nurse is assessing a 9-year-old boy during a back-to-school check up. Which finding is a factor for childhood injury?

Mother reports she has abused alcohol and drugs

You are going to provide an education program to early grade-school children. Which of the following topics would address the number one cause of death for this age group?

The importance of crossing streets safely