ESSENTIALS OF PEDIATRIC NURSING CH 1 EXAMS REVIEWS

ESSENTIALS OF PEDIATRIC NURSING CH 1 EXAMS REVIEWS Origin: Chapter 1, 1 The nurse providing family-centered care in a hospital setting reflects on the focus of the health care provided in today's society. Which statement best describes the current definition of health? A) Health is described as 'an absence of disease.' B) Health is measured by monitoring mortality and morbidity of a group. C) Health is a state of complete physical, mental, and social well-being. D) Technological gains made in health care are shared equally among all children. - CORRECT ANSWER-Ans: C Feedback: In the past, health was defined simply as the absence of disease; health was measured by monitoring the mortality and morbidity of a group. Over the past century, however, the focus of health has shifted to disease prevention, health promotion, and wellness. The World Health Organization (2013) defines health as "a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity." The gains in child health have been huge, but, unfortunately, these gains are not shared equally among all children. Origin: Chapter 1, 2 The student nurse is learning about the past history of child health and health care in the United States. Which statement accurately reflects the condition of health care in the past and current centuries? A) In past centuries in the United States, the health of the country was better than it is today due to the simpler style of living. B) In the current century, mortality rates are high, but life expectancy has increased due to technological advances. C) In the late eighteenth and early nineteenth centuries urban public health improvements made cities healthier places for growing children. D) By the late twentieth century unintentional injuries rather than infectious diseases had become the leading cause of death for children older than 1 year old. - CORRECT ANSWER-Ans: D Feedback: In past centuries in the United States, the health of the country was poorer than it is today; mortality rates were high and life expectancy was short. Over the years the health of children received more and more attention, leading to a better understanding of sources of illness and improvements in sanitation, water, and nutrition. As a result, by the late twentieth century unintentional injuries rather than infectious diseases had become the leading cause of death for children older than 1 year old. Origin: Chapter 1, 3 The nurse is administering a number of therapeutic interventions for neonates, infants, and children on the pediatric unit. Which intervention contributes to an increase in chronic illness seen in early childhood? A) Administering antibiotics to prevent lethal infections B) Vaccinating children to prevent childhood diseases C) Using mechanical ventilation for premature infants D) Using corticosteroids as a treatment for asthma - CORRECT ANSWER-Ans: C Feedback: Using mechanical ventilation and medications to foster lung development in premature infants increases their survival rate. Yet the infants who survive are often faced with myriad chronic illnesses. Administering antibiotics to prevent lethal infections, vaccinating children to prevent childhood diseases, and using corticosteroids as a treatment for asthma may cause side effects, but do not contribute to chronic illness in children. Origin: Chapter 1, 4 The nurse is reviewing a copy of the U.S. Surgeon General's Report, Healthy People. Which nursing action best reflects the nurse fostering this health care agenda? A) The nurse signs up for classes to obtain an advanced degree in nursing B) The nurse volunteers at a local health care clinic providing free vaccinations for lowincome populations C) The nurse performs an in-service on basic hospital equipment for student nurses D) The nurse compiles nursing articles on evidence-based practices in nursing to present at a hospital training seminar - CORRECT ANSWER-Ans: B Feedback: Healthy People is a comprehensive health promotion and disease prevention agenda that is working toward improving the quantity and quality of life for all Americans (U.S. Department of Health and Human Services, 2010). Overarching goals are to eliminate preventable disease, disability, injury, and premature death; achieve health equity, eliminate disparities, and improve the health of all groups; create physical and social environments that promote good health; and promote healthy development and behaviors across every stage of life. Volunteering at a local health care clinic directly reflects the goal of improving the health of all groups of people. Signing up for classes, performing in-services on equipment, and compiling nursing articles on evidence-based practices in nursing are all worthwhile activities that foster health care delivery, but are not as directly linked to the agenda of promoting health in the community. Origin: Chapter 1, 5 The neonatal nurse researches the neonatal and mortality rates in the United States. Which statements accurately describe these measurements of child health? Select all that apply. A) Neonatal mortality is the number of infant deaths occurring in the first 28 days of life per 1,000 live births. B) The infant mortality rate refers to the number of deaths occurring in the first 6 months of life. C) Neonatal mortality is documented as the number of deaths in relation to 1,000 live births. D) The infant mortality rate is used as an index of the general health of a country. E) In 2007, the infant mortality rate in the United States was 6.8 per 1,000 live births. F) The infant mortality rate is consistent from state to state as well as between ethnic groups. - CORRECT ANSWER-Ans: A, C, D, E Feedback: Neonatal mortality is the number of infant deaths occurring in the first 28 days of life per 1,000 live births. The infant mortality rate refers to the number of deaths occurring in the first 12 months of life and is documented as the number of deaths in relation to 1,000 live births. The infant mortality rate is used as an index of the general health of a country; generally, this statistic is one of the most significant measures of children's health. In 2007, the infant mortality rate in the United States was 6.8 per 1,000 live births. The infant mortality rate varies greatly from state to state as well as between ethnic groups. Origin: Chapter 1, 6 The nurse researcher investigates the morbidity rate in the United States. Which statement accurately reflects this concept? A) Morbidity measures the prevalence of a specific illness in a population at a particular time. B) Morbidity is presented in rates per 100,000 population. C) Morbidity statistics are revised more frequently because of the ease in defining or obtaining the information. D) In general, 76% of children in the United States enjoyed excellent health and 27% had very good health in a 2007 report. - CORRECT ANSWER-Ans: A Feedback: Morbidity is the measure of prevalence of a specific illness in a population at a particular time. It is presented in rates per 1,000 population. Morbidity is often difficult to define and record because the definitions used vary widely. For example, morbidity may be defined as visits to the physician or diagnosis for hospital admission. Also, data may be difficult to obtain. Morbidity statistics are revised less frequently because of the difficulty in defining or obtaining the information. In general, 56% of children in the United States enjoyed excellent health and 27% had very good health as reported in a summary of health statistics for children in 2007. Origin: Chapter 1, 7 When assessing a family for barriers to health care, the nurse documents checks for psychosocial barriers. What is an example of this type of health care deficit? A) Academic difficulties B) Respiratory illness C) Poor sanitation D) Inherited diseases - CORRECT ANSWER-Ans: A Feedback: Environmental and psychosocial factors are now an identified area of concern in children. They include academic differences, complex psychiatric disorders, self-harm and harm to others, use of firearms, hostility at school, substance abuse, HIV/AIDS, and adverse effects of the media. Respiratory illness and inherited diseases are health problems, and poor sanitation is an environmental factor. Origin: Chapter 1, 8 When integrating the principles of family-centered care, the nurse would include which concept? A) Parents want nurses to make decisions about their child's treatment. B) Families are unable to make informed choices. C) People have taken increased responsibility for their own health. D) Families require little information to make appropriate decisions. - CORRECT ANSWER-Ans: C Feedback: Due to the influence of managed care, the focus on prevention, better education, and technological advances, people have taken increased responsibility for their own health. Parents now want information about their child's illness, to participate in making decisions about treatment, and to accompany their children to all health care situations. Origin: Chapter 1, 9 The nurse is caring for a 2-week-old girl with a metabolic disorder. Which activity would deviate from the characteristics of family-centered care? A) Softening unpleasant information or prognoses B) Evaluating and changing the nursing plan of care C) Collaborating with the child and family as equals D) Showing respect for the family's beliefs and wishes - CORRECT ANSWER-Ans: A Feedback: Family-centered care requires that the nurse provide open and honest information to the child and family. It is inappropriate to soften unpleasant information or prognoses. Evaluating and changing the nursing plan of care to fit the needs of the child and family, collaborating with them as equals, and showing respect for their beliefs and wishes are guidelines for family-centered care. Origin: Chapter 1, 10 The nurse is caring for a 14-year-old girl with multiple health problems. Which of the following activities would best reflect evidence-based practice by the nurse? A) Following blood pressure monitoring recommendations B) Determining how often the vital signs are monitored C) Using hospital protocol for ordering diagnostic tests D) Deciding the prescribed medication dose - CORRECT ANSWER-Ans: A Feedback: Using hospital protocol for ordering a diagnostic test, determining how often the vital signs are monitored, and deciding the medication dose ordered would be the physician's responsibility. However, following blood pressure monitoring recommendations would be part of evidence-based practice reflected in the nursing care delivered. Origin: Chapter 1, 11 The nurse is caring for a 10-year-old boy with a neuroblastoma. Which activities best describe the role of the nurse as a care coordinator, collaborator, and consultant? Select all that apply. A) Collaborating with the family throughout the care path B) Advancing the interests of children and their families by knowing their needs C) Informing children and families of their rights and options D) Coordinating care provided by the interdisciplinary team E) Ensuring that the child's and family's needs are met through activities such as support groups F) Providing appropriate client education based on the child's developmental level - CORRECT ANSWER-Ans: A, D, E Feedback: The pediatric nurse serves as a collaborator, care coordinator, and consultant. Collaborating with the interdisciplinary health care team, the pediatric nurse integrates the child's and family's needs into a coordinated plan of care. In the role of consultant, the pediatric nurse ensures that the child's and family's needs are met through such activities as support group facilitation or working with the school nurse to plan the child's care. In the role as a child and family advocate, the nurse safeguards and advances the interests of children and their families by knowing their needs and resources, informing them of their rights and options, and assisting them to make informed decisions. In the role of educator, the nurse instructs and counsels children and their families about all aspects of health and illness. In this role the pediatric nurse also ensures that communication with the child and family is based on the child's age and developmental level. Origin: Chapter 1, 12 The pediatric nurse operates according to the standards of professional performance according to the American Nurses Association (ANA) Scope and Standards of Pediatric Nursing Practice. Which statements accurately reflect these standards? Select all that apply. A) The pediatric nurse uses research findings in practice and participates in the generation of new knowledge. B) The pediatric nurse plans and delivers safe, effective nursing care regardless of the cost and its impact on practice. C) The pediatric nurse acts as an advocate for the hospital staff, physicians, and other health care team members involved in care of the child. D) The pediatric nurse's decisions and actions in all areas of practice are determined in an ethical manner. E) The pediatric nurse collaborates with the child, family, and physician in providing care for the child. F) The health care administrators, not the pediatric - CORRECT ANSWER-Ans: A, D, E Feedback: