PEDS exam 2/6

· An infant was abandoned at an early age and has been in foster care. Which actions should the nurse implement to monitor for a common problem experienced by children in this situation? -Daily weight and plotting on growth chart -Lead screening for exposure to lead in the home -Compliance with vaccinations -Adequacy of formula for feeding at home

o Daily weight and plotting on growth chart

· The nurse is doing an admission interview for a school-age child who is being admitted for respiratory problems. The child has several family members present. What should the nurse do initially?

o Determine who is appropriate to speak to as the head of the household.

· The nurse is performing a cultural assessment on an 8-year-old child with juvenile Tay-Sachs disease. What questions would be important for the nurse to ask?

o What culture do you consider yourself part of o Are your cultural beliefs important to you o Do you have a social support system within your cultural community

· A nurse is caring for a pre-school child who has recently undergone chemotherapy. The patient's appetite has been poor and the family asks, "May we bring in some chicken noodle soup? It is what he is asking for and all he will eat when he is sick. How should the nurse respond?

o Yes, anything that is special to him, that he will eat and that is not restricted is allowed.

· Which of the following describes the "Denial" stage of grief as theorized by Kübler-Ross?

o A refusal to believe that an infant or child is dead or dying

A nurse observes a mother who is unable to calm her crying five-year-old child turn to her ten-year-old child who is standing quietly nearby. The mother states in a stern, loud voice, "Children really need to behave, especially in the hospital." What type of communication pattern did the nurse observe?

Clear and indirect

· The nurse in the hospital is caring for an adolescent patient with end-stage renal disease (ESRD) who is on hospice care. The nurse notes a heart rate of 40, shallow agonal breaths at 10, and lower limbs that are bluish in color. Which action should the nurse take initially? 1. contact pts PCP 2. contact the pts hospice nurse 3. contact the pharmacist 4. contact the social worker

Contact the patient's hospice nurse, the patient is exhibiting signs of end of life and the hospice nurse should be notified to be at the bedside to provide end of life care.

· The nurse is providing education about pediatric meals while in the hospital to a school age child and her family. When discussing the dietary information what statement by the parents would indicate a need for further instruction? 1."Children will more likely eat foods they have often." 2."Home eating times should be maintained as much as possible during the hospital stay." 3."Parents should allow children to eat alone in their rooms so they can focus on getting better." 4."Food storage practices may require two separate refrigerators."

o "parents should allow children to eat alone in their rooms so they focus on getting better" NO! o Parents should be encouraged to eat meals with their child to promote normalcy and socialization

· The senior nurse is explaining the principles of failure to thrive to a student nurse. What statement by the student alerts the nurse that teaching reinforcement is needed?

o A child less than fifth percentile in weight can have failure to thrive

· Which anticipatory guideline would the nurse understand to be appropriate for a 4-year-old child? 1. A child this age will be learning to use scissors 2. A child this age will be learning how to draw a circle with a pencil. 3. A child this age will be learning to dress themselves. 4. A child this age will be learning to speak full sentences.

o A child this age will be learning to use scissors

· Which child does the nurse identify as demonstrating a conventional level of moral development according to Kohlberg?

o A client who asks to be hall monitor in school to assure all are following rules

· The nurse is preparing a 12-year-old girl for her annual check-up. She expects to see the following difference from last year's measurement: 1.No significant change in weight 2.No significant change in height 3.Slow, uniform gain in height and weight 4.A growth spurt since last year's visit

o A growth spurt since last year's visit

· The nurse is discussing safe toy selection for a 13-month-old child with the parents. Which examples stated by the parents would be appropriate? Select all that apply. 1. A ride on animal car 2. A mobile with colorful animals and lights 3. A tricycle with large wheels 4. Marbles of various colors 5. A shape sorter with various blocks

o A ride on animal car o A tricycle with large wheels o A shape sorter with various blocks

· A nurse is doing a needs assessment of a school-age child with cystic fibrosis (CF). The nurse notes that the child comes from a low socioeconomic family in a rural setting. What are the biggest obstacles the nurse could identify for this patient? Select all that apply. 1.Access to nutritious foods and/or the ability to pay for nutritious food 2.Access to a full grocer that supplies fresh fruit and vegetables and healthy food options 3.Access to a primary care provider (PCP) or health care clinic 4.Access to a Level 1 trauma center to care for the critically ill or injured pediatric patient 5.Access to education on the disease process and the necessary care

o Access to nutritious foods and/or the ability to pay for nutritious food o Access to a full grocer that supplies fresh fruit and veggies and healthy food options o Access to a level 1 trauma center to care for critically ill or injured pediatric patient

· The nurse is teaching a group of student nurses about the application of Kohlberg's moral theory of development. What should the nurse include in the teaching? -Children acquire moral reasoning in spontaneous ways, based on their environment. -Kohlberg's theory of moral development is widely accepted among different cultures. -According to Kohlberg, moral development can be advanced through formal education. -According to Kohlberg, individuals are born with some level of morals, but the environment shapes them throughout their lifespan.

o According to Kohlberg, the moral development can be advanced through formal education

· A hospice nurse is conducting a transcultural assessment on a school-age child. During the assessment, the nurse identifies that the family wishes to have prayer five times daily by kneeling to the east and that they would like the child to continue this practice for as long as possible. How should the nurse respond?

o Allow the child and family to fulfill their spiritual practice but monitor closely for complications.

· A nurse is caring for a school-age child with an end-stage cancer. The patient comes from a large family. In what way could the nurse accommodate the cultural needs of the family?

o Allow the extended family to visit the home as often as is comfortable for the patient

· The mother of an infant became visibly upset and stopped the nurse as she attempted to remove a red string that was placed on the child's wrist prior to an intravenous infusion insertion. What are the most appropriate nursing actions? Select all that apply. 1. Allow the mother to choose another site or put the string on the other hand. 2. Find out about the significance of the string placement. 3. Find out what is the matter with the mother. 4. Apologize for your action. 5. Tell her the child needs the procedure more than the string.

o Allow the mother to choose another site or put the string on the other hand o Find out about the significance of the string placement o Find out what is the matter with the mother o Apologize for your action

· The nurse is caring for a 3-year-old client in the emergency room. The doctor orders a urinalysis via straight catheterization of the bladder. What action by the nurse promotes family-centered care?

o Allow the parent to remain at the bedside during the procedure o Explain the procedure thoroughly to the parents o Explain the procedure in appropriate developmental terms to the patient o Allow the parents to ask questions about the procedure

· During communication with migrant families, the nurse should be culturally aware by ensuring adherence to the following strategies. Select all that apply. 1. Ask the caregivers for input into care and beliefs 2. The nurse should have self-awareness 3. Be respectful in order to enhance the therapeutic environment 4. Be reflective of past cultural experiences that may affect interpersonal communication and care delivery. 5. Disclose conflicting values might affect care delivery to families.

o Ask the caregivers for input into care and beliefs o The nurse should have self-awareness o Be respectful in order to enhance the therapeutic environment o Be reflective of past cultural experiences that may affect interpersonal communication and care delivery

· A nurse is present at the time of death for a for a pre-school age child of Jewish faith. What is the most appropriate action the nurse should take initially?

o Ask the family what need they have and how they can best be met

· The mother of an adolescent patient asks for a special meal tray due to her observance of a religious food restriction. Which action should the nurse take in regards to the patient's meal tray? 1. Order the same meal for the patient. 2. Ask the parent if the child must observe the same food restrictions. 3. Ask the patient what meal is preferred and if he or she observes any food restrictions. 4. Substitute a salad off of the cart to avoid the issue.

o Ask the patient what meal is preferred and if he or she obserbes any food restrictions.

· An infant is placed under hospice care for a congenital heart defect. The nurse notes a high-pitched cry, heart rate of 165, respirations of 60, and knees drawn up to the chest. What action should the nurse take first? 1. put on oxygen 2. contact PCP 3. assess further for other signs of pain 4. burp baby

o Assess for further signs of pain, because these are all signs of pain.

· The nurse is caring for toddler whose family is of the Jewish faith. The nurse and many family and friends are at the bedside when the child passes away. What are the most therapeutic interventions the nurse can carry out at this time?

o Assist the family to carry out any special cultural or religious practices that are appropriate o Offer the family time alone with their child o Assist the family in collecting or making any special mementos or keepsakes they request

· A nurse is providing education to the family of a child who has end-stage heart failure. Identify what is important to include in the teaching to the family.

o Current medical treatments avaiable including all available options o Explanation of what will happen to the body at the time of death and after death o Potential outcomes, with discussion of time frame when possible o What to expect during the dying process

· The nurse is caring for a pre-school age client with a neuroblastoma, who is in the end stages. Which interventions would facilitate effective communication between a dying client and family? Select all that apply. 1. Assisting the client and family to carry out spiritually meaningful practices 2. Maintaining a calm attitude and one of acceptance when the family or client expresses anger 3. Making decisions for the client and family to relieve them of unnecessary demands 4. Encouraging the client and family to identify and discuss feelings openly 5. Limiting visiting time daily to allow the client to get more rest

o Assisting the client and family to carry out spiritually meaningful practices o Maintaining a calm attitude and one of acceptance when the family or client expresses anger o Encouraging the client to identify and discuss feelings openly

· Which of the following measures should be used to prevent sudden infant death syndrome (SIDS)?

o Baby on back to sleep o Firm mattress o Fitted sheet o No more than 2 inches between crib slats o No blanket, using a fitted onesie instead

· The nurse is assessing a school-age patient who is dying from a brain tumor. The patient states, "I just want to live long enough to go on our trip to Disney World. If I can do that with my family, I'll be ready to go." Which stage of grief is this patient experiencing?

o Bargaining, tries to make a deal to gain something

· Which attributes are imperatives for maintaining a positive nurse-patient therapeutic relationship in the care of children and families?

o Being culturally competent o Addressing one's cultural biases o Integrating evidence-based practice Good listening skills

· The nurse is teaching the parents of a 6-month-old infant what to expect as their baby's gross motor skills develop. By the baby's first birthday, what gross motor skills are expected? Select all that apply. 1.Jumps 2.Can pull self to standing position 3.Can sit unsupported 4.Walks holding on to furniture 5.May walk two to three steps independently

o Can pull self to standing position o Can sit unsupported o Walks holding on to furniture o May walk two to three steps independently

· The nurse is caring for a newborn infant. When teaching the mother about physical development, the nurse explains that infants can control their heads and neck before they can control their arms and legs. This type of development is referred to as:

o Cephalocaudal

· The father of a 4-year-old female is concerned because she continually asks why her brother has different genitalia. The best response from the nurse is:

o Children at this age are often curious about anatomic differences. It is a normal process

· The parent of a 20-month-old expresses concern that the child continually says "no" whenever asked to do something and wants to know what punishment is appropriate at this age for his disobedience. The nurse should respond by stating: -"Children at this age often show autonomy by vocalizing no, so should not be criticized or punished.\" -"The child is showing signs of disobedience and should receive an appropriate time-out for the behavior." -"The child does not seem to have an understanding of language appropriate for this age and should be referred for assessment." -"Is your child exposed to this type of communication at home? Possibly it is learned behavior."

o Children at this age often show autonomy by vocalizing no, so should not be criticized or punished

· A nurse is caring for a school age child from a very quiet and soft spoken family. When asking the child questions about how he is feeling after his surgery, the child will never say anything negative and goes out of his way to be polite. How should the nurse interpret this behavior?

o Children often respond in the way that their caregivers would respond, or in an "Acceptable" way rather than one that communicates their feelings.

· During the admission of a toddler to the ward, the nurse observed that all questions were answered by only the male family member without consultation from other members. This is characteristic of which family structure?

o Closed =communication and decision making is made by the head of the household or the most influential person.

· The nurse is evaluating a new patient using the transcultural assessment model. Which aspects should the nurse use to evaluate the patient?

o Communication and how thoughts and feelings are expressed o Personal space between the individuals who are communicating o Time, both the perception of time and when daily events should occur in general o Biological variations, such as appropriate weight and development

· A hospice nurse is caring for an adolescent child with acquired immune deficiency syndrome (AIDS). The parents are divorced and the father has sole custody. The mother has come to visit for the first time and is asking many personal healthcare-related questions. How should the nurse best handle this situation? 1. Tell the mother whatever she wants to know. 2. Tell the mother they cannot disclose that information. 3. Tell the mother she must talk to the father of the child. 4. Consult the chart prior to giving out any information.

o Consult the chart prior to giving out any information, because this is a family custodial situation. If there is a legal reason to withhold information do so.

· The nurse is making a home visit on a school-age child with newly diagnosed diabetes mellitus Type 1. The nurse notes the home is dirty, cluttered, and several kids are running around. The mother states, "I don't know if I can handle one more thing around here. This place is like a zoo as it is." What is an appropriate action for the nurse? 1. Contact social services to get assistance to help and make a referral to the diabetes educator. 2. Call the Children's Administration hotline to report the family for abuse or neglect. 3. Tell the mother, "Don't worry, it will all work out." 4. Explain how the mother needs to start putting the child's needs first now.

o Contact social services to get assistance to help and make a referral to diabetes educator. Assess the situation and to make appropriate referrals.

· Which statement by the nursing student related to growth and development would require correction by the nurse? 1."Growth proceeds in a head-to-tail direction." 2."Growth proceeds from the center of the body to peripheral." 3."Control of the arms and extremities will occur before a child is able to maintain trunk control." 4."Development will progress from simple to more complex."

o Control of the arms and extremities will occur before a child is able to maintain trunk control

· A nurse is caring for a Native-American school-age patient who is dying from complications of diabetes. Friends and family members surround the patient's bedside. Which therapeutic techniques should the nurse use when communicating in this situation?

o Discuss what is happening in an open and honest matter o Be culturally appropriate, considering the culture of the patient and family in all communications o Treat the patinet and family with kindness and compassion o Be developmentally appropriate

· After administering the Denver Development Screening Test (DDST), the nurse noted that the child had more than two cautions. What questions should be asked to complete the health assessment and guide nursing care.

o Do you have lead-based paint in you house? o What is your source of drinking water? o Do you have access to safe parks o Were you exposed to any viral illnesses during pregnancy?

· A female nurse from the emergency department (ED) accompanies the healthcare provider to the waiting room to tell a man of a different culture than the nurse that his son was killed in an accident. The nurse reaches out and puts her hands on the man's hands and states, "I am so sorry, I know this is devastating news." The man pulls his hands away from the nurse. What should a nurse supervisor say to the ED nurse regarding this interaction?

o Due to the patients culture that touch could be considered inappropriate and might not be interpreted as you intended.

· A nurse is providing care for a terminally ill child. When communicating with the parents of the child, the nurse recalls her personal sense of helplessness and loss when assisting other families. She also recalls the recent death of her eight-year-old granddaughter. Which term best defines the nurse's capability to relate to the parents?

o Empathetic= empathy is a deep understanding of a persons feelings, which is often developed though an individuals personal experiences

· The nurse is caring for a school-age child in need of a blood transfusion to improve his rare condition. The family are Jehovah's Witnesses and will not allow it due to their religious beliefs. What action should the nurse take? 1. Examine personal beliefs and how they differ from the patient's. Provide non-judgmental care. 2. Refuse to care for the patient. 3. Tell the patient's family that they are killing their child with their decision. 4. Say nothing and ignore the internal conflict.

o Examine the personal beliefs and how they differ from the patients'. Provide non-judgmental care.

· A school-age child who was recently on hospice, is undergoing a full code in a family-centered respite house. The patient stopped breathing with the family at the bedside and would need extensive resuscitation. What intervention by the nurse would be best for the family?

o Explain to the parents exactly what will go on and ask them what they prefer. This is the best in a family centered care environment.

· A nurse is providing education to a school-age child who has end-stage leukemia. Identify what is important for the nurse to include in the teaching to the client. Select all that apply. 1.Explanation of cause for terminal diagnosis and how the disease will cause death 2.Explanation of when time of death will occur 3.Explanation of current medical interventions needed and what the client should expect 4.Explanation of the dying process, with appropriate explanation of what to expect 5.Explanation of what will happen to the body at the time of death and after death

o Explanation of cause for terminal diagnosis and how the disease will cause death o Explanation of current medical interventions needed and what the client should expect o Explanation of the dying process with appropriate explanation of what to expect

· The nurse is reviewing the length and weight of a 3-month-old infant and notices that since the infant's first well-baby check-up, the baby has not increased in weight. Which condition is the nurse most worried about?

o Failure to thrive

· The nurse understands that early parent-child relationships play a role in a child's social development. What statement made by the mother of a 4-year-old tells the nurse that the mother understands this concept? -"I have to anticipate all of my child's needs." -"Feeling loved and cared for is good for my child's cognitive development." -I shall make sure my child has the best toys." -"I shall make sure my child has everything he ever wants."

o Feeling loved and cared for is good for my child's cognitive development

· The nurse must obtain a signature on the consent for surgery form for a preschool child. The lady at the bedside states she is the child's aunt and that the child lives with her at this time. How should the nurse proceed? 1. Have the aunt sign the consent form. 2. Wait for the parent to come in and fill out the consent from. 3. Find out who the legal guardian is for the child and have that person sign the consent form. 4. Have two physicians sign the form since the parents are not present.

o Find out who the legal guardian is for the child and have that person sign the consent form.

· The mother of a toddler placed a small figurine on the child while in the cot. Recognizing that this might have cultural importance, but may also have health implications, what strategies should the nurse implement?

o Give affirming smile to the mother o Explore the importance of this action for the family o Educate the mother about the potential safety risks o Spend more time with the family to understand the implication for care

· The mother of a toddler placed a beaded necklace on the child while in the cot. Recognizing that this might have cultural importance, but may also have health implications, what strategies should the nurse implement? Select all that apply. 1.Give an affirming smile to the mother. 2.Remove the necklace due to safety concerns. 3.Explore the importance of this action for the family. 4.Educate the mother about the potential safety risks. 5.Spend more time with the family to understand the implication for care.

o Give an affirming smile to the mother o Explore the importance of this action for the family o Educate the mother about the potential safety risks o Spend more time with the family to understand the implication for care

· The nurse is teaching the parents of a school-age child about behaviorist theory. Which example should the nurse provide when teaching the parents about classical conditioning? -Allowing the child to play video games after they clean their room. -Giving the child dessert if they finish all of their vegetables at dinner. -Taking away the child's iPad if they act out in public. -Giving a child a cookie for each section of their homework they complete, along with positive affirmation.

o Giving a child a cookie for each section of their homework they complete, along with positive affirmation

· An infant born at 32 weeks' gestation is now seen in the clinic for a six-month visit. Assuming a full gestation of 40 weeks and adjusting for gestational age, which developmental milestone does the nurse anticipate the infant should be demonstrating? Select all that apply. 1. Pulls self up to stand 2. Grasps toys 3. Supports upper body with arms when lying on stomach 4. Transfers object from one hand to the other 5. Follows objects with eyes to midline

o Grasps toys o Supports upper body with arms when lying on stomach o Follow objects with eyes to the midline

· The nurse is planning to teach a 4-year-old client regarding her upcoming procedure. The nurse knows that at this age, the client can developmentally: 1. Think abstractly 2.Make rational judgments 3.Have thoughts that are often influenced by fantasy 4.Use deductive reasoning

o Have thoughts that are often influenced by fantasy

· With the projected demographic change in the American society by 2020, nursing management is taking what steps to ensure cultural competence among staff? Select all that apply. 1.Having an organizational cultural competence audit 2.Having continuous nursing education in cultural diversity 3.Integrating the beliefs and values of diverse cultures into care 4.Displaying signs with multiple languages 5.Employing diverse groups that are multilingual

o Having an organizational cultural competence audit= provides evidence-based information to guide decision making towards organizational culture and the need for change o Having continuous nursing education in cultural diversity o Integrating the beliefs and values of diverse cultures into care - Employing diverse groups that are multilingual

· The pediatric nurse works as part of a collaborative team to provide health care to patients. What should the nurse identify as integral parts of a multidisciplinary relationship? SATA 1.Healthcare providers work as a team and share information as appropriate. 2.Respect any differences of opinion. 3.The senior member should get the final say in any disagreement. 4.The patient's best interest is kept in mind by all care providers. 5.Ethics consultations should be avoided when there are differences.

o Healthcare providers work as a team and share information as appropriate o Respect any differences of opinion o The patients best interest is kept in mind by all care providers

· Which sequence would the nurse identify to describe the process of cephalocaudal development? 1. Rolling over prior to grasping at an object 2. Crawling or scooting prior to walking 3. Holding the head steadily upright prior to sitting 4. Grasping an object prior to bringing to the mouth

o Holding the head steadily upright prior to sitting

· The nurse is discussing end-of-life care with the family of a terminally ill toddler. The family is of the Hindu faith, have many religious objects, and are saying prayers at the bedside. Which statement by the nurse would show spiritually and culturally appropriate communication? 1."If you are going to use oils and incense, you will need to do that outside of the hospital." 2."How may I best accommodate your needs?" 3."Please let me approve anything before you put it on your child's body." 4."May I call a pastor for you?"

o How may I best accommodate your needs? The nurse should always clarify with the patient and/or family what is important to them and how their needs can best be met.

· During a well child check, the nurse discusses choking hazards with the parents of a 12-month-old child. The nurse knows the teaching has been effective with which parent statement?

o I will cut the hotdog lengthwise first, then cut the halves into small pieces

· The nurse is taking the health history of a school-age child. The parents are at the bedside to answer questions. What question would be most important for the nurse to determine in regards to the patient's management of care?

o If the patient has used any alternative practitioners or therapies.

· The nurse is providing care to a family after the loss of their child. The mother states, "I am just so angry! This isn't fair. My baby shouldn't be gone." How should the nurse respond to the mother? A: "No, it isn't fair. This is an awful tragedy." B: :"You shouldn't feel that way. He is in a better place." C: "It is normal to feel that way. Everyone grieves at different stages." D: "It will be okay. You will feel better in time."

o It is normal to feel that way, everyone grieves at different stages. Validate feelings!

· A mother asks what age is appropriate for her daughter to start brushing her own teeth. The nurse should respond by stating: -"Children as young as 3 can begin to brush their own teeth." -"It will vary from child to child, but she should be able to by age 5." -"This will be determined by your dentist once she is old enough for routine cleanings." -"Children should start caring for their own teeth as soon as the first tooth emerges."

o It will vary from child to child, but she should be able to by age 5

· What safety considerations are important for the nurse to include in teaching parents of a 14-month-old?

o Keep electrical sockets covered at all times

· Which items does the nurse understand to represent the influence of nurturing on child development? Select all that apply. 1. Maternal smoking during pregnancy 2. Maternal diet during pregnancy 3. A choice of public versus private school 4. A congenital heart defect that will require prolonged hospital stay 5. Brown eyes

o Maternal smoking during pregnancy o Maternal diet during pregnancy o A choice of public versus private school

· The nurse is conducting a developmental assessment on an infant who was born at 32 weeks' gestation. The child is now 4 months old chronologically. After adjusting for age, which milestones should the nurse use to complete the assessment? -Milestones for a 4-month-old infant -Milestones for a 2-month-old infant -The nurse cannot conduct a developmental assessment until age 2 when the child catches up with developmental milestones. -Milestones for a 3-month-old infant

o Milestones for a 2 month old infant

· The nurse is teaching the parents of a newborn about differentiation. Which response by the parent shows that they have understood the teaching?

o My baby will learn how to crawl before it can walk

· A nurse is caring for a toddler whose parents only speak Spanish. The nurse needs to obtain consent to perform an emergency appendectomy. What options are recommended if an interpreter is not readily available?

o Use pictures to communicate ideas o Use family members to serve as interpreters Use the internet for interpretation

· A nurse is providing education to the family of a child who needs end-of-life care and is considering hospice. Which statement by the family indicates an understanding of the goal of hospice care? 1."My child will be given the best treatments to fight this disease until the end." 2."I know my child will be in the hospital and will have all options available if needed." 3."My child will be kept comfortable and will experience a peaceful death." 4."This is going to mean the end, but we will keep fighting this disease as long as we can."

o My child will be kept comfortable and will experience a peaceful death

· The organ donation approach team nurse is providing education to the family of a child on hospice about organ donation. The nurse will consider the teaching effective when the parent makes which statement? 1."My child will pass away in the operating room, so we will need to say goodbye here." 2."I can't wait to keep in touch with the people who get my child's organs." 3."My child's organs can only go to other kids." 4."I'm glad I will get to have a say in who will get my child's organs."

o My child will pass away in the operating room so we will need to say goodbye here

· A mother states that she required iron therapy during pregnancy due to anemia. Which physical finding would the nurse want to look for in the newborn to detect a potential complication related to this condition? 1.Irritability 2.Low birth weight 3.Cleft lip and palate 4.Pale mucus membranes

o Pale mucous membranes

· The nurse is developing a therapeutic relationship with the patient and family. To do this the nurse should take into account what practices?

o Recognizing appropriate boundaries o Keeping information confidential o Building mutual respect and trust

· The nurse is performing a cultural assessment on a new patient. Which areas should the nurse include in the assessment?

o Religious beliefs o Patient and family perception of current health status o Food preferences o Typical daily schedule

· A nurse is providing education on using a patient-controlled analgesia (PCA) pump for pain control to a school age child who is recovering from surgery. The patient's parent states, "We don't believe in using narcotic medications for pain, it is fundamentally against our beliefs. My child will be fine without it." How should the nurse respond? 1. Respect the patient and the family's beliefs and work with them to find nonpharmacological measures for pain relief .2. Tell the family you cannot accommodate their preference that the surgery was too painful and this treatment is in the best interest of the patient. 3. Report the family to social services. 4. Tell the family they are being unreasonable and causing their child unnecessary harm.

o Respect the patient and the family's beliefs and works with them to find nonpharmacological measures for pain relief.

The nurse is providing health-promotion education to a group of new parents on how to avoid sudden infant death syndrome (SIDS). The teaching would be considered successful if the participants were able to identify which facts about SIDS?

o SIDS is one of the leading causes of death for infants 1 month to 1 year of age o The peak time for SIDS deaths is 2 to 4 months of age o Babies should be put " back to sleep" o Use a firm mattress NOT A SOFT ONE

· Health disparities are a leading contributor of ill health in some ethnic groups and affect children negatively. The nurse is aware that the most important strategy for addressing these disparities and promoting health equity nationally would be what?

o Social justice policies=promote equity at all levels by addressing individual, community, organizational national, and international factors affecting health and well being.

· The nurse sets up a reward system for a child in the hospital to recognize appropriate behaviors. The nurse is using which theory of development? -Social learning theory -Theory of psychosocial development -Theory of psychosexual development -Psychointellectual developmental theory

o Social learning theory

· Place the types of play in order of development according to Erickson's Psychosocial Development Theory:

o Solitary play o Parallel play o Associative play o Cooperative play

· The mother of a 10-month-old client wants to know when she should start potty training her child. What is the nurse's best response?

o Sphincter muscles mature between ages 1 and 3; some children are ready to potty train earlier than others

· The nurse is providing education about end-of-life care to members of a large family who recently found out their school-age child was diagnosed with a terminal illness. Which initial statement by the nurse demonstrates understanding of appropriate communication? 1. "I need to talk to the parents alone about this situation." 2. "Tell me about what you already know concerning your child's condition." 3. "Let me give you this information in writing so that you will have it to reflect on later." 4. "I am going to give you detailed medical information about how this diagnosis will affect your child."

o Tell me about what you already know concerning your child's condition

· A nurse is caring for a school-age child with asthma who comes in regularly. The nurse notices unusual bruising on the child's upper arm as well as an abrasion to the left cheek. The child states, "Please don't tell anyone, you know my dad. He didn't mean to. I just made him mad is all. He won't do it anymore, he promised." What action should the nurse take? 1.Tell the child, "I understand, but you need to contact 911 if it happens again." 2.Tell the child, "I can't keep secrets like that. I have to report this as part of my job." 3.Tell the child, "You should have told someone right away. Now it's too late." 4.Tell the child, "Just call me if you are ever in trouble and I will help you."

o Tell the child, I cant keep secrets like that, I have to report this as part of my job.

· The nurse is assessing a 2-year-old child brought in to the emergency department (ED) after a fall. Which pain scale would be most appropriate to use for a 2-year-old child?

o The Faces, Legs, Activity, Cry, and Consolability scale for newborn to 7 years. This assess the patients facial expression, leg positioning, and flexion, activity level, and consolability.

· The nurse is teaching an infant's parents about development. Which statement alerts the nurse that the teaching was understood by the parents?

o We should be careful not to wean the baby too soon

· A hospice nurse is caring for a child with end-stage cancer who has a "Do Not Resuscitate" order (DNR) on file. The patient stops breathing and is found to have no pulse while the grandmother is at the bedside. The grandmother, who is not the legal guardian, states, "The child lives with me and I want everything possible done to save his life!" What initial statement should the nurse make? 1."Yes, we will start CPR right away." 2."I can see you are very upset right now, but I am going to have to ask you to leave." 3."The child's legal guardian has a do-not-resuscitate order in place, and that is what we have to follow." 4."You do not have the right to make that decision."

o The child's legal guardian has a DNR in place, and that is what we have to follow.

· The nurse is caring for a client with leukemia. The nurse understands that he must tailor his teaching to this client who is in the formal operational phase. What must the nurse keep in mind when teaching the client? Select all that apply. 1. The client is capable of hypothetical and deductive reasoning. 2. The client's thinking is influenced by fantasy and imagination. 3. The client has perception of actions and consequences. 4. The client is able to understand the reason for hospitalization. 5. Teaching through discussion is ineffective.

o The client is capable of hypothetical and deductive reasoning o The client has perception of actions and consequences - The client is able to understand the reason for hospitalization

· The pediatric nurse is assessing several children for routine check-ups. Which client would the nurse assume to be in the industry versus inferiority stage of development -The client who states, "I can't wait to go shopping after this. My friends are going to be so jealous of my new outfits!" -The client who states, "The rest of my friends cheat on tests, but I don't because the teacher said we shouldn't." -The client who states, "I can't wait to go to college so I can finally gain some sort of independence." -The client who states, "I stole a cookie last night and I don't feel good about it."

o The client who states, "the rest of my friends cheat on tests, but I don't because the teacher said we shouldn't".

· The nurse is teaching the parents of a child about Freudian theory. Which statement made by the nurse is correct in describing the ego? -"The ego drives the seeking of pleasure." -"The ego is the realistic part of the person." -"The ego contains values and conscious thoughts." -"The ego follows the unconscious mind and is driven by irrational instincts."

o The ego is the realistic part of the person

· The nurse completed a cultural assessment on an adolescent patient who is being treated for recurrent episodes of gallbladder problems. Which finding should the nurse associate as being most useful when providing care for this patient's condition?

o The family prefers all natural foods and cooks with many hot spices

· An infant weighed 7 pounds at birth and is now being evaluated for a 6-month well child visit. The mother asks how much weight the child should have gained by this age. Which is the correct response from the nurse? 1.The infant should have gained approximately 7 pounds. 2. The infant should have gained approximately 14 pounds. 3.There is no way to estimate weight because of so many variable factors. 4.The infant should have gained approximately 4.5 pounds.

o The infant should have gained approximately 7 pounds

· What modifications should the nurse make when conducting a developmental assessment of a child who recently immigrated to the United States? 1. The nurse should conduct the developmental assessment without any modifications or considerations. 2. The nurse should conduct the assessment with an understanding that language may change the results. 3.Cultural identity is dependent upon the age of the child; a very young child will not have any cultural influences. 4.The child should be taught the meaning of various words being used in the test.

o The nurse should conduct the assessment with an understanding that language may change the results

· An adolescent with diabetes is increasingly resistant to coming in to the school nurse clinic for insulin administration at lunch time. What developmental principle should guide the nurse in working with the child? 1.This is normal behavior for a teenaged client. 2.The teen is exhibiting depressive symptoms and should be referred for therapy. 3.The teen is incapable of considering consequences to their own actions. 4.The teen is in the phase of developing conscience so may not understand their actions.

o This is normal behavior for a teenaged client

· The mother of a toddler who was previously toilet trained is concerned about the child needing diapers while in the hospital. The best response from the nurse is based on an understanding of the following principle: -This is a normal response during illness and hospitalization -.The child may need a referral to a urologist. -The child was not ready to potty train and so is showing regression. -Child life should be consulted to evaluate for other signs of developmental delay. -This is a normal response during

o This is normal response during Illness and hospitalization

· The nurse is taking health history information from the family of a child who has an upper respiratory problem. There are several family members present and the nurse notices that all of the family members sit quietly, nodding, looking to the grandfather who is answering the questions. How should the nurse interpret this situation?

o Through the family's verbal and nonverbal communication they indicate that the grandfather is the family spokesperson

· A family is gathered around the bed of child with terminal Hodgkin's lymphoma. Together, the primary care provider (PCP) and the parents make the decision to withdraw care. Which interventions should the nurse make? Select all that apply. 1. Turn off any monitors. 2. Give a dose of pain medication to make the patient comfortable. 3. Disconnect all invasive lines. 4. Apply oxygen to provide comfort. 5. Create a comfortable, undisturbed, peaceful, and private environment for the family.

o Turn off any monitors o Disconnect all invasive lines o Create a comfortable, undisturbed, peaceful, and private environment for the family

· A nurse is giving preoperative instruction for a pre-school age patient with Japanese-speaking parents who cannot understand the English language. To effectively communicate with someone who speaks a different language, which intervention should the nurse implement? 1.Make eye contact and speak where the parents can see you better. 2.Speak more slowly and use sign language. 3.Use an interpreter to translate. 4.Speak in a louder tone of voice using simple words.

o Use an interpreter to translate, most appropriate way to communicate.

· The nurse is talking with the five-year-old sibling of a child who has end-stage brain cancer. The sibling is crying and states, "It's all my fault. I was mad at him for always taking my game and wished he would die. I made this happen." What is the nurse's best response? 1."Don't talk like that; it is not true." 2."You did nothing wrong. Your brother is very sick, but you did not cause it." 3."You should not feel that way. He has been sick for a long time." 4."Your brother is going to get better; don't worry about it."

o You did nothing wrong, your brother is very sick, but you did not cause it.

· Cultural diversity in health care institutions is necessary due to mass migration. Which ethical principle is the most important for culturally competent care? 1.Fidelity 2.Respect 3.Justice 4.Beneficence

o respect

· The most important strategy to support cultural competence and equity in healthcare environments would require the nurse to do which of the following action?

· The most important strategy to support cultural competence and equity in healthcare environments would require the nurse to do which of the following action?