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Exam (elaborations)

Variations of Nursing Interventions.

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Variations of Nursing Interventions.

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Variations of Nursing Interventions
|Pediatric Exam Questions and Correct
Answers 2023 (A Graded)
Chapter 45: Pediatric Variations of Nursing
Interventions - ...
... - 1. What should the nurse consider when having consent forms signed for surgery
and procedures on children?

a. - Only a parent or legal guardian can give consent.

b. - The person giving consent must be at least 18 years old.

c. - The risks and benefits of a procedure are part of the consent process.

d. - A mental age of 7 years or older is required for a consent to be considered
"informed."

ANS: - C

The informed consent must include the nature of the procedure, benefits and risks, and
alternatives to the procedure. In special circumstances such as emancipated minors,
the consent can be given by someone younger than 18 years without the parent or legal
guardian. A mental age of 7 years is too young for consent to be informed. - ...

PTS: - 1 DIF: Cognitive Level: Comprehension REF: 1245

OBJ: - Client Needs: Safe and Effective Care Environment

TOP: - Nursing Process: Planning

... - 2. The nurse is planning how to prepare a 4-year-old child for some diagnostic
procedures. Guidelines for preparing this preschooler should include to:

a. - Plan for a short teaching session of about 30 minutes.

b. - Tell the child that procedures are never a form of punishment.

c. - Keep equipment out of the child's view.

,d. - Use correct scientific and medical terminology in explanations.

ANS: - B

Illness and hospitalization may be viewed as punishment in preschoolers. Always state
directly that procedures are never a form of punishment. Teaching sessions for this age
group should be 10 to 15 minutes in length. Demonstrate the use of equipment and
allow the child to play with miniature or actual equipment. Explain the procedure in
simple terms and how it affects the child. - ...

PTS: - 1 DIF: Cognitive Level: Application REF: 1248

OBJ: - Client Needs: Health Promotion and Maintenance

TOP: - Nursing Process: Implementation

... - 3. Katie, 4 years old, is admitted to outpatient surgery for removal of a cyst on her
foot. Her mother puts the hospital gown on her, but Katie is crying because she wants to
leave on her underpants. The most appropriate nursing action is to:

a. - Allow her to wear her underpants.

b. - Discuss with her mother why this is important to Katie.

c. - Ask her mother to explain to her why she cannot wear them.

d. - Explain in a kind, matter-of-fact manner that this is hospital policy.

ANS: - A

It is appropriate for the child to leave her underpants on. This allows her some measure
of control during the foot surgery. The mother should not be required to make the child
more upset. Katie is too young to understand what hospital policy means. - ...

PTS: - 1 DIF: Cognitive Level: Application REF: 1249

OBJ: - Client Needs: Health Promotion and Maintenance

TOP: - Nursing Process: Implementation

... - 4. Using knowledge of child development, the best approach when preparing a
toddler for a procedure is to:

a. - Avoid asking the child to make choices.

b. - Demonstrate the procedure on a doll.

,c. - Plan for the teaching session to last about 20 minutes.

d. - Show necessary equipment without allowing child to handle it.

ANS: - B

Prepare toddlers for procedures by using play. Demonstrate on a doll, but avoid the
child's favorite doll because the toddler may think the doll is really "feeling" the
procedure. In preparing a toddler for a procedure, the child is allowed to participate in
care and help whenever possible. Teaching sessions for toddlers should be about 5 to
10 minutes. Use a small replica of the equipment and allow the child to handle it. - ...

PTS: - 1 DIF: Cognitive Level: Application REF: 1248

OBJ: - Client Needs: Health Promotion and Maintenance

TOP: - Nursing Process: Planning

... - 5. The nurse is preparing a 12-year-old girl for a bone marrow aspiration. She tells
the nurse that she wants her mother with her "like before." The most appropriate
nursing action is to:

a. - Grant her request.

b. - Explain why this is not possible.

c. - Identify an appropriate substitute for her mother.

d. - Offer to provide support to her during the procedure.

ANS: - A

The parents' preferences for assisting, observing, or waiting outside the room should be
assessed, as well as the child's preference for parental presence. The child's choice
should be respected. If the mother and child are agreeable, the mother is welcome to
stay. An appropriate substitute for the mother is necessary only if the mother does not
wish to stay. Support is offered to the child regardless of parental presence. - ...

PTS: - 1 DIF: Cognitive Level: Application REF: 1249

OBJ: - Client Needs: Health Promotion and Maintenance

TOP: - Nursing Process: Implementation

, ... - 6. The emergency department nurse is cleaning multiple facial abrasions on 9-year-
old Mike. His mother is present. He is crying and screaming loudly. The nurse should:

a. - Ask him to be quieter.

b. - Have his mother tell him to relax.

c. - Tell him it is okay to cry and scream.

d. - Suggest that he talk to his mother instead of crying.

ANS: - C

The child should be allowed to express feelings of anger, anxiety, fear, frustration, or
any other emotion. The child needs to know that it is all right to cry. There is no reason
for him to be quieter. He is too upset and needs to be able to express his feelings. - ...

PTS: - 1 DIF: Cognitive Level: Application REF: 1250

OBJ: - Client Needs: Health Promotion and Maintenance

TOP: - Nursing Process: Implementation

... - 7. In some genetically susceptible children anesthetic agents can trigger malignant
hyperthermia. The nurse should be alert in observing that, in addition to an increased
temperature, an early sign of this disorder is:

a. - Apnea. c. Muscle rigidity.

b. - Bradycardia. d. Decreased blood pressure.

ANS: - C

Early signs of malignant hyperthermia include tachycardia, increasing blood pressure,
tachypnea, mottled skin, and muscle rigidity. Apnea is not a sign of malignant
hyperthermia. Tachycardia, not bradycardia, is an early sign of malignant hyperthermia.
Increased, not decreased, blood pressure is characteristic of malignant hyperthermia. -
...

PTS: - 1 DIF: Cognitive Level: Comprehension REF: 1253

OBJ: - Client Needs: Physiologic Integrity TOP: Nursing Process: Assessment

... - 8. The nurse is caring for an unconscious child. Skin care should include:

a. - Avoiding use of pressure reduction on the bed.

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