, Chapter1. IssuesandTrendsin Pediatric Nursing MULTIPLE
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m CHOICE
1. Anurseisreviewingchanges in healthcare deliveryand funding for pediatric populations. Which m n m n m
mcurrent trend in the pediatric setting should the nurse expect to find?
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a. Increasedhospitalization ofchildren m
b. Decreasednumber of uninsured children m m n
c. An increase inambulatorycare
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d. Decreaseduseofmanagedcare n
ACURATE ANSWER: C
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One effect ofmanaged care is that pediatric healthcare delivery has shifted dramatically from the acute care
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settingtotheambulatorysetting. Thenumber of hospital beds being used hasdecreased as more care is
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mprovided in outpatient and home settings. The number ofuninsured children in the United States continues to
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grow. One of the biggest changes in healthcare has been the growth ofmanaged care.
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DIF:Cognitive Level: Comprehension REF: p. 3 m m m m m
OBJ: NursingProcess Step: PlanningMSC: Safeand Effective Care Environment
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2. Anurse is referringalow-incomefamilywiththreechildren undertheage of 5 yearstoa programthat
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massists with supplemental food supplies. Which program should the nurse refer this family to?
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a. Medicaid
b. Medicare
c. Earlyand Periodic Screening, Diagnostic, and Treatment (EPSDT) program
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d. Women, Infants,and Children (WIC) program ACURATEANSWER: D
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WIC is a federal program that provides supplemental food supplies to low-income women who are pregnant
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or breast-feedingand to their children until the age of 5 years. Medicaid and the Medicaid Early and Periodic
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Screening, Diagnostic, and Treatment (EPSDT) program provides for well-child examinations and related
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treatment of medical problems. Children in the WIC program are often referred forimmunizations, butthatis
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not theprimaryfocusoftheprogram. Public Law 99-457 providesfinancial incentives tostates to establish
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comprehensiveearlyintervention services for infantsandtoddlers with, or at risk for, developmental
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disabilities.
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Medicare is the program for Senior Citizens. DIF: Cognitive Level: Application REF: p. 7 OBJ: Nursing
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Process Step: Implementation MSC: Health Promotionand Maintenance
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,3. In m m most states,adolescents whoare notemancipated minorsmust haveparentalpermission before: n n
a. treatment fordrugabuse.
n
b. treatmentforsexuallytransmitteddiseases(STDs).
c. obtaining birth control.
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d. surgery.
ACURATEANSWER: D m
An emancipated minor is a minor child who has the legal competence of an adult. Legal counsel may be
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consultedtoverifythestatusoftheemancipatedminor forconsent purposes. Most states allowminorsto
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obtain treatment for drug or alcohol abuse and STDs and allow access to birth control without parental
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consent.
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DIF: Cognitive Level: Application REF: p.12
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OBJ: NursingProcess Step: PlanningMSC: Safeand Effective Care Environment
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4. A nurse iscompleting a clinical pathwayfor achildadmitted tothe hospital with pneumonia. Which
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mcharacteristic of a clinical pathway is correct?
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a. Developedandimplementedbynurses
b. Usedprimarilyinthe pediatric setting m m
c. Specifictime linesforsequencing interventions n
d. Oneofthestepsinthenursingprocess ACURATEANSWER: C m m
Clinical pathways measureoutcomes of client care and are developed bymultiple healthcare professionals.
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Each pathway outlines specific time lines for sequencing interventions and reflects interdisciplinary
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interventions. Clinicalpathwaysareused inmultiplesettings andforclientsthroughout the life span. The steps
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of the nursing process are assessment, diagnosis, planning, implementation, and evaluation.
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DIF:Cognitive Level: Comprehension REF: p. 6
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OBJ: NursingProcess Step: PlanningMSC: Safeand Effective Care Environment
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, 5. When planninga parentingclass, thenurseshouldexplain that the leadingcause of deathinchildren 1 to 4
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myears of age in the United States is:
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a. premature birth. n
b. congenitalanomalies.
c. accidental death. n
d. respiratorytractillness.
ACURATEANSWER: C m
Accidents are the leading cause of death in children ages 1 to 19 years. Disorders of short gestation and
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unspecified low birth weight make up one of the leading causes of death in neonates. One of the leading causes
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ofinfant deathafterthefirst monthoflifeiscongenital anomalies. Respiratorytractillnessesarea major cause
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mof morbidity in children.
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DIF: Cognitive Level: Application REF: p.9 OBJ: NursingProcess Step: ImplementationMSC: Safeand
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Effective Care Environment
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6. Which statement is trueregarding the qualityassurance or incidentreport?
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a. Thereport assures the legal department thatthere is noproblem.
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b. Reports are apermanent partoftheclientschart.
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c. Thenursesnotesshouldcontainthefollowing: Incidentreportfiledand copyplacedin chart. m n n
d. Thisreportisa form of documentationofaneventthatmayresult in legalaction.
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ACURATEANSWER: D m
An incident reportisawarningtothelegal department tobepreparedforpotential legalaction; itis not a part of
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the clients chart or nurse documentation.
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DIF: Cognitive Level: Knowledge REF: p. 14 OBJ: Nursing Process Step: Implementation MSC: Safe and
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Effective Care Environment
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7. Which clientsituation fails to meetthe first requirement of informedconsent?
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a. Theparent doesnotunderstandthephysiciansexplanations.
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b. Thephysiciangivestheparent m onlyapartiallistofpossiblesideeffectsandcomplications.
c. No parentis available and the physician asks the adolescent tosign theconsent form.
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