FULLTESTBANK
ESSENTIALS OF PEDIATRIC NURSING
4TH EDITION BY THERESA
KYLE; SUSAN CARMAN
PRINTED PDF | ORIGINAL DIRECTLY FROM THE
PUBLISHER | 100% VERIFIED ANSWERS |
DOWNLOAD IMMEDIATELY AFTER THE ORDER
,Chapter 1 Introduction to Child Health and
Pediatric Nursing
MULTIPLE CHOICE
1. A Nurse is planning a teaching session for parents of preschool children.
Which statement explains why the nurse should include information about
morbidity andmortality?
a. Life-span statistics are included in the data.
b. It explains effectiveness of treatment.
c. Cost-effective treatment is detailed for the general population.
d. High-risk age groups for certain disorders or hazards are
identified.
ANSWER: D
Analysis of morbidity and mortality data provides the parents with information about
which groups of individuals are at risk for which health problems. Life-span statistics is a
part of the mortality data. Treatment modalities and cost are not included in morbidity
and mortality data.
POINTS: 1 DIFFICULTY: Cognitive Level:
Apply REF: 6-8TOPIC; Integrated
PROCESS: NURSING PROCESS:
Planning
MEDSC: Area of Client Needs: Health Promotion and Maintenance
2. A clinic nurse is planning a teaching session about childhood obesity prevention for
parents of school-age children. The nurse should include which associated risk of
obesity in the teaching plan?
a. Type I diabetes
b. Respiratory disease
c. Celiac disease
d. Type II diabetes
ANSWER: D
,Childhood obesity has been associated with the rise of type II diabetes in children. Type I
diabetes is not associated with obesity and has a genetic component. Respiratory disease
is not associated with obesity, and celiac disease is the inability to metabolize gluten in
foods and is not associated with obesity.
POINTS: 1 DIFFICULTY: Cognitive Level: Apply REF: 3
TOPIC; Integrated PROCESS: NURSING PROCESS: Planning
MEDSC: Area of Client Needs: Health Promotion and Maintenance
3. Which is the leading cause of death in infants younger than 1 year?
a. Congenital anomalies
b. Sudden infant death syndrome
c. Respiratory distress syndrome
d. Bacterial sepsis of the newborn
ANSWER: A
Congenital anomalies account for 20.1% of deaths in infants younger than 1 year. Sudden
infant death syndrome accounts for 8.2% of deaths in this age group. Respiratory distress
syndrome accounts for 3.4% of deaths in this age group. Infections specific to the
perinatal period account for 2.7% of deaths in this age group.
POINTS: 1 DIFFICULTY: Cognitive Level: REF: 7
TOPIC; Integrated PROCESS: NURSING PROCESS:
Assessment
MEDSC: Area of Client Needs: Health Promotion and Maintenance
4. Which leading cause of death topic should the NURSE emphasize to a
group ofAfrican- American boys ranging in ages 15 to 19 years?
a. Suicide
b. Cancer
c. Firearm homicide
d. Occupational injuries
ANSWER: C
Firearm homicide is the second overall cause of death in this age group and the leading
cause of death in African-American males. Suicide is the third-leading cause of death in
this population. Cancer, although a major health problem, is the fourth-leading cause of
death in this age group. Occupational injuries do not contribute to a significant death rate
for this age group.
POINTS: 1 DIFFICULTY: Cognitive Level:
Understand REF: 5 | 8TOPIC; Integrated
PROCESS: NURSING PROCESS: Planning
MEDSC: Area of Client Needs: Health Promotion and Maintenance
5. Which is the major cause of death for children older than 1 year?
a. Cancer
b. Heart disease
c. Unintentional injuries
d. Congenital anomalies
ANSWER: C
Unintentional injuries (accidents) are the leading cause of death after age 1 year through
adolescence. Congenital anomalies are the leading cause of death in those younger than 1
year. Cancer ranks either second or fourth, depending on the age group, and heart disease
ranks fifth in the majority of the age groups.
,POINTS: 1 DIFFICULTY: Cognitive Level: REF:
8 TOPIC; Integrated PROCESS: NURSING
PROCESS: Planning
MEDSC: Area of Client Needs: Health Promotion and Maintenance
6. Which is the leading cause of death from unintentional injuries for females ranging in
age from 1 to 14?
a. Mechanical suffocation
b. Drowning
c. Motorvehicle-related fatalities
d. Fire- and burn-related fatalities
ANSWER: C
Motorvehicle-related fatalities are the leading cause of death for females ranging in age
from 1 to 14, either as passengers or as pedestrians. Mechanical suffocation is fourth or
fifth, depending on the age. Drowning is the second- or third-leading cause of death,
depending on the age. Fire- and burn-related fatalities are the second-leading cause of
death.
POINTS: 1 DIFFICULTY: Cognitive Level: REF: 4
TOPIC; Integrated PROCESS: NURSING PROCESS:
Assessment
MEDSC: Area of Client Needs: Health Promotion and Maintenance
,7. Which factor most impacts the type of injury a child is susceptible to, according to the
childs age?
a. Physical health of the child
b. Developmental level of the child
c. Educational level of the child
d. Number of responsible adults in the home
ANSWER: B
The childs developmental stage determines the type of injury that is likely to occur. The
childs physical health may facilitate the childs recovery from an injury but does not
impact the type of injury. Educational level is related to developmental level, but it is not
as important as the childs developmental level in determining the type of injury. The
number of responsible adults in the home may affect the number of unintentional injuries,
but the type of injury is related to the childs developmental stage.
POINTS: 1 DIFFICULTY: Cognitive Level:
Understand REF: 3-4TOPIC; Integrated PROCESS:
NURSING PROCESS: Planning
MEDSC: Area of Client Needs: Health Promotion and Maintenance
8. Which is now referred to as the new morbidity?
a. Limitations in the major activities of daily living
b. Unintentional injuries that cause chronic health problems
c. Discoveries of new therapies to treat health problems
d. Behavioral, social, and educational problems that alter health
ANSWER: D
The new morbidity reflects the behavioral, social, and educational problems that interfere
with the childs social and academic development. It is currently estimated that the
incidence of these issues is from 5% to 30%. Limitations in major activities of daily
living and unintentional injuries that result in chronic health problems are included in
morbidity data. Discovery of new therapies would be reflected in changes in morbidity
data over time.
POINTS: 1 DIFFICULTY: Cognitive Level: REF: 3
TOPIC; Integrated PROCESS: NURSING PROCESS:
Assessment
MEDSC: Area of Client Needs: Health Promotion and Maintenance
9. A NURSE on a pediatric unit is practicing family-centered care.
Which ismost descriptive of the care the NURSE is delivering?
a. Taking over total care of the child to reduce stress on the family
b. Encouraging family dependence on health care systems
c. Recognizing that the family is the constant in a childs life
d. Excluding families from the decision-making process
ANSWER: C
The three key components of family-centered care are respect, collaboration, and support.
Family-centered care recognizes the family as the constant in the childs life. Taking over
total care does not include the family in the process and may increase stress instead of
reducing stress. The family should be enabled and empowered to work with the health
care system. The family is expected to be part of the decision-making process.
POINTS: 1 DIFFICULTY: Cognitive Level: REF: 8
TOPIC; Integrated PROCESS: NURSING PROCESS:
Implementation MEDSC: Area of Client Needs: Health
Promotion and Maintenance
,10. The NURSE is preparing an in-service education to staff about atraumatic care
forpediatric patients. Which intervention should the NURSE include?
a. Prepare the child for separation from parents during hospitalization by reviewing a
video.
b. Prepare the child before any unfamiliar treatment or procedure by demonstrating on a
stuffed animal.
c. Help the child accept the loss of control associated with hospitalization.
d. Help the child accept pain that is connected with a treatment or procedure.
ANSWER: B
Preparing the child for any unfamiliar treatments, controlling pain, allowing privacy,
providing play activities for expression of fear and aggression, providing choices, and
respecting cultural differences are components of atraumatic care. In the provision of
atraumatic care, the separation of child from parents during hospitalization is minimized.
The NURSE should promote a sense of control for the child. Preventing and minimizing
bodily injury and pain are major components of atraumatic care.
POINTS: 1 DIFFICULTY: Cognitive Level: Understand REF: 9
TOPIC; Integrated PROCESS: NURSING PROCESS:
ImplementationMEDSC: Area of Client Needs: Psychosocial
Integrity
11. Which is most suggestive that a NURSE has a nontherapeutic relationship with a
patientand family?
a. Staff is concerned about the NURSES actions with the patient and family.
b. Staff assignments allow the NURSE to care for same patient and family over an
extendedtime.
c. NURSE is able to withdraw emotionally when emotional overload occurs but
stillremains committed.
d. NURSE uses teaching skills to instruct patient and family rather than doing
everythingfor them.
ANSWER: A
An important clue to a nontherapeutic staff-patient relationship is concern of other staff
members. Allowing the NURSE to care for the same patient over time would be
therapeuticfor the patient and family. NURSES who are able to somewhat withdraw
emotionally can protect themselves while providing therapeutic care. NURSES using
teaching skills to instruct patient and family will assist in transitioning the child and
family to self-care.
POINTS: 1 DIFFICULTY: Cognitive Level: Analyze REF: 9
TOPIC; Integrated PROCESS: NURSING PROCESS:
AssessmentMEDSC: Area of Client Needs:
Psychosocial Integrity
12. Which is most descriptive of clinical reasoning?
a. A simple developmental process
b. Purposeful and goal-directed
c. Based on deliberate and irrational thought
d. Assists individuals in guessing what is most appropriate
ANSWER: B
Clinical reasoning is a complex, developmental process based on rational and deliberate
thought. Clinical reasoning is not a developmental process. Clinical reasoning is based on
rational and deliberate thought. Clinical reasoning is not a guessing process.
POINTS: 1 DIFFICULTY: Cognitive Level: Understand REF: 12
,TOPIC; Integrated PROCESS: NURSING PROCESS: Planning
MEDSC: Area of Client Needs: Safe and Effective Care Environment: Management of
Care
13. A NURSE makes the decision to apply a topical anesthetic to a childs
skinbefore drawing blood. Which ethical principle is the NURSE
demonstrating?
a. Autonomy
b. Beneficence
c. Justice
d. Truthfulness
ANSWER: B
Beneficence is the obligation to promote the patients well-being. Applying a topical
anesthetic before drawing blood promotes reducing the discomfort of the venipuncture.
Autonomy is the patients right to be self-governing. Justice is the concept of fairness.
Truthfulness is the concept of honesty.
POINTS: 1 DIFFICULTY: Cognitive Level: Understand REF: 11
TOPIC; Integrated PROCESS: NURSING PROCESS:
ImplementationMEDSC: Area of Client Needs: Physiological
Integrity
14. Which action by the NURSE demonstrates use of evidence-based practice (EBP)?
a. Gathering equipment for a procedure
b. Documenting changes in a patients status
c. Questioning the use of daily central line dressing changes
d. Clarifying a physicians prescription for morphine
ANSWER: C
The NURSE who questions the daily central line dressing change is ascertaining
whether clinical interventions result in positive outcomes for patients. This demonstrates
evidence-based practice (EBP), which implies questioning why something is effective
and whether a better approach exists. Gathering equipment for a procedure and
documenting changes in a patients status are practices that follow established guidelines.
Clarifying a physicians prescription for morphine constitutes safe NURSING care.
POINTS: 1 DIFFICULTY: Cognitive Level: Apply REF: 11
TOPIC; Integrated PROCESS: NURSING PROCESS: Evaluation
MEDSC: Area of Client Needs: Safe and Effective Care Environment: Management of
Care
15. A NURSE is admitting a toddler to the hospital. The toddler is with both parents
and is currently sitting comfortably on a parents lap. The parents state they will need to
leave for a brief period. Which type of NURSING diagnosis should the NURSE
formulate forthis child?
a. Risk for anxiety
b. Anxiety
c. Readiness for enhanced coping
d. Ineffective coping
ANSWER: A
A potential problem is categorized as a risk. The toddler has a risk to become anxious
when the parents leave. NURSING interventions will be geared toward reducing the
risk. The child is not showing current anxiety or ineffective coping. The child is not at a
pointfor readiness for enhanced coping, especially because the parents will be leaving.
POINTS: 1 DIFFICULTY: Cognitive Level: REF:
12 TOPIC; Integrated PROCESS: NURSING
,PROCESS: Diagnosis
,MEDSC: Area of Client Needs: Health Promotion and Maintenance
16. A child has a postoperative appendectomy incision covered by a dressing. The
NURSE has just completed a prescribed dressing change for this child. Which
descriptionis an accurate documentation of this procedure?
a. Dressing change to appendectomy incision completed, child tolerated procedure well,
parent present
b. No complications noted during dressing change to appendectomy incision
c. Appendectomy incision non-reddened, sutures intact, no drainage noted on old
dressing, new dressing applied, procedure tolerated well by child
d. No changes to appendectomy incisional area, dressing changed, child complained of
pain during procedure, new dressing clean, dry and intact
ANSWER: C
The NURSE should document assessments and reassessments. Appearance of the
incision described in objective terms should be included during a dressing change. The
NURSE should document patients response and the outcomes of the care provided. In
this example, these include drainage on the old dressing, the application of the new
dressing,and the childs response. The other statements partially fulfill the requirements
of documenting assessments and reassessments, patients response, and outcome, but do
notinclude all three.
POINTS: 1 DIFFICULTY: Cognitive Level: Analyze REF: 14
TOPIC; Integrated PROCESS: NURSING PROCESS: Implementation
MEDSC: Area of Client Needs: Safe and Effective Care Environment: Management of
Care
17. A NURSE is planning a class on accident prevention for parents of
toddlers.Which safety topic is the priority for this class?
a. Appropriate use of car seat restraints
b. Safety crossing the street
c. Helmet use when riding a bicycle
d. Poison control numbers
ANSWER: A
Motor vehicle accidents (MVAs) continue to be the most common cause of death in
children older than 1 year, therefore the priority topic is appropriate use of car seat
restraints. Safety crossing the street and bicycle helmet use are topics that should be
included for preschool parents but are not priorities for parents of toddlers. Information
about poison control is important for parents of toddlers and would be a safety topic to
include but is not the priority over appropriate use of car seat restraints.
POINTS: 1 DIFFICULTY: Cognitive Level:
Apply REF: 3-4TOPIC; Integrated
PROCESS: NURSING PROCESS:
Planning
MEDSC: Area of Client Needs: Health Promotion and
MaintenanceMULTIPLE RESPONSE
1. Which behaviors by the NURSE indicate a therapeutic relationship with children
andfamilies? (Select all that apply.)
a. Spending off-duty time with children and families
b. Asking questions if families are not participating in the care
c. Clarifying information for families
d. Buying toys for a hospitalized child
e. Learning about the familys religious preferences
, ANSWER: B, C, E
Asking questions if families are not participating in the care, clarifying information for
families, and learning about the familys religious preferences are positive actions and
foster therapeutic relationships with children and families. Spending off-duty time with
children and families and buying toys for a hospitalized child are negative actions and
indicate overinvolvement with children and families, which is nontherapeutic.
POINTS: 1 DIFFICULTY: Cognitive Level:
Understand REF: 9-10 TOPIC; Integrated PROCESS:
NURSING PROCESS: EvaluationMEDSC: Area of
Client Needs: Psychosocial Integrity ESSAY
1. A NURSE is formulating a clinical question for evidence-based practice. Place in
order the steps the NURSE should use to clarify the scope of the problem and clinical
topic of interest. Begin with the first step of the process and proceed ordering the steps
ending with the final step of the process. Provide answer as lowercase letters separated
by commas (e.g., a, b, c, d, e).
a. Intervention
b. Outcome
c. Population
d. Time
e. Control
ANSWE
R:
c, a, e, b, d
When formulating a clinical question for evidence-based practice, the NURSE should
follow a concise, organized way that allows for clear answers. Good clinical questions
should be asked in the PICOT (population, intervention, control, outcome, time) format
to assist with clarity and literature searching. PICOT questions assist with clarifying the
scope of the problem and clinical topic of interest.
CHAPTER 2 Factors Influencing Child
Health MULTIPLE CHOICE
1. A NURSE is selecting a family theory to assess a patients family dynamics.
Which family theory best describes a series of tasks for the family throughout its
life span?
a. Interactional theory
b. Developmental systems theory
c. Structural-functional theory
d. Duvalls developmental theory
ANSWER: D
Duvalls developmental theory describes eight developmental tasks of the family
throughout its life span. Interactional theory and structural-functional theory are not
family theories. Developmental systems theory is an outgrowth of Duvalls theory. The
family is described as a small group, a semiclosed system of personalities that interact
with the larger cultural system. Changes do not occur in one part of the family without
changes in others.
POINTS: 1 DIFFICULTY: Cognitive Level:
Understand REF: 24-26TOPIC; Integrated PROCESS:
NURSING PROCESS: Assessment
MEDSC: Area of Client Needs: Health Promotion and Maintenance
ESSENTIALS OF PEDIATRIC NURSING
4TH EDITION BY THERESA
KYLE; SUSAN CARMAN
PRINTED PDF | ORIGINAL DIRECTLY FROM THE
PUBLISHER | 100% VERIFIED ANSWERS |
DOWNLOAD IMMEDIATELY AFTER THE ORDER
,Chapter 1 Introduction to Child Health and
Pediatric Nursing
MULTIPLE CHOICE
1. A Nurse is planning a teaching session for parents of preschool children.
Which statement explains why the nurse should include information about
morbidity andmortality?
a. Life-span statistics are included in the data.
b. It explains effectiveness of treatment.
c. Cost-effective treatment is detailed for the general population.
d. High-risk age groups for certain disorders or hazards are
identified.
ANSWER: D
Analysis of morbidity and mortality data provides the parents with information about
which groups of individuals are at risk for which health problems. Life-span statistics is a
part of the mortality data. Treatment modalities and cost are not included in morbidity
and mortality data.
POINTS: 1 DIFFICULTY: Cognitive Level:
Apply REF: 6-8TOPIC; Integrated
PROCESS: NURSING PROCESS:
Planning
MEDSC: Area of Client Needs: Health Promotion and Maintenance
2. A clinic nurse is planning a teaching session about childhood obesity prevention for
parents of school-age children. The nurse should include which associated risk of
obesity in the teaching plan?
a. Type I diabetes
b. Respiratory disease
c. Celiac disease
d. Type II diabetes
ANSWER: D
,Childhood obesity has been associated with the rise of type II diabetes in children. Type I
diabetes is not associated with obesity and has a genetic component. Respiratory disease
is not associated with obesity, and celiac disease is the inability to metabolize gluten in
foods and is not associated with obesity.
POINTS: 1 DIFFICULTY: Cognitive Level: Apply REF: 3
TOPIC; Integrated PROCESS: NURSING PROCESS: Planning
MEDSC: Area of Client Needs: Health Promotion and Maintenance
3. Which is the leading cause of death in infants younger than 1 year?
a. Congenital anomalies
b. Sudden infant death syndrome
c. Respiratory distress syndrome
d. Bacterial sepsis of the newborn
ANSWER: A
Congenital anomalies account for 20.1% of deaths in infants younger than 1 year. Sudden
infant death syndrome accounts for 8.2% of deaths in this age group. Respiratory distress
syndrome accounts for 3.4% of deaths in this age group. Infections specific to the
perinatal period account for 2.7% of deaths in this age group.
POINTS: 1 DIFFICULTY: Cognitive Level: REF: 7
TOPIC; Integrated PROCESS: NURSING PROCESS:
Assessment
MEDSC: Area of Client Needs: Health Promotion and Maintenance
4. Which leading cause of death topic should the NURSE emphasize to a
group ofAfrican- American boys ranging in ages 15 to 19 years?
a. Suicide
b. Cancer
c. Firearm homicide
d. Occupational injuries
ANSWER: C
Firearm homicide is the second overall cause of death in this age group and the leading
cause of death in African-American males. Suicide is the third-leading cause of death in
this population. Cancer, although a major health problem, is the fourth-leading cause of
death in this age group. Occupational injuries do not contribute to a significant death rate
for this age group.
POINTS: 1 DIFFICULTY: Cognitive Level:
Understand REF: 5 | 8TOPIC; Integrated
PROCESS: NURSING PROCESS: Planning
MEDSC: Area of Client Needs: Health Promotion and Maintenance
5. Which is the major cause of death for children older than 1 year?
a. Cancer
b. Heart disease
c. Unintentional injuries
d. Congenital anomalies
ANSWER: C
Unintentional injuries (accidents) are the leading cause of death after age 1 year through
adolescence. Congenital anomalies are the leading cause of death in those younger than 1
year. Cancer ranks either second or fourth, depending on the age group, and heart disease
ranks fifth in the majority of the age groups.
,POINTS: 1 DIFFICULTY: Cognitive Level: REF:
8 TOPIC; Integrated PROCESS: NURSING
PROCESS: Planning
MEDSC: Area of Client Needs: Health Promotion and Maintenance
6. Which is the leading cause of death from unintentional injuries for females ranging in
age from 1 to 14?
a. Mechanical suffocation
b. Drowning
c. Motorvehicle-related fatalities
d. Fire- and burn-related fatalities
ANSWER: C
Motorvehicle-related fatalities are the leading cause of death for females ranging in age
from 1 to 14, either as passengers or as pedestrians. Mechanical suffocation is fourth or
fifth, depending on the age. Drowning is the second- or third-leading cause of death,
depending on the age. Fire- and burn-related fatalities are the second-leading cause of
death.
POINTS: 1 DIFFICULTY: Cognitive Level: REF: 4
TOPIC; Integrated PROCESS: NURSING PROCESS:
Assessment
MEDSC: Area of Client Needs: Health Promotion and Maintenance
,7. Which factor most impacts the type of injury a child is susceptible to, according to the
childs age?
a. Physical health of the child
b. Developmental level of the child
c. Educational level of the child
d. Number of responsible adults in the home
ANSWER: B
The childs developmental stage determines the type of injury that is likely to occur. The
childs physical health may facilitate the childs recovery from an injury but does not
impact the type of injury. Educational level is related to developmental level, but it is not
as important as the childs developmental level in determining the type of injury. The
number of responsible adults in the home may affect the number of unintentional injuries,
but the type of injury is related to the childs developmental stage.
POINTS: 1 DIFFICULTY: Cognitive Level:
Understand REF: 3-4TOPIC; Integrated PROCESS:
NURSING PROCESS: Planning
MEDSC: Area of Client Needs: Health Promotion and Maintenance
8. Which is now referred to as the new morbidity?
a. Limitations in the major activities of daily living
b. Unintentional injuries that cause chronic health problems
c. Discoveries of new therapies to treat health problems
d. Behavioral, social, and educational problems that alter health
ANSWER: D
The new morbidity reflects the behavioral, social, and educational problems that interfere
with the childs social and academic development. It is currently estimated that the
incidence of these issues is from 5% to 30%. Limitations in major activities of daily
living and unintentional injuries that result in chronic health problems are included in
morbidity data. Discovery of new therapies would be reflected in changes in morbidity
data over time.
POINTS: 1 DIFFICULTY: Cognitive Level: REF: 3
TOPIC; Integrated PROCESS: NURSING PROCESS:
Assessment
MEDSC: Area of Client Needs: Health Promotion and Maintenance
9. A NURSE on a pediatric unit is practicing family-centered care.
Which ismost descriptive of the care the NURSE is delivering?
a. Taking over total care of the child to reduce stress on the family
b. Encouraging family dependence on health care systems
c. Recognizing that the family is the constant in a childs life
d. Excluding families from the decision-making process
ANSWER: C
The three key components of family-centered care are respect, collaboration, and support.
Family-centered care recognizes the family as the constant in the childs life. Taking over
total care does not include the family in the process and may increase stress instead of
reducing stress. The family should be enabled and empowered to work with the health
care system. The family is expected to be part of the decision-making process.
POINTS: 1 DIFFICULTY: Cognitive Level: REF: 8
TOPIC; Integrated PROCESS: NURSING PROCESS:
Implementation MEDSC: Area of Client Needs: Health
Promotion and Maintenance
,10. The NURSE is preparing an in-service education to staff about atraumatic care
forpediatric patients. Which intervention should the NURSE include?
a. Prepare the child for separation from parents during hospitalization by reviewing a
video.
b. Prepare the child before any unfamiliar treatment or procedure by demonstrating on a
stuffed animal.
c. Help the child accept the loss of control associated with hospitalization.
d. Help the child accept pain that is connected with a treatment or procedure.
ANSWER: B
Preparing the child for any unfamiliar treatments, controlling pain, allowing privacy,
providing play activities for expression of fear and aggression, providing choices, and
respecting cultural differences are components of atraumatic care. In the provision of
atraumatic care, the separation of child from parents during hospitalization is minimized.
The NURSE should promote a sense of control for the child. Preventing and minimizing
bodily injury and pain are major components of atraumatic care.
POINTS: 1 DIFFICULTY: Cognitive Level: Understand REF: 9
TOPIC; Integrated PROCESS: NURSING PROCESS:
ImplementationMEDSC: Area of Client Needs: Psychosocial
Integrity
11. Which is most suggestive that a NURSE has a nontherapeutic relationship with a
patientand family?
a. Staff is concerned about the NURSES actions with the patient and family.
b. Staff assignments allow the NURSE to care for same patient and family over an
extendedtime.
c. NURSE is able to withdraw emotionally when emotional overload occurs but
stillremains committed.
d. NURSE uses teaching skills to instruct patient and family rather than doing
everythingfor them.
ANSWER: A
An important clue to a nontherapeutic staff-patient relationship is concern of other staff
members. Allowing the NURSE to care for the same patient over time would be
therapeuticfor the patient and family. NURSES who are able to somewhat withdraw
emotionally can protect themselves while providing therapeutic care. NURSES using
teaching skills to instruct patient and family will assist in transitioning the child and
family to self-care.
POINTS: 1 DIFFICULTY: Cognitive Level: Analyze REF: 9
TOPIC; Integrated PROCESS: NURSING PROCESS:
AssessmentMEDSC: Area of Client Needs:
Psychosocial Integrity
12. Which is most descriptive of clinical reasoning?
a. A simple developmental process
b. Purposeful and goal-directed
c. Based on deliberate and irrational thought
d. Assists individuals in guessing what is most appropriate
ANSWER: B
Clinical reasoning is a complex, developmental process based on rational and deliberate
thought. Clinical reasoning is not a developmental process. Clinical reasoning is based on
rational and deliberate thought. Clinical reasoning is not a guessing process.
POINTS: 1 DIFFICULTY: Cognitive Level: Understand REF: 12
,TOPIC; Integrated PROCESS: NURSING PROCESS: Planning
MEDSC: Area of Client Needs: Safe and Effective Care Environment: Management of
Care
13. A NURSE makes the decision to apply a topical anesthetic to a childs
skinbefore drawing blood. Which ethical principle is the NURSE
demonstrating?
a. Autonomy
b. Beneficence
c. Justice
d. Truthfulness
ANSWER: B
Beneficence is the obligation to promote the patients well-being. Applying a topical
anesthetic before drawing blood promotes reducing the discomfort of the venipuncture.
Autonomy is the patients right to be self-governing. Justice is the concept of fairness.
Truthfulness is the concept of honesty.
POINTS: 1 DIFFICULTY: Cognitive Level: Understand REF: 11
TOPIC; Integrated PROCESS: NURSING PROCESS:
ImplementationMEDSC: Area of Client Needs: Physiological
Integrity
14. Which action by the NURSE demonstrates use of evidence-based practice (EBP)?
a. Gathering equipment for a procedure
b. Documenting changes in a patients status
c. Questioning the use of daily central line dressing changes
d. Clarifying a physicians prescription for morphine
ANSWER: C
The NURSE who questions the daily central line dressing change is ascertaining
whether clinical interventions result in positive outcomes for patients. This demonstrates
evidence-based practice (EBP), which implies questioning why something is effective
and whether a better approach exists. Gathering equipment for a procedure and
documenting changes in a patients status are practices that follow established guidelines.
Clarifying a physicians prescription for morphine constitutes safe NURSING care.
POINTS: 1 DIFFICULTY: Cognitive Level: Apply REF: 11
TOPIC; Integrated PROCESS: NURSING PROCESS: Evaluation
MEDSC: Area of Client Needs: Safe and Effective Care Environment: Management of
Care
15. A NURSE is admitting a toddler to the hospital. The toddler is with both parents
and is currently sitting comfortably on a parents lap. The parents state they will need to
leave for a brief period. Which type of NURSING diagnosis should the NURSE
formulate forthis child?
a. Risk for anxiety
b. Anxiety
c. Readiness for enhanced coping
d. Ineffective coping
ANSWER: A
A potential problem is categorized as a risk. The toddler has a risk to become anxious
when the parents leave. NURSING interventions will be geared toward reducing the
risk. The child is not showing current anxiety or ineffective coping. The child is not at a
pointfor readiness for enhanced coping, especially because the parents will be leaving.
POINTS: 1 DIFFICULTY: Cognitive Level: REF:
12 TOPIC; Integrated PROCESS: NURSING
,PROCESS: Diagnosis
,MEDSC: Area of Client Needs: Health Promotion and Maintenance
16. A child has a postoperative appendectomy incision covered by a dressing. The
NURSE has just completed a prescribed dressing change for this child. Which
descriptionis an accurate documentation of this procedure?
a. Dressing change to appendectomy incision completed, child tolerated procedure well,
parent present
b. No complications noted during dressing change to appendectomy incision
c. Appendectomy incision non-reddened, sutures intact, no drainage noted on old
dressing, new dressing applied, procedure tolerated well by child
d. No changes to appendectomy incisional area, dressing changed, child complained of
pain during procedure, new dressing clean, dry and intact
ANSWER: C
The NURSE should document assessments and reassessments. Appearance of the
incision described in objective terms should be included during a dressing change. The
NURSE should document patients response and the outcomes of the care provided. In
this example, these include drainage on the old dressing, the application of the new
dressing,and the childs response. The other statements partially fulfill the requirements
of documenting assessments and reassessments, patients response, and outcome, but do
notinclude all three.
POINTS: 1 DIFFICULTY: Cognitive Level: Analyze REF: 14
TOPIC; Integrated PROCESS: NURSING PROCESS: Implementation
MEDSC: Area of Client Needs: Safe and Effective Care Environment: Management of
Care
17. A NURSE is planning a class on accident prevention for parents of
toddlers.Which safety topic is the priority for this class?
a. Appropriate use of car seat restraints
b. Safety crossing the street
c. Helmet use when riding a bicycle
d. Poison control numbers
ANSWER: A
Motor vehicle accidents (MVAs) continue to be the most common cause of death in
children older than 1 year, therefore the priority topic is appropriate use of car seat
restraints. Safety crossing the street and bicycle helmet use are topics that should be
included for preschool parents but are not priorities for parents of toddlers. Information
about poison control is important for parents of toddlers and would be a safety topic to
include but is not the priority over appropriate use of car seat restraints.
POINTS: 1 DIFFICULTY: Cognitive Level:
Apply REF: 3-4TOPIC; Integrated
PROCESS: NURSING PROCESS:
Planning
MEDSC: Area of Client Needs: Health Promotion and
MaintenanceMULTIPLE RESPONSE
1. Which behaviors by the NURSE indicate a therapeutic relationship with children
andfamilies? (Select all that apply.)
a. Spending off-duty time with children and families
b. Asking questions if families are not participating in the care
c. Clarifying information for families
d. Buying toys for a hospitalized child
e. Learning about the familys religious preferences
, ANSWER: B, C, E
Asking questions if families are not participating in the care, clarifying information for
families, and learning about the familys religious preferences are positive actions and
foster therapeutic relationships with children and families. Spending off-duty time with
children and families and buying toys for a hospitalized child are negative actions and
indicate overinvolvement with children and families, which is nontherapeutic.
POINTS: 1 DIFFICULTY: Cognitive Level:
Understand REF: 9-10 TOPIC; Integrated PROCESS:
NURSING PROCESS: EvaluationMEDSC: Area of
Client Needs: Psychosocial Integrity ESSAY
1. A NURSE is formulating a clinical question for evidence-based practice. Place in
order the steps the NURSE should use to clarify the scope of the problem and clinical
topic of interest. Begin with the first step of the process and proceed ordering the steps
ending with the final step of the process. Provide answer as lowercase letters separated
by commas (e.g., a, b, c, d, e).
a. Intervention
b. Outcome
c. Population
d. Time
e. Control
ANSWE
R:
c, a, e, b, d
When formulating a clinical question for evidence-based practice, the NURSE should
follow a concise, organized way that allows for clear answers. Good clinical questions
should be asked in the PICOT (population, intervention, control, outcome, time) format
to assist with clarity and literature searching. PICOT questions assist with clarifying the
scope of the problem and clinical topic of interest.
CHAPTER 2 Factors Influencing Child
Health MULTIPLE CHOICE
1. A NURSE is selecting a family theory to assess a patients family dynamics.
Which family theory best describes a series of tasks for the family throughout its
life span?
a. Interactional theory
b. Developmental systems theory
c. Structural-functional theory
d. Duvalls developmental theory
ANSWER: D
Duvalls developmental theory describes eight developmental tasks of the family
throughout its life span. Interactional theory and structural-functional theory are not
family theories. Developmental systems theory is an outgrowth of Duvalls theory. The
family is described as a small group, a semiclosed system of personalities that interact
with the larger cultural system. Changes do not occur in one part of the family without
changes in others.
POINTS: 1 DIFFICULTY: Cognitive Level:
Understand REF: 24-26TOPIC; Integrated PROCESS:
NURSING PROCESS: Assessment
MEDSC: Area of Client Needs: Health Promotion and Maintenance
