,Chapter 1. Issues and Trends in Pediatric Nursing
MULTIPLE CHOICE
1. A nurse is reviewing changes in healthcare delivery and funding for pediatric populations. Which current trend in the
pediatric setting should the nurse expect to find?
a. Increased hospitalization of children
b. Decreased number of uninsured children
c. An increase in ambulatory care
d. Decreased use of managed care
ANS: C
One effect of managed care is that pediatric healthcare delivery has shifted dramatically from the acute care setting to
the ambulatory setting. The number of hospital beds being used has decreased as more care is provided in outpatient
and home settings. The number of uninsured children in the United States continues to grow. One of the biggest
changes in healthcare has been the growth of managed care.
DIF: Cognitive Level: Comprehension REF: p. 3
OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment
2. A nurse is referring a low-income family with three children under the age of 5 years to a program that assists with
supplemental food supplies. Which program should the nurse refer this family to?
a. Medicaid
b. Medicare
c. Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program
d. Women, Infants, and Children (WIC) program
ANS: D
,WIC is a federal program that provides supplemental food supplies to low-income women who are pregnant or breast-
feeding and to their children until the age of 5 years. Medicaid and the Medicaid Early and Periodic Screening,
Diagnostic, and Treatment (EPSDT) program provides for well-child examinations and related treatment of medical
problems. Children in the WIC program are often referred for immunizations, but that is not the primary focus of the
program. Public Law 99-457 provides financial incentives to states to establish comprehensive early intervention services
for infants and toddlers with, or at risk for, developmental disabilities.
Medicare is the program for Senior Citizens. DIF: Cognitive Level: Application REF: p. 7 OBJ: Nursing Process Step:
Implementation MSC: Health Promotion and Maintenance
3. In most states, adolescents who are not emancipated minors must have parental permission before:
a. treatment for drug abuse.
b. treatment for sexually transmitted diseases (STDs).
c. obtaining birth control.
d. surgery.
ANS: D
An emancipated minor is a minor child who has the legal competence of an adult. Legal counsel may be consulted to
verify the status of the emancipated minor for consent purposes. Most states allow minors to obtain treatment for drug
or alcohol abuse and STDs and allow access to birth control without parental consent.
DIF: Cognitive Level: Application REF: p. 12
OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment
4. A nurse is completing a clinical pathway for a child admitted to the hospital with pneumonia. Which
characteristic of a clinical pathway is correct?
a. Developed and implemented by nurses
b. Used primarily in the pediatric setting
c. Specific time lines for sequencing interventions
d. One of the steps in the nursing process
, ANS: C
Clinical pathways measure outcomes of client care and are developed by multiple healthcare professionals. Each
pathway outlines specific time lines for sequencing interventions and reflects interdisciplinary interventions. Clinical
pathways are used in multiple settings and for clients throughout the life span. The steps of the nursing process are
assessment, diagnosis, planning, implementation, and evaluation.
DIF: Cognitive Level: Comprehension REF: p. 6
OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment
5. When planning a parenting class, the nurse should explain that the leading cause of death in children 1 to 4
years of age in the United States is:
a. premature birth.
b. congenital anomalies.
c. accidental death.
d. respiratory tract illness.
ANS: C
Accidents are the leading cause of death in children ages 1 to 19 years. Disorders of short gestation and unspecified
low birth weight make up one of the leading causes of death in neonates. One of the leading causes of infant death
after the first month of life is congenital anomalies. Respiratory tract illnesses are a major cause of morbidity in children.
DIF: Cognitive Level: Application REF: p. 9 OBJ: Nursing Process Step: Implementation MSC: Safe and Effective Care
Environment
6. Which statement is true regarding the quality assurance or incident report?
a. The report assures the legal department that there is no problem.
b. Reports are a permanent part of the clients chart.
MULTIPLE CHOICE
1. A nurse is reviewing changes in healthcare delivery and funding for pediatric populations. Which current trend in the
pediatric setting should the nurse expect to find?
a. Increased hospitalization of children
b. Decreased number of uninsured children
c. An increase in ambulatory care
d. Decreased use of managed care
ANS: C
One effect of managed care is that pediatric healthcare delivery has shifted dramatically from the acute care setting to
the ambulatory setting. The number of hospital beds being used has decreased as more care is provided in outpatient
and home settings. The number of uninsured children in the United States continues to grow. One of the biggest
changes in healthcare has been the growth of managed care.
DIF: Cognitive Level: Comprehension REF: p. 3
OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment
2. A nurse is referring a low-income family with three children under the age of 5 years to a program that assists with
supplemental food supplies. Which program should the nurse refer this family to?
a. Medicaid
b. Medicare
c. Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program
d. Women, Infants, and Children (WIC) program
ANS: D
,WIC is a federal program that provides supplemental food supplies to low-income women who are pregnant or breast-
feeding and to their children until the age of 5 years. Medicaid and the Medicaid Early and Periodic Screening,
Diagnostic, and Treatment (EPSDT) program provides for well-child examinations and related treatment of medical
problems. Children in the WIC program are often referred for immunizations, but that is not the primary focus of the
program. Public Law 99-457 provides financial incentives to states to establish comprehensive early intervention services
for infants and toddlers with, or at risk for, developmental disabilities.
Medicare is the program for Senior Citizens. DIF: Cognitive Level: Application REF: p. 7 OBJ: Nursing Process Step:
Implementation MSC: Health Promotion and Maintenance
3. In most states, adolescents who are not emancipated minors must have parental permission before:
a. treatment for drug abuse.
b. treatment for sexually transmitted diseases (STDs).
c. obtaining birth control.
d. surgery.
ANS: D
An emancipated minor is a minor child who has the legal competence of an adult. Legal counsel may be consulted to
verify the status of the emancipated minor for consent purposes. Most states allow minors to obtain treatment for drug
or alcohol abuse and STDs and allow access to birth control without parental consent.
DIF: Cognitive Level: Application REF: p. 12
OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment
4. A nurse is completing a clinical pathway for a child admitted to the hospital with pneumonia. Which
characteristic of a clinical pathway is correct?
a. Developed and implemented by nurses
b. Used primarily in the pediatric setting
c. Specific time lines for sequencing interventions
d. One of the steps in the nursing process
, ANS: C
Clinical pathways measure outcomes of client care and are developed by multiple healthcare professionals. Each
pathway outlines specific time lines for sequencing interventions and reflects interdisciplinary interventions. Clinical
pathways are used in multiple settings and for clients throughout the life span. The steps of the nursing process are
assessment, diagnosis, planning, implementation, and evaluation.
DIF: Cognitive Level: Comprehension REF: p. 6
OBJ: Nursing Process Step: Planning MSC: Safe and Effective Care Environment
5. When planning a parenting class, the nurse should explain that the leading cause of death in children 1 to 4
years of age in the United States is:
a. premature birth.
b. congenital anomalies.
c. accidental death.
d. respiratory tract illness.
ANS: C
Accidents are the leading cause of death in children ages 1 to 19 years. Disorders of short gestation and unspecified
low birth weight make up one of the leading causes of death in neonates. One of the leading causes of infant death
after the first month of life is congenital anomalies. Respiratory tract illnesses are a major cause of morbidity in children.
DIF: Cognitive Level: Application REF: p. 9 OBJ: Nursing Process Step: Implementation MSC: Safe and Effective Care
Environment
6. Which statement is true regarding the quality assurance or incident report?
a. The report assures the legal department that there is no problem.
b. Reports are a permanent part of the clients chart.
