TEST BANK
KA
G
U
A
TEST BANK
,Marilyn J. Hockenberry: Wong's Nursing Care of Infants and Children
Chapter 01: Perspectives of Pediatric Nursing
MULTIPLE CHOICE
1. What is the major cause of death for children in the United States?
a. Heart disease
b. Childhood cancer
c. Injuries
d. Congenital anomalies
ANS: C
Unintentional injuries (accidents) are the leading cause of death after age 1 year through adolescence.
The leading cause of death for those younger than 1 year is congenital anomalies, and childhood
cancers and heart disease cause a significantly lower percentage of deaths in children older than 1 year
of age.
KA
DIF: Cognitive Level: Understanding TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
2. Parents of a hospitalized toddler ask the nurse, “What is meant by family-centered care?” The nurse
should respond with which statement?
G
a. Family-centered care reduces the effect of cultural diversity on the family.
b. Family-centered care encourages family dependence on the health care system.
c. Family-centered care recognizes that the family is the constant in a child’s life.
U
d. Family-centered care avoids expecting families to be part of the decision-making
process.
ANS: C
A
The three key components of family-centered care are respect, collaboration, and support. Family-
centered care recognizes the family as the constant in the child’s life. The family should be enabled
and empowered to work with the health care system and is expected to be part of the decision-making
process. The nurse should also support the family’s cultural diversity, not reduce its effect.
DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
3. Evidence-based practice (EBP), a decision-making model, is best described as which?
a. Using information in textbooks to guide care
b. Combining knowledge with clinical experience and intuition
c. Using a professional code of ethics as a means for decision making
d. Gathering all evidence that applies to the child’s health and family situation
ANS: B
EBP helps focus on measurable outcomes; the use of demonstrated, effective interventions; and
questioning the best approach. EBP involves decision making based on the integration of the best
research evidence combined with clinical expertise and patient values.
, DIF: Cognitive Level: Remembering TOP: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
4. The nurse is talking to a group of parents of school-age children at an after-school program about
childhood health problems. Which statement should the nurse include in the teaching?
a. Childhood obesity is the most common nutritional problem among children.
b. Immunization rates are the same among children of different races and ethnicity.
c. Dental caries is not a problem commonly seen in children since the introduction of
fluorinated water.
d. Mental health problems are typically not seen in school-age children but may be
diagnosed in adolescents.
ANS: A
When teaching parents of school-age children about childhood health problems, the nurse should
include information about childhood obesity because it is the most common problem among children
and is associated with type 2 diabetes. Teaching parents about ways to prevent obesity is important to
include. Immunization rates differ depending on the child’s race and ethnicity; dental caries continues
to be a common chronic disease in childhood; and mental health problems are seen in children as
KA
young as school age, not just in adolescents.
DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
5. The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to
G
ensure atraumatic care?
a. Limit explanation of procedures because the child is preschool aged.
b. Ask that all family members leave the room when performing procedures.
U
c. Allow the child to choose the type of juice to drink with the administration of oral
medications.
d. Explain that EMLA cream cannot be used for the morning lab draw because there
A
is not time for it to be effective.
ANS: C
The overriding goal in providing atraumatic care is first, do no harm. Allowing the child, a choice of
juice to drink when taking oral medications provides the child with a sense of control. The preschool
child should be prepared before procedures, so limiting explanations of procedures would increase
anxiety. The family should be allowed to stay with the child during procedures, minimizing stress.
Lidocaine/prilocaine (EMLA) cream is a topical local anesthetic. The nurse should plan to use the
prescribed cream in time for morning laboratory draws to minimize pain.
DIF: Cognitive Level: Applying TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
6. Which situation denotes a nontherapeutic nurse–patient–family relationship?
a. The nurse is planning to read a favorite fairy tale to a patient.
b. During shift report, the nurse is criticizing parents for not visiting their child.
c. The nurse is discussing with a fellow nurse the emotional draw to a certain patient.
d. The nurse is working with a family to find ways to decrease the family’s
dependence on health care providers.
, ANS: B
Criticizing parents for not visiting in shift report is nontherapeutic and shows an under involvement
with the parents. Reading a fairy tale is a therapeutic and age-appropriate action. Discussing feelings
of an emotional draw with a fellow nurse is therapeutic and shows a willingness to understand
feelings. Working with parents to decrease dependence on health care providers is therapeutic and
helps to empower the family.
DIF: Cognitive Level: Analyzing TOP: Integrated Process: Caring
MSC: Client Needs: Psychosocial Integrity
7. The nurse is aware that which age-group is at risk for childhood injury because of the cognitive
characteristic of magical and egocentric thinking?
a. Preschool
b. Young school age
c. Middle school age
d. Adolescent
ANS: A
KA
Preschool children have the cognitive characteristic of magical and egocentric thinking, meaning they
are unable to comprehend danger to self or others. Young and middle school-aged children have
transitional cognitive processes, and they may attempt dangerous acts without detailed planning but
recognize danger to themselves or others. Adolescents have formal operational cognitive processes and
are preoccupied with abstract thinking.
G
DIF: Cognitive Level: Understanding TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment
U
8. The school nurse is assessing children for risk factors related to childhood injuries. Which child has
the most risk factors related to childhood injury?
a. Female, multiple siblings, stable home life
A
b. Male, high activity level, stressful home life
c. Male, even tempered, history of previous injuries
d. Female, reacts negatively to new situations, no serious previous injuries
ANS: B
Boys have a preponderance for injuries over girls because of a difference in behavioral characteristics,
a high activity temperament is associated with risk-taking behaviors, and stress predisposes children to
increased risk taking and self-destructive behaviors. Therefore, a male child with a high activity level
and living in a stressful environment has the highest number of risk factors. A girl with several siblings
and a stable home life is low risk. A boy with previous injuries has two risk factors, but an even temper
is not a risk factor for injuries. A girl who reacts negatively to new situations but has no previous
serious illnesses has only one risk factor.
DIF: Cognitive Level: Analyzing TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment
9. An adolescent patient wants to make decisions about treatment options, along with his parents. Which
moral value is the nurse displaying when supporting the adolescent to make decisions?
a. Justice
, b. Autonomy
c. Beneficence
d. Nonmaleficence
ANS: B
Autonomy is the patient’s right to be self-governing. The adolescent is trying to be autonomous, so the
nurse is supporting this value. Justice is the concept of fairness. Beneficence is the obligation to
promote the patient’s well-being. Nonmaleficence is the obligation to minimize or prevent harm.
DIF: Cognitive Level: Analyzing TOP: Nursing Process: Evaluation
MSC: Client Needs: Health Promotion and Maintenance
MULTIPLE RESPONSE
1. Which responsibilities are included in the pediatric nurse’s promotion of the health and well-being of
children? (Select all that apply.)
a. Promoting disease prevention
b. Providing financial assistance
KA
c. Providing support and counseling
d. Establishing lifelong friendships
e. Establishing a therapeutic relationship
f. Participating in ethical decision making
ANS: A, C, E, F
G
The pediatric nurse’s role includes promoting disease prevention, providing support and counseling,
establishing a therapeutic relationship, and participating in ethical decision making; a pediatric nurse
does not need to establish lifelong friendships or provide financial assistance to children and their
U
families. Boundaries should be set and clear.
DIF: Cognitive Level: Applying TOP: Nursing Process: Planning
A
MSC: Client Needs: Health Promotion and Maintenance
2. The nurse is conducting a teaching session for parents on nutrition. Which characteristics of families
should the nurse consider, that can cause families to struggle in providing adequate nutrition? (Select
all that apply.)
a. Homelessness
b. Lower income
c. Migrant status
d. Working parents
e. Single parent status
ANS: A, B, C
Families that struggle with lower incomes, homelessness, and migrant status generally lack the
resources to provide their children with adequate food intake, nutritious foods such as fresh fruits and
vegetables, and appropriate protein intake. Working parents and single parent status do not mean the
families will struggle to provide adequate nutrition.
DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
,3. The nurse is preparing to complete documentation on a patient’s chart. Which should be included in
documentation of nursing care? (Select all that apply.)
a. Reassessments
b. Incident reports
c. Initial assessments
d. Nursing care provided
e. Patient’s response of care provided
ANS: A, C, D, E
The patient’s medical record should include initial assessments, reassessments, nursing care provided,
and the patient’s response of care provided. Incident reports are not documented in the patient’s chart.
DIF: Cognitive Level: Applying
TOP: Integrated Process: Communication and Documentation
MSC: Client Needs: Safe and Effective Care Environment
4. Which actions by the nurse demonstrate over involvement with patients and their families? (Select all
KA
that apply.)
a. Buying clothes for the patients
b. Showing favoritism toward a patient
c. Focusing on technical aspects of care
d. Spending off-duty time with patients and families
e. Asking questions if families are not participating in care
G
ANS: A, B, D
Actions that show over involvement include buying clothes for patients, showing favoritism toward a
U
patient, and spending off-duty time with patients and families. Focusing on technical aspects of care is
an action that indicates under involvement, and asking questions if families are not participating in
care indicates a positive action.
A
DIF: Cognitive Level: Analyzing TOP: Integrated Process: Caring
MSC: Client Needs: Health Promotion and Maintenance
5. Which are included in the evaluation step of the nursing process? (Select all that apply.)
a. Determination if the outcome has been met
b. Ascertaining if the plan requires modification
c. Establish priorities and selecting expected patient goals
d. Selecting alternative interventions if the outcome has not been met
e. Determining if a risk or actual dysfunctional health problem exists
ANS: A, B, D
Evaluation is the last step in the nursing process. The nurse gathers, sorts, and analyzes data to
determine whether (1) the established outcome has been met, (2) the nursing interventions were
appropriate, (3) the plan requires modification, or (4) other alternatives should be considered.
Establishing priorities and selecting expected patient goals are done in the outcomes identification
stage. Determining if a risk or actual dysfunctional health problem exists is done in the diagnosis stage
of the nursing process.
DIF: Cognitive Level: Understanding TOP: Nursing Process: Evaluation
, MSC: Client Needs: Health Promotion and Maintenance
6. Which should the nurse teach to parents regarding oral health of children? (Select all that apply.)
a. Fluoridated water should be used.
b. Early childhood caries is a preventable disease.
c. Dental caries is a rare chronic disease of childhood.
d. Dental hygiene should begin with the first tooth eruption.
e. Childhood caries does not happen until after 2 years of age.
ANS: A, B, D
Oral health instructions to parents of children should include use of fluoridated water and dental
hygiene beginning with the first tooth eruption. In addition, early childhood caries is a preventable
disease and should be included in the teaching session. Dental caries is a common, not rare, chronic
disease of childhood. Childhood caries may begin before the first birthday.
DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
KA
7. The school nurse is explaining to older school children that obesity increases the risk for which
disorders? (Select all that apply.)
a. Asthma
b. Hypertension
c. Dyslipidemia
d. Irritable bowel disease
G
e. Altered glucose metabolism
ANS: B, C, E
U
Overweight youth have increased risk for a cluster of cardiovascular factors that include hypertension,
altered glucose metabolism, and dyslipidemia. Irritable bowel disease and asthma are not linked to
obesity.
A
DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
8. Which actions by the nurse demonstrate clinical reasoning? (Select all that apply.)
a. Basing decisions on intuition
b. Considering alternative action
c. Using formal and informal thinking to gather data
d. Giving deliberate thought to a patient’s problem
e. Developing an outcome focused on optimum patient care
ANS: B, C, D, E
Clinical reasoning is a cognitive process that uses formal and informal thinking to gather and analyze
patient data, evaluate the significance of the information, and consider alternative actions. Clinical
reasoning is a complex developmental process based on rational and deliberate thought and developing
an outcome focused on optimum patient care. Clinical reasoning is based on the scientific method of
inquiry; it is not based solely on intuition.
DIF: Cognitive Level: Applying TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe and Effective Care Environment
,COMPLETION
1. The nurse is determining if a newborn is classified in the low birth weight (LBW) category of less than
2500 g. The newborn’s weight is 5 pounds, 4 oz. What is the newborn’s weight in grams? Record your
answer in a whole number.
ANS:
2386
Convert the 4 oz to a decimal by dividing 4 by 16 = 0.25. Use 5.25 pounds and divide by 2.2 to get
2.386 kg. Multiply by 1000 to convert to grams = 2386.
DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
KA
G
U
A
,Chapter 02: Family, Social, Cultural, and Religious Influences on Child Health Promotion
Hockenberry: Wong’s Nursing Care of Infants and Children, 12th Edition
MULTIPLE CHOICE
1. Children are taught the values of their culture through observation and feedback relative to their own
behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may
be culturally determined?
a. Ethnicity
b. Racial variation
c. Status
d. Geographic boundaries
ANS: C
Status is culturally determined and varies according to each culture. Some cultures ascribe higher
status to age or socioeconomic position. Social roles also are influenced by the culture. Ethnicity is an
affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. It is one
component of culture. Race and culture are two distinct attributes. Whereas racial grouping describes
transmissible traits, culture is determined by the pattern of assumptions, beliefs, and practices that
unconsciously frames or guides the outlook and decisions of a group of people. Cultural development
KA
may be limited by geographic boundaries, but the boundaries are not culturally determined.
DIF: Cognitive Level: Analyzing TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Psychosocial Integrity
2. The nurse is planning care for a patient with a different ethnic background. Which should be an
G
appropriate goal?
a. Adapt, as necessary, ethnic practices to health needs.
b. Attempt, in a nonjudgmental way, to change ethnic beliefs.
U
c. Encourage continuation of ethnic practices in the hospital setting.
d. Strive to keep ethnic background from influencing health needs.
A
, ANS: A
Whenever possible, nurses should facilitate the integration of ethnic practices into health care
provision. The ethnic background is part of the individual; it should be difficult to eliminate the
influence of ethnic background. The ethnic practices need to be evaluated within the context of the
health care setting to determine whether they are conflicting.
DIF: Cognitive Level: Applying TOP: Integrated Process: Caring
MSC: Client Needs: Psychosocial Integrity
3. How is the family systems theory best described?
a. The family is viewed as the sum of individual members.
b. A change in one family member cannot create a change in other members.
c. Individual family members are readily identified as the source of a problem.
d. When the family system is disrupted, change can occur at any point in the system.
ANS: D
Family systems theory describes an interactional model. Any change in one member will create change
in others. Although the family is the sum of the individual members, family systems theory focuses on
KA
the number of dyad interactions that can occur. The interactions, not the individual members, are the
problem.
DIF: Cognitive Level: Analyzing TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
G
4. When discussing discipline with the mother of a 4-year-old child, which should the nurse include?
a. Parental control should be consistent.
b. Withdrawal of love and approval is effective at this age.
U
c. Children as young as 4 years rarely need to be disciplined.
d. One should expect rules to be followed rigidly and unquestioningly.
ANS: A
A
For effective discipline, parents must be consistent and must follow through with agreed-on actions.
Withdrawal of love and approval is never appropriate or effective. The 4-year-old child will test limits
and may misbehave. Children of this age do not respond to verbal reasoning. Realistic goals should be
set for this age-group. Discipline is necessary to reinforce these goals. Discipline strategies should be
appropriate to the child’s age and temperament and the severity of the misbehavior. Following rules
rigidly and unquestioningly is beyond the developmental capabilities of a 4-year-old child.
DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Psychosocial Integrity
5. A parent of a school-age child tells the school nurse that the parents are going through a divorce. The
child has not been doing well in school and sometimes has trouble sleeping. The nurse should
recognize this as what?
a. Indicative of maladjustment
b. A common reaction to divorce
c. Suggestive of a lack of adequate parenting
d. An unusual response that indicates a need for referral
ANS: B
KA
G
U
A
TEST BANK
,Marilyn J. Hockenberry: Wong's Nursing Care of Infants and Children
Chapter 01: Perspectives of Pediatric Nursing
MULTIPLE CHOICE
1. What is the major cause of death for children in the United States?
a. Heart disease
b. Childhood cancer
c. Injuries
d. Congenital anomalies
ANS: C
Unintentional injuries (accidents) are the leading cause of death after age 1 year through adolescence.
The leading cause of death for those younger than 1 year is congenital anomalies, and childhood
cancers and heart disease cause a significantly lower percentage of deaths in children older than 1 year
of age.
KA
DIF: Cognitive Level: Understanding TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
2. Parents of a hospitalized toddler ask the nurse, “What is meant by family-centered care?” The nurse
should respond with which statement?
G
a. Family-centered care reduces the effect of cultural diversity on the family.
b. Family-centered care encourages family dependence on the health care system.
c. Family-centered care recognizes that the family is the constant in a child’s life.
U
d. Family-centered care avoids expecting families to be part of the decision-making
process.
ANS: C
A
The three key components of family-centered care are respect, collaboration, and support. Family-
centered care recognizes the family as the constant in the child’s life. The family should be enabled
and empowered to work with the health care system and is expected to be part of the decision-making
process. The nurse should also support the family’s cultural diversity, not reduce its effect.
DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
3. Evidence-based practice (EBP), a decision-making model, is best described as which?
a. Using information in textbooks to guide care
b. Combining knowledge with clinical experience and intuition
c. Using a professional code of ethics as a means for decision making
d. Gathering all evidence that applies to the child’s health and family situation
ANS: B
EBP helps focus on measurable outcomes; the use of demonstrated, effective interventions; and
questioning the best approach. EBP involves decision making based on the integration of the best
research evidence combined with clinical expertise and patient values.
, DIF: Cognitive Level: Remembering TOP: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
4. The nurse is talking to a group of parents of school-age children at an after-school program about
childhood health problems. Which statement should the nurse include in the teaching?
a. Childhood obesity is the most common nutritional problem among children.
b. Immunization rates are the same among children of different races and ethnicity.
c. Dental caries is not a problem commonly seen in children since the introduction of
fluorinated water.
d. Mental health problems are typically not seen in school-age children but may be
diagnosed in adolescents.
ANS: A
When teaching parents of school-age children about childhood health problems, the nurse should
include information about childhood obesity because it is the most common problem among children
and is associated with type 2 diabetes. Teaching parents about ways to prevent obesity is important to
include. Immunization rates differ depending on the child’s race and ethnicity; dental caries continues
to be a common chronic disease in childhood; and mental health problems are seen in children as
KA
young as school age, not just in adolescents.
DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
5. The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to
G
ensure atraumatic care?
a. Limit explanation of procedures because the child is preschool aged.
b. Ask that all family members leave the room when performing procedures.
U
c. Allow the child to choose the type of juice to drink with the administration of oral
medications.
d. Explain that EMLA cream cannot be used for the morning lab draw because there
A
is not time for it to be effective.
ANS: C
The overriding goal in providing atraumatic care is first, do no harm. Allowing the child, a choice of
juice to drink when taking oral medications provides the child with a sense of control. The preschool
child should be prepared before procedures, so limiting explanations of procedures would increase
anxiety. The family should be allowed to stay with the child during procedures, minimizing stress.
Lidocaine/prilocaine (EMLA) cream is a topical local anesthetic. The nurse should plan to use the
prescribed cream in time for morning laboratory draws to minimize pain.
DIF: Cognitive Level: Applying TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
6. Which situation denotes a nontherapeutic nurse–patient–family relationship?
a. The nurse is planning to read a favorite fairy tale to a patient.
b. During shift report, the nurse is criticizing parents for not visiting their child.
c. The nurse is discussing with a fellow nurse the emotional draw to a certain patient.
d. The nurse is working with a family to find ways to decrease the family’s
dependence on health care providers.
, ANS: B
Criticizing parents for not visiting in shift report is nontherapeutic and shows an under involvement
with the parents. Reading a fairy tale is a therapeutic and age-appropriate action. Discussing feelings
of an emotional draw with a fellow nurse is therapeutic and shows a willingness to understand
feelings. Working with parents to decrease dependence on health care providers is therapeutic and
helps to empower the family.
DIF: Cognitive Level: Analyzing TOP: Integrated Process: Caring
MSC: Client Needs: Psychosocial Integrity
7. The nurse is aware that which age-group is at risk for childhood injury because of the cognitive
characteristic of magical and egocentric thinking?
a. Preschool
b. Young school age
c. Middle school age
d. Adolescent
ANS: A
KA
Preschool children have the cognitive characteristic of magical and egocentric thinking, meaning they
are unable to comprehend danger to self or others. Young and middle school-aged children have
transitional cognitive processes, and they may attempt dangerous acts without detailed planning but
recognize danger to themselves or others. Adolescents have formal operational cognitive processes and
are preoccupied with abstract thinking.
G
DIF: Cognitive Level: Understanding TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment
U
8. The school nurse is assessing children for risk factors related to childhood injuries. Which child has
the most risk factors related to childhood injury?
a. Female, multiple siblings, stable home life
A
b. Male, high activity level, stressful home life
c. Male, even tempered, history of previous injuries
d. Female, reacts negatively to new situations, no serious previous injuries
ANS: B
Boys have a preponderance for injuries over girls because of a difference in behavioral characteristics,
a high activity temperament is associated with risk-taking behaviors, and stress predisposes children to
increased risk taking and self-destructive behaviors. Therefore, a male child with a high activity level
and living in a stressful environment has the highest number of risk factors. A girl with several siblings
and a stable home life is low risk. A boy with previous injuries has two risk factors, but an even temper
is not a risk factor for injuries. A girl who reacts negatively to new situations but has no previous
serious illnesses has only one risk factor.
DIF: Cognitive Level: Analyzing TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment
9. An adolescent patient wants to make decisions about treatment options, along with his parents. Which
moral value is the nurse displaying when supporting the adolescent to make decisions?
a. Justice
, b. Autonomy
c. Beneficence
d. Nonmaleficence
ANS: B
Autonomy is the patient’s right to be self-governing. The adolescent is trying to be autonomous, so the
nurse is supporting this value. Justice is the concept of fairness. Beneficence is the obligation to
promote the patient’s well-being. Nonmaleficence is the obligation to minimize or prevent harm.
DIF: Cognitive Level: Analyzing TOP: Nursing Process: Evaluation
MSC: Client Needs: Health Promotion and Maintenance
MULTIPLE RESPONSE
1. Which responsibilities are included in the pediatric nurse’s promotion of the health and well-being of
children? (Select all that apply.)
a. Promoting disease prevention
b. Providing financial assistance
KA
c. Providing support and counseling
d. Establishing lifelong friendships
e. Establishing a therapeutic relationship
f. Participating in ethical decision making
ANS: A, C, E, F
G
The pediatric nurse’s role includes promoting disease prevention, providing support and counseling,
establishing a therapeutic relationship, and participating in ethical decision making; a pediatric nurse
does not need to establish lifelong friendships or provide financial assistance to children and their
U
families. Boundaries should be set and clear.
DIF: Cognitive Level: Applying TOP: Nursing Process: Planning
A
MSC: Client Needs: Health Promotion and Maintenance
2. The nurse is conducting a teaching session for parents on nutrition. Which characteristics of families
should the nurse consider, that can cause families to struggle in providing adequate nutrition? (Select
all that apply.)
a. Homelessness
b. Lower income
c. Migrant status
d. Working parents
e. Single parent status
ANS: A, B, C
Families that struggle with lower incomes, homelessness, and migrant status generally lack the
resources to provide their children with adequate food intake, nutritious foods such as fresh fruits and
vegetables, and appropriate protein intake. Working parents and single parent status do not mean the
families will struggle to provide adequate nutrition.
DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
,3. The nurse is preparing to complete documentation on a patient’s chart. Which should be included in
documentation of nursing care? (Select all that apply.)
a. Reassessments
b. Incident reports
c. Initial assessments
d. Nursing care provided
e. Patient’s response of care provided
ANS: A, C, D, E
The patient’s medical record should include initial assessments, reassessments, nursing care provided,
and the patient’s response of care provided. Incident reports are not documented in the patient’s chart.
DIF: Cognitive Level: Applying
TOP: Integrated Process: Communication and Documentation
MSC: Client Needs: Safe and Effective Care Environment
4. Which actions by the nurse demonstrate over involvement with patients and their families? (Select all
KA
that apply.)
a. Buying clothes for the patients
b. Showing favoritism toward a patient
c. Focusing on technical aspects of care
d. Spending off-duty time with patients and families
e. Asking questions if families are not participating in care
G
ANS: A, B, D
Actions that show over involvement include buying clothes for patients, showing favoritism toward a
U
patient, and spending off-duty time with patients and families. Focusing on technical aspects of care is
an action that indicates under involvement, and asking questions if families are not participating in
care indicates a positive action.
A
DIF: Cognitive Level: Analyzing TOP: Integrated Process: Caring
MSC: Client Needs: Health Promotion and Maintenance
5. Which are included in the evaluation step of the nursing process? (Select all that apply.)
a. Determination if the outcome has been met
b. Ascertaining if the plan requires modification
c. Establish priorities and selecting expected patient goals
d. Selecting alternative interventions if the outcome has not been met
e. Determining if a risk or actual dysfunctional health problem exists
ANS: A, B, D
Evaluation is the last step in the nursing process. The nurse gathers, sorts, and analyzes data to
determine whether (1) the established outcome has been met, (2) the nursing interventions were
appropriate, (3) the plan requires modification, or (4) other alternatives should be considered.
Establishing priorities and selecting expected patient goals are done in the outcomes identification
stage. Determining if a risk or actual dysfunctional health problem exists is done in the diagnosis stage
of the nursing process.
DIF: Cognitive Level: Understanding TOP: Nursing Process: Evaluation
, MSC: Client Needs: Health Promotion and Maintenance
6. Which should the nurse teach to parents regarding oral health of children? (Select all that apply.)
a. Fluoridated water should be used.
b. Early childhood caries is a preventable disease.
c. Dental caries is a rare chronic disease of childhood.
d. Dental hygiene should begin with the first tooth eruption.
e. Childhood caries does not happen until after 2 years of age.
ANS: A, B, D
Oral health instructions to parents of children should include use of fluoridated water and dental
hygiene beginning with the first tooth eruption. In addition, early childhood caries is a preventable
disease and should be included in the teaching session. Dental caries is a common, not rare, chronic
disease of childhood. Childhood caries may begin before the first birthday.
DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
KA
7. The school nurse is explaining to older school children that obesity increases the risk for which
disorders? (Select all that apply.)
a. Asthma
b. Hypertension
c. Dyslipidemia
d. Irritable bowel disease
G
e. Altered glucose metabolism
ANS: B, C, E
U
Overweight youth have increased risk for a cluster of cardiovascular factors that include hypertension,
altered glucose metabolism, and dyslipidemia. Irritable bowel disease and asthma are not linked to
obesity.
A
DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
8. Which actions by the nurse demonstrate clinical reasoning? (Select all that apply.)
a. Basing decisions on intuition
b. Considering alternative action
c. Using formal and informal thinking to gather data
d. Giving deliberate thought to a patient’s problem
e. Developing an outcome focused on optimum patient care
ANS: B, C, D, E
Clinical reasoning is a cognitive process that uses formal and informal thinking to gather and analyze
patient data, evaluate the significance of the information, and consider alternative actions. Clinical
reasoning is a complex developmental process based on rational and deliberate thought and developing
an outcome focused on optimum patient care. Clinical reasoning is based on the scientific method of
inquiry; it is not based solely on intuition.
DIF: Cognitive Level: Applying TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe and Effective Care Environment
,COMPLETION
1. The nurse is determining if a newborn is classified in the low birth weight (LBW) category of less than
2500 g. The newborn’s weight is 5 pounds, 4 oz. What is the newborn’s weight in grams? Record your
answer in a whole number.
ANS:
2386
Convert the 4 oz to a decimal by dividing 4 by 16 = 0.25. Use 5.25 pounds and divide by 2.2 to get
2.386 kg. Multiply by 1000 to convert to grams = 2386.
DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
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A
,Chapter 02: Family, Social, Cultural, and Religious Influences on Child Health Promotion
Hockenberry: Wong’s Nursing Care of Infants and Children, 12th Edition
MULTIPLE CHOICE
1. Children are taught the values of their culture through observation and feedback relative to their own
behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may
be culturally determined?
a. Ethnicity
b. Racial variation
c. Status
d. Geographic boundaries
ANS: C
Status is culturally determined and varies according to each culture. Some cultures ascribe higher
status to age or socioeconomic position. Social roles also are influenced by the culture. Ethnicity is an
affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. It is one
component of culture. Race and culture are two distinct attributes. Whereas racial grouping describes
transmissible traits, culture is determined by the pattern of assumptions, beliefs, and practices that
unconsciously frames or guides the outlook and decisions of a group of people. Cultural development
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may be limited by geographic boundaries, but the boundaries are not culturally determined.
DIF: Cognitive Level: Analyzing TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Psychosocial Integrity
2. The nurse is planning care for a patient with a different ethnic background. Which should be an
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appropriate goal?
a. Adapt, as necessary, ethnic practices to health needs.
b. Attempt, in a nonjudgmental way, to change ethnic beliefs.
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c. Encourage continuation of ethnic practices in the hospital setting.
d. Strive to keep ethnic background from influencing health needs.
A
, ANS: A
Whenever possible, nurses should facilitate the integration of ethnic practices into health care
provision. The ethnic background is part of the individual; it should be difficult to eliminate the
influence of ethnic background. The ethnic practices need to be evaluated within the context of the
health care setting to determine whether they are conflicting.
DIF: Cognitive Level: Applying TOP: Integrated Process: Caring
MSC: Client Needs: Psychosocial Integrity
3. How is the family systems theory best described?
a. The family is viewed as the sum of individual members.
b. A change in one family member cannot create a change in other members.
c. Individual family members are readily identified as the source of a problem.
d. When the family system is disrupted, change can occur at any point in the system.
ANS: D
Family systems theory describes an interactional model. Any change in one member will create change
in others. Although the family is the sum of the individual members, family systems theory focuses on
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the number of dyad interactions that can occur. The interactions, not the individual members, are the
problem.
DIF: Cognitive Level: Analyzing TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
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4. When discussing discipline with the mother of a 4-year-old child, which should the nurse include?
a. Parental control should be consistent.
b. Withdrawal of love and approval is effective at this age.
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c. Children as young as 4 years rarely need to be disciplined.
d. One should expect rules to be followed rigidly and unquestioningly.
ANS: A
A
For effective discipline, parents must be consistent and must follow through with agreed-on actions.
Withdrawal of love and approval is never appropriate or effective. The 4-year-old child will test limits
and may misbehave. Children of this age do not respond to verbal reasoning. Realistic goals should be
set for this age-group. Discipline is necessary to reinforce these goals. Discipline strategies should be
appropriate to the child’s age and temperament and the severity of the misbehavior. Following rules
rigidly and unquestioningly is beyond the developmental capabilities of a 4-year-old child.
DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Psychosocial Integrity
5. A parent of a school-age child tells the school nurse that the parents are going through a divorce. The
child has not been doing well in school and sometimes has trouble sleeping. The nurse should
recognize this as what?
a. Indicative of maladjustment
b. A common reaction to divorce
c. Suggestive of a lack of adequate parenting
d. An unusual response that indicates a need for referral
ANS: B
