Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 1 Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 2
Table of Contents Chapter 01: Perspectives of Pediatric Nursing
Table of Contents 1 MULTIPLE CHOICE
Chapter 01: Perspectives of Pediatric Nursing 2
1. A nurse is planning a teaching session for parents of preschool children. Which statement explains why the
Chapter 02: Family, Social, Cultural, and Religious Influences on Child Health Promotion
nurse should include information about morbidity and mortality?
8 a. Life-span statistics are included in the data.
Chapter 03: Developmental and Genetic Influences on Child Health Promotion 22 b. It explains effectiveness of treatment.
Chapter 04: Communication and Physical Assessment of the Child 39 c. Cost-effective treatment is detailed for the general population.
Chapter 05: Pain Assessment and Management in Children 68 d. High-risk age groups for certain disorders or hazards are identified.
Chapter 06: Childhood Communicable and Infectious Diseases 77
Chapter 07: Health Promotion of the Newborn and Family 92 ANS: D
Chapter 08: Health Problems of Newborns 115 Analysis of morbidity and mortality data provides the parents with information about which groups of
Chapter 09: Health Promotion of the Infant and Family 137 individuals are at risk for which health problems. Life-span statistics is a part of the mortality data. Treatment
Chapter 10: Health Problems of Infants 148 modalities and cost are not included in morbidity and mortality data.
Chapter 11: Health Promotion of the Toddler and Family 157 PTS: 1 DIF: Cognitive Level: Apply REF: 6
Chapter 12: Health Promotion of the Preschooler and Family 168 TOP: Integrated Process: Nursing Process: Planning
Chapter 13: Health Problems of Toddlers and Preschoolers 175 MSC: Area of Client Needs: Health Promotion and Maintenance
Chapter 14: Health Promotion of the School-Age Child and Family 189
Chapter 15: Health Promotion of the Adolescent and Family 196 2. A clinic nurse is planning a teaching session about childhood obesity prevention for parents of school-age
Chapter 16: Health Problems of School-Age Children and Adolescents 203 children. The nurse should include which associated risk of obesity in the teaching plan?
Chapter 17: Quality of Life for Children Living with Chronic or Complex Diseases 216 a. Type I diabetes
Chapter 18: Impact of Cognitive or Sensory Impairment on the Child and Family 228 b. Respiratory disease
c. Celiac disease
Chapter 19: Family-Centered Care of the Child During Illness and Hospitalization 240
d. Type II diabetes
Chapter 20: Pediatric Variations of Nursing Interventions 253
Chapter 21: The Child with Respiratory Dysfunction 268 ANS: D
Chapter 22: The Child with Gastrointestinal Dysfunction 283 Childhood obesity has been associated with the rise of type II diabetes in children. Type I diabetes is not
Chapter 23: The Child with Cardiovascular Dysfunction 300 associated with obesity and has a genetic component. Respiratory disease is not associated with obesity, and
Chapter 24: The Child with Hematologic or Immunologic Dysfunction 314 celiac disease is the inability to metabolize gluten in foods and is not associated with obesity.
Chapter 25: The Child with Cancer 329
Chapter 26: The Child with Genitourinary Dysfunction 357 PTS: 1 DIF: Cognitive Level: Apply REF: 3
Chapter 27: The Child with Cerebral Dysfunction 369 TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance
Chapter 28: The Child with Endocrine Dysfunction 384
Chapter 29: The Child with Musculoskeletal or Articular Dysfunction 393 3. Which is the leading cause of death in infants younger than 1 year?
Chapter 30: The Child with Neuromuscular or Muscular Dysfunction 405 a. Congenital anomalies
b. Sudden infant death syndrome
c. Respiratory distress syndrome
d. Bacterial sepsis of the newborn
ANS: A
Congenital anomalies account for 20.1% of deaths in infants younger than 1 year. Sudden infant death
syndrome accounts for 8.2% of deaths in this age group. Respiratory distress syndrome accounts for 3.4% of
deaths in this age group. Infections specific to the perinatal period account for 2.7% of deaths in this age group.
PTS: 1 DIF: Cognitive Level: Remember REF: 7
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance
4. Which leading cause of death topic should the nurse emphasize to a group of African-American boys
ranging in ages 15 to 19 years?
a. Suicide
b. Cancer
c. Firearm homicide
d. Occupational injuries
ANS: C
,Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 3 Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 4
Firearm homicide is the second overall cause of death in this age group and the leading cause of death in b. Unintentional injuries that cause chronic health problems
African-American males. Suicide is the third-leading cause of death in this population. Cancer, although a c. Discoveries of new therapies to treat health problems
major health problem, is the fourth-leading cause of death in this age group. Occupational injuries do not d. Behavioral, social, and educational problems that alter health
contribute to a significant death rate for this age group.
ANS: D
PTS: 1 DIF: Cognitive Level: Understand REF: 5 The new morbidity reflects the behavioral, social, and educational problems that interfere with the childs social
TOP: Integrated Process: Nursing Process: Planning and academic development. It is currently estimated that the incidence of these issues is from 5% to 30%.
MSC: Area of Client Needs: Health Promotion and Maintenance Limitations in major activities of daily living and unintentional injuries that result in chronic health problems
are included in morbidity data. Discovery of new therapies would be reflected in changes in morbidity data
5. Which is the major cause of death for children older than 1 year? over time.
a. Cancer
b. Heart disease PTS: 1 DIF: Cognitive Level: Remember REF: 3
c. Unintentional injuries TOP: Integrated Process: Nursing Process: Assessment
d. Congenital anomalies MSC: Area of Client Needs: Health Promotion and Maintenance
ANS: C 9. A nurse on a pediatric unit is practicing family-centered care. Which is most descriptive of the care the nurse
Unintentional injuries (accidents) are the leading cause of death after age 1 year through adolescence. is delivering?
Congenital anomalies are the leading cause of death in those younger than 1 year. Cancer ranks either second a. Taking over total care of the child to reduce stress on the family
or fourth, depending on the age group, and heart disease ranks fifth in the majority of the age groups. b. Encouraging family dependence on health care systems
c. Recognizing that the family is the constant in a childs life
PTS: 1 DIF: Cognitive Level: Remember REF: 8 d. Excluding families from the decision-making process
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance ANS: C
The three key components of family-centered care are respect, collaboration, and support. Family-centered
6. Which is the leading cause of death from unintentional injuries for females ranging in age from 1 to 14? care recognizes the family as the constant in the childs life. Taking over total care does not include the family
a. Mechanical suffocation in the process and may increase stress instead of reducing stress. The family should be enabled and empowered
b. Drowning to work with the health care system. The family is expected to be part of the decision-making process.
c. Motorvehicle-related fatalities
d. Fire- and burn-related fatalities PTS: 1 DIF: Cognitive Level: Remember REF: 8
TOP: Integrated Process: Nursing Process: Implementation
ANS: C MSC: Area of Client Needs: Health Promotion and Maintenance
Motorvehicle-related fatalities are the leading cause of death for females ranging in age from 1 to 14, either as
passengers or as pedestrians. Mechanical suffocation is fourth or fifth, depending on the age. Drowning is the 10. The nurse is preparing an in-service education to staff about atraumatic care for pediatric patients. Which
second- or third-leading cause of death, depending on the age. Fire- and burn-related fatalities are the second- intervention should the nurse include?
leading cause of death. a. Prepare the child for separation from parents during hospitalization by reviewing a video.
b. Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal.
PTS: 1 DIF: Cognitive Level: Remember REF: 4 c. Help the child accept the loss of control associated with hospitalization.
TOP: Integrated Process: Nursing Process: Assessment d. Help the child accept pain that is connected with a treatment or procedure.
MSC: Area of Client Needs: Health Promotion and Maintenance
ANS: B
7. Which factor most impacts the type of injury a child is susceptible to, according to the childs age? Preparing the child for any unfamiliar treatments, controlling pain, allowing privacy, providing play activities
a. Physical health of the child for expression of fear and aggression, providing choices, and respecting cultural differences are components of
b. Developmental level of the child atraumatic care. In the provision of atraumatic care, the separation of child from parents during hospitalization
c. Educational level of the child is minimized. The nurse should promote a sense of control for the child. Preventing and minimizing bodily
d. Number of responsible adults in the home injury and pain are major components of atraumatic care.
ANS: B PTS: 1 DIF: Cognitive Level: Understand REF: 9
The childs developmental stage determines the type of injury that is likely to occur. The childs physical health TOP: Integrated Process: Nursing Process: Implementation
may facilitate the childs recovery from an injury but does not impact the type of injury. Educational level is MSC: Area of Client Needs: Psychosocial Integrity
related to developmental level, but it is not as important as the childs developmental level in determining the
type of injury. The number of responsible adults in the home may affect the number of unintentional injuries, 11. Which is most suggestive that a nurse has a nontherapeutic relationship with a patient and family?
but the type of injury is related to the childs developmental stage. a. Staff is concerned about the nurses actions with the patient and family.
b. Staff assignments allow the nurse to care for same patient and family over an extended time.
PTS: 1 DIF: Cognitive Level: Understand REF: 3 c. Nurse is able to withdraw emotionally when emotional overload occurs but still remains committed.
TOP: Integrated Process: Nursing Process: Planning d. Nurse uses teaching skills to instruct patient and family rather than doing everything for them.
MSC: Area of Client Needs: Health Promotion and Maintenance
ANS: A
8. Which is now referred to as the new morbidity? An important clue to a nontherapeutic staff-patient relationship is concern of other staff members. Allowing
a. Limitations in the major activities of daily living the nurse to care for the same patient over time would be therapeutic for the patient and family. Nurses who are
,Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 5 Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 6
able to somewhat withdraw emotionally can protect themselves while providing therapeutic care. Nurses using b. Anxiety
teaching skills to instruct patient and family will assist in transitioning the child and family to self-care. c. Readiness for enhanced coping
d. Ineffective coping
PTS: 1 DIF: Cognitive Level: Analyze REF: 9
TOP: Integrated Process: Nursing Process: Assessment ANS: A
MSC: Area of Client Needs: Psychosocial Integrity A potential problem is categorized as a risk. The toddler has a risk to become anxious when the parents leave.
Nursing interventions will be geared toward reducing the risk. The child is not showing current anxiety or
12. Which is most descriptive of clinical reasoning? ineffective coping. The child is not at a point for readiness for enhanced coping, especially because the parents
a. A simple developmental process will be leaving.
b. Purposeful and goal-directed
c. Based on deliberate and irrational thought PTS: 1 DIF: Cognitive Level: Remember REF: 12
d. Assists individuals in guessing what is most appropriate TOP: Integrated Process: Nursing Process: Diagnosis
MSC: Area of Client Needs: Health Promotion and Maintenance
ANS: B
Clinical reasoning is a complex, developmental process based on rational and deliberate thought. Clinical 16. A child has a postoperative appendectomy incision covered by a dressing. The nurse has just completed a
reasoning is not a developmental process. Clinical reasoning is based on rational and deliberate thought. prescribed dressing change for this child. Which description is an accurate documentation of this procedure?
Clinical reasoning is not a guessing process. a. Dressing change to appendectomy incision completed, child tolerated procedure well, parent present
b. No complications noted during dressing change to appendectomy incision
PTS: 1 DIF: Cognitive Level: Understand REF: 12 c. Appendectomy incision non-reddened, sutures intact, no drainage noted on old dressing, new dressing
TOP: Integrated Process: Nursing Process: Planning applied, procedure tolerated well by child
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care d. No changes to appendectomy incisional area, dressing changed, child complained of pain during procedure,
new dressing clean, dry and intact
13. A nurse makes the decision to apply a topical anesthetic to a childs skin before drawing blood. Which
ethical principle is the nurse demonstrating? ANS: C
a. Autonomy The nurse should document assessments and reassessments. Appearance of the incision described in objective
b. Beneficence terms should be included during a dressing change. The nurse should document patients response and the
c. Justice outcomes of the care provided. In this example, these include drainage on the old dressing, the application of
d. Truthfulness the new dressing, and the childs response. The other statements partially fulfill the requirements of
documenting assessments and reassessments, patients response, and outcome, but do not include all three.
ANS: B
Beneficence is the obligation to promote the patients well-being. Applying a topical anesthetic before drawing PTS: 1 DIF: Cognitive Level: Analyze REF: 14
blood promotes reducing the discomfort of the venipuncture. Autonomy is the patients right to be self- TOP: Integrated Process: Nursing Process: Implementation
governing. Justice is the concept of fairness. Truthfulness is the concept of honesty. MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care
PTS: 1 DIF: Cognitive Level: Understand REF: 11 17. A nurse is planning a class on accident prevention for parents of toddlers. Which safety topic is the priority
TOP: Integrated Process: Nursing Process: Implementation for this class?
MSC: Area of Client Needs: Physiological Integrity a. Appropriate use of car seat restraints
b. Safety crossing the street
14. Which action by the nurse demonstrates use of evidence-based practice (EBP)? c. Helmet use when riding a bicycle
a. Gathering equipment for a procedure d. Poison control numbers
b. Documenting changes in a patients status
c. Questioning the use of daily central line dressing changes ANS: A
d. Clarifying a physicians prescription for morphine Motor vehicle accidents (MVAs) continue to be the most common cause of death in children older than 1 year,
therefore the priority topic is appropriate use of car seat restraints. Safety crossing the street and bicycle helmet
ANS: C use are topics that should be included for preschool parents but are not priorities for parents of toddlers.
The nurse who questions the daily central line dressing change is ascertaining whether clinical interventions Information about poison control is important for parents of toddlers and would be a safety topic to include but
result in positive outcomes for patients. This demonstrates evidence-based practice (EBP), which implies is not the priority over appropriate use of car seat restraints.
questioning why something is effective and whether a better approach exists. Gathering equipment for a
procedure and documenting changes in a patients status are practices that follow established guidelines. PTS: 1 DIF: Cognitive Level: Apply REF: 3
Clarifying a physicians prescription for morphine constitutes safe nursing care. TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance
PTS: 1 DIF: Cognitive Level: Apply REF: 11
TOP: Integrated Process: Nursing Process: Evaluation MULTIPLE RESPONSE
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care
1. Which behaviors by the nurse indicate a therapeutic relationship with children and families? (Select all that
15. A nurse is admitting a toddler to the hospital. The toddler is with both parents and is currently sitting apply.)
comfortably on a parents lap. The parents state they will need to leave for a brief period. Which type of nursing a. Spending off-duty time with children and families
diagnosis should the nurse formulate for this child? b. Asking questions if families are not participating in the care
a. Risk for anxiety c. Clarifying information for families
, Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 7 Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 8
d. Buying toys for a hospitalized child Chapter 02: Family, Social, Cultural, and Religious Influences on Child
e. Learning about the familys religious preferences
Health Promotion
ANS: B, C, E
Asking questions if families are not participating in the care, clarifying information for families, and learning MULTIPLE CHOICE
about the familys religious preferences are positive actions and foster therapeutic relationships with children
and families. Spending off-duty time with children and families and buying toys for a hospitalized child are 1. A nurse is selecting a family theory to assess a patients family dynamics. Which family theory best describes
negative actions and indicate overinvolvement with children and families, which is nontherapeutic. a series of tasks for the family throughout its life span?
a. Interactional theory
PTS: 1 DIF: Cognitive Level: Understand REF: 9 b. Developmental systems theory
TOP: Integrated Process: Nursing Process: Evaluation c. Structural-functional theory
MSC: Area of Client Needs: Psychosocial Integrity d. Duvalls developmental theory
ESSAY ANS: D
Duvalls developmental theory describes eight developmental tasks of the family throughout its life span.
1. A nurse is formulating a clinical question for evidence-based practice. Place in order Interactional theory and structural-functional theory are not family theories. Developmental systems theory is
the steps the nurse should use to clarify the scope of the problem and clinical topic of interest. Begin with the an outgrowth of Duvalls theory. The family is described as a small group, a semiclosed system of personalities
first step of the process and proceed ordering the steps ending with the final step of the process. Provide that interact with the larger cultural system. Changes do not occur in one part of the family without changes in
answer as lowercase letters separated by commas (e.g., a, b, c, d, e). others.
a. Intervention
b. Outcome PTS: 1 DIF: Cognitive Level: Understand REF: 16
c. Population TOP: Integrated Process: Nursing Process: Assessment
d. Time MSC: Area of Client Needs: Health Promotion and Maintenance
e. Control
2. Which family theory explains how families react to stressful events and suggests factors that promote
adaptation to these events?
ANS: a. Interactional theory
c, a, e, b, d b. Developmental systems theory
When formulating a clinical question for evidence-based practice, the nurse should follow a concise, organized c. Family stress theory
way that allows for clear answers. Good clinical questions should be asked in the PICOT (population, d. Duvalls developmental theory
intervention, control, outcome, time) format to assist with clarity and literature searching. PICOT questions
assist with clarifying the scope of the problem and clinical topic of interest. ANS: C
Family stress theory explains the reaction of families to stressful events. In addition, the theory helps suggest
PTS: 1 DIF: Cognitive Level: Understand REF: 11 factors that promote adaptation to the stress. Stressors, both positive and negative, are cumulative and affect
TOP: Integrated Process: Nursing Process: Assessment the family. Adaptation requires a change in family structure or interaction. Interactional theory is not a family
MSC: Area of Client Needs: Health Promotion and Maintenance theory. Interactions are the basis of general systems theory. Developmental systems theory is an outgrowth of
Duvalls theory. The family is described as a small group, a semiclosed system of personalities that interact
with the larger cultural system. Changes do not occur in one part of the family without changes in others.
Duvalls developmental theory describes eight developmental tasks of the family throughout its life span.
PTS: 1 DIF: Cognitive Level: Understand REF: 16
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance
3. Which is the term for a family in which the paternal grandmother, the parents, and two minor children live
together?
a. Blended
b. Nuclear
c. Binuclear
d. Extended
ANS: D
An extended family contains at least one parent, one or more children, and one or more members (related or
unrelated) other than a parent or sibling. A blended family contains at least one step-parent, step-sibling, or
half-sibling. The nuclear family consists of two parents and their children. No other relatives or nonrelatives
are present in the household. In binuclear families, parents continue the parenting role while terminating the
spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and
responsibilities for the minor child or children.
Table of Contents Chapter 01: Perspectives of Pediatric Nursing
Table of Contents 1 MULTIPLE CHOICE
Chapter 01: Perspectives of Pediatric Nursing 2
1. A nurse is planning a teaching session for parents of preschool children. Which statement explains why the
Chapter 02: Family, Social, Cultural, and Religious Influences on Child Health Promotion
nurse should include information about morbidity and mortality?
8 a. Life-span statistics are included in the data.
Chapter 03: Developmental and Genetic Influences on Child Health Promotion 22 b. It explains effectiveness of treatment.
Chapter 04: Communication and Physical Assessment of the Child 39 c. Cost-effective treatment is detailed for the general population.
Chapter 05: Pain Assessment and Management in Children 68 d. High-risk age groups for certain disorders or hazards are identified.
Chapter 06: Childhood Communicable and Infectious Diseases 77
Chapter 07: Health Promotion of the Newborn and Family 92 ANS: D
Chapter 08: Health Problems of Newborns 115 Analysis of morbidity and mortality data provides the parents with information about which groups of
Chapter 09: Health Promotion of the Infant and Family 137 individuals are at risk for which health problems. Life-span statistics is a part of the mortality data. Treatment
Chapter 10: Health Problems of Infants 148 modalities and cost are not included in morbidity and mortality data.
Chapter 11: Health Promotion of the Toddler and Family 157 PTS: 1 DIF: Cognitive Level: Apply REF: 6
Chapter 12: Health Promotion of the Preschooler and Family 168 TOP: Integrated Process: Nursing Process: Planning
Chapter 13: Health Problems of Toddlers and Preschoolers 175 MSC: Area of Client Needs: Health Promotion and Maintenance
Chapter 14: Health Promotion of the School-Age Child and Family 189
Chapter 15: Health Promotion of the Adolescent and Family 196 2. A clinic nurse is planning a teaching session about childhood obesity prevention for parents of school-age
Chapter 16: Health Problems of School-Age Children and Adolescents 203 children. The nurse should include which associated risk of obesity in the teaching plan?
Chapter 17: Quality of Life for Children Living with Chronic or Complex Diseases 216 a. Type I diabetes
Chapter 18: Impact of Cognitive or Sensory Impairment on the Child and Family 228 b. Respiratory disease
c. Celiac disease
Chapter 19: Family-Centered Care of the Child During Illness and Hospitalization 240
d. Type II diabetes
Chapter 20: Pediatric Variations of Nursing Interventions 253
Chapter 21: The Child with Respiratory Dysfunction 268 ANS: D
Chapter 22: The Child with Gastrointestinal Dysfunction 283 Childhood obesity has been associated with the rise of type II diabetes in children. Type I diabetes is not
Chapter 23: The Child with Cardiovascular Dysfunction 300 associated with obesity and has a genetic component. Respiratory disease is not associated with obesity, and
Chapter 24: The Child with Hematologic or Immunologic Dysfunction 314 celiac disease is the inability to metabolize gluten in foods and is not associated with obesity.
Chapter 25: The Child with Cancer 329
Chapter 26: The Child with Genitourinary Dysfunction 357 PTS: 1 DIF: Cognitive Level: Apply REF: 3
Chapter 27: The Child with Cerebral Dysfunction 369 TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance
Chapter 28: The Child with Endocrine Dysfunction 384
Chapter 29: The Child with Musculoskeletal or Articular Dysfunction 393 3. Which is the leading cause of death in infants younger than 1 year?
Chapter 30: The Child with Neuromuscular or Muscular Dysfunction 405 a. Congenital anomalies
b. Sudden infant death syndrome
c. Respiratory distress syndrome
d. Bacterial sepsis of the newborn
ANS: A
Congenital anomalies account for 20.1% of deaths in infants younger than 1 year. Sudden infant death
syndrome accounts for 8.2% of deaths in this age group. Respiratory distress syndrome accounts for 3.4% of
deaths in this age group. Infections specific to the perinatal period account for 2.7% of deaths in this age group.
PTS: 1 DIF: Cognitive Level: Remember REF: 7
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance
4. Which leading cause of death topic should the nurse emphasize to a group of African-American boys
ranging in ages 15 to 19 years?
a. Suicide
b. Cancer
c. Firearm homicide
d. Occupational injuries
ANS: C
,Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 3 Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 4
Firearm homicide is the second overall cause of death in this age group and the leading cause of death in b. Unintentional injuries that cause chronic health problems
African-American males. Suicide is the third-leading cause of death in this population. Cancer, although a c. Discoveries of new therapies to treat health problems
major health problem, is the fourth-leading cause of death in this age group. Occupational injuries do not d. Behavioral, social, and educational problems that alter health
contribute to a significant death rate for this age group.
ANS: D
PTS: 1 DIF: Cognitive Level: Understand REF: 5 The new morbidity reflects the behavioral, social, and educational problems that interfere with the childs social
TOP: Integrated Process: Nursing Process: Planning and academic development. It is currently estimated that the incidence of these issues is from 5% to 30%.
MSC: Area of Client Needs: Health Promotion and Maintenance Limitations in major activities of daily living and unintentional injuries that result in chronic health problems
are included in morbidity data. Discovery of new therapies would be reflected in changes in morbidity data
5. Which is the major cause of death for children older than 1 year? over time.
a. Cancer
b. Heart disease PTS: 1 DIF: Cognitive Level: Remember REF: 3
c. Unintentional injuries TOP: Integrated Process: Nursing Process: Assessment
d. Congenital anomalies MSC: Area of Client Needs: Health Promotion and Maintenance
ANS: C 9. A nurse on a pediatric unit is practicing family-centered care. Which is most descriptive of the care the nurse
Unintentional injuries (accidents) are the leading cause of death after age 1 year through adolescence. is delivering?
Congenital anomalies are the leading cause of death in those younger than 1 year. Cancer ranks either second a. Taking over total care of the child to reduce stress on the family
or fourth, depending on the age group, and heart disease ranks fifth in the majority of the age groups. b. Encouraging family dependence on health care systems
c. Recognizing that the family is the constant in a childs life
PTS: 1 DIF: Cognitive Level: Remember REF: 8 d. Excluding families from the decision-making process
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance ANS: C
The three key components of family-centered care are respect, collaboration, and support. Family-centered
6. Which is the leading cause of death from unintentional injuries for females ranging in age from 1 to 14? care recognizes the family as the constant in the childs life. Taking over total care does not include the family
a. Mechanical suffocation in the process and may increase stress instead of reducing stress. The family should be enabled and empowered
b. Drowning to work with the health care system. The family is expected to be part of the decision-making process.
c. Motorvehicle-related fatalities
d. Fire- and burn-related fatalities PTS: 1 DIF: Cognitive Level: Remember REF: 8
TOP: Integrated Process: Nursing Process: Implementation
ANS: C MSC: Area of Client Needs: Health Promotion and Maintenance
Motorvehicle-related fatalities are the leading cause of death for females ranging in age from 1 to 14, either as
passengers or as pedestrians. Mechanical suffocation is fourth or fifth, depending on the age. Drowning is the 10. The nurse is preparing an in-service education to staff about atraumatic care for pediatric patients. Which
second- or third-leading cause of death, depending on the age. Fire- and burn-related fatalities are the second- intervention should the nurse include?
leading cause of death. a. Prepare the child for separation from parents during hospitalization by reviewing a video.
b. Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal.
PTS: 1 DIF: Cognitive Level: Remember REF: 4 c. Help the child accept the loss of control associated with hospitalization.
TOP: Integrated Process: Nursing Process: Assessment d. Help the child accept pain that is connected with a treatment or procedure.
MSC: Area of Client Needs: Health Promotion and Maintenance
ANS: B
7. Which factor most impacts the type of injury a child is susceptible to, according to the childs age? Preparing the child for any unfamiliar treatments, controlling pain, allowing privacy, providing play activities
a. Physical health of the child for expression of fear and aggression, providing choices, and respecting cultural differences are components of
b. Developmental level of the child atraumatic care. In the provision of atraumatic care, the separation of child from parents during hospitalization
c. Educational level of the child is minimized. The nurse should promote a sense of control for the child. Preventing and minimizing bodily
d. Number of responsible adults in the home injury and pain are major components of atraumatic care.
ANS: B PTS: 1 DIF: Cognitive Level: Understand REF: 9
The childs developmental stage determines the type of injury that is likely to occur. The childs physical health TOP: Integrated Process: Nursing Process: Implementation
may facilitate the childs recovery from an injury but does not impact the type of injury. Educational level is MSC: Area of Client Needs: Psychosocial Integrity
related to developmental level, but it is not as important as the childs developmental level in determining the
type of injury. The number of responsible adults in the home may affect the number of unintentional injuries, 11. Which is most suggestive that a nurse has a nontherapeutic relationship with a patient and family?
but the type of injury is related to the childs developmental stage. a. Staff is concerned about the nurses actions with the patient and family.
b. Staff assignments allow the nurse to care for same patient and family over an extended time.
PTS: 1 DIF: Cognitive Level: Understand REF: 3 c. Nurse is able to withdraw emotionally when emotional overload occurs but still remains committed.
TOP: Integrated Process: Nursing Process: Planning d. Nurse uses teaching skills to instruct patient and family rather than doing everything for them.
MSC: Area of Client Needs: Health Promotion and Maintenance
ANS: A
8. Which is now referred to as the new morbidity? An important clue to a nontherapeutic staff-patient relationship is concern of other staff members. Allowing
a. Limitations in the major activities of daily living the nurse to care for the same patient over time would be therapeutic for the patient and family. Nurses who are
,Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 5 Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 6
able to somewhat withdraw emotionally can protect themselves while providing therapeutic care. Nurses using b. Anxiety
teaching skills to instruct patient and family will assist in transitioning the child and family to self-care. c. Readiness for enhanced coping
d. Ineffective coping
PTS: 1 DIF: Cognitive Level: Analyze REF: 9
TOP: Integrated Process: Nursing Process: Assessment ANS: A
MSC: Area of Client Needs: Psychosocial Integrity A potential problem is categorized as a risk. The toddler has a risk to become anxious when the parents leave.
Nursing interventions will be geared toward reducing the risk. The child is not showing current anxiety or
12. Which is most descriptive of clinical reasoning? ineffective coping. The child is not at a point for readiness for enhanced coping, especially because the parents
a. A simple developmental process will be leaving.
b. Purposeful and goal-directed
c. Based on deliberate and irrational thought PTS: 1 DIF: Cognitive Level: Remember REF: 12
d. Assists individuals in guessing what is most appropriate TOP: Integrated Process: Nursing Process: Diagnosis
MSC: Area of Client Needs: Health Promotion and Maintenance
ANS: B
Clinical reasoning is a complex, developmental process based on rational and deliberate thought. Clinical 16. A child has a postoperative appendectomy incision covered by a dressing. The nurse has just completed a
reasoning is not a developmental process. Clinical reasoning is based on rational and deliberate thought. prescribed dressing change for this child. Which description is an accurate documentation of this procedure?
Clinical reasoning is not a guessing process. a. Dressing change to appendectomy incision completed, child tolerated procedure well, parent present
b. No complications noted during dressing change to appendectomy incision
PTS: 1 DIF: Cognitive Level: Understand REF: 12 c. Appendectomy incision non-reddened, sutures intact, no drainage noted on old dressing, new dressing
TOP: Integrated Process: Nursing Process: Planning applied, procedure tolerated well by child
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care d. No changes to appendectomy incisional area, dressing changed, child complained of pain during procedure,
new dressing clean, dry and intact
13. A nurse makes the decision to apply a topical anesthetic to a childs skin before drawing blood. Which
ethical principle is the nurse demonstrating? ANS: C
a. Autonomy The nurse should document assessments and reassessments. Appearance of the incision described in objective
b. Beneficence terms should be included during a dressing change. The nurse should document patients response and the
c. Justice outcomes of the care provided. In this example, these include drainage on the old dressing, the application of
d. Truthfulness the new dressing, and the childs response. The other statements partially fulfill the requirements of
documenting assessments and reassessments, patients response, and outcome, but do not include all three.
ANS: B
Beneficence is the obligation to promote the patients well-being. Applying a topical anesthetic before drawing PTS: 1 DIF: Cognitive Level: Analyze REF: 14
blood promotes reducing the discomfort of the venipuncture. Autonomy is the patients right to be self- TOP: Integrated Process: Nursing Process: Implementation
governing. Justice is the concept of fairness. Truthfulness is the concept of honesty. MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care
PTS: 1 DIF: Cognitive Level: Understand REF: 11 17. A nurse is planning a class on accident prevention for parents of toddlers. Which safety topic is the priority
TOP: Integrated Process: Nursing Process: Implementation for this class?
MSC: Area of Client Needs: Physiological Integrity a. Appropriate use of car seat restraints
b. Safety crossing the street
14. Which action by the nurse demonstrates use of evidence-based practice (EBP)? c. Helmet use when riding a bicycle
a. Gathering equipment for a procedure d. Poison control numbers
b. Documenting changes in a patients status
c. Questioning the use of daily central line dressing changes ANS: A
d. Clarifying a physicians prescription for morphine Motor vehicle accidents (MVAs) continue to be the most common cause of death in children older than 1 year,
therefore the priority topic is appropriate use of car seat restraints. Safety crossing the street and bicycle helmet
ANS: C use are topics that should be included for preschool parents but are not priorities for parents of toddlers.
The nurse who questions the daily central line dressing change is ascertaining whether clinical interventions Information about poison control is important for parents of toddlers and would be a safety topic to include but
result in positive outcomes for patients. This demonstrates evidence-based practice (EBP), which implies is not the priority over appropriate use of car seat restraints.
questioning why something is effective and whether a better approach exists. Gathering equipment for a
procedure and documenting changes in a patients status are practices that follow established guidelines. PTS: 1 DIF: Cognitive Level: Apply REF: 3
Clarifying a physicians prescription for morphine constitutes safe nursing care. TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Health Promotion and Maintenance
PTS: 1 DIF: Cognitive Level: Apply REF: 11
TOP: Integrated Process: Nursing Process: Evaluation MULTIPLE RESPONSE
MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care
1. Which behaviors by the nurse indicate a therapeutic relationship with children and families? (Select all that
15. A nurse is admitting a toddler to the hospital. The toddler is with both parents and is currently sitting apply.)
comfortably on a parents lap. The parents state they will need to leave for a brief period. Which type of nursing a. Spending off-duty time with children and families
diagnosis should the nurse formulate for this child? b. Asking questions if families are not participating in the care
a. Risk for anxiety c. Clarifying information for families
, Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 7 Test Bank - Wong's Essentials of Pediatric Nursing (10th Edition by Hockenberry) 8
d. Buying toys for a hospitalized child Chapter 02: Family, Social, Cultural, and Religious Influences on Child
e. Learning about the familys religious preferences
Health Promotion
ANS: B, C, E
Asking questions if families are not participating in the care, clarifying information for families, and learning MULTIPLE CHOICE
about the familys religious preferences are positive actions and foster therapeutic relationships with children
and families. Spending off-duty time with children and families and buying toys for a hospitalized child are 1. A nurse is selecting a family theory to assess a patients family dynamics. Which family theory best describes
negative actions and indicate overinvolvement with children and families, which is nontherapeutic. a series of tasks for the family throughout its life span?
a. Interactional theory
PTS: 1 DIF: Cognitive Level: Understand REF: 9 b. Developmental systems theory
TOP: Integrated Process: Nursing Process: Evaluation c. Structural-functional theory
MSC: Area of Client Needs: Psychosocial Integrity d. Duvalls developmental theory
ESSAY ANS: D
Duvalls developmental theory describes eight developmental tasks of the family throughout its life span.
1. A nurse is formulating a clinical question for evidence-based practice. Place in order Interactional theory and structural-functional theory are not family theories. Developmental systems theory is
the steps the nurse should use to clarify the scope of the problem and clinical topic of interest. Begin with the an outgrowth of Duvalls theory. The family is described as a small group, a semiclosed system of personalities
first step of the process and proceed ordering the steps ending with the final step of the process. Provide that interact with the larger cultural system. Changes do not occur in one part of the family without changes in
answer as lowercase letters separated by commas (e.g., a, b, c, d, e). others.
a. Intervention
b. Outcome PTS: 1 DIF: Cognitive Level: Understand REF: 16
c. Population TOP: Integrated Process: Nursing Process: Assessment
d. Time MSC: Area of Client Needs: Health Promotion and Maintenance
e. Control
2. Which family theory explains how families react to stressful events and suggests factors that promote
adaptation to these events?
ANS: a. Interactional theory
c, a, e, b, d b. Developmental systems theory
When formulating a clinical question for evidence-based practice, the nurse should follow a concise, organized c. Family stress theory
way that allows for clear answers. Good clinical questions should be asked in the PICOT (population, d. Duvalls developmental theory
intervention, control, outcome, time) format to assist with clarity and literature searching. PICOT questions
assist with clarifying the scope of the problem and clinical topic of interest. ANS: C
Family stress theory explains the reaction of families to stressful events. In addition, the theory helps suggest
PTS: 1 DIF: Cognitive Level: Understand REF: 11 factors that promote adaptation to the stress. Stressors, both positive and negative, are cumulative and affect
TOP: Integrated Process: Nursing Process: Assessment the family. Adaptation requires a change in family structure or interaction. Interactional theory is not a family
MSC: Area of Client Needs: Health Promotion and Maintenance theory. Interactions are the basis of general systems theory. Developmental systems theory is an outgrowth of
Duvalls theory. The family is described as a small group, a semiclosed system of personalities that interact
with the larger cultural system. Changes do not occur in one part of the family without changes in others.
Duvalls developmental theory describes eight developmental tasks of the family throughout its life span.
PTS: 1 DIF: Cognitive Level: Understand REF: 16
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance
3. Which is the term for a family in which the paternal grandmother, the parents, and two minor children live
together?
a. Blended
b. Nuclear
c. Binuclear
d. Extended
ANS: D
An extended family contains at least one parent, one or more children, and one or more members (related or
unrelated) other than a parent or sibling. A blended family contains at least one step-parent, step-sibling, or
half-sibling. The nuclear family consists of two parents and their children. No other relatives or nonrelatives
are present in the household. In binuclear families, parents continue the parenting role while terminating the
spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and
responsibilities for the minor child or children.
