Peds - Chapter 01: Introduction to Child Health and Pediatric Nursing

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? a) 12 b) 16 c) 18 d) 7

7

The nursery nurse is preparing a consent form for the circumcision of a newborn. The mother of the child is 16 years of age. The baby's father is not participating in the care. When planning to complete the surgical consent, which action by the nurse is most appropriate? a) Ask the grandmother of the newborn to sign the surgical consent b) Determine if the baby's father is older than 18 years, and if so ask for him to sign c) Recommend that the court appoint a guardian for the baby d) Ask the baby's mother to sign the surgical consent

Ask the baby's mother to sign the surgical consent

An instructor is describing the issues of research involving children. Which of the following would the instructor include? a) Little if any issues arise when children are part of a research study. b) Children have a lesser risk for nonphysical injury than for physical injury. c) The Common Rule is rarely applicable to research involving children. d) Children are considered vulnerable subjects at high risk for injury.

Children are considered vulnerable subjects at high risk for injury.

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 is the most important first step in developing the nursing care plan for these children? a) Seeking permission from parents of children needing counseling for them to participate b) Arranging for counseling for the children who saw the accident c) Arranging for friends of the injured child to receive counseling d) Determining whether the children were traumatized by the accident

Determining whether the children were traumatized by the accident

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? a) Determining the mother cannot read the form b) Finding out the mother is younger than 18 years of age c) Establishing the mother was never married d) Learning the mother is not the custodial parent

Learning the mother is not the custodial parent

A nurse is caring for a child. Which individual would the nurse identify as being primarily responsible for initiating and coordinating healthcare? a) Social worker b) Parents c) Case manager d) Community

Parents

The following events were milestones in the support of children's health. Place them in the correct sequence, from oldest to most recent: _____ a. Declaration of the Rights of the Child approved _____ b. WIC program established _____ c. U.S. Children's Bureau established _____ d. Sheppard-Towner Act passed _____ e. Family and Medical Leave Act passed _____ f. Education for all Handicapped Children Act passed.

c. U.S. Children's Bureau established d. Sheppard-Towner Act passed a. Declaration of the Rights of the Child approved b. WIC program established f. Education for all Handicapped Children Act passed. e. Family and Medical Leave Act passed

A nurse is considering employment in a practice that promotes family-centered care. When considering this position, the nurse recognizes that this philosophy will: a) promote the involvement of the child and parents as members of the health care team. b) focus primarily on the use of herbal remedies to manage health concerns. c) consider the wishes of the child as the leading force in planning care. d) embrace teaching the parents to manage the health care needs of their child.

promote the involvement of the child and parents as members of the health care team.

The nurse is caring for a 5-year-old girl with meningitis. What action by the nurse may be considered ethical behavior? a) Scheduling a laboratory procedure at lunchtime b) Referring to the child as "her" when she is present c) Starting intravenous fluids even though the child protests d) Telling her an intramuscular injection won't hurt

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? a) Help integrate exercise practices and programs into the lifestyles of individuals and communities. b) Teach injury prevention and proper safety practices. c) Advocate for more research into control of environmental toxins. d) Provide guidance regarding proper nutrition.

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? a) Treating the minor and obtaining written informed consent when the parent arrives b) Explaining the needed treatment to the minor and documenting this action c) Telephone consent with two witnesses listening simultaneously d) Contacting the institution's attorney to provide and document consent

Telephone consent with two witnesses listening simultaneously

The line at the well-child walk-in clinic is long, with closing time near. Which child does the nurse assess based on knowledge of morbidity data? a) The teen needing a sports assessment b) The foreign-born adopted child c) The toddler with a "poor appetite" d) The infant at the 25th percentile on the growth chart

The foreign-born adopted child

A 15-year-old with leukemia tells the nurse that she wants to file for emancipation in order to control her own treatment plan. The nurse explains the process by stating: Select all that apply. a) The minor must live with parents or guardians. b) The process is governed by individual state laws. c) The minor must demonstrate the ability to manage financial affairs. d) The minor must be married or in the armed forces. e) The minor must be able to claim a share of the parent's income by law. f) The minor must be at least 14 years of age.

• The process is governed by individual state laws. • The minor must demonstrate the ability to manage financial affairs. • The minor must be at least 14 years of age.

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. a) Special education b) Financial assistance c) Psychological services d) Infant stimulation e) Speech therapy

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

The nurse is assessing the vital signs of a child who is being evaluated in an urgent care center. The child is to be seen by the pediatric nurse practitioner (PNP). The mother asks, "Why is my child seeing the PNP and not the doctor?" What is the best response by the nurse? 1. "The PNP functions similar to the physician's assistant, so you should be perfectly at ease." 2. "The child may be seen by the physician instead if you'd like." 3. "Seeing the PNP is just one more step in having your child evaluated in this setting." 4. "The PNP is an experienced RN with advanced education in the diagnosis and treatment of children."

"The PNP is an experienced RN with advanced education in the diagnosis and treatment of children."

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? a) "There is some risk that the medication could cause him to have seizures." b) "We can stop participating in the study at any time if we choose." c) "We get reimbursed for parking when we come in for the study visit." d) "All the information collected is recorded by a code number instead of his name."

"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? a) "Although there are risks involved, our son needs the surgery to cure the problem." b) "We are amazed that he'll be up and walking around the day after surgery." c) "He might miss some school afterwards, but he'll be feeling much better." d) "We had to sign the form right away so the surgery could get scheduled."

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

The school nurse is planning a screening program. What items should be included to address issues related to the "new morbidity"? 1. Academic difficulties, violence, and other mental health issues 2. The number of children with chronic illness at the school 3. Statistics related to health insurance coverage of the children 4. HIV infection, asthma, and respiratory allergy testing

Academic difficulties, violence, and other mental health issues

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? a) 7 years b) 9 years c) 12 years d) 14 years

7 years

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? a) The local JCAHCO branch b) The American Association of Nurses c) A nurse mentor d) An institutional ethics committee

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? a) Adapting technologies for use outside of the home b) Helping the child modify trendy clothing to his needs c) Consulting with the school nurse at the child's school d) Assessing the child's daily oxygen supplement needs

Assessing the child's daily oxygen supplement needs

Morbidity data indicate that support is needed from pediatric nursing groups to establish improved and additional services for children with what health issues? a) Mental health and behavioral disorders b) Illnesses due to environmental toxins c) Digestive system problems d) Poor immunization status

Mental health and behavioral disorders

A single18-year-old woman in her second trimester presents at the clinic with vaginal bleeding. She confides to the nurse in confidence that she has been using cocaine to "calm her nerves" and hopes it didn't harm her baby. What would be the nurse's best response to this situation? a) Explain the effects of cocaine on the fetus and tell the mother that she must quit for her baby's sake. b) Tell the doctor about the mother's drug use and ask him to intervene in the situation. c) Consult with the healthcare facility's institutional ethics committee for an appropriate response. d) Refer the mother to a drug and alcohol rehabilitation program and follow up with her recovery.

Consult with the healthcare facility's institutional ethics committee for an appropriate response

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? a) Contact the hospital attorney. b) Ask the child what their preference will be. c) Document the parents' requests. d) Explain to the parents that the surgeon will make the final decision in the event a blood transfusion is needed by the child.

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? a) Self guardian b) Independent practitioner c) Health care surrogate by proxy d) Emancipated minor

Emancipated minor

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

Environmental factors

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

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: a) Government b) Family c) Community d) Healthcare facility

Family

Which of the following would be a current trend that is influencing child care? a) Greater use of alternative treatment modalities b) Less interest in child care c) Decreased regionalization of care d) More families living in apartments

Greater use of alternative treatment modalities

Which of the following is NOT a trend in child health care today? a) Health restoration is stressed over health promotion. b) Children are hospitalized for observation less often than previously. c) Nursing roles are increasing because of the decreasing centrality of families. d) Child health care is moving into regional centers.

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 is the most effective way of advocating for this child and family? a) Locating the best price on a high-frequency chest compression vest b) Teaching the parents how to perform chest physiotherapy c) Assisting the parents in getting the child on a lung transplant list d) Helping parents access the area's multidisciplinary cystic fibrosis clinic

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? a) Discussing with the physician the merits of sutures versus staples for wound closure b) Telling the child, "Stop screaming! You are scaring the other kids here!" c) Holding the child's hand in order to facilitate removal of the glass d) Asking the parent to leave the emergency room cubicle due to crowding

Holding the 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? a) It provides health insurance to children whose families are not eligible for Medicaid but cannot afford to purchase health insurance. b) Medicaid enrollment is necessary to receive a basic set of comprehensive services for children for health promotion and early treatment. c) The program provides monthly payments to income-eligible individuals, including children who are blind or disabled. d) States use federal funds for preventive, primary, and specialty care programs for pregnant women, mothers, infants, children, and adolescents.

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 boy who had his appendix removed. Which action could jeopardize the privacy of the child's medical records? a) Encrypting any e-mail transmissions b) Changing identification and passwords regularly and according to institutional policy c) Letting another nurse use the nurse's log-in session d) Closing files before stepping away from the computer

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? a) Keeping the family apprised of all developments in care b) Teaching the parents how to perform chest physiotherapy c) Educating the parents about the lung transplant list d) Locating the best deal on a high frequency chest compression vest

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? a) Low adolescent delivery rates b) Early pre-natal care c) Home deliveries d) Low birth weight

Low birth weight

The school nurse is caring for several children who witnessed an 8-year-old girl get hit by car on the way to school. Which intervention is least important to the nursing plan of care for these children? a) Making phone calls to the parents of the children counseled b) Arranging for counseling for the children who saw the accident c) Including friends of the injured child to receive counseling too d) Determining that the children were traumatized by what they saw

Making phone calls to the parents of the children counseled

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

Medical records reveal a history of asthma

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? a) Tell the parents to state in writing that they will not participate in the treatment and give the letter to their physician. b) Reassure the family that the doctor is acting in their best interests and they should reconsider the treatment. c) Tell the doctor that the procedure is not in the best interests of his patient and ask him to respect the rights of the family. d) Meet with the physician and disclose the concerns of the family; refer the case to the institutional ethics committee if not resolved.

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

The nurse is assessing a 9-year-old boy during a back-to-school check up. Which finding is a factor for childhood injury? a) The parents adopted the boy from Guatemala. b) Records show child weighed 2,450 g at birth. c) Mother reports she has abused alcohol and drugs. d) Mother reports the child is hostile to other children.

Mother reports she has abused alcohol and drugs.

What is the number one cause for mortality among children? 1. Human immunodeficiency virus 2. Congenital anomalies 3. Motor vehicle accidents 4. Low birthweight

Motor vehicle accidents

More nurses are stepping into the role of the advanced practice nurse. Which of the following would be the nurse to provide care for children under the age of 18? a) Clinical nurse specialist b) Women's health nurse practitioner c) Case manager d) Pediatric nurse practitioner

Pediatric nurse practitioner

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? a) Administering analgesics b) Performing cardiopulmonary resuscitation c) Administering oxygen d) Suctioning the child

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: a) Prevalence of asthma episodes b) Race and ethnicity c) Causes of mortality d) Chronic health conditions

Race and ethnicity

The nurse is focusing on health promotion for a 6-year-old girl. Which intervention best supports Healthy People goals? a) Providing information about after-school child care b) Explaining proper diet in the child's terms c) Recommending a helmet for biking d) Discussing needed amount of sleep

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? a) Describing self-care for brushing teeth b) Explaining how to toddler proof the house c) Explaining how to teach self hand washing d) Reminding that child will imitate parents

Reminding that child will imitate parents

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? a) Reminding the mother that the child will imitate her b) Discussing with the mother anticipated developmental milestones c) Describing physical changes taking place in her child d) Showing the mother how to teach hand washing to her child

Showing the mother how to teach hand washing to her child

A nurse is looking for information about advocacy activities related to promoting literacy. Which of the following would be most appropriate for the nurse to contact? a) Society of Pediatric Nurses (SPN) b) Annie E. Casey Foundation c) National Association of School Nurses (NASN) d) National Association of Pediatric Nurse Practitioners (NAPNAP)

Society of Pediatric Nurses (SPN)

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? a) Take the issue to the Institutional Ethics Committee for advice. b) Contact the Institutional Review Board for guidelines as to how best to proceed. c) Support the parents' decision making for their child regardless of the outcome. d) Provide care to the child without getting involved either way.

Take the issue to the Institutional Ethics Committee for advice.

An older couple approaches the nurse's station seeking information about their hospitalized grandchild. What should be the nurse's response? a) Ask to see identification from the two individuals. b) Answer the grandparents' questions in a less public place. c) Assume "busy-looking" behaviors and move away. d) Tell the couple to seek information directly from the child's parents.

Tell the couple to seek information directly from the child's parents.

A group of students are reviewing information about Medicaid. The students demonstrate a need for additional study when they identify which of the following? a) The federal government is responsible for administering it. b) It is financed by state funds. c) The states determine income-eligibility criteria. d) It provides compensation for healthcare services.

The federal government is responsible for administering it.

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? a) The importance of crossing streets safely b) The importance of immunizations c) Prevention of infection and communicable disease d) Exercise and good nutrition

The importance of crossing streets safely

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? a) Infectious diseases continue to be prevalent. b) Infant mortality rates have dropped. c) The prevalence of chronic disease is increasing. d) Birth rates for teen moms have dramatically increased.

The prevalence of chronic disease 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? a) Nurses make clinical decisions—this action is acceptable. b) This nurse has not met the standard of care that constitutes adequate nursing practice identified in Pediatric Nursing: Scope of Standards and Practice. c) The intervention on the nursing care plan came from the family, not the nurse—the nurse may omit it. d) Sexuality education is a function of the schools—the nurse need not assume the function.

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

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). a) False b) True

True

When caring for an adolescent, in which case must the nurse share information with the parents no matter which state the care is provided in? 1. Pregnancy counseling 2. Depression 3. Contraception 4. Tuberculosis

Tuberculosis

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? a) Administering medications to patients on a timely basis b) Accurately documenting and reporting patient conditions c) Working to change agency policy to better serve families d) Teaching parents the proper way to administer insulin to their child

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: a) disability and chronic illness have increased with the appearance of more genetic abnormalities. b) uninsured families can access these services. c) increasing numbers of children live with chronic disabilities due to advances in healthcare that allow children with formerly fatal diseases to survive. d) there are fewer positions for nurses in institutions providing acute care. e) more disabilities are occurring in children because many women are delaying pregnancy and giving birth to babies later in life.

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

Nurses can help to decrease the United States' mortality rate by advocating for improved access to healthcare for which ethnic groups in particular? Select all that apply. a) American Indians and Native Alaskans b) Mexican-Americans c) Puerto Rican-Americans d) Asian-Americans e) African-Americans

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

A nurse caring for children and their families must respect the rights of the parents and guardians and their charges relevant to child health issues. Which statement best describes these rights? Select all that apply. a) The right to educations is not viewed as an entitlement for children. b) Parents are able to raise the child according to their religion. c) What is best for the child is always considered when parents choose a course of action for their child. d) Parents and guardians can give permission for treatment. e) Court appointed guardians are usually the closest relatives of the child. f) The mother of the child assumes parental responsibility when the couple is not married.

• Parents are able to raise the child according to their religion. • Parents and guardians can give permission for treatment. • The mother of the child assumes parental responsibility when the couple is not married

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? Select all that apply. a) The parents and child are told whom to contact in the agency if they have any questions or concerns. b) The parents and child are made aware of strategies to protect their identifies. c) The parents and child are told of the direct and indirect benefits of participation. d) The parents and child are informed of the possible adverse effects of the research. e) The parents and child are told the physical and nonphysical risks associated with the research. f) The parents and child are aware they can withdraw from the study at any time without prejudice.

• 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.