Pediatric Nursing Exam 1 (testbank) Questions With Verified Answers

Which nursing role is not directly involved when providing family-centered approach to the pediatric population? 1. Advocacy 2. Case management 3. Patient education 4. Researcher - Answer 4. Researcher A nurse is working with pediatric clients in a research facility. The nurse recognizes that federal guidelines are in place that delineate which pediatrics clients must give assent for participation in research trials. Based upon the clients age, the nurse would seek assent from which children? Select all that apply. 1. The precocious 4-year-old starting as a cystic fibrosis research-study participant. 2. The 7-year-old leukemia client electing to receive a newly developed medication, now being researched. 3. The 10-year-old starting in an investigative study for clients with precocious puberty. 4. The 13-year-old client beginning participation in a research program for ADHD treatments. - Answer 2. The 7-year-old leukemia client electing to receive a newly developed medication, now being researched. 3. The 10-year-old starting in an investigative study for clients with precocious puberty. 4. The 13-year-old client beginning participation in a research program for ADHD treatments. The nurse in a pediatric acute-care unit is assigned the following tasks. Which task is not appropriate for the registered to nurse complete? 1. Diagnose an 8-year-old with acute otitis media and prescribe an antibiotic. 2. Listen to the concerns of an adolescent about being out of school for a lengthy surgical recovery. 3. Provide information to a mother of a newly diagnosed 4-year-old diabetic about local support-group options. 4. Diagnose a 6-year-old with Diversional Activity Deficit related to placement in isolation. - Answer 1. Diagnose an 8-year-old with acute otitis media and prescribe an antibiotic. A 7-year-old child is admitted for acute appendicitis. The parents are questioning the nurse about expectations during the childs recovery. Which information tool would be most useful in answering a parents questions about the timing of key events? 1. Healthy People 2020 2. Clinical pathways 3. Child mortality statistics 4. National clinical practice guidelines - Answer 2. Clinical pathways The nurse recognizes that the pediatric client is from a cultural background different from that of the hospital staff. Which goal is most appropriate for this client when planning nursing care? 1. Overlook or minimize the differences that exist. 2. Facilitate the family's ability to comply with the care needed. 3. Avoid inadvertently offending the family by imposing the nurses perspective. 4. Encourage complementary beneficial cultural practices as primary therapies. - Answer 2. Facilitate the family's ability to comply with the care needed. The telephone triage nurse at a pediatric clinic knows each call is important. Which call would require extra attentiveness from the registered nurse because of an increased risk of mortality? 1. A 3-week-old infant born at 35 weeks gestation with gastroenteritis 2. A term 2-week-old infant of American Indian descent with an upper respiratory infection 3. A post term 4-week-old infant non-Hispanic black descent with moderate emesis after feeding 4. A 1-week-old infant born at 40 weeks gestation with symptoms of colic - Answer 1. A 3-week-old infant born at 35 weeks gestation with gastroenteritis Despite the availability of Childrens Health Insurance Programs (CHIP), many eligible children are not enrolled. Which nursing intervention would be the most appropriate to help children become enrolled in CHIP? 1. Assessment of the details of the familys income and expenditures 2. Case management to limit costly, unnecessary duplication of services 3. To advocate for the child by encouraging the family to investigate its CHIP eligibility 4. To educate the family about the need for keeping regular well-childvisit appointments - Answer 3. To advocate for the child by encouraging the family to investigate its CHIP eligibility A supervisor is reviewing the documentation of the nurses in the unit. Which client documentation is the most accurate and contains all the required part for a narrative entry? 1. 2/2/05 1630 Catheterized using an 8 French catheter, 45 mL clear yellow urine obtained, specimen sent to lab, squirmed and cried softly during insertion of catheter. Quiet in mothers arms following catheter removal. M. May RN 2. 1/9/05 2 pm NG tube placement confirmed and irrigated with 30 ml sterile water. Suction set at low, intermittent. Oxygen via nasal canal at 2 L/min. Nares patent, pink, and nonirritated. K. Earnst RN 3. 4:00 Trach dressing removed with dime-size stain of dry serous exudate. Site cleansed with normal saline. Dried with sterile gauze. New sterile trach sponge and trach ties applied. Respirations regular and even throughout the procedure. F. Luck RN 4. Feb. 05 Port-A-Cath assessed with Huber needle. Blood return present. Flushed with NaCl sol., IV gamma globins hung and infusing at 30cc/hr. Child smiling and playful throughout the procedure. P. Potter, RN - Answer 1. 2/2/05 1630 Catheterized using an 8 French catheter, 45 mL clear yellow urine obtained, specimen sent to lab, squirmed and cried softly during insertion of catheter. Quiet in mothers arms following catheter removal. M. May RN A 12-year-old pediatric client is in need of surgery. Which member of the health care team is legally responsible for obtaining informed consent for an invasive procedure? 1. Nurse 2. Physician 3. Unit secretary 4. Social worker - Answer 2. Physician A child is being prepared for an invasive procedure. The mother of the child has legal custody but is not present. After details of the procedure are explained, who can provide legal consent on behalf of a minor child for treatment? 1. The divorced parent without custody 2. A cohabitating unmarried boyfriend of the childs mother 3. A grandparent who lives in the home with the child 4. A babysitter with written proxy consent - Answer 4. A babysitter with written proxy consent A 12-year-old child is admitted to the unit for a surgical procedure. The child is accompanied by two parents and a younger sibling. What is the level of involvement in treatment decision making for this child? 1. That of an emancipated minor. 2. That of a mature minor. 3. That of assent. 4. None. - Answer 3. That of assent. Which nursing intervention is most appropriate when providing education to the pediatric client and family? 1. Giving primary care for high-risk children who are in hospital settings 2. Giving primary care for healthy children 3. Working toward the goal of informed choices with the family 4. Obtaining a physician consultation for any technical procedures at delivery - Answer 3. Working toward the goal of informed choices with the family What is the pediatric nurses best defense against an accusation of malpractice or negligence? 1. Following the physicians written orders 2. Meeting the scope and standards of practice for pediatric nursing 3. Being a nurse practitioner or clinical nurse specialist 4. Acting on the advice of the nurse manager - Answer 2. Meeting the scope and standards of practice for pediatric nursing Which legal or ethical offense would be committed if a nurse tells family members the condition of a newborn baby without first consulting the parents? 1. A breach of privacy 2. Negligence 3. Malpractice 4. A breach of ethics - Answer 1. A breach of privacy Pediatric nurses have foundational knowledge obtained in nursing school and add specific competencies related to the pediatric client. Which would be considered an additional specific expected competency of the pediatric nurse? 1. Physical assessment 2. Anatomical and developmental differences 3. Nursing process 4. Management of healthcare conditions - Answer 2. Anatomical and developmental differences The nurse is planning care for an adolescent client who will be hospitalized for several weeks following a traumatic brain injury. Which interventions will enhance family-centered care for this client and family? Select all that apply. 1. Making all ADL decisions for the adolescent and family 2. Asking the adolescent what foods to include during meal time 3. Allowing the family time to pray each day with the adolescent 4. Encouraging the adolescents friends to visit during visiting hours 5. Leaving all questions for the healthcare provider - Answer 2. Asking the adolescent what foods to include during meal time 3. Allowing the family time to pray each day with the adolescent 4. Encouraging the adolescents friends to visit during visiting hours A new pediatric hospital will open soon. While planning nursing care, the hospital administration is considering two models of providing health care: family-focused care and family-centered care. Which action best implements family-centered care? 1. Telling the family what must be done for the familys health 2. Assuming the role of an expert professional to direct the health care 3. Intervening for the child and family as a unit 4. Conferring with the family in deciding which healthcare option will be chosen - Answer 4. Conferring with the family in deciding which healthcare option will be chosen A school-age client tells you that Grandpa, Mommy, Daddy, and my brother live at my house. Which type of family will the nurse identify in the medical record based on this description? 1. Binuclear family 2. Extended family 3. Gay or lesbian family 4. Traditional nuclear family - Answer 2. Extended family The nurse is performing an assessment of a childs biologic family history. Which situation would necessitate the nurses asking the mother for information should use the term childs father instead of your husband? 1. Traditional nuclear family 2. Traditional extended family 3. Two-income nuclear family 4. Cohabitating informal stepfamily - Answer 4. Cohabitating informal stepfamily Several children arrived at the emergency department accompanied only by their fathers. Which father may legally sign emergency medical consent for treatment? 1. The divorced one from the binuclear family 2. The stepfather from the blended or reconstituted family 3. The divorced one when the single-parent mother has custody 4. The nonbiologic one from the heterosexual cohabitating family - Answer 1. The divorced one from the binuclear family The community-health nurse is assessing several families for various strengths and needs in regard to after-school and backup child-care arrangements. Which family type will benefit the most from this assessment and subsequent interventions? 1. The binuclear family 2. The extended family 3. The single-parent family 4. The traditional nuclear family - Answer 3. The single-parent family The nurse is working on parenting skills with a group of mothers. Which mother would need the fewest discipline-related suggestions? 1. Authoritarian one 2. Authoritative one 3. Indifferent one 4. Permissive one - Answer 2. Authoritative one The nurse in the pediatric clinic observes a parental lack of warmth and interest toward the child. Which family style will the nurse most likely document in this situation? 1. Authoritarian 2. Authoritative 3. Indifferent 4. Permissive - Answer 3. Indifferent The nurse is working on parenting skills with a mother of three children. The nurse demonstrates a strategy that uses reward to increase positive behavior. Which strategy will the nurse document in the medical record based on this description? 1. Time out 2. Reasoning 3. Behavior modification 4. Experiencing consequences of misbehavior - Answer 3. Behavior modification The nurse is assessing a family's effective coping strategies and ineffective defensive strategies. Which family-social-system theory is the nurse using in this assessment of the family? 1. Family-stress theory 2. Family-development theory 3. Family-systems theory 4. Family life-cycle theory - Answer 1. Family-stress theory The nurse is assigned to a child in a spica cast for a fractured femur suffered in an automobile accident. The childs teenage brother was driving the car, which was totaled. The nurse learns that the father lost his job three weeks ago and the mother has just accepted a temporary waitress job. Which nursing diagnosis will the nurse use when planning care for this child and family? 1. Compromised Family Coping Related to the Effects of Multiple Simultaneous Stressors 2. Impaired Social Interaction (Parent and Child) Related to the Lack of Family or Respite Support 3. Interrupted Family Processes Related to Child with Significant Disability Requiring Alteration in Family Functioning 4. Risk for Caregiver Role Strain Related to Child with a Newly Acquired Disability and the Associated Financial Burden - Answer 1. Compromised Family Coping Related to the Effects of Multiple Simultaneous Stressors A nurse is working with the family of a pediatric client. When planning to obtain an accurate family assessment, which initial step is the most appropriate? 1. Establish a trusting relationship with the family. 2. Select the most relevant family-assessment tool. 3. Focus primarily upon the mother, while learning her greatest concern. 4. Observe the family in the home setting, since this step always proves indispensable. - Answer 1. Establish a trusting relationship with the family. The camp nurse is assessing a group of children attending summer camp. The nurse will expect which children to most likely have problems perceiving a sense of belonging? 1. Children whose parents divorced recently 2. Children who gained a stepparent recently 3. Children recently placed into foster care 4. Children adopted as infants - Answer 3. Children recently placed into foster care There are several tools that help with obtaining a cultural assessment of a client and his family. Which tool would be appropriate to gather 12 major concepts of cultural assessment? 1. Sunrise enabler 2. Model for cultural competence 3. Transcultural assessment model 4. Health traditions model - Answer 2. Model for cultural competence Cultures have many different childrearing practices. Which culture is known to value the male child more than the female child, and often teaches children to avoid displaying emotion? 1. Mexican 2. Amish 3. Chinese 4. Navajo - Answer 3. Chinese The nurse is planning care for a school-age client and family who have expressed wanting to use complementary and alternative modalities (CAM) in the treatment plan. Which interventions can the nurse safely implement into the plan of care? Select all that apply. 1. Substituting an herbal remedy for a prescribed medication 2. Encouraging the parents to share which modalities they would like to implement 3. Educating on the benefits and risks for each modality 4. Using essential oils to decrease nausea 5. Discouraging the use of faith-based therapies - Answer 2. Encouraging the parents to share which modalities they would like to implement 3. Educating on the benefits and risks for each modality 4. Using essential oils to decrease nausea While in the pediatricians office for their childs 12-month well-child exam, the parents ask the nurse for advice on age-appropriate toys for their child. Based on the child's developmental level, which types of toys would the nurse suggest? Select all that apply. 1. Soft toys that can be manipulated 2. Small toys that can pop apart and go back together 3. Jack-in-the-box toys 4. Toys with black and white patterns 5. Push-and-pull toys - Answer 1. Soft toys that can be manipulated 3. Jack-in-the-box toys 5. Push-and-pull toys A mother of a school-age client who recently had surgery for the removal of tonsils and adenoids complains that the child has begun sucking his thumb again. Which coping mechanisms is the child using to cope with the surgery and hospitalization? 1. Repression 2. Rationalization 3. Regression 4. Fantasy - Answer 3. Regression While being comforted in the emergency department, a young school-age sibling of a pediatric trauma victim blurts out to the nurse, Its all my fault! When we were fighting yesterday, I told him I wished he was dead! Which response is most appropriate by the nurse? 1. Asking the child if she would like to sit down and drink some water 2. Sitting the child down in an empty room with markers and paper so that she can draw a picture 3. Calmly discussing the catheters, tubes, and equipment that the patient requires and explaining to the sibling why the patient needs them 4. Reassuring the child that it is normal to get angry and say things that we do not mean but that we have no control over whether or not an accident happens - Answer 4. Reassuring the child that it is normal to get angry and say things that we do not mean but that we have no control over whether or not an accident happens While assessing the development of a 9-month-old infant, the nurse asks the mother if the child actively looks for toys when they are placed out of sight. Which developmental task is the nurse assessing this infant for? 1. Object permanence 2. Centration 3. Transductive reasoning 4. Conservation - Answer 1. Object permanence The nurse is counseling the parents of a 6-1/2-month-old infant. Which age-appropriate toy is most appropriate for the nurse to suggest to these parents? 1. Soft, fluid-filled ring that can be chilled in the refrigerator 2. Colorful rattle 3. Jack-in-the-box toy 4. Push-and-pull toy - Answer 1. Soft, fluid-filled ring that can be chilled in the refrigerator A nurse is assessing language development in all the infants presenting at the doctors office for well-child visits. At which age range would the nurse expect a child to verbalize the words dada and mama? 1. 3 and 5 months 2. 6 and 8 months 3. 9 and 12 months 4. 13 and 18 months - Answer 3. 9 and 12 months The parents of an 8-year-old state that their son seems very interested in trying new activities. When the parents ask for suggested activities for this age child, the nurse recommends scouts as an activity that will foster growth and development. In which stage of Eriksons psychosocial stages of development is this child? 1. Trust versus mistrust 2. Initiative versus guilt 3. Industry versus inferiority 4. Identity versus role confusion - Answer 3. Industry versus inferiority Two 3-year-olds are playing in a hospital playroom together. One is working on a puzzle while the other is stacking blocks. Which type of play are these children exhibiting? 1. Cooperative play 2. Associative play 3. Parallel play 4. Solitary play - Answer 3. Parallel play The nurse, talking with the parents of a toddler who is struggling with toilet training, reassures them that their child is demonstrating a typical developmental stage. According to Erikson, which developmental stage will the nurse document in the medical record for this toddler? 1. Trust versus mistrust 2. Autonomy versus shame and doubt 3. Initiative versus guilt 4. Industry versus inferiority - Answer 2. Autonomy versus shame and doubt