TEST BANK
Essentials of Pediatric Nursing
Terri Kyle, and Susan Carman
5th Edition
,Table of Contents
Chapter 01 Introduction to Child Health and Pediatric Nursing 1
Chapter 02 Factors Influencing Child Health 14
Chapter 03 Growth and Development of the Newborn and Infant 27
Chapter 04 Growth and Development of the Toddler 39
Chapter 05 Growth and Development of the Preschooler 51
Chapter 06 Growth and Development of the School-Age Child 63
Chapter 07 Growth and Development of the Adolescent 75
Chapter 08 Atraumatic Care of Children and Families 87
Chapter 09 Health Supervision 100
Chapter 10 Health Assessment of Children 112
Chapter 11 Caring for Children in Diverse Settings 123
Chapter 12 Caring for the Child With Special Health Care Needs 135
Chapter 13 Key Pediatric Nursing Interventions 147
Chapter 14 Nursing Care of the Child With an Alteration in Comfort–Pain Assessment
and Management 159
Chapter 15 Nursing Care of the Child With an Infection 171
Chapter 16 Nursing Care of the Child With an Alteration in Intracranial Regulation or
Neurologic Disorder 183
Chapter 17 Nursing Care of the Child With an Alteration in Sensory Perception/Disorder
of the Eyes or Ears 194
Chapter 18 Nursing Care of the Child With an Alteration in Gas Exchange/Respiratory
Disorder 205
Chapter 19 Nursing Care of the Child With an Alteration in Perfusion/Cardiovascular
Disorder 217
Chapter 20 Nursing Care of the Child With an Alteration in Bowel Elimination/
Gastrointestinal Disorder 229
Chapter 21 Nursing Care of the Child With an Alteration in Urinary Elimination/
Genitourinary Disorder 241
Chapter 22 Nursing Care of the Child With an Alteration in Mobility/Neuromuscular or
Musculoskeletal Disorder 252
Chapter 23 Nursing Care of the Child With an Alteration in Tissue Integrity/
Integumentary Disorder 264
Chapter 24 Nursing Care of the Child With an Alteration in Cellular Regulation/
Hematologic or Neoplastic Disorder 275
Chapter 25 Nursing Care of the Child With an Alteration in Immunity or Immunologic
Disorder 287
Chapter 26 Nursing Care of the Child With an Alteration in Metabolism/Endocrine
Disorder 298
Chapter 27 Nursing Care of the Child With an Alteration in Genetics 310
Chapter 28 Nursing Care of the Child With an Alteration in Behavior, Cognition, or
Development 322
,Chapter 29 Nursing Care During a Pediatric Emergency 333
,______________________________________________________________________________________________
Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
Chapter 1, Introduction to Child Health and Pediatric Nursing
1. The nurse is caring for a 10-year-old child with a neuroblastoma. Which activity(ies)
describes the role of the nurse as a care coordinator, collaborator, and consultant? Select all
that apply.
A) collaborating with the family throughout the care path
B) advancing the interests of children and their families by knowing their needs
C) informing children and families of their rights and options
D) coordinating care provided by the interdisciplinary team
E) ensuring that the child's and family's needs are met through activities such as
support groups
F) providing appropriate client education based on the child's developmental level
ANS: A, D, E
The pediatric nurse serves as a collaborator, care coordinator, and consultant. Collaborating
with the interdisciplinary health care team, the pediatric nurse integrates the child's and
family's needs into a coordinated plan of care. In the role of consultant, the pediatric nurse
ensures that the child's and family's needs are met through such activities as support group
facilitation or working with the school nurse to plan the child's care. In the role of child and
family advocate, the nurse safeguards and advances the interests of children and their
families by knowing their needs and resources, informing them of their rights and options,
and assisting them to make informed decisions. In the role of educator, the nurse instructs
and counsels children and their families about all aspects of health and illness. In this role,
the pediatric nurse also ensures that communication with the child and family is based on
the child's age and developmental level.
PTS: 1 REF: Page and Header: 11, Role of the Pediatric Nurse
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Selection
2. The nurse is providing care for a 9-year-old child who uses mechanical ventilation. Which is
an example of the nursing role of collaboration?
A) informing the team members on progress of the treatment
B) discussing the child's needs with a school nurse
C) advising the pulmonologist of respiratory symptoms
D) arranging for after-school attendance at a day care facility
ANS: A
Informing team members of the progress of treatment is an act of collaboration. Discussing
the child's needs with a school nurse is done in the role of a consultant. Advising the
pulmonologist of respiratory symptoms and arranging after-school attendance at a day care
facility are care coordinator activities.
PTS: 1 REF: Page and Header: 7, Measurement of Children's Health Status
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
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Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
BLM: Cognitive Level: Apply NOT: Multiple Choice
3. The nurse is providing care to a child and their family. Which activity reflects the use of the
assessment step of the nursing process when providing care for children?
A) collecting data about the child and family
B) analyzing data to make judgments about the child's health state
C) evaluating care provided by the interdisciplinary team
D) developing a care plan that incorporates child goals
ANS: A
The nursing process is applicable to all health care settings and consists of five steps:
assessment, nursing diagnosis, outcome identification and planning, implementation, and
outcome evaluation. Collecting data about the child and family occurs in the assessment step
of the nursing process. Analyzing data to make judgments about the child's health state
involves nursing diagnosis. Evaluating care provided by the interdisciplinary team is
performed in the outcome evaluation. Developing a care plan that incorporates child goals
occurs in the planning stage.
PTS: 1 REF: Page and Header: 12, Role of the Pediatric Nurse
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Choice
4. The nurse is caring for a newborn who has Down syndrome. Which nursing action reflects
the nurse's use of the ethical principle of nonmaleficence?
A) The nurse speaks truthfully to the parents regarding their newborn's prognosis.
B) The nurse provides safe, competent nursing care to avoid harming the newborn.
C) The nurse involves the parents in making health care decisions for their newborn.
D) The nurse fairly allocates resources for caring for newborns in a facility.
ANS: B
Ethics includes the basic principles of autonomy, beneficence, nonmaleficence, justice,
veracity, and fidelity. Nonmaleficence means to avoid causing harm, intentionally or
unintentionally. One example is providing safe, competent nursing care. Speaking truthfully
to the parents is an example of veracity. Generally, parents have the autonomy to make
health care decisions for their children. Justice refers to acting fairly and involves allocating
resources fairly.
PTS: 1
REF: Page and Header: 15, Ethical Issues Related to Working With Children and Their
Families
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Choice
5. The nurse is helping the family of a child with a terminal illness to fill out an advance
directives form. Which intervention(s) is determined by this document? Select all that apply.
A) withholding food
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Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
B) withholding water
C) withholding antibiotics
D) do-not-resuscitate (DNR) order
E) withholding ventilation
F) providing artificial nutrition
ANS: C, D, E, F
Advance directives determine the child's and family's wishes should life-sustaining care
become necessary. After discussion with other family members, friends, and spiritual
advisors, the parents may make the decision to forego life-sustaining medical treatment,
either withdrawing treatment or deciding to withhold certain further treatment, or opt not to
resuscitate in the event of cardiopulmonary arrest. Food and water are not withheld;
however, some children may not be able to drink or eat and artificial nutrition may be
withheld.
PTS: 1
REF: Page and Header: 18, Legal Issues Related to Working With Children and Their
Families
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Selection
6. The school nurse is reviewing the records of students in an elementary school. Based on
current child morbidity rates, which child is the nurse most careful to monitor for days
missed from school?
A) a child with asthma
B) a child with contact dermatitis
C) a child with severe allergic rhinitis (hay fever)
D) a child with food allergies
ANS: A
Morbidity refers to illness present in a specific population at a given time. Asthma is the
leading chronic disease in children, affecting 14% of children in the United States; 13% of
children suffer from skin allergies, 9% have hay fever, and 6% have food allergies.
PTS: 1 REF: Page and Header: 9, Morbidity Data
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
7. The nurse in charge of the quality department is reviewing cases regarding Health Insurance
Portability and Accountability Act (HIPAA) compliance. In which case(s) does the nurse
correctly determine that HIPAA standards were followed? Select all that apply.
A) A child is diagnosed with an inner ear infection and follow-up care instructions are
given to the child's aunt, who provides a medical consent form from the parents,
who are on vacation.
B) The emergency department nurse manager reports the suspicion of abuse to the
child welfare department for a child admitted with suspicious injuries.
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,______________________________________________________________________________________________
Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
C) When asked, the nurse informs the grandparents of a child on the medical floor
when their grandchild will be released home to the parents.
D) The physician reports the diagnosis of hepatitis C of a 14-year-old child with
injectable substance use disorder to the health department.
E) The nurse manager tells the superintendent of schools that a high school student is
infected with HIV so that proper precautions can be implemented in the school.
ANS: A, B, D
The Health Insurance Portability and Accountability Act (HIPAA) addresses security and
privacy issues involving health information about individuals. Information can be shared
with the client's aunt because medical consent has been granted by the legal guardians
(parents). An exception to the rule is the requirement to report suspected physical or sexual
abuse of a child. In addition, public health laws require reporting certain infectious diseases,
such as hepatitis C. The nurse should not provide information to the grandparents without
written consent from the legal guardian, nor should the nurse discuss a client's health with
the school superintendent. This information should be shared only with the local health
department.
PTS: 1
REF: Page and Header: 19, Legal Issues Related to Working With Children and Their
Families
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Selection
8. The pediatric nurse is participating in the role of advocate when completing which action?
A) instructing parents on the side effects of vaccinations they are requesting for their
child
B) contributing input on a task force with the aim of reducing the rate of mortality of
infants and children
C) teaching parents to keep their prescribed medication safely out of reach of children
D) explaining to parents the reason for each medication their child was recently
prescribed
ANS: B
The role of advocacy is being fulfilled when the nurse works to safeguard and advance the
interest of children and infants through many means, including contributing to the learning
and application of a task force aimed at reducing infant and child mortality. The actions of
instructing about side effects, explaining the purposes of medications, and teaching about
medication safety would fall under the role of educator.
PTS: 1 REF: Page and Header: 11, Role of the Pediatric Nurse
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Caring BLM: Cognitive Level: Understand
NOT: Multiple Choice
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Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
9. The nurse manager and a newly licensed nurse plan to obtain informed consent for several
procedures on various clients on a pediatric unit. Which statement(s) by the newly licensed
nurse alerts the nurse manager to provide additional education about informed consent?
Select all that apply.
A) "The parent of the child was pushing their spouse to agree to the procedure, so I
offered to return later, after they have had time to discuss the procedure."
B) "When I went to the room, the child was calling the adult in the room 'friend,' so I
want to clarify their relationship before I prepare to get the consent signed."
C) "After lunch, I will go into the room and explain the procedure, including the risks
and benefits, and the alternative options available for the child."
D) "The parent of the infant explained to me what procedure the infant was having
and indicated they were comfortable signing the consent for the procedure."
E) "I am still going to ask the parents to sign the consent for the procedure even
though the child is legally emancipated from the parents."
F) "The medical record shows the child's foster parents have legal guardianship of the
child, but I am still required to have the child's birth parent sign the consent for the
procedure."
ANS: C, E, F
Nurses working with the pediatric population must be aware of the legal issues surrounding
informed consent for procedures and treatments. The nurse manager will provide additional
teaching if the newly licensed nurse does not know that it is the health care provider's
responsibility to explain the procedure, the risks/benefits, and alternative options to the
parent, not the nurse's. If a child is legally emancipated, the child is able to sign their own
consent for procedures/treatments and the parents of the child would not be asked to sign.
The legal guardian would be asked to sign the consent, and not the birth parents, if the child
was in foster care and legal guardianship was noted on the chart. The nurse was correct to
not obtain consent and offer to come back later for discussion when the nurse noticed there
was coercion (by one parent to the other). The relationship of the adult signing the consent
must be verified and the parent of the infant was able to explain the procedure in their own
words and express comfort, so the consent should be signed at that time.
PTS: 1
REF: Page and Header: 16, Legal Issues Related to Working With Children and Their
Families
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Communication and Documentation
BLM: Cognitive Level: Apply NOT: Multiple Selection
10. The nurse is caring for a school-aged child in the home who has a newly inserted gastric
tube and several new medications. The nurse is participating in the role of the educator
when completing which action(s)? Select all that apply.
A) arranging for the physical therapist to consult with the child regarding mobility
B) writing the medication purposes and schedule on paper and putting it on the wall in
the kitchen
C) reminding the parents of the importance of the child completing the entire dose of
antibiotic
D) engaging the child by watching a video together about a child with gastric tubes
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Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
E) observing the child show a return demonstration of the cleansing of the gastric tube
site
F) assessing the home for medications the child could inadvertently access
ANS: B, C, D, E
The nurse is participating in the educator role when asking the child to demonstrate proper
care of the gastric tube site and would further educate if the return demonstration was not
accurate. Additionally, the nurse is educating the parents about medication by assuring they
have the medication schedule and medication purpose available in writing, and reminding
the parents to give the entire course of antibiotics. Watching a video for children with
gastric tubes is educating the child about their medical equipment. Assessing the home for
safety concerns (accessible medications) and arranging therapy appointments fall under the
role of the care manager.
PTS: 1 REF: Page and Header: 18, Advance Directives
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Understand NOT: Multiple Selection
11. A 7-year-old child with a chronic illness is currently hospitalized. Which recommendation
should the nurse make for this child?
A) Involve the child and family in self-care activities performed at home.
B) Restrict visiting hours to maintain a quiet environment.
C) Discourage siblings from visiting to reduce infection risk.
D) Educate the child separately from the parents to avoid confusion.
ANS: A
Involving the child and family in self-care promotes family-centered care, which is an
approach that supports a mutually beneficial relationship between the child, family, and
health care professionals. Restricting visiting hours, discouraging siblings from visiting, and
providing education separately for children and parents all reduce the collaboration with
family and do not reflect effective family-centered care approaches.
PTS: 1 REF: Page and Header: 12, Implementing the Nursing Process
NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Caring BLM: Cognitive Level: Apply
NOT: Multiple Choice
12. A nurse is providing care to an adolescent client undergoing a painful procedure. Which
intervention(s) should the nurse perform to provide atraumatic care? Select all that apply.
A) Offer distractions such as music or guided imagery during the procedure.
B) Provide age-appropriate information about the procedure in a clear manner.
C) Administer sedation prior to discussing the procedure with the client.
D) Encourage the client to "be brave" during the procedure.
E) Avoid providing information about the procedure to reduce anxiety.
ANS: A, B
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Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
The goal of atraumatic care is to reduce physical and psychological distress for children and
their families. Offering distractions provides the opportunity for the adolescent to be
involved in their care, which can reduce psychological distress as well as reduce pain and
physical distress. Providing age-appropriate information assists in understanding the care,
which can also reduce psychological distress. Administering sedation prior to discussion and
not providing information could cause increased distress in the client due to lack of
information. Encouraging the client to be brave does not support a reduction in distress.
PTS: 1 REF: Page and Header: 10, Philosophy of Pediatric Nursing
NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Caring BLM: Cognitive Level: Apply
NOT: Multiple Selection
13. A nurse working in public health finds that their colleagues use different approaches to
managing injection pain for immunizations in toddlers. What step will the nurse take to
determine the best approach for reducing and managing pain in these clients?
A) Review research literature and evidence about managing injection pain in toddlers.
B) Ask a colleague about what they think the best approach should be for consistency.
C) Explain to colleagues injection techniques that have worked best in the nurse's
experience.
D) Survey parents to see what they think might be most effective for their children's
immunizations.
ANS: A
Evidence-based care involves staying informed about current research and applying it to
clinical practice. Consulting the latest research supports learning about evidence and best
practices. Asking a colleague or explaining the nurse's current practice does not adequately
explore and analyze evidence. Surveying parents may be helpful in understanding the parent
perspective, but it does not integrate evidence-based practice.
PTS: 1 REF: Page and Header: 9, Morbidity Data
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
14. A nurse is supporting a project that aims to reduce childhood mortality in the region. Which
intervention would most effectively support the goal of mortality reduction?
A) providing free bicycle helmets for children
B) providing free exercise classes for children
C) providing education about healthy nutrition for families
D) providing first aid kits for families
ANS: A
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Essentials of Pediatric Nursing
Terri Kyle, and Susan Carman
5th Edition
,Table of Contents
Chapter 01 Introduction to Child Health and Pediatric Nursing 1
Chapter 02 Factors Influencing Child Health 14
Chapter 03 Growth and Development of the Newborn and Infant 27
Chapter 04 Growth and Development of the Toddler 39
Chapter 05 Growth and Development of the Preschooler 51
Chapter 06 Growth and Development of the School-Age Child 63
Chapter 07 Growth and Development of the Adolescent 75
Chapter 08 Atraumatic Care of Children and Families 87
Chapter 09 Health Supervision 100
Chapter 10 Health Assessment of Children 112
Chapter 11 Caring for Children in Diverse Settings 123
Chapter 12 Caring for the Child With Special Health Care Needs 135
Chapter 13 Key Pediatric Nursing Interventions 147
Chapter 14 Nursing Care of the Child With an Alteration in Comfort–Pain Assessment
and Management 159
Chapter 15 Nursing Care of the Child With an Infection 171
Chapter 16 Nursing Care of the Child With an Alteration in Intracranial Regulation or
Neurologic Disorder 183
Chapter 17 Nursing Care of the Child With an Alteration in Sensory Perception/Disorder
of the Eyes or Ears 194
Chapter 18 Nursing Care of the Child With an Alteration in Gas Exchange/Respiratory
Disorder 205
Chapter 19 Nursing Care of the Child With an Alteration in Perfusion/Cardiovascular
Disorder 217
Chapter 20 Nursing Care of the Child With an Alteration in Bowel Elimination/
Gastrointestinal Disorder 229
Chapter 21 Nursing Care of the Child With an Alteration in Urinary Elimination/
Genitourinary Disorder 241
Chapter 22 Nursing Care of the Child With an Alteration in Mobility/Neuromuscular or
Musculoskeletal Disorder 252
Chapter 23 Nursing Care of the Child With an Alteration in Tissue Integrity/
Integumentary Disorder 264
Chapter 24 Nursing Care of the Child With an Alteration in Cellular Regulation/
Hematologic or Neoplastic Disorder 275
Chapter 25 Nursing Care of the Child With an Alteration in Immunity or Immunologic
Disorder 287
Chapter 26 Nursing Care of the Child With an Alteration in Metabolism/Endocrine
Disorder 298
Chapter 27 Nursing Care of the Child With an Alteration in Genetics 310
Chapter 28 Nursing Care of the Child With an Alteration in Behavior, Cognition, or
Development 322
,Chapter 29 Nursing Care During a Pediatric Emergency 333
,______________________________________________________________________________________________
Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
Chapter 1, Introduction to Child Health and Pediatric Nursing
1. The nurse is caring for a 10-year-old child with a neuroblastoma. Which activity(ies)
describes the role of the nurse as a care coordinator, collaborator, and consultant? Select all
that apply.
A) collaborating with the family throughout the care path
B) advancing the interests of children and their families by knowing their needs
C) informing children and families of their rights and options
D) coordinating care provided by the interdisciplinary team
E) ensuring that the child's and family's needs are met through activities such as
support groups
F) providing appropriate client education based on the child's developmental level
ANS: A, D, E
The pediatric nurse serves as a collaborator, care coordinator, and consultant. Collaborating
with the interdisciplinary health care team, the pediatric nurse integrates the child's and
family's needs into a coordinated plan of care. In the role of consultant, the pediatric nurse
ensures that the child's and family's needs are met through such activities as support group
facilitation or working with the school nurse to plan the child's care. In the role of child and
family advocate, the nurse safeguards and advances the interests of children and their
families by knowing their needs and resources, informing them of their rights and options,
and assisting them to make informed decisions. In the role of educator, the nurse instructs
and counsels children and their families about all aspects of health and illness. In this role,
the pediatric nurse also ensures that communication with the child and family is based on
the child's age and developmental level.
PTS: 1 REF: Page and Header: 11, Role of the Pediatric Nurse
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Selection
2. The nurse is providing care for a 9-year-old child who uses mechanical ventilation. Which is
an example of the nursing role of collaboration?
A) informing the team members on progress of the treatment
B) discussing the child's needs with a school nurse
C) advising the pulmonologist of respiratory symptoms
D) arranging for after-school attendance at a day care facility
ANS: A
Informing team members of the progress of treatment is an act of collaboration. Discussing
the child's needs with a school nurse is done in the role of a consultant. Advising the
pulmonologist of respiratory symptoms and arranging after-school attendance at a day care
facility are care coordinator activities.
PTS: 1 REF: Page and Header: 7, Measurement of Children's Health Status
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
______________________________________________________________________________________________
1|Page
,______________________________________________________________________________________________
Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
BLM: Cognitive Level: Apply NOT: Multiple Choice
3. The nurse is providing care to a child and their family. Which activity reflects the use of the
assessment step of the nursing process when providing care for children?
A) collecting data about the child and family
B) analyzing data to make judgments about the child's health state
C) evaluating care provided by the interdisciplinary team
D) developing a care plan that incorporates child goals
ANS: A
The nursing process is applicable to all health care settings and consists of five steps:
assessment, nursing diagnosis, outcome identification and planning, implementation, and
outcome evaluation. Collecting data about the child and family occurs in the assessment step
of the nursing process. Analyzing data to make judgments about the child's health state
involves nursing diagnosis. Evaluating care provided by the interdisciplinary team is
performed in the outcome evaluation. Developing a care plan that incorporates child goals
occurs in the planning stage.
PTS: 1 REF: Page and Header: 12, Role of the Pediatric Nurse
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Choice
4. The nurse is caring for a newborn who has Down syndrome. Which nursing action reflects
the nurse's use of the ethical principle of nonmaleficence?
A) The nurse speaks truthfully to the parents regarding their newborn's prognosis.
B) The nurse provides safe, competent nursing care to avoid harming the newborn.
C) The nurse involves the parents in making health care decisions for their newborn.
D) The nurse fairly allocates resources for caring for newborns in a facility.
ANS: B
Ethics includes the basic principles of autonomy, beneficence, nonmaleficence, justice,
veracity, and fidelity. Nonmaleficence means to avoid causing harm, intentionally or
unintentionally. One example is providing safe, competent nursing care. Speaking truthfully
to the parents is an example of veracity. Generally, parents have the autonomy to make
health care decisions for their children. Justice refers to acting fairly and involves allocating
resources fairly.
PTS: 1
REF: Page and Header: 15, Ethical Issues Related to Working With Children and Their
Families
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Choice
5. The nurse is helping the family of a child with a terminal illness to fill out an advance
directives form. Which intervention(s) is determined by this document? Select all that apply.
A) withholding food
______________________________________________________________________________________________
2|Page
,______________________________________________________________________________________________
Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
B) withholding water
C) withholding antibiotics
D) do-not-resuscitate (DNR) order
E) withholding ventilation
F) providing artificial nutrition
ANS: C, D, E, F
Advance directives determine the child's and family's wishes should life-sustaining care
become necessary. After discussion with other family members, friends, and spiritual
advisors, the parents may make the decision to forego life-sustaining medical treatment,
either withdrawing treatment or deciding to withhold certain further treatment, or opt not to
resuscitate in the event of cardiopulmonary arrest. Food and water are not withheld;
however, some children may not be able to drink or eat and artificial nutrition may be
withheld.
PTS: 1
REF: Page and Header: 18, Legal Issues Related to Working With Children and Their
Families
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Selection
6. The school nurse is reviewing the records of students in an elementary school. Based on
current child morbidity rates, which child is the nurse most careful to monitor for days
missed from school?
A) a child with asthma
B) a child with contact dermatitis
C) a child with severe allergic rhinitis (hay fever)
D) a child with food allergies
ANS: A
Morbidity refers to illness present in a specific population at a given time. Asthma is the
leading chronic disease in children, affecting 14% of children in the United States; 13% of
children suffer from skin allergies, 9% have hay fever, and 6% have food allergies.
PTS: 1 REF: Page and Header: 9, Morbidity Data
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
7. The nurse in charge of the quality department is reviewing cases regarding Health Insurance
Portability and Accountability Act (HIPAA) compliance. In which case(s) does the nurse
correctly determine that HIPAA standards were followed? Select all that apply.
A) A child is diagnosed with an inner ear infection and follow-up care instructions are
given to the child's aunt, who provides a medical consent form from the parents,
who are on vacation.
B) The emergency department nurse manager reports the suspicion of abuse to the
child welfare department for a child admitted with suspicious injuries.
______________________________________________________________________________________________
3|Page
,______________________________________________________________________________________________
Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
C) When asked, the nurse informs the grandparents of a child on the medical floor
when their grandchild will be released home to the parents.
D) The physician reports the diagnosis of hepatitis C of a 14-year-old child with
injectable substance use disorder to the health department.
E) The nurse manager tells the superintendent of schools that a high school student is
infected with HIV so that proper precautions can be implemented in the school.
ANS: A, B, D
The Health Insurance Portability and Accountability Act (HIPAA) addresses security and
privacy issues involving health information about individuals. Information can be shared
with the client's aunt because medical consent has been granted by the legal guardians
(parents). An exception to the rule is the requirement to report suspected physical or sexual
abuse of a child. In addition, public health laws require reporting certain infectious diseases,
such as hepatitis C. The nurse should not provide information to the grandparents without
written consent from the legal guardian, nor should the nurse discuss a client's health with
the school superintendent. This information should be shared only with the local health
department.
PTS: 1
REF: Page and Header: 19, Legal Issues Related to Working With Children and Their
Families
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Selection
8. The pediatric nurse is participating in the role of advocate when completing which action?
A) instructing parents on the side effects of vaccinations they are requesting for their
child
B) contributing input on a task force with the aim of reducing the rate of mortality of
infants and children
C) teaching parents to keep their prescribed medication safely out of reach of children
D) explaining to parents the reason for each medication their child was recently
prescribed
ANS: B
The role of advocacy is being fulfilled when the nurse works to safeguard and advance the
interest of children and infants through many means, including contributing to the learning
and application of a task force aimed at reducing infant and child mortality. The actions of
instructing about side effects, explaining the purposes of medications, and teaching about
medication safety would fall under the role of educator.
PTS: 1 REF: Page and Header: 11, Role of the Pediatric Nurse
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Caring BLM: Cognitive Level: Understand
NOT: Multiple Choice
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Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
9. The nurse manager and a newly licensed nurse plan to obtain informed consent for several
procedures on various clients on a pediatric unit. Which statement(s) by the newly licensed
nurse alerts the nurse manager to provide additional education about informed consent?
Select all that apply.
A) "The parent of the child was pushing their spouse to agree to the procedure, so I
offered to return later, after they have had time to discuss the procedure."
B) "When I went to the room, the child was calling the adult in the room 'friend,' so I
want to clarify their relationship before I prepare to get the consent signed."
C) "After lunch, I will go into the room and explain the procedure, including the risks
and benefits, and the alternative options available for the child."
D) "The parent of the infant explained to me what procedure the infant was having
and indicated they were comfortable signing the consent for the procedure."
E) "I am still going to ask the parents to sign the consent for the procedure even
though the child is legally emancipated from the parents."
F) "The medical record shows the child's foster parents have legal guardianship of the
child, but I am still required to have the child's birth parent sign the consent for the
procedure."
ANS: C, E, F
Nurses working with the pediatric population must be aware of the legal issues surrounding
informed consent for procedures and treatments. The nurse manager will provide additional
teaching if the newly licensed nurse does not know that it is the health care provider's
responsibility to explain the procedure, the risks/benefits, and alternative options to the
parent, not the nurse's. If a child is legally emancipated, the child is able to sign their own
consent for procedures/treatments and the parents of the child would not be asked to sign.
The legal guardian would be asked to sign the consent, and not the birth parents, if the child
was in foster care and legal guardianship was noted on the chart. The nurse was correct to
not obtain consent and offer to come back later for discussion when the nurse noticed there
was coercion (by one parent to the other). The relationship of the adult signing the consent
must be verified and the parent of the infant was able to explain the procedure in their own
words and express comfort, so the consent should be signed at that time.
PTS: 1
REF: Page and Header: 16, Legal Issues Related to Working With Children and Their
Families
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Communication and Documentation
BLM: Cognitive Level: Apply NOT: Multiple Selection
10. The nurse is caring for a school-aged child in the home who has a newly inserted gastric
tube and several new medications. The nurse is participating in the role of the educator
when completing which action(s)? Select all that apply.
A) arranging for the physical therapist to consult with the child regarding mobility
B) writing the medication purposes and schedule on paper and putting it on the wall in
the kitchen
C) reminding the parents of the importance of the child completing the entire dose of
antibiotic
D) engaging the child by watching a video together about a child with gastric tubes
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Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
E) observing the child show a return demonstration of the cleansing of the gastric tube
site
F) assessing the home for medications the child could inadvertently access
ANS: B, C, D, E
The nurse is participating in the educator role when asking the child to demonstrate proper
care of the gastric tube site and would further educate if the return demonstration was not
accurate. Additionally, the nurse is educating the parents about medication by assuring they
have the medication schedule and medication purpose available in writing, and reminding
the parents to give the entire course of antibiotics. Watching a video for children with
gastric tubes is educating the child about their medical equipment. Assessing the home for
safety concerns (accessible medications) and arranging therapy appointments fall under the
role of the care manager.
PTS: 1 REF: Page and Header: 18, Advance Directives
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Understand NOT: Multiple Selection
11. A 7-year-old child with a chronic illness is currently hospitalized. Which recommendation
should the nurse make for this child?
A) Involve the child and family in self-care activities performed at home.
B) Restrict visiting hours to maintain a quiet environment.
C) Discourage siblings from visiting to reduce infection risk.
D) Educate the child separately from the parents to avoid confusion.
ANS: A
Involving the child and family in self-care promotes family-centered care, which is an
approach that supports a mutually beneficial relationship between the child, family, and
health care professionals. Restricting visiting hours, discouraging siblings from visiting, and
providing education separately for children and parents all reduce the collaboration with
family and do not reflect effective family-centered care approaches.
PTS: 1 REF: Page and Header: 12, Implementing the Nursing Process
NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Caring BLM: Cognitive Level: Apply
NOT: Multiple Choice
12. A nurse is providing care to an adolescent client undergoing a painful procedure. Which
intervention(s) should the nurse perform to provide atraumatic care? Select all that apply.
A) Offer distractions such as music or guided imagery during the procedure.
B) Provide age-appropriate information about the procedure in a clear manner.
C) Administer sedation prior to discussing the procedure with the client.
D) Encourage the client to "be brave" during the procedure.
E) Avoid providing information about the procedure to reduce anxiety.
ANS: A, B
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Test Bank - Essentials of Pediatric Nursing, 5th Edition (Kyle, 2025)
The goal of atraumatic care is to reduce physical and psychological distress for children and
their families. Offering distractions provides the opportunity for the adolescent to be
involved in their care, which can reduce psychological distress as well as reduce pain and
physical distress. Providing age-appropriate information assists in understanding the care,
which can also reduce psychological distress. Administering sedation prior to discussion and
not providing information could cause increased distress in the client due to lack of
information. Encouraging the client to be brave does not support a reduction in distress.
PTS: 1 REF: Page and Header: 10, Philosophy of Pediatric Nursing
NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Caring BLM: Cognitive Level: Apply
NOT: Multiple Selection
13. A nurse working in public health finds that their colleagues use different approaches to
managing injection pain for immunizations in toddlers. What step will the nurse take to
determine the best approach for reducing and managing pain in these clients?
A) Review research literature and evidence about managing injection pain in toddlers.
B) Ask a colleague about what they think the best approach should be for consistency.
C) Explain to colleagues injection techniques that have worked best in the nurse's
experience.
D) Survey parents to see what they think might be most effective for their children's
immunizations.
ANS: A
Evidence-based care involves staying informed about current research and applying it to
clinical practice. Consulting the latest research supports learning about evidence and best
practices. Asking a colleague or explaining the nurse's current practice does not adequately
explore and analyze evidence. Surveying parents may be helpful in understanding the parent
perspective, but it does not integrate evidence-based practice.
PTS: 1 REF: Page and Header: 9, Morbidity Data
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Introduction to Child Health and Pediatric Nursing
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
14. A nurse is supporting a project that aims to reduce childhood mortality in the region. Which
intervention would most effectively support the goal of mortality reduction?
A) providing free bicycle helmets for children
B) providing free exercise classes for children
C) providing education about healthy nutrition for families
D) providing first aid kits for families
ANS: A
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