RN-Peds-Ch 1-5

The nurse is assessing a pediatric patient in the emergency room for injuries sustained from a fall. The nurse asks the parents how the child was injured. Which response by the parent uses the most productive communication pattern? 1. "My wife forgot to check the baby gate like I had asked her to." 2. "I am the only one who checks the baby gate all the time." 3. "Typical man; he just doesn't follow directions." 4. "I forgot the check the baby gate when I came home."

"I forgot the check the baby gate when I came home."

The nurse is assessing an adolescent patient in the emergency department after she was attacked at a party. The patient refuses to give her parent's contact information and states, "They will kill me when they find out that I went to the party." What is the nurse's best response? 1. "They will understand. Let me call them to at least get the insurance information." 2. "Since you are a minor, we need their consent to legally treat you." 3. "We will treat you, and your parents do not have to know that you are here." 4. "I need to contact the social worker, as we have a duty to report this attack to your family and the authorities."

"I need to contact the social worker, as we have a duty to report this attack to your family and the authorities."

The nurse is providing care to an adolescent patient with cystic fibrosis in the acute care setting. The patient tells the nurse, "You are my favorite because you always listen to me, not like the other nurse who hates me." Which response by the nurse is most appropriate? 1. "I will report the other nurse immediately, and you won't have to see her again." 2. "If you have any concerns, I can ask the charge nurse to talk to you, but we all work as a team." 3. "That's nice of you to say. I will try hard to keep you happy while here as my patient." 4. "I understand. She has been reported by the other staff members for playing favorites."

"If you have any concerns, I can ask the charge nurse to talk to you, but we all work as a team."

The nurse at a family clinic is providing care to an adolescent patient diagnosed with diabetes. The patient has verbalized discomfort with the feelings of isolation when unable to drink alcohol with their friends. Which of the following would be the most appropriate response to this statement? 1. "Drinking alcohol is not only illegal but dangerous for your blood sugar control and overall well-being." 2. "You can still drink alcohol, in moderation, if you control the sugar spike with more insulin." 3. "Prepare for alcohol intake with more water and less carbohydrates before drinking in order to slow sugar spikes." 4. "It is understandable that you want to be included, but perhaps we can work out a plan on how to avoid those situations."

"It is understandable that you want to be included, but perhaps we can work out a plan on how to avoid those situations."

The nurse is providing care for a pediatric patient who is receiving end-of-life care at the age of 12 years. In addition to the patient, the nurse is caring for the family members from a Middle Eastern culture, including younger siblings of the patient. Which comment by the nurse exemplifies appropriate communication? 1. "Please let me know if you have pain so that I can make you more comfortable." 2. "I know your son is going to heaven and all of you will be together in the future." 3. "Your brother is suffering, and you need to be strong and brave for him now." 4. "I understand you will be ready to move away from this life and on to the next."

"Please let me know if you have pain so that I can make you more comfortable."

The nurse is presenting information to pregnant couples about the "safe to sleep" campaign to prevent SIDS. One attendee states, "Babies sleep best on their bellies. What difference does position make?" Which answer by the nurse is best? 1. "Positioning on the back opens the airway fully." 2. "Sleeping face down increases the risk of aspiration." 3. "The most dangerous time is 2 to 4 months of age." 4. "Of greater importance is not using blankets."

"Positioning on the back opens the airway fully."

A nurse is providing care to an adolescent patient. Which statement by the nurse is most likely to enhance communication with the patient? 1. "Are you participating in any risky behaviors?" 2. "What concerns do you have about your health?" 3. "Are you taking your medication as prescribed?" 4. "Is there a reason why you waited so long to come in?"

"What concerns do you have about your health?"

The nurse is conducting a health assessment on a 10-year-old boy from an Asian culture who has bruises on his arms and back. The bruises appear similar in size and shape. The nurse is familiar with Asian culture but should evaluate the patient by asking which questions? Select all that apply. 1. "Have you fallen or injured yourself recently?" 2. "How often do you feel hungry?" 3. "What does your family do to heal illness?" 4. "Are you playing any sports in school?" 5. "Has anyone hit you or otherwise hurt you?"

1. "Have you fallen or injured yourself recently?" 3. "What does your family do to heal illness?" 5. "Has anyone hit you or otherwise hurt you?"

The charge nurse on a pediatric unit is aware that the nurses do not demonstrate culturally competent care. Which actions does the charge nurse implement to help the nurses develop this competency? Select all that apply. 1. Arrange for classes to learn about culturally competent care. 2. Identify the cultural groups most frequently served by the facility. 3. Share the reasons why nurses need to be culturally competent. 4. Teach nurses that their own cultures and beliefs are to be eliminated. 5. Provide cultural assessment tools for the unit nurses to use.

1. Arrange for classes to learn about culturally competent care. 2. Identify the cultural groups most frequently served by the facility. 3. Share the reasons why nurses need to be culturally competent. 5. Provide cultural assessment tools for the unit nurses to use.

The nurse is providing care to an 11-month-old child who is hospitalized with pneumonia. Which nursing interventions are appropriate for this child? Select all that apply. 1. Communicate primarily with parents regarding treatment. 2. Allow the child to tour the facility before treatments. 3. Use simple terminology when talking to the child. 4. Use a singsong wide-eyed approach to interact. 5. Promote a sense of security with use of gentle touch.

1. Communicate primarily with parents regarding treatment. 4. Use a singsong wide-eyed approach to interact. 5. Promote a sense of security with use of gentle touch.

The nurse is providing end-of-life education to parents of a child diagnosed with a terminal illness. Which topics of education are important for the nurse to provide? Select all that apply. 1. Explain how the progression of the disease will affect their child. 2. Describe the physical changes that will occur during the dying process. 3. Suggest several funeral homes to be contacted before death. 4. Explain that pain management will interfere with communication. 5. Describe what to expect after death including how the child will look.

1. Explain how the progression of the disease will affect their child. 2. Describe the physical changes that will occur during the dying process. 5. Describe what to expect after death including how the child will look.

The nurse is aware that pediatric patients and their families have cultural needs and influences during periods of hospitalization. Which cultural elements does the nurse specifically provide for the hospitalized patient? Select all that apply. 1. Follow the schedules for meals and sleep times observed at home. 2. Encourage visitations and play times with the patient's siblings. 3. Provide a private and suitable place for caregiver hygiene and meals. 4. Set scheduled times for parents to have uninterrupted access to the patient. 5. Promote staff acceptance to parenteral input to the patient's plan of care.

1. Follow the schedules for meals and sleep times observed at home. 2. Encourage visitations and play times with the patient's siblings.

The nurse must obtain data for a routine assessment of the 8-month-old patient. Which of the following are part of that assessment? Select all that apply. 1. Measure the head circumference and record results. 2. Enter height and weight in the growth chart. 3. Assess bilateral hand grasp strength and function. 4. Input the Tanner scale results in the chart. 5. List most recent immunizations in the chart.

1. Measure the head circumference and record results. 2. Enter height and weight in the growth chart. 5. List most recent immunizations in the chart.

Which statement best describes the common core concepts of the different models of pediatric nursing? 1. All models focus on the open communication between the child and nurse. 2. All models focus on importance of family relationship to the child. 3. All models focus on safeguarding the child's dignity during care. 4. All models focus on coordination of care needs that arise during illness.

All models focus on importance of family relationship to the child.

The nurse is providing care to a 4-year-old child who is recovering from an orthopedic injury in the hospital. The nurse notes there are two siblings who are ages 6 years and 1 year. The father is the primary caregiver, and the mother is the primary wage earner. During the assessment, the nurse notes that the 6-year-old seems to be the primary nurturer of the 1-year-old, while the father tends to the 4-year-old, and the mother talks on her cell phone. Which nursing diagnosis is appropriate for this family? 1. Compromised family coping r/t insufficient reciprocal support between the parents as evidenced by family behavior during hospital visits. 2. Risk for delayed development r/t lack of parental involvement as evidenced by family behavior, mother and siblings not interacting. 3. Ineffective family health management r/t family conflict as evidenced by mother's inability to interact with the child during hospitalization. 4. Interrupted family processes r/t hospitalized child as evidenced by lack of full family interactions during hospitalization.

Compromised family coping r/t insufficient reciprocal support between the parents as evidenced by family behavior during hospital visits.

A 16-year-old patient is approaching the terminal stage of a brain tumor. The nurse notices the patient is calling friends and making plans for a social gathering several months away. When friends are present the patient assures them of a full recovery because of a new doctor. The nurse recognizes the patient is experiencing which stage of grief? 1. Acceptance 2. Denial 3. Anger 4. Bargaining

Denial

The nurse is providing care to a 5-year-old child who is recovering from a tonsillectomy in the hospital. The nurse notes that the 9-year-old sibling is tending to the psychosocial needs of the patient, while the parents discuss their marital conflicts in front of the children. Which nursing diagnosis is appropriate for this family? 1. Dysfunctional family processes 2. Risk for parent-child attachment 3. Spiritual distress 4. Risk for impaired parenting

Dysfunctional family processes

The nurse is providing care for a pediatric patient whose family culture is Hispanic. Which action is best when the nurse notices the patient is eating poorly at meals and rejecting snacks? 1. Ask the family members to share the types of foods preferred by the patient. 2. Encourage the family to prepare and bring favorite foods to the patient. 3. Offer the patient a variety of healthy and nutritious foods every 2 hours. 4. Contact the health-care provider and ask that dietary supplements be ordered.

Encourage the family to prepare and bring favorite foods to the patient.

Which of the following continuing education courses would best enhance the pediatric nurse's practice in relationship to current trends? 1. Evidence-based practice on improving antibiotic adherence with education to the family unit 2. Evidence-based practice on proper administration of antibiotics for children with autoimmune diseases 3. How to enhance communication with children in regards to adherence to antibiotic use 4. How to decrease instances of exacerbation of infections of children with autoimmune diseases with antibiotics

Evidence-based practice on improving antibiotic adherence with education to the family unit

The nurse is providing care to a hospitalized 1-year-old patient. The nurse locks the exits per protocol to prevent the removal of the child from the unit. The grandparents become angry about this, because they want to take the infant outside for "some fresh air." What is the appropriate measure that the staff take to promote patient safety at this time? 1. Explain that the child is not to leave the floor without express permission from the parents. 2. Explain to the grandparents that this is a measure to prevent abduction of the patient. 3. Permit the grandparents to take the child after they sign a waiver for any possible injuries incurred off the unit. 4. Permit the grandparents a limited amount of time off the unit, due to treatment schedules.

Explain to the grandparents that this is a measure to prevent abduction of the patient.

The nurse works in a pediatric hospice unit in an acute care facility. The nurse is currently providing care to an infant. Which assessment tool does the nurse use to identify the infant's level of pain? 1. Faces scale 2. FLACC 3. Visual analogy scale 4. NIPS

FLACC

A child who is 10 years of age is brought to the clinic with symptoms of a serious lower respiratory infection. The attending adult self-identifies as a grandparent. The child states the grandparent is the only family of the patient. Which is the most important information for the nurse to acquire prior to treatment? 1. How to reach one of the patient's parents 2. Which other family members live with the patient 3. If the grandparent has legal custody of the patient 4. What caused the grandparent to seek medical care

If the grandparent has legal custody of the patient

The pediatric nurse is providing care to an 8-year-old client who has Down syndrome and wants to ensure he is providing evidence-based care. Which of the following resources would best offer evidence-based practice guidelines related to the care of this patient? 1. Journal of Specialists in Pediatric Nursing 2. Journal of Child and Adolescent Psychiatric Nursing 3. National Database of Nursing Quality Indicators 4. American Journal of Maternal/Child Nursing

Journal of Specialists in Pediatric Nursing

The nurse recognizes that the American Nurses Association characterizes which fundamental nursing practice within the Pediatric Nursing Standards of Practice and Professional Performance for Nurses? 1. Nursing utilizes evidence-based practice for the rationale of interventions. 2. Nursing complies with the physician orders to maintain scope of practice. 3. Nursing maintains the institutional review boards that monitor care. 4. Nursing facilitates the rules of laws within the health-care continuum.

Nursing utilizes evidence-based practice for the rationale of interventions.

The medical-surgical float nurse is assigned to the pediatric unit for the first time and states that the skills are "the same as general nursing since children are little adults with smaller bodies." What component of pediatric nursing contraindicates this statement? 1. Pediatric nursing involves care based on the developmental level of the patient. 2. Pediatric nursing involves the patient's family in the plan of care. 3. Pediatric nursing in based on prevention of infectious diseases. 4. Pediatric nursing involves cultural sensitivity in patient care.

Pediatric nursing involves care based on the developmental level of the patient.

The nurse recognizes the needs of professional development to provide safe and effective care to the pediatric population by attending which of the following courses? 1. Procedure with rationale to administer HPV vaccines to the middle school population 2. Study review of the incidence of bullying and intimidation in the elementary school population 3. Demographic study of the U.S. population with regard to cultural diversity and practices 4. How to provide individual health care education for the children without parental interference

Procedure with rationale to administer HPV vaccines to the middle school population

The pediatric nurse is developing interventions for a school-aged child based on the nursing diagnosis of impaired body image related to BMI of 37 and poor food choices as evidenced by patient's mother's food diary for the family and child's statements of food preferences. Which of the following would be an appropriate nursing intervention? 1. Provide the child and family with information from MyPlate.gov for healthy food options. 2. Increase the child's activity by incorporating the child's friends into a plan of healthy exercise options. 3. Explain the importance of balancing diet and exercise to prevent obesity to the child and family. 4. Provide information on the increased risk for potential disease processes such as diabetes and hypertension.

Provide the child and family with information from MyPlate.gov for healthy food options.

The nurse is preparing a 13-year-old patient for a full physical examination by the primary care provider (PCP). The patient asks that her mother leave the room because of the sensitive nature of the examination. What is the best course of action to be taken by the nurse to protect the interested parties? 1. Ask the mother to leave the room, and allow the patient to discuss her concerns privately with the PCP. 2. Allow the mother to stay in the room, and explain that she has the right to witness any care provided by the PCP. 3. Act as a chaperone and remain with the patient and mother in the room during the full examination. 4. Reassure the mother that the nurse will remain as a chaperone while she leaves the room.

Reassure the mother that the nurse will remain as a chaperone while she leaves the room.

The nurse is preparing to provide care to a child from a culture that is unfamiliar to the nurse. Which action by the nurse is most effective in providing culturally competent care? 1. Researching the culture on the Internet 2. Recognizing that each person and family is unique 3. Seeking advice from a coworker from the same culture 4. Determining which family member is the decision maker

Recognizing that each person and family is unique

The parents of a toddler, diagnosed to be in the end stage of a terminal illness, are concerned about how to manage pain without the sedation effects of pain medications. Which suggestion by the nurse is likely to meet the needs of both the parents and the patient? 1. Encourage the parents to bring favorite toys and books. 2. Initiate playtime in the playroom with other patients. 3. Provide age-appropriate videos for patient distraction. 4. Suggest a parent hold the patient and perform gentle massage.

Suggest a parent hold the patient and perform gentle massage.

The nurse is considering taking classes to learn another language besides English. Which factor has the greatest impact on the nurse deciding which language to study? 1. The current cultural makeup of the area around the facility. 2. The availability of foreign language classes within travel distance. 3. The languages that are currently covered by professional interpreters. 4. The 2020 projected ethnicity breakdown in the United States.

The 2020 projected ethnicity breakdown in the United States.

The nurses on a unit that cares for terminal pediatric patients wish to implement a change in facility policy to allow parents/guardians to remain during a patient code. Which is the most powerful reason that nurses can present to administration? 1. Family-centered care can be continued during a very stressful situation. 2. The family knows everything possible was done to save the patient. 3. The family experiences greater communication and decreased confusion. 4. Family may desire to stay during specific interventions that seem inappropriate.

The family knows everything possible was done to save the patient.

The nurse is completing the admission process for a pediatric patient by obtaining information related to the patient's culture. Which area of assessment is most important if the patient is an infant? 1. The religious beliefs of the patient's family 2. The family's perception of the current health status 3. The patient's food preferences 4. The typical daily schedule followed by family and patient

The family's perception of the current health status

The nurse is assessing the family of a pediatric patient in the home-care setting. Which of the following family APGAR findings best correlates with the nursing diagnosis of caregiver role strain? 1. They have recently moved to the area and have not been able to form relationships within the community. 2. They show affection to each other and are able to devote time to other family members. 3. They have formed a partnership to carry forth the usual household responsibilities and support each other. 4. The mother provides primary care of the ill child and household while the father works two jobs to provide financial support.

The mother provides primary care of the ill child and household while the father works two jobs to provide financial support.

The nurse is attempting to provide education to the family of a newborn in the home-care setting. Which nursing intervention will assess comprehension of the communication with the family? 1. The nurse identifies the primary caregiver of the infant for instructions and asks for privacy with the individual. 2. The nurse provides both written and verbal instructions at an age-appropriate level and asks for a return demonstration. 3. The nurse provides descriptions of signs and symptoms to report to the primary care provider. 4. The nurse requests to see their calendar with approximate dates for immunizations.

The nurse provides both written and verbal instructions at an age-appropriate level and asks for a return demonstration.

Which of the following tasks is associated with the pediatric medical home care model of pediatric nursing? 1. The nurse refers the family to a childhood cancer support group prior to discharge from the hospital. 2. The nurse includes a simple explanation of the procedure to the child based upon the child's developmental level. 3. The nurse includes the family's cultural celebrations and observations while providing care to the child. 4. The nurse develops the plan of care with the child and family as the focal point of the interventions.

The nurse refers the family to a childhood cancer support group prior to discharge from the hospital.

Which of the following behaviors serves as an example of the nurse directly upholding the American Nurses Association's (ANA's) Code of Ethics for Nurses? 1. The nursing union develops a safe patient-to-nurse ratio. 2. The nurse joins a professional specialty organization. 3. The nurse maintains sterile technique during procedures. 4. The nurse develops a plan of care for a community-wide illness.

The nursing union develops a safe patient-to-nurse ratio.

Which of the following behaviors serves as an example of the nurse directly upholding the ANA Code of Ethics for Nurses? 1. The nursing union develops a safe patient-to-nurse ratio. 2. The nurse joins a professional specialty organization. 3. The nurse maintains sterile technique during procedures. 4. The nurse develops a plan of care for a community-wide illness.

The nursing union develops a safe patient-to-nurse ratio.

The nurse is providing care to a pediatric patient in the mental health facility. The nurse asks the patient to draw a picture of her family. What is the function of this activity? 1. This drawing depicts the child's perspective of the family unit. 2. This drawing provides an outlet from the therapy sessions. 3. This activity is a tool to facilitate communication via play. 4. This activity develops problem-solving skills for the child.

This drawing depicts the child's perspective of the family unit.

The nurse is providing care to a child in the home care setting. The nurse often provides the mother with advice that varies from how to perform the child's medical care to marital advice. The nurse has stated that this is her favorite patient and has made this child's home the last stop of her shift to use her free time for visits. What is the relationship status between the nurse and family? 1. This is a therapeutic relationship based on family-centered care, with a focus on empathy. 2. This is not a therapeutic relationship, as the nurse has become enmeshed within the family. 3. This is a therapeutic relationship, with the nurse focusing on the well-being of the whole family. 4. This is not a therapeutic relationship, as the nurse has not included the whole family in the care.

This is not a therapeutic relationship, as the nurse has become enmeshed within the family.

The nurse is providing care for a pediatric patient who is 11 years of age. The patient is diagnosed with an aggressive form of cancer and is scheduled to begin chemotherapy. The patient tells the nurse, "I think I am going to die, but I also think I will get much sicker first." Which communication by the nurse is most appropriate for this patient? 1. Explain to the patient the importance of maintaining a hopeful outlook. 2. Encourage the patient to ask the doctor to explain what is going to happen. 3. Use basic terms to explain the disease progression and side effects of treatment. 4. Provide information about the different options that can be considered for the patient.

Use basic terms to explain the disease progression and side effects of treatment.

The nurse is providing care to a 17-year-old patient in the family practice clinic. The patient reports concern for the parents, as she is the last one of the four children to leave the home. She is concerned that her parents may "fall apart" when she leaves for college in the fall. What is the best response from the nurse based on the family systems theory? 1. "Although changes that occur in one family member's life affects the entire family, keep in mind that your family is dynamic." 2. "Each member of the family has to differentiate themselves, whether good or bad, to influence family relationships." 3. "Although this may put a strain on their relationship, a healthy family recognizes the need love and growth." 4. "Although the family is growing apart, this is a time for your parents to refocus on extended family relationships."

"Although changes that occur in one family member's life affects the entire family, keep in mind that your family is dynamic."

The nurse has provided a presentation to middle school children about nursing as a career. One of the children stated that he wanted to be a pediatric nurse, because he wants to take care of babies and little "kids." What would be an appropriate response to this middle school-aged child? 1. "Nursing is a general practice; all nurses must know how to take care of all ages of patients." 2. "As a pediatric nurse, you would get to care for babies and little kids as well as children through their teenage years." 3. "What you are describing is actually a neonatal nurse. Neonatal nurses work with newborn babies, toddlers, and preschool-age children." 4. "Being a pediatric nurse requires a master's degree, so be sure to work hard in school!"

"As a pediatric nurse, you would get to care for babies and little kids as well as children through their teenage years."

The nurse is attempting to collect information from the parents of a critically ill child brought to the emergency department. The parents are from a different country, and English is their second language. The child's father suddenly shouts, "I cannot talk with you, care for my child now!" Which response by the nurse is correct? 1. "I will get an interpreter to help us understand each other." 2. "This information is important for providing care for your child." 3. "Getting angry will just complicate things; you need to calm down." 4. "I know that you are frustrated, but getting this information is important."

"I will get an interpreter to help us understand each other."

The nurse is assessing an adolescent patient in the emergency department with a suspected intentional overdose. After given treatment, the patient refuses to give her parent's contact information and states, "It is none of their business." What is the nurse's best response? 1. "Now that you are safe, let me help you develop a plan to prevent a recurrence." 2. "I'm sorry, but I'm obligated to tell them. Let me help you develop a plan for their possible responses." 3. "Although most of your health care is confidential, we are obligated to notify them." 4. "I think you should tell them, but we will honor your confidentiality and not disclose the reason for your visit."

"I'm sorry, but I'm obligated to tell them. Let me help you develop a plan for their possible responses."

The emergency department nurse is providing care to a 3-year-old child who has suffered a major accident. The parents ask the nurse, "Is our child going to be okay?" What is the most effective communication response at this time? 1. "Your child has suffered a severe laceration to the spinal cord and may have terminal paralysis." 2. "Your child is being assessed at this time. I am confident the physician will resolve the problem." 3. "Your child has suffered a major injury; let me give you some privacy. May I call the chaplain just to be with you?" 4. "Your child has suffered a major injury. Please wait here while we finish assessing the injuries."

"Your child has suffered a major injury; let me give you some privacy. May I call the chaplain just to be with you?"

The nurse in a pediatric clinic is concerned about health-care disparities among the patient population. Which patient or family comment indicates the presence of health disparities related to culture? Select all that apply. 1. "I didn't bring my child sooner because I have a limited income." 2. "I tried all the remedies my mother used, but he just got sicker." 3. "My mother does not speak English and will need an interpreter." 4. "I felt certain that you would see my child who is now an adolescent." 5. "We took a bus and transferred twice to get our sick child here."

1. "I didn't bring my child sooner because I have a limited income." 2. "I tried all the remedies my mother used, but he just got sicker." 5. "We took a bus and transferred twice to get our sick child here."

The nurse provides care in a pediatric health-care facility with a culturally diverse patient population. In which manner will the nurse promote effective and culturally considerate communication with patients? Select all that apply. 1. Communicate in a language understood by the patient and family. 2. Identify the person responsible for making the patient's medical decisions. 3. Utilize opportunities to learn about interacting with diverse cultures. 4. Identify patient's/family's perception about the cause of physical illness. 5. Learn about and practice culturally correct nonverbal communication.

1. Communicate in a language understood by the patient and family. 2. Identify the person responsible for making the patient's medical decisions. 3. Utilize opportunities to learn about interacting with diverse cultures. 4. Identify patient's/family's perception about the cause of physical illness. 5. Learn about and practice culturally correct nonverbal communication.

The nurse is developing a health fair for children aged 5 and 6 years. Which of the following would be appropriate topics for this population based on current trends? Select all that apply. 1. How to deal with bullying on the internet 2. How to prevent the flu with hand washing 3. How to choose and eat healthy foods 4. How to recognize suicidal thoughts 5. Ways to stay active and stay healthy

1. How to deal with bullying on the internet 2. How to prevent the flu with hand washing 3. How to choose and eat healthy foods 5. Ways to stay active and stay healthy

The pediatric nurse is providing care to a 5-year-old patient for speech impediments that were caused by repeated incidences of otitis media. Which of the following is an example of current issues regarding this type of medical problem? Select all that apply. 1. Increased admissions based on environmental risk factors, such as smoking 2. Increased admissions based on knowledge deficits due to language barriers 3. Increased awareness of childhood health issues from social media and Internet 4. Shift in the focus of medical care from disease treatment to disease prevention 5. Deficient knowledge that has negatively impacted the adherence to the antibiotic regimen

1. Increased admissions based on environmental risk factors, such as smoking 2. Increased admissions based on knowledge deficits due to language barriers 5. Deficient knowledge that has negatively impacted the adherence to the antibiotic regimen

The parents of a dying child have decided to withdraw medical treatment and allow their child to die peacefully. Which nursing actions will occur after the withdrawal is implemented? Select all that apply. 1. Monitoring equipment is turned off. 2. All invasive lines are disconnected. 3. Periodic validation is sought from the family regarding the decision to end care. 4. A comfortable, peaceful environment is created for the patient and family. 5. The family is provided with undisturbed privacy.

1. Monitoring equipment is turned off. 2. All invasive lines are disconnected. 4. A comfortable, peaceful environment is created for the patient and family. 5. The family is provided with undisturbed privacy.

A pediatric patient with a terminal disease is placed in hospice care. In addition to patient care, which other services provided by a multidisciplinary team will meet the needs of the patient and family? Select all that apply. 1. Social work 2. Child-life specialist 3. Community programs 4. Physician 5. Grief counselor

1. Social work 2. Child-life specialist 4. Physician

The school nurse is providing care to the student population in the urban elementary school. The nurse notes that the children do not feel safe playing outside during recess due to the recent violent incidents in the surrounding area. What are some disease processes that the nurse may notice due to this inactivity? Select all that apply. 1. The general population is at higher risk for obesity. 2. The students are at higher risk for increased bullying. 3. The students are at a higher risk for learning disabilities. 4. The students are at higher risk for diabetes mellitus. 5. The students are at higher risk for earlier onset of puberty.

1. The general population is at higher risk for obesity. 4. The students are at higher risk for diabetes mellitus.

Which of the following nursing actions is an example of a function of the Code of Ethics for Nurses directly relating to the health-care environment? Select all that apply. 1. The nurse cowrote a policy on nurse:patient ratio for the unit. 2. The nurse includes the extended family in discharge instructions. 3. The nurse joined a local professional organization that shapes community policy. 4. The nurse enrolled in a basic American Sign Language course. 5. The nurse joins the safety and infection control committees.

1. The nurse cowrote a policy on nurse:patient ratio for the unit. 3. The nurse joined a local professional organization that shapes community policy. 5. The nurse joins the safety and infection control committees.

Which of the following are examples of a nurse adhering to the pediatric standards of practice? Select all that apply. 1. The nurse educates the parents on how to administer insulin to their 9-year-old child. 2. The nurse asks the 3-year-old child to describe their level of pain with a Faces or Oucher scale. 3. The nurse refuses to divulge medical information to the parents of a pregnant adolescent. 4. The nurse provides extra free supplies to the family of an underinsured ill child. 5. The nurse uses evidence-based practice to maintain competency of new practices.

1. The nurse educates the parents on how to administer insulin to their 9-year-old child. 2. The nurse asks the 3-year-old child to describe their level of pain with a Faces or Oucher scale. 3. The nurse refuses to divulge medical information to the parents of a pregnant adolescent. 5. The nurse uses evidence-based practice to maintain competency of new practices.

The nurse is providing care to a toddler recently diagnosed with asthma. The parents have become verbally aggressive with staff and have challenged many of the unit rules. Which of the following may have contributed to the family's challenging behavior? Select all that apply. 1. The parents are both working professionals in leadership roles and fear loss of control. 2. The family has researched asthma on the Internet and does not agree with the treatment protocol. 3. The staff members have maintained therapeutic communication with the patient and family. 4. The nurse has developed a mutual set of goals and interventions with the family. 5. The staff members have provided a medically trained translator to promote understanding in care.

1. The parents are both working professionals in leadership roles and fear loss of control. 2. The family has researched asthma on the Internet and does not agree with the treatment protocol.

The nurse works on a pediatric unit that allows parents to remain in the room if the patient is coded. The nurse is aware that having persons in the room other than medical personnel can present safety issues. Which concerns are important to address? Select all that apply. 1. The possibility of an accidental shock during cardiac shock delivery 2. The possibility of accidental contamination of sterile fields and procedures 3. The possibility of medical staff being blocked from access to the patient 4. The possibility of medical staff being interrupted by emotional verbalization 5. The possibility of overcrowding interfering with needed medical equipment

1. The possibility of an accidental shock during cardiac shock delivery 3. The possibility of medical staff being blocked from access to the patient 5. The possibility of overcrowding interfering with needed medical equipment

The new nurse on the pediatric unit asks not to be assigned a child whose family is from the Middle East. Which personal questions does the nurse manager suggest the nurse contemplate as a method to develop self-awareness related to cultural differences? Select all that apply. 1. What have been my experiences with those of different cultures? 2. Is my unacceptance related to political differences between countries? 3. Am I attempting to not reject the culture of my family and my upbringing? 4. Are there conflicting values between the patient/family and myself? 5. Why do I feel so guilty and ashamed for not accepting a different culture?

1. What have been my experiences with those of different cultures? 4. Are there conflicting values between the patient/family and myself?

A 17-year-old pediatric patient is admitted for a fractured femur. The patient exhibits signs of being withdrawn and emotional throughout the day. During reassessment by the nurse, which approaches will reveal spiritual distress? Select all that apply. 1. Asking the patient about pain level using a scale of 0 to 10 2. Inquiring about the meaning of the fracture and hospitalization to the patient 3. Observing for and explaining the meaning of swelling and erythema of the leg 4. Performing an assessment of the patient's behaviors using the FICA scale 5. Discussing the patient's previous methods of handling distress with the parents

2. Inquiring about the meaning of the fracture and hospitalization to the patient 4. Performing an assessment of the patient's behaviors using the FICA scale

Which of the following interventions are examples of a family-focused strategy? Select all that apply. 1. Coordinating care with other departments to lessen sleep disruptions 2. Providing storage and prep of meals from home for family members 3. Stipulating unilateral visiting rules for all patients and their families 4. Involving the parents in nursing change of shift reports and care plans 5. Providing dedicated family space with basic needs for rooming in parents

2. Providing storage and prep of meals from home for family members 4. Involving the parents in nursing change of shift reports and care plans 5. Providing dedicated family space with basic needs for rooming in parents

Which of the following examples accurately represent the unique role of the pediatric nurse? Select all that apply. 1. The nurse developed an intervention that correlated with the patient's particular cultural practice. 2. The nurse shared information on the progress and interventions with the family and patient. 3. The nurse engaged in one-to-one conversations with the family members as well as the patient. 4. The nurse requested the family to leave during invasive procedures to maintain privacy. 5. The nurse developed interventions based on the knowledge of human growth and development.

2. The nurse shared information on the progress and interventions with the family and patient. 3. The nurse engaged in one-to-one conversations with the family members as well as the patient. 5. The nurse developed interventions based on the knowledge of human growth and development.

As the director of nursing (DON), who is responsible for planning the needs of a pediatric unit for the next several years, the DON focuses on the changing demographics for the pediatric population. Based on Federal statistics, which needs does the DON prioritize for culturally sensitive care? Select all that apply. 1. Suggest for increased availability of educational literature in Chinese. 2. Plan to acquire more interpreters to serve the French population. 3. Determine whether local changes reflect national demographic changes. 4. Identify the probable increase in Hispanic children requiring care. 5. Obtain literature that is presented in both English and Spanish.

3. Determine whether local changes reflect national demographic changes. 4. Identify the probable increase in Hispanic children requiring care. 5. Obtain literature that is presented in both English and Spanish.

The nurse is making a home visit for a patient and family who are from a different culture than the nurse. Which assessment findings during the visit cause the nurse concern? Select all that apply. 1. The family home currently houses three generations of the family. 2. The household income is supplemented by government programs. 3. The interior of the home exhibits a lack of physical updates. 4. The children are accompanied by an adult to a playground. 5. The family lives 5 miles from a pediatric health-care facility.

3. The interior of the home exhibits a lack of physical updates. 5. The family lives 5 miles from a pediatric health-care facility.

The pediatric nurse is providing care for a terminally ill patient who is 17 years of age. The patient has been resistant to aggressive chemotherapy because of undesirable side effects. The patient states, "I have finally convinced my parents to sign a DNR order. It is my life, and I should be able to decide how I want to live." Which legal consideration causes the nurse greatest concern? 1. A DNR order can be reversed at any time by the legal guardians. 2. The primary physician can deny a DNR if the patient is a minor. 3. The patient does not understand all aspects of the DNR order. 4. A DNR can be written to provide partial life-sustaining interventions.

A DNR order can be reversed at any time by the legal guardians.

The nurse is providing care to a hospitalized pediatric patient, and the patient is refusing all pain medication despite signs of obvious distress. The patient tells the nurse, "All you nurses lied, and the shots hurt." What is the most appropriate nursing measure at this time? 1. Provide the medication in a cup of juice. 2. Have the parents administer the medication. 3. Explain not all medications are shots. 4. Admit to the patient that the shots hurt but explain they help.

Admit to the patient that the shots hurt but explain they help.

A 2-year-old has recently been diagnosed with a terminal type of cancer but is not experiencing any severe symptoms of the illness at this time. The mother of the patient is depressed and feels guilt over the illness. She admits to mentally planning the funeral and expecting to be devastated. The nurse identifies the mother as experiencing which stage of grief? 1. Anticipatory 2. Anger 3. Denial 4. Bargaining

Anticipatory

The home care nurse is assessing the home environment for the pediatric patient. The nurse notes that the family is unable to perform some of the physical therapy exercises safely. What is the most appropriate initial nursing action? 1. Consult with the physical therapist to arrange more educational sessions. 2. Consult with the health-care provider for admission to a rehabilitation center. 3. Assess the exercises per the worksheet provided by the physical therapist. 4. Assess the family's understanding of a safe of the physical therapy exercises.

Assess the family's understanding of a safe of the physical therapy exercises.

The nurse is providing care for a pediatric patient and family during the time when death of the patient seems imminent. The family is of American Indian culture and has summoned tribal members to come and chant and pray at the bedside. Which behavior by the nurse is culturally correct? 1. Move the patient, family, and tribal members to an isolated location. 2. Ask the family to respect other patients by keeping the volume of chanting low. 3. Ask if the family has any additional needs, close the door, and provide privacy. 4. Call the nursing supervisor and ask for assistance in managing the situation.

Ask if the family has any additional needs, close the door, and provide privacy.

The nurse is assessing an infant during a well-baby visit in the family practice clinic. During this assessment, the nurse asks the mother several routine questions regarding the infant's progress and notes that the mother nods her head but is looking at her cell phone. Which response by the nurse is most appropriate in this situation? 1. Continue the assessment and note the mother's disinterest in the infant's chart. 2. Continue to ask the questions repeatedly until an acceptable answer is provided. 3. Ask the mother if she could please put the phone down and discuss her infant's progress. 4. Contact the facility's social worker for a referral to child protective services for an in-home visit.

Ask the mother if she could please put the phone down and discuss her infant's progress.

The nurse is assessing a newborn who has been brought to the family clinic for her first well-child visit. The nurse accidentally drops a metal pan on the floor near the child. The child is startled, but the mother does not react. What is the most appropriate intervention at this time? 1. Speak loudly and clearly to mother to enhance comprehension. 2. Read the infant's chart to verify how to communicate. 3. Continue with the assessment and document the findings. 4. Ask the mother if she needs an interpreter to communicate.

Ask the mother if she needs an interpreter to communicate.

A nurse is caring for an infant from a different culture than her own. The mother allows the infant to continue to cry without assessing for a cause of the distress. The nurse is disturbed about this parenting. Which is the best action for the nurse to take initially? 1. Ask the mother to share what she believes about infant crying. 2. Teach the mother that infants cry for a reason that needs to be identified. 3. Consult with the child-life specialist about the appropriateness of mother's behavior. 4. Become a role model by demonstrating proper care of the infant to the mother.

Ask the mother to share what she believes about infant crying.

The nurse is presenting information to a group of parents regarding pediatric safety and the most common causes of death. One attendee states, "I am so happy that my youngest child is now 16." Which information does the nurse present in response to this comment? 1. The 16-year-old child is at high risk for death related to cancer. 2. Life expectancy with congenital or genetic defects is 13 to 19 years. 3. Adolescents between 5 and 19 years of age most commonly die from suicide. 4. Between 15 and 19 years of age the death rate is 45.5 deaths/100,000.

Between 15 and 19 years of age the death rate is 45.5 deaths/100,000.

The nurse is providing care for a child of a family who are migrant workers. According to Dr. Madeleine Leininger's cultural care theory, which component of the theory is key for providing culturally competent nursing care? 1. Gaining the trust of patients/families of the culture 2. Capturing and articulating how culture impacts health 3. Understanding the environment created by migration 4. Learning the culture practices embraced by the patient/family

Capturing and articulating how culture impacts health

A nurse is providing relationship-based care to a pediatric patient. Which of the following is a challenge the nurse is likely to encounter while using this model of care? 1. Maintaining a sterile field for a procedure with a restless toddler 2. Communicating with the blended family on regular basis 3. Treating children with antibiotic-resistant illnesses 4. Caring for a larger number of children with autism spectrum disorders and childhood depression

Communicating with the blended family on regular basis

The nurse is performing a functional family assessment of a chronically ill pediatric patient. In what way can the nurse enhance communication with the family? 1. Identify the leader of the family and provide options for respite care. 2. Assess for abuse and report suspected abuse to the authorities. 3. Complete a family APGAR questionnaire and share the results. 4. Educate the family on resources in the community to help with care.

Complete a family APGAR questionnaire and share the results.

The nurse is providing discharge instructions to the family of a 14-year-old patient who was treated for an exacerbation of a chronic illness. The nurse recognizes that this will add stress to the family unit and has developed a plan of care based on the family-centered care model. Which intervention best addresses the crisis experienced by the family unit at this time? 1. Encourage the patient to contact friends from school for visits. 2. Discuss treatment options and alternatives with the family. 3. Provide privacy to discuss their options independently of staff. 4. Request clergy to counsel the family prior to discharge.

Discuss treatment options and alternatives with the family.

In an acute care setting, the pediatric nurse is providing care to a 4-year-old patient with an exacerbation of cystic fibrosis. The nurse notes that there is little interaction between the patient and the older siblings when they visit. The siblings often seek to divert the staff's attention during their visits. What is the most appropriate nursing intervention at this time? 1. Ask the parents to leave the siblings at home to avoid disruptions. 2. Interact with the siblings and show them the playroom during visits. 3. Encourage the siblings to visit and bring familiar objects to the hospital. 4. Develop a plan to include the siblings in age-appropriate care of the patient.

Encourage the siblings to visit and bring familiar objects to the hospital.

The school nurse is developing a teaching session for the population of children in a middle school. The nurse has determined that the greatest need for the overall health of the children is promotion of healthy foods. Which of the following interventions is most likely to be effective? 1. Remove all unhealthy snacks from the vending machines. 2. Have a poster contest on healthy eating options. 3. Survey the student population during lunch breaks. 4. Engage the students in healthy choices with cooking lessons.

Engage the students in healthy choices with cooking lessons.

The nurse works in a neighborhood pediatric clinic that serves a multicultural population. The nurse uses the Giger and Davidhizar transcultural assessment model. Which of the six aspects is most helpful when performing pediatric assessments? 1. Acceptance of social organizations of which the patient and family are members 2. Awareness of personal space between the individuals who are communicating 3. Recognition of communication and how thoughts and feelings are expressed 4. Knowledge of biological variations, such as appropriate weight and development

Knowledge of biological variations, such as appropriate weight and development

The nurse is assessing the psychosocial needs of a family that has a chronically ill child. During the interview process, the nurse notes that the grandmother answers for all the family members. What nursing intervention is most appropriate at this time? 1. Ask the grandmother if a medical translator is necessary. 2. Continue with the interview and document the findings. 3. Identify the grandmother as the primary source of information. 4. Ask the grandmother to leave the room for privacy.

Identify the grandmother as the primary source of information.

The nurse is providing care to a 10-year-old patient hospitalized for multiple injuries from a motor vehicle crash. Which nursing intervention is appropriate for communication with this child?3 1. Include the child in some decisions regarding care, such as choosing food from the hospital menu. 2. Offer the child a chance to play with the medical instruments when possible. 3. Communicate primarily to the parents regarding treatments and the child's progress. 4. Recognize that behavior may fluctuate between adult and childlike during hospitalization.

Include the child in some decisions regarding care, such as choosing food from the hospital menu.

The culturally sensitive pediatric nurse is aware of the changes in the racial population of the United States. Which of the following reflects the historical changes in the projected demographics of the U.S. pediatric population in 2020? 1. The American Indian and Alaska Native population will continue to decrease. 2. Less than half of the children will represent less than half of the population. 3. The Asian children will reflect no change from 2015 into 2020. 4. Non-Hispanic children who represent two or more races will increase in 2020.

Less than half of the children will represent less than half of the population.

The nurse is developing interventions for a transgender adolescent based on the nursing diagnosis decreased self-esteem related to transgender identity as evidenced by statements of feeling "worthless, different, and alone." What would be the most appropriate intervention based on the diagnosis? 1. Give positive feedback on personal choices as appropriate. 2. Provide gender-affirming care to transgender youth. 3. Provide information on support groups for patient and family. 4. Assess risk factors for depression and suicidal thoughts.

Provide information on support groups for patient and family.

With endorsement from the family, the physician initiates hospice care for an adolescent patient who is terminally ill. For which family expectation about hospice care will the nurse provide additional information? 1. The patient will have a graceful, natural death. 2. The patient will die in the hospital. 3. Compassionate care will be focused on patient comfort. 4. The family can be involved in care as much as desired.

The patient will die in the hospital.

The nurse is providing care to the mechanically ventilated 4-year-old patient who is believed to be the victim of abuse from the parents. The parents refuse to permit removal of the ventilator. The nurse believes this is because the parents are afraid that they will be charged with murder if the child dies. What is the recourse for the health-care team in this ethical dilemma? 1. Provide the treatment even in the face of undue burden of resources. 2. Provide the parents with their financial burden of this care. 3. Provide information to the courts for legal involvement. 4. Provide support to the parents even if the team would choose differently.

Provide information to the courts for legal involvement.

The nurse works on a pediatric unit where patients are on life support. Frequently, death is delayed for the benefit of organ donation and procurement. Which protocols for organ donation and procurement does the nurse always need to follow? Select all that apply. 1. The nurse approaches the family of a patient who is a viable candidate. 2. The best matched pediatric patients on the transplant list are notified. 3. The consent for organ donation can be given only by legal guardians. 4. The facility pediatric surgical team will procure the organs for transplant. 5. The parents only can accompany the patient to the operating room.

The consent for organ donation can be given only by legal guardians.

The coroner is informed of the unexpected death of an infant at 3 months of age. The infant died during the night in the home of the parents. Which expectation does the nurse have regarding follow-up to the infant's death? 1. The hospital will pay for an autopsy if requested by the physician. 2. The coroner's office will not charge the parents if they request an autopsy. 3. The coroner can legally request an autopsy without the parent's consent. 4. The parents must give consent before an autopsy is performed for any reason.

The coroner can legally request an autopsy without the parent's consent

The nurse is providing care to a 6-year-old child who is recovering from an infection after a round of chemotherapy in the hospital. The parents appear overwhelmed with the situation of wanting "quality time" and voice guilt over missing the healthy children's school functions when at the hospital. Which is an appropriate nursing goal for this family? 1. The family will demonstrate knowledge of the regimen and prevent further infections. 2. The family will meet and seek counseling for each family member prior to the patient's discharge to home. 3. The family will acknowledge the range of emotions during the child's hospitalization. 4. The family will meet with the social worker to coordinate community resources to facilitate the transition to home.

The family will meet with the social worker to coordinate community resources to facilitate the transition to home.

The nurse is providing discharge teaching to the family of a hospitalized 9-year-old patient, recently diagnosed with asthma. The family states that they feel overwhelmed with the treatment plans and cannot perform the necessary nebulizer treatments. Which nursing intervention best reflects the professional performance aspect of pediatric nursing standards? 1. The nurse arranges for a home care respiratory therapy consultation to teach the family proper techniques in the home setting. 2. The nurse contacts the physician to delay the patient's discharge from the hospital until the family is able to perform treatments. 3. The nurse collects comprehensive data pertinent to the patient's situation by reviewing the home situation. 4. The nurse evaluates progress toward the attainment of outcomes by having the family perform return demonstrations.

The nurse arranges for a home care respiratory therapy consultation to teach the family proper techniques in the home setting

The nurse understands that the nursing profession has standards of care that promote the covenant between patient and nurse. Which of the following is an example of this covenant? 1. The nurse adheres to strict guidelines regarding medication administration and procedures. 2. The nurse develops a care plan with mutually developed goals and interventions with the patient. 3. The nurse attends continuing education courses to maintain competency in skills. 4. The nurse considers each patient's cultural practices without bias or judgment.

The nurse develops a care plan with mutually developed goals and interventions with the patient.

The nurse is providing end-of-life care to a pediatric patient and family. The nurse understands the need for communicating with the multidisciplinary care team regarding the patient and family needs. For which reason is multidisciplinary communication with the patient's nurse so important? 1. The nurse has the most contact with the patient and family and acts as an advocate and voice for their care. 2. The multidisciplinary team relies on the nurse to provide appropriate education to the patient and family during end-of-life care. 3. As the sole communicator, the nurse can make sure that all members of the multidisciplinary team are equally informed. 4. The patient and family can communicate with the nurse with whom they have built a trusting relationship.

The nurse has the most contact with the patient and family and acts as an advocate and voice for their care.

The pediatric nurse desires to expand her career options to become the hospital's nurse educator of pediatrics. Which of the following is necessary for this nurse to achieve this career goal? 1. The nurse must earn a minimum of a master's degree in nursing. 2. The nurse must earn a minimum of a doctorate degree in nursing. 3. The nurse must implement and develop research in nursing practice. 4. The nurse must implement a plan to obtain certification in pediatrics.

The nurse must earn a minimum of a master's degree in nursing

The emergency department nurse is providing care to a 5-year-old child with a repeated exacerbation of otitis media. When it becomes apparent that the parents smoke and refuse to prevent the child's exposure to secondhand smoke, the nurse voices frustration to the family that they are causing the child's otitis media. Which of the provisions of the ANA Code of Ethics for Nurses has the nurse failed to follow? 1. The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient. 2. The nurse practices with compassion and respect for dignity, unrestricted by the nature of health problems. 3. The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient. 4. The patient's right to self-determination must be upheld, justified only when justified by law.

The nurse practices with compassion and respect for dignity, unrestricted by the nature of health problems.

The pediatric nurse begins a research project on 8-year-old patients with the medical diagnosis of pediatric acute onset neuropsychiatric syndrome, PANS. The family has consented to the research, but as the nurse begins to administer the intervention, the patient refuses to cooperate. What is the appropriate response to this refusal? 1. The nurse should discuss with the family the options of performing the intervention without the child's knowledge. 2. The nurse should explain to the child that this is necessary and promise a reward at the end of the research project. 3. The nurse should refuse to perform the intervention until the child consents to the intervention and project. 4. The nurse should discuss the pros and cons of the research project with the child and focus on the outcomes.

The nurse should refuse to perform the intervention until the child consents to the intervention and project.

The nurse is assessing preschool twins during a well-child visit in the family clinic. Which of the following statements by the parents would indicate a healthy transition for the family per Duvall's family development theory? 1. The parents state that they have maintained scheduled play dates to help the children socialize. 2. The parents have maintained the children's well-child examinations and immunizations. 3. The parents have compiled a list of goals and request suggested interventions. 4. The parents and children appear to interact well and display nurturing and affection.

The parents state that they have maintained scheduled play dates to help the children socialize.

The nurse is admitting a 15-year-old girl of Asian descent for abdominal pain lasting 3 days. The accompanying parent reports that the patient is exhibiting intense pain, vomiting, and diarrhea. The nurse notes that the patient places her pain level at 3 on a scale of 0 to 10. Which conclusion does the nurse draw regarding the discrepancy in the level of pain? 1. The patient's response may be related to cultural expectations. 2. The patient is angry that the parent insisted on seeking medical treatment. 3. The parent's fear of serious illness is causing an exaggeration of symptoms. 4. The parent wants to make sure the daughter gets immediate medical care.

The patient's response may be related to cultural expectations.

The nurse assesses a toddler with an apparent ear infection in the emergency department. During the assessment, the nurse finds that the child is not up to date on immunizations or well-baby checkups. Upon further investigation, the nurse discovers that the family is uninsured and undocumented immigrants. What are the most likely barriers to effective communication at this time? 1. The insurance status affects many health-care practices such as immunizations. 2. The possible language issue may affect the family's comprehension of instructions. 3. The family may have barriers to transportation, employment, or knowledge. 4. The family may not have a primary care provider and relies upon emergency

The possible language issue may affect the family's comprehension of instructions.

The nurse assesses the pain level of a school-age patient who is receiving end-of-life care and determines a need for pain medication. The physician has prescribed morphine sulfate to be administered either orally or rectally. For which reason will the nurse decide to administer the medication orally? 1. To prevent the patient from being embarrassed by rectal administration 2. To ensure the pain medication is absorbed as quickly as possible 3. To avoid stimulation of rectal spasms during insertion of the medication 4. To decrease the risk of respiratory suppression

To prevent the patient from being embarrassed by rectal administration

During orientation, the new nurse on a pediatric unit is informed that Leininger's cultural care theory is implemented because of a large multicultural population at the facility. Which aspect of Leininger's theory best defines the theory's impact on nursing care? 1. Transcultural nursing occurs when the nurse incorporates the patient's culture into the care provided. 2. The theory considers the complexity and interrelatedness of an individual within an environment and the community to which he or she belongs. 3. The theory helps explain how practices handed down from generations can impact an individual's health today. 4. Leininger's theory has been able to capture and articulate how culture affects health.

Transcultural nursing occurs when the nurse incorporates the patient's culture into the care provided.

The nurse is preparing an 8-year-old patient for a cancer protocol that has a significant amount of risk. The parents have provided informed consent for this trial, but the patient has refused to partake in this research. What is the most appropriate course of action for this situation? 1. Treatment is carried forth, despite the patient's dissent. 2. Treatment must be delayed until the parents and patient agree. 3. Treatment is delayed for review by the ethics committee. 4. Treatment is canceled until the patient assents.

Treatment is canceled until the patient assents.