Chapter 26 - Pediatric Surgery
a. painful stimuli such as eye surgery or abdominal retraction. - ANS-Young children are
predisposed to parasympathetic hypertonia (increased vagal tone), which can be induced by:
a. painful stimuli such as eye surgery or abdominal retraction.
b. anxiety stimuli such as separation from a parent.
c. environmental stimuli such as loud noise or flashes of light.
d. thermal stimuli such as ambient excessive heat or cold.
c. Opioids and hypnotics - ANS-The immature blood-brain barrier and decreased protein binding
in infants increase their sensitivity to which group of drugs?
a. Anticholinergics, parasympatholytics
b. Antidysrhythmic agents
c. Opioids and hypnotics
d. Adrenergics
a. Blood pressure within acceptable range - ANS-The pediatric patient is at risk for imbalanced
fluid volume related to invasive surgery and accompanying blood loss. Select the outcome
indicator that would best reflect that the goal of maintained fluid balance was attained.
a. Blood pressure within acceptable range
b. Bounding peripheral pulses
c. Three wet diapers in 24 hours
d. Intact mucous membranes
c. Anxiety related to separation from family and friends - ANS-The perioperative nurse explained
to the child at a developmentally appropriate level, what he or she will experience in the
preoperative, intraoperative, and postoperative phases of care. The nurse briefly described the
roles of various staff members who will be a part of the team responsible for the child's care in
the operating room (OR). She explained to the child and family the length of time that they will
be separated from each other during the procedure and when they can be reunited in the
postanesthesia care unit (PACU). She addressed the child within a developmental framework,
taking into account the child's cognitive and psychosocial abilities. She used medical play items,
audiovisual aids, puppets, and photographs in the education process. While the nurse
addressed the need for knowledge of the impending surgical procedure and provided education,
she also employed interventions aimed at which nursing diag
a. Dr. Erik Erikson; Dr. Jean Piaget - ANS-A child's comprehension of, and responses to, the
environment are based on his or her developmental age. Many theorists have provided
excellent guidelines for assessing the pediatric patient's developmental level in order to use
appropriate interventions. The infant develops the belief that the world can be counted on to
meet basic needs through the trust versus mistrust concept based on the stages of
psychosocial and emotional needs. This theoretical framework of stages was described by
, ______________, while the stages based on changes in cognition and ability to think were
described by _____________.
a. Dr. Erik Erikson; Dr. Jean Piaget
b. Dr. John Watson; Dr. Albert Bandura
c. Dr. Jean Piaget; Dr. John Watson
d. Dr. Karl Jung; Dr. Sigmund Freud
b. Give only simple choices and involve them in actions when possible. - ANS-The toddler uses
symbols and engages in creative play. Toddlers are beginning to develop free will and control
over their bodies. Which of the interventions below is age-appropriate for toddlers?
a. Sing songs from your own childhood that the child may be able to learn.
b. Give only simple choices and involve them in actions when possible.
c. Make up a story about their personal comfort item as you give it to their parent to keep.
d. Ask them about their concerns and offer information to decrease their fears.
d. Infancy through adolescence - ANS-Personal comfort or security items should be permitted to
accompany children to the OR who are in which developmental age?
a. Infancy to 1 year
b. Toddler to early childhood
c. School age to adolescence
d. Infancy through adolescence
b. Pediatric patients having MIS procedures have less prevalence of adhesion formation. -
ANS-Improvements in instrumentation and the development of equipment in smaller sizes have
resulted in the evolution of minimally invasive surgery (MIS) from that of a rapidly growing field
to one of routine practice in the pediatric surgical arena. The advantages of MIS for the pediatric
population include which true statement?
a. There is less risk for injury or complications with pneumoperitoneum insufflation.
b. Pediatric patients having MIS procedures have less prevalence of adhesion formation.
c. There is less possibility for abdominal injury from Foley catheter decompression.
d. MIS procedures on children do not require the use of thromboembolic devices.
a. Nissen fundoplication - ANS-Infants and children with severe gastroesophageal (GE) reflux
can have life-threatening complications, including obstructive apnea, aspiration pneumonia,
esophagitis, and failure to thrive. What is the name of the procedure, performed open or
laparoscopically, that is designed to create a competent antireflux barrier?
a. Nissen fundoplication
b. Roux-en-Y bypass
c. Pyloromyotomy with pyloroplasty
d. Sphincterotomy
c. All testes that are undescended after 1 year require surgical placement in the scrotum. -
ANS-An orchiopexy is the surgical placement and fixation of the testicle in a normal anatomic
a. painful stimuli such as eye surgery or abdominal retraction. - ANS-Young children are
predisposed to parasympathetic hypertonia (increased vagal tone), which can be induced by:
a. painful stimuli such as eye surgery or abdominal retraction.
b. anxiety stimuli such as separation from a parent.
c. environmental stimuli such as loud noise or flashes of light.
d. thermal stimuli such as ambient excessive heat or cold.
c. Opioids and hypnotics - ANS-The immature blood-brain barrier and decreased protein binding
in infants increase their sensitivity to which group of drugs?
a. Anticholinergics, parasympatholytics
b. Antidysrhythmic agents
c. Opioids and hypnotics
d. Adrenergics
a. Blood pressure within acceptable range - ANS-The pediatric patient is at risk for imbalanced
fluid volume related to invasive surgery and accompanying blood loss. Select the outcome
indicator that would best reflect that the goal of maintained fluid balance was attained.
a. Blood pressure within acceptable range
b. Bounding peripheral pulses
c. Three wet diapers in 24 hours
d. Intact mucous membranes
c. Anxiety related to separation from family and friends - ANS-The perioperative nurse explained
to the child at a developmentally appropriate level, what he or she will experience in the
preoperative, intraoperative, and postoperative phases of care. The nurse briefly described the
roles of various staff members who will be a part of the team responsible for the child's care in
the operating room (OR). She explained to the child and family the length of time that they will
be separated from each other during the procedure and when they can be reunited in the
postanesthesia care unit (PACU). She addressed the child within a developmental framework,
taking into account the child's cognitive and psychosocial abilities. She used medical play items,
audiovisual aids, puppets, and photographs in the education process. While the nurse
addressed the need for knowledge of the impending surgical procedure and provided education,
she also employed interventions aimed at which nursing diag
a. Dr. Erik Erikson; Dr. Jean Piaget - ANS-A child's comprehension of, and responses to, the
environment are based on his or her developmental age. Many theorists have provided
excellent guidelines for assessing the pediatric patient's developmental level in order to use
appropriate interventions. The infant develops the belief that the world can be counted on to
meet basic needs through the trust versus mistrust concept based on the stages of
psychosocial and emotional needs. This theoretical framework of stages was described by
, ______________, while the stages based on changes in cognition and ability to think were
described by _____________.
a. Dr. Erik Erikson; Dr. Jean Piaget
b. Dr. John Watson; Dr. Albert Bandura
c. Dr. Jean Piaget; Dr. John Watson
d. Dr. Karl Jung; Dr. Sigmund Freud
b. Give only simple choices and involve them in actions when possible. - ANS-The toddler uses
symbols and engages in creative play. Toddlers are beginning to develop free will and control
over their bodies. Which of the interventions below is age-appropriate for toddlers?
a. Sing songs from your own childhood that the child may be able to learn.
b. Give only simple choices and involve them in actions when possible.
c. Make up a story about their personal comfort item as you give it to their parent to keep.
d. Ask them about their concerns and offer information to decrease their fears.
d. Infancy through adolescence - ANS-Personal comfort or security items should be permitted to
accompany children to the OR who are in which developmental age?
a. Infancy to 1 year
b. Toddler to early childhood
c. School age to adolescence
d. Infancy through adolescence
b. Pediatric patients having MIS procedures have less prevalence of adhesion formation. -
ANS-Improvements in instrumentation and the development of equipment in smaller sizes have
resulted in the evolution of minimally invasive surgery (MIS) from that of a rapidly growing field
to one of routine practice in the pediatric surgical arena. The advantages of MIS for the pediatric
population include which true statement?
a. There is less risk for injury or complications with pneumoperitoneum insufflation.
b. Pediatric patients having MIS procedures have less prevalence of adhesion formation.
c. There is less possibility for abdominal injury from Foley catheter decompression.
d. MIS procedures on children do not require the use of thromboembolic devices.
a. Nissen fundoplication - ANS-Infants and children with severe gastroesophageal (GE) reflux
can have life-threatening complications, including obstructive apnea, aspiration pneumonia,
esophagitis, and failure to thrive. What is the name of the procedure, performed open or
laparoscopically, that is designed to create a competent antireflux barrier?
a. Nissen fundoplication
b. Roux-en-Y bypass
c. Pyloromyotomy with pyloroplasty
d. Sphincterotomy
c. All testes that are undescended after 1 year require surgical placement in the scrotum. -
ANS-An orchiopexy is the surgical placement and fixation of the testicle in a normal anatomic
