Wong’s Nursing Care of Infants and Children, 12th Edition —
Chapter 1: Perspectives of Pediatric Nursing.
Chapter & Subtopic: Chapter 1 – Perspectives of Pediatric
Nursing, Infant Mortality
Stem: A community health nurse is analyzing data from the
local health department. Which finding, if present, would most
significantly contribute to a high infant mortality rate in the
community?
Options:
A) A high rate of adolescent vaping.
B) A low rate of childhood immunization.
C) A high rate of low-birth-weight (LBW) infants.
D) A high rate of type 2 diabetes in adolescents.
Correct Answer: C) A high rate of low-birth-weight (LBW)
infants.
Rationales:
• Correct: Low birth weight is a leading contributor to infant
mortality, as it is associated with numerous complications
including respiratory distress syndrome, infections, and
neurological deficits. (Wong's, Ch. 1, Infant Mortality)
• Incorrect A: While adolescent vaping is a serious health
concern, it is not a primary direct cause of infant death.
• Incorrect B: A low immunization rate increases childhood
morbidity but is not a leading cause of infant mortality.
, • Incorrect D: Type 2 diabetes is a growing pediatric issue
but contributes more to long-term morbidity than
immediate infant death.
Teaching Point: LBW is a key preventable factor targeted to
reduce infant mortality rates.
Question 2
Chapter & Subtopic: Chapter 1 – Perspectives of Pediatric
Nursing, Role of the Pediatric Nurse
Stem: A school nurse is implementing a program to teach
proper handwashing techniques to first-grade students. This
action best demonstrates which primary role of the pediatric
nurse?
Options:
A) Family advocacy
B) Health teaching
C) Coordination and collaboration
D) Therapeutic relationship
Correct Answer: B) Health teaching
Rationales:
• Correct: Health teaching is a fundamental role of the
pediatric nurse, involving the education of children and
families to promote wellness and prevent illness. (Wong's,
Ch. 1, Role of the Pediatric Nurse)
• Incorrect A: Advocacy involves supporting the child's and
family's needs within the healthcare system, which is not
the primary focus of this scenario.
, • Incorrect C: Coordination involves organizing care among
multiple providers, which is not described here.
• Incorrect D: A therapeutic relationship is the foundation
for all nursing care but is a broader concept than the
specific act of teaching.
Teaching Point: Health teaching empowers children and
families with knowledge for self-care and disease
prevention.
Question 3
Chapter & Subtopic: Chapter 1 – Perspectives of Pediatric
Nursing, Clinical Judgment and Reasoning
Stem: A nurse in the emergency department assesses a 2-year-
old with a cough, wheezing, and nasal flaring. The nurse
recognizes these findings as cues for which priority hypothesis?
Options:
A) Impending respiratory failure
B) Bacterial pneumonia
C) Mild upper respiratory infection
D) Foreign body aspiration
Correct Answer: A) Impending respiratory failure
Rationales:
• Correct: Nasal flaring is a late sign of respiratory distress in
infants and young children, indicating increased work of
breathing and potential progression to respiratory failure.
This requires immediate intervention. (Wong's, Ch. 1,
Recognize Cues / Prioritize Hypotheses)
, • Incorrect B & D: While pneumonia and aspiration are
possible hypotheses, the cue of nasal flaring elevates the
urgency beyond these specific etiologies.
• Incorrect C: A mild URI would not typically present with
signs of significant distress like nasal flaring.
Teaching Point: Nasal flaring is a critical cue signaling
severe respiratory distress and hypoxia in young children.
Question 4
Chapter & Subtopic: Chapter 1 – Perspectives of Pediatric
Nursing, Family Advocacy and Caring
Stem: The parents of a child newly diagnosed with epilepsy
express feeling overwhelmed and scared. Which action by the
nurse best demonstrates the principle of family-centered care?
Options:
A) Providing the parents with detailed written information
about anticonvulsant medications.
B) Reassuring the parents that the medical team will make all
the best decisions for their child.
C) Assessing the parents' understanding and involving them in
creating the child's daily management plan.
D) Scheduling a social work consult to address the parents'
emotional state.
Correct Answer: C) Assessing the parents' understanding and
involving them in creating the child's daily management plan.
Rationales:
Chapter 1: Perspectives of Pediatric Nursing.
Chapter & Subtopic: Chapter 1 – Perspectives of Pediatric
Nursing, Infant Mortality
Stem: A community health nurse is analyzing data from the
local health department. Which finding, if present, would most
significantly contribute to a high infant mortality rate in the
community?
Options:
A) A high rate of adolescent vaping.
B) A low rate of childhood immunization.
C) A high rate of low-birth-weight (LBW) infants.
D) A high rate of type 2 diabetes in adolescents.
Correct Answer: C) A high rate of low-birth-weight (LBW)
infants.
Rationales:
• Correct: Low birth weight is a leading contributor to infant
mortality, as it is associated with numerous complications
including respiratory distress syndrome, infections, and
neurological deficits. (Wong's, Ch. 1, Infant Mortality)
• Incorrect A: While adolescent vaping is a serious health
concern, it is not a primary direct cause of infant death.
• Incorrect B: A low immunization rate increases childhood
morbidity but is not a leading cause of infant mortality.
, • Incorrect D: Type 2 diabetes is a growing pediatric issue
but contributes more to long-term morbidity than
immediate infant death.
Teaching Point: LBW is a key preventable factor targeted to
reduce infant mortality rates.
Question 2
Chapter & Subtopic: Chapter 1 – Perspectives of Pediatric
Nursing, Role of the Pediatric Nurse
Stem: A school nurse is implementing a program to teach
proper handwashing techniques to first-grade students. This
action best demonstrates which primary role of the pediatric
nurse?
Options:
A) Family advocacy
B) Health teaching
C) Coordination and collaboration
D) Therapeutic relationship
Correct Answer: B) Health teaching
Rationales:
• Correct: Health teaching is a fundamental role of the
pediatric nurse, involving the education of children and
families to promote wellness and prevent illness. (Wong's,
Ch. 1, Role of the Pediatric Nurse)
• Incorrect A: Advocacy involves supporting the child's and
family's needs within the healthcare system, which is not
the primary focus of this scenario.
, • Incorrect C: Coordination involves organizing care among
multiple providers, which is not described here.
• Incorrect D: A therapeutic relationship is the foundation
for all nursing care but is a broader concept than the
specific act of teaching.
Teaching Point: Health teaching empowers children and
families with knowledge for self-care and disease
prevention.
Question 3
Chapter & Subtopic: Chapter 1 – Perspectives of Pediatric
Nursing, Clinical Judgment and Reasoning
Stem: A nurse in the emergency department assesses a 2-year-
old with a cough, wheezing, and nasal flaring. The nurse
recognizes these findings as cues for which priority hypothesis?
Options:
A) Impending respiratory failure
B) Bacterial pneumonia
C) Mild upper respiratory infection
D) Foreign body aspiration
Correct Answer: A) Impending respiratory failure
Rationales:
• Correct: Nasal flaring is a late sign of respiratory distress in
infants and young children, indicating increased work of
breathing and potential progression to respiratory failure.
This requires immediate intervention. (Wong's, Ch. 1,
Recognize Cues / Prioritize Hypotheses)
, • Incorrect B & D: While pneumonia and aspiration are
possible hypotheses, the cue of nasal flaring elevates the
urgency beyond these specific etiologies.
• Incorrect C: A mild URI would not typically present with
signs of significant distress like nasal flaring.
Teaching Point: Nasal flaring is a critical cue signaling
severe respiratory distress and hypoxia in young children.
Question 4
Chapter & Subtopic: Chapter 1 – Perspectives of Pediatric
Nursing, Family Advocacy and Caring
Stem: The parents of a child newly diagnosed with epilepsy
express feeling overwhelmed and scared. Which action by the
nurse best demonstrates the principle of family-centered care?
Options:
A) Providing the parents with detailed written information
about anticonvulsant medications.
B) Reassuring the parents that the medical team will make all
the best decisions for their child.
C) Assessing the parents' understanding and involving them in
creating the child's daily management plan.
D) Scheduling a social work consult to address the parents'
emotional state.
Correct Answer: C) Assessing the parents' understanding and
involving them in creating the child's daily management plan.
Rationales:
