EXAM TEST FOR ESSENTIALS OF PEDIATRIC NURSING CH 10

EXAM TEST FOR ESSENTIALS OF PEDIATRIC NURSING CH 10 Origin: Chapter 10, 1 The nurse is conducting a health history for a 9-year-old child with stomach pains. What is a recommended guideline when approaching the child for information? A) Wear a white examination coat when conducting the interview. B) Allow the child to control the pace and order of the health history. C) Use quick deliberate gestures to get your point across. D) Do not make physical contact with the child during the interview. - CORRECT ANSWER-Ans: B Feedback: The nurse should elicit the child's cooperation by allowing him or her control over the pace and order of the health history, or anything else that the child can control while still allowing the nurse to obtain the information needed. A white examination coat or allwhite uniform may be frightening to children, who may associate the uniform with painful experiences or find it too unfamiliar. The nurse should use slow deliberate gestures rather than very quick or grand ones, which may be frightening to shy children. The nurse should make physical contact with the child in a nonthreatening way at first by briefly cuddling newborns before returning them to caregivers, laying a hand on the head or arm of toddlers and preschoolers, and warmly shaking the hand of older children and teens to convey a gentle demeanor. Origin: Chapter 10, 2 For which children would the nurse conduct an immediate comprehensive health history? A) A child who is brought to the emergency room with labored breathing B) A child who is a new client in a pediatric office C) A child who is a routine client and presents with signs of a sinus infection D) A child whose condition is improving - CORRECT ANSWER-Ans: B Feedback: The purpose of the examination will determine how comprehensive the history must be. A comprehensive history would be performed for a new child in a pediatric office or a child who is admitted to the hospital. Also, if the physician or nurse practitioner rarely sees the child or if the child is critically ill, a complete and detailed history is in order, no matter what the setting. The child who has received routine health care and presents with a mild illness may need only a problem-focused history. In critical situations, some of the history taking must be delayed until after the child's condition is stabilized. Origin: Chapter 10, 3 The nurse is performing a health history on a 6-year-old boy who is having trouble adjusting to school. Which question would be most likely to elicit valuable information? A) 'Do you like your new school?' B) 'Are you happy with your teacher?' C) 'Do you enjoy reading a book?' D) 'What are your new classmates like?' - CORRECT ANSWER-Ans: D Feedback: A careful conversation and interview with the child and/or the caregiver will provide important information about the child's health. Depending on the intent of the health assessment, many of the questions will be direct, and many will require the caregiver or child to answer simply "yes" or "no." In other than emergency situations, though, asking open-ended questions such as 'What are your classmates like?' offers an excellent opportunity to learn more about the child's life. Origin: Chapter 10, 4 The nurse performing a health history on a child asks the parents if their child has experienced increased appetite or thirst. What body system is the nurse assessing with this question? A) Endocrine B) Genitourinary C) Hematologic D) Neurologic - CORRECT ANSWER-Ans: A Feedback: Indicators of problems with the endocrine system include increased thirst, excessive appetite, delayed or early pubertal changes, and problems with growth. For the genitourinary system the nurse would assess urinary patterns and genitals. For the hematologic system the nurse would assess lymph nodes, skin color, and bruising. Signs of neurologic problems include numbness, tingling, difficulty learning, altered mood or ability to stay alert, tremors, tics, and seizures. Origin: Chapter 10, 5 The nurse is questioning the parents of a 2-year-old child to obtain a functional history. Which topics might the nurse include? Select all answers that apply. A) The child's toileting habits B) Use of car seats and other safety measures C) Problems with growth and development D) Prenatal and perinatal history E) The child's race and ethnicity F) Use of supplements and vitamins - CORRECT ANSWER-Ans: A, B, F Feedback: The functional history should contain information about the child's daily routine, such as toileting habits, safety measures, and nutrition. Problems with growth and development would be covered in the developmental history. Prenatal and perinatal history is assessed in the past health history and the child's race and ethnicity is part of the demographics. Origin: Chapter 10, 6 The nurse is conducting a physical examination of a child following a comprehensive health history. What should be the focus of the physical examination? A) The child B) The parents C) Chief complaint D) Developmental age - CORRECT ANSWER-Ans: C Feedback: The next step after the health history is the physical examination. It should focus on the chief complaint or any of the systems that engaged the nurse's critical thinking while obtaining the history. The child and parents are involved in the assessment but the focus is on the health problem. The nurse should conduct a physical examination with the child's developmental age in mind. The nurse is teaching the student nurse how to perform a physical assessment based on the child's developmental stage. Which statements accurately describes a recommended guideline for setting the tone of the examination for a school-age child? A) Keep up a running dialogue with the caregiver, explaining each step as you do it. B) Include the child in all parts of the examination; speak to the caregiver before and after the examination. C) Speak to the child using mature language and appeal to his or her desire for selfcare. D) Address the child by name; speak to the caregiver and do the most invasive parts last. - CORRECT ANSWER-Ans: B Feedback: For a school-age child, the nurse should include the child in all parts of the examination, and speak to the caregiver before and after the examination. For a newborn the nurse should keep up a running dialogue with the caregiver, explaining each step as it is done. The nurse should speak to the early teen using mature language and appeal to his or her desire for self-care. For an infant, the nurse should address the child by name, and speak to the caregiver and do the most invasive parts last. Origin: Chapter 10, 8 Which would be least effective in gaining the cooperation of a toddler during a physical examination? A) Tell the child that another child the same age wasn't afraid. B) Allow the child to touch and hold the equipment when possible. C) Permit the child to sit on the parent's lap during the examination. D) Offer immediate praise for holding still or doing what was asked. - CORRECT ANSWER-Ans: A Feedback: Toddlers are egocentric, and telling the toddler how well another child behaved or cooperated probably will not help gain this child's cooperation. Allowing the child to touch and hold the equipment, permitting the child to sit on the parent's lap during the exam, and offering praise immediately for cooperating would foster cooperation.