Pediatric Success- A Q&A Review Applying Critical Thinking to Test Taking, 2nd Edition - Beth Richardson

TEST BANK Q & A Pediatric Success A Q&A Review Applying Critical Thinking to Test Taking SECOND EDITION Beth Richardson, PhD, RN, CPNP, FAANP Associate Professor Emeritus Indiana University School of Nursing Indianapolis, Indiana Pediatric Nurse Practitioner HealthNet Indianapolis, Indiana 1 Fundamentals of Critical Thinking Related to Test Taking: The RACE Model 01 HOW TO USE THIS REVIEW BOOK 01 2 Growth and Development 05 KEYWORDS 05 ABBREVIATIONS 05 QUESTIONS 05 ANSWERS AND RATIONALES 15 3 Issues Related to Pediatric Health 27 KEYWORDS 27 ABBREVIATIONS 27 QUESTIONS 28 ANSWERS AND RATIONALES 37 4 Respiratory Disorders 51 KEYWORDS 51 ABBREVIATIONS 51 QUESTIONS 52 ANSWERS AND RATIONALES 61 5 Neurological Disorders 75 KEYWORDS 75 ABBREVIATIONS 75 QUESTIONS 76 ANSWERS AND RATIONALES 85 6 Cardiovascular Disorders 97 KEYWORDS 97 ABBREVIATIONS 97 QUESTIONS 97 ANSWERS AND RATIONALES 105 7 Hematological or Immunological Disorders 115 KEYWORDS 115 ABBREVIATIONS 115 QUESTIONS 116 ANSWERS AND RATIONALES 124 8 Gastrointestinal Disorders 135 KEYWORDS 135 ABBREVIATIONS 136 QUESTIONS 136 ANSWERS AND RATIONALES 146 xvii xviii CONTENTS 9 Genitourinary Disorders 157 KEYWORDS 157 ABBREVIATIONS 157 QUESTIONS 158 ANSWERS AND RATIONALES 167 10 Endocrine Disorders 177 KEYWORDS 177 ABBREVIATIONS 177 QUESTIONS 178 ANSWERS AND RATIONALES 188 11 Neuromuscular or Muscular Disorders 199 KEYWORDS 199 ABBREVIATIONS 199 QUESTIONS 199 ANSWERS AND RATIONALES 209 12 Orthopedic Disorders 219 KEYWORDS 219 ABBREVIATIONS 219 QUESTIONS 219 ANSWERS AND RATIONALES 229 13 Leadership and Management 239 KEYWORDS 239 ABBREVIATIONS 239 QUESTIONS 239 ANSWERS AND RATIONALES 249 14 Pharmacology 263 KEYWORDS 263 ABBREVIATIONS 264 CONVERSIONS 264 QUESTIONS 264 ANSWERS AND RATIONALES 272 15 Comprehensive Exam 281 QUESTIONS 281 ANSWERS AND RATIONALES 296 Glossary of English Words Commonly Encountered on Nursing Examinations 313 Index 317 Pediatric Success: A Q&A Review Applying Critical Thinking to Test Taking is designed to help you, the student, complete your nursing program as well as succeed on the NCLEX–RN® examination. This book applies critical thinking skills primarily to multiple choice questions and to some alternate test items. It provides practice test questions and test-taking hints to help you analyze each item and choose the correct response. Another book in the Success series, Fundamentals Success by Nugent and Vitale, explains critical thinking and the RACE Model, which are used in each book in the series. This in- formation will help you answer questions on tests in your nursing courses and on the NCLEX-RN examination. The key to successful studying is knowing the material that will be covered on the examinations. Course notes should be studied every night and corre- sponding readings done before class. This will help you learn the material and retain it longer. Once you know the material, it is important for you to be able to answer primarily multiple choice questions correctly. The RACE Model will help you succeed with answer- ing questions. The book contains 14 chapters, a final comprehensive examination, and practice questions online. Test-taking hints are included with each question. This chapter provides guidelines for course test preparation and includes an example of how to use the RACE Model. Chapter 2 focuses on growth and development of children from infancy through adolescence. Chapter 3 covers material on issues related to pediatric health. Chapters 4 through 12 follow pediatric health problems through each of the body systems. Each chapter contains practice questions, answers, and rationales for the correct answer, includ- ing test-taking hints, keywords, and abbreviations. Chapter 13, “Leadership and Management,” relates to pediatric nursing. Chapter 14, “Pharmacology,” has been included because of the expressed need of students for extra testing in this area. In the NCLEX-RN test plan (), pharmacology and management of care have a large number of test items. Graduates need to have a working knowledge of issues in these areas. This chapter includes questions centered on what the student nurse caring for children of all ages needs to know about administering medications, drug actions, dosages, expected effects, adverse effects, and teaching families. Chapter 15 is a final 100-question comprehensive examination. There are also two 100-question exit examinations available online. You can take the online tests prior to the final exam if you wish. Questions in this book are written primarily at the application and analysis level and are either multiple-choice, with four response choices, or alternate-item format. Nursing faculty members write tests in these formats to familiarize students with the NCLEX-RN examination style. 1 2 PEDIATRIC SUCCESS Test Preparation One of the most important strategies for you is to study your course materials thoroughly and know the assigned concepts for each examination in your class. It is best to study daily so that you really learn the material. Don’t wait and try to learn it all at one time. The more time you spend studying the topic, the better you will retain the material. After you feel confident that you know the material, choose the chapter(s) in this book that correspond(s) with the assigned test material in your nursing course. Answer the prac- tice questions to determine your level of knowledge about the topic. Carefully review the questions you miss, making sure you read and understand the rationale for choosing the wrong distracter and why the correct response is indeed correct. The rationales provide a great deal of information about the correct and incorrect options, which helps you under- stand the content better. The test-taking hints are strategies to help you logically determine the correct response. If you still feel uncomfortable with the content area, review that chapter in your textbook for better understanding. This method of preparing for an exam- ination will help you identify your strengths and areas to focus on as you continue to study. You may want to start with the Chapter 14, “Pharmacology,” because you will be admin- istering medications to children throughout your pediatric nursing course. This chapter will help you focus on teaching strategies for families of children receiving medications, differences in delivering drugs to children, and calculating dosages. RACE Model The RACE Model is a critical thinking strategy to be used when answering multiple choice questions. The RACE Model helps you analyze the question stem and determine the correct response. For more detailed information about the RACE Model, see Test Success: Test-Taking Techniques for Beginning Nursing Students by Nugent and Vitale. The RACE Model comprises: R - Recognize the keywords in the stem. A - Ask what the question is asking the nurse to do. C - Critically analyze each option in relation to the information in the stem. E - Eliminate as many options as possible to narrow your choice to the correct response. Some students believe they know the material but have difficulty choosing the correct response when answering multiple choice questions. Using the RACE Model will greatly increase your chances of choosing the correct response. To use it effectively during timed tests, you need to practice. Using the RACE Model as you prepare yourself with the chapter tests will help you. Following is a sample question: 1. A 6-month-old is being seen in the clinic for a well-child checkup. The parents want to know about starting solid foods. How should the nurse counsel them? 1. “Since you started rice cereal from a spoon 2 months ago, you can add a new strained vegetable each week.” 2. “Introduce some mashed fruits first. After the infant is eating that well, start vegetables and rice cereal.” 3. “Infants do best eating solids if you spoon-feed a new strained vegetable every other day to see what their preferences are.” 4. “Add rice cereal to each bottle. Next you can add fruits and vegetables fed by spoon.” CHAPTER 1 FUNDAMENTALS OF CRITICAL THINKING RELATED TO TEST TAKING: THE RACE MODEL 3 Using the RACE Model: R - The client in the stem is the parent. A - The parents want to know how to add solid foods to their infant’s diet. C - Infants start rice cereal between 4 and 6 months. This is fed to the infant by spoon unless there is an indication to place it in the bottle. That is not stated in the stem of this question. Either strained fruits or vegetables are added to the infant’s diet at about 6 months of age. The infant stays on that choice for several days to determine if the infant is allergic. E - Now you can eliminate choices 2, 3, and 4 because they do not contain choices that you know are correct. The remaining choice is 1, the correct response. The following words include English vocabulary, nursing/medical terminology, concepts, principles, or information relevant to content specifically addressed in the chapter or associated with topics presented in it. English dictionaries, your nursing textbooks, and medical dictionaries such as Taber’s Cyclopedic Medical Dictionary are resources that can be used to expand your knowledge and understanding of these words and related information. Anemia Auscultate Autonomy Dehydration Detachment Gynecomastia Hepatitis B Industry Inguinal hernia Initiative Palpate Atrial septal defect (ASD) Emergency department (ED) Face, legs, action, consolability, crying (FLACC) Failure to thrive (FTT) Intramuscular (IM) Intravenous (IV) Nothing by mouth (NPO) Ounce (oz) Pound (lb) Infants 1. A 6-month-old male is at his well-child checkup. The nurse weighs him, and his mother asks if his weight is normal for his age. The nurse’s best response is: 1. “At 6 months his weight should be approximately three times his birth weight.” 2. “Each child gains weight at his or her own pace.” 3. “At 6 months his weight should be approximately twice his birth weight.” 4. “At 6 months a child should weigh about 10 lb more than his or her birth weight.” 5 6 PEDIATRIC SUCCESS 2. How can the nurse best facilitate the trust relationship between infant and parents while the infant is hospitalized? The nurse should: 1. Encourage the parents to remain at their child’s bedside as much as possible. 2. Keep parents informed about all aspects of their child’s condition. 3. Encourage the parents to hold their child as much as possible. 4. Advise the parents to participate actively in their child’s care. 3. The nurse is going to give a 6-month-old a dose of Rocephin IM. What must the nurse do when the 1.5-mL dose arrives from the pharmacy? 1. Administer the injection into the deltoid muscle. 2. Divide the dose into two injections. 3. Administer the injection into the dorsogluteal muscle. 4. Give dose as a single injection into the vastus lateralis muscle. 4. Which statement by an infant’s mother leads the nurse to believe that she needs further education about the nutritional needs of a 6-month-old? 1. “I will continue to breastfeed my son and will give him rice cereal three times a day.” 2. “I will start my son on fruits and gradually introduce vegetables.” 3. “I will start my son on carrots and will introduce one new vegetable every few days.” 4. “I will not give my son any more than 8 ounces of baby juice per day.” 5. Which statement accurately describes the best method for assessing a 12-month-old? 1. The nurse should assess the child on the examining table. 2. The nurse should assess the child in a head-to-toe sequence. 3. The nurse should have the child’s mother assist in holding her down. 4. The nurse should assess the child while she is in her mother’s lap. 6. The nurse is instructing a new breastfeeding mother in the need to provide her pre- mature infant with an adequate source of iron in her diet. Which statement reflects a need for further education of the new mother? 1. “I will use only breast milk or an iron-fortified formula as a source of milk for my baby until she is at least 12 months old.” 2. “My baby will need to have iron supplements introduced when she is 4 months old.” 3. “I will need to add iron supplements to my baby’s diet when she is 2 months old.” 4. “When my baby begins to eat solid foods, I should introduce iron-fortified cereals to her diet.” 7. A first-time mother brings in her 5-day-old baby for a well-child visit. The nurse weighs the infant and reports a weight of 7 lb 5 oz to the mother. The mother looks concerned and tells the nurse that her baby weighed 7 lb 10 oz when she was discharged 4 days ago. The nurse’s best response to the mother is: 1. “I will let the doctor know, and he will talk with you about possible causes of your infant’s weight loss.” 2. “Al weight loss of a few ounces is common among newborns, especially for breast- feeding mothers.” 3. “I can tell you are a first-time mother. Don’t worry; we will find out why she is losing weight.” 4. “Maybe she isn’t getting enough milk. How often are you breastfeeding her?” 8. Which toy is the best choice for a 12-month-old? 1. Baby doll. 2. Musical rattle. 3. Board book. 4. Colorful beads. CHAPTER 2 GROWTH AND DEVELOPMENT 7 9. The parents of a newborn are asking the nurse how to use the infant car seat and where it should be placed in their vehicle. Which is the next most appropriate action by the nurse? 1. Give the parents a pamphlet explaining how to install the car seat. 2. Accompany the parents to the car, and show them how to install the car seat. 3. Contact the hospital’s car-seat safety officer, and ask the officer to accompany the parents to the car for car-seat installation. 4. Show the parents a video on car-seat installation and safety, and ask if they are comfortable with the information. 10. The mother of a newborn asks the nurse when the infant will receive the first hepatitis B immunization. Which is the nurse’s best response? 1. “Babies receive the hepatitis B vaccine only if their mother is hepatitis B–positive.” 2. “The first dose of the hepatitis B vaccine will be given prior to discharge today.” 3. “The first dose of hepatitis B vaccine is given at 1 year of age.” 4. “Babies receive their first hepatitis B vaccine at 6 months of age.” 11. Which finding would the nurse consider abnormal when performing a physical assessment on a 6-month-old? 1. Posterior fontanel is open. 2. Anterior fontanel is open. 3. Beginning signs of tooth eruption. 4. Able to track and follow objects. 12. A mother requests that her child receive the varicella vaccine at the 9-month well-child checkup. The nurse tells the mother that: 1. Children who are vaccinated will likely develop a mild case of the disease. 2. The vaccine cannot be given at that visit. 3. The vaccine will be administered after the physician examines the child. 4. A booster vaccination will be needed at 18 months of age. 13. What should parents understand is one of the most common causes of injury and death for a 7-month-old infant? 1. Poisoning. 2. Child abuse. 3. Aspiration. 4. Dog bites. 14. An 8-day-old was admitted to the hospital with vomiting and dehydration. The newborn’s heart rate is 170, respiratory rate is 44, blood pressure is 85/52, and temperature is 99°F (37.2°C). What is the nurse’s best response to the parents who ask if the vital signs are normal? 1. “The blood pressure is elevated, but the other vital signs are within normal limits.” 2. “The temperature is elevated, but the other vital signs are within normal limits.” 3. “The respiratory rate is elevated, but the other vital signs are within normal limits.” 4. “The heart rate is elevated, but the other vital signs are within normal limits.” 15. The mother of an 11-month-old with iron deficiency anemia tells the nurse that her infant is currently taking iron and a multivitamin. Which statement made by the mother should be of concern to the nurse? 1. “I give the iron and multivitamin at the same time each morning.” 2. “I give the iron and multivitamin in the morning 6-oz bottle.” 3. “I give the iron and multivitamin 2 hours before I feed the morning bottle.” 4. “I give the iron and multivitamin in oral syringes toward the back of the cheek.” 16. The nurse is using the FLACC scale to rate the pain level in a 9-month-old. Which is the nurse’s best response to the father’s question of what the FLACC scale is? 1. “It estimates a child’s level of pain utilizing vital sign information.” 2. “It estimates a child’s level of pain based on parents’ perception.” 3. “It estimates a child’s level of pain utilizing behavioral and physical responses.” 4. “It estimates a child’s level of pain utilizing a numeric scale from 0 to 5.”