Wong’s Nursing Care of Infants and Children, 12th Edition —
Chapter 1: Perspectives of Pediatric Nursing.
1. Chapter 1 – Perspectives of Pediatric Nursing
Key Concept: Family-centered care; atraumatic care
Question Stem: A hospitalized 4-year-old is anxious during
dressing change. Which nursing action best reflects atraumatic,
family-centered care? (≤65 words)
A. Ask parents to wait outside to reduce distractions.
B. Provide age-appropriate explanation and allow parent to
hold child.
C. Restrain the child to prevent movement and speed
procedure.
D. Perform the dressing quickly without explanation.
Correct Answer: B
Rationale (Correct): Providing age-appropriate explanation and
parental presence reduces stress and supports family-centered,
atraumatic care. Wong: Chapter 1 — Perspectives of Pediatric
Nursing; Family-centered and atraumatic care sections.
Incorrect: A — Excluding parents increases child distress;
family-centered care encourages involvement. C — Restraint
causes trauma and is last resort. D — Lack of explanation
increases fear and reduces cooperation.
Teaching Point: Atraumatic care minimizes physical and
psychological stress through family involvement.
, 2. Chapter 2 – Family, Social, Cultural, and Religious
Influences on Child Health Promotion
Key Concept: Cultural competence in care planning
Question Stem: A nurse caring for a child whose family declines
a blood transfusion for religious reasons should first: (≤65
words)
A. Administer the transfusion because it’s life-saving.
B. Document refusal and proceed with another provider’s order.
C. Explore family’s beliefs and discuss alternatives and risks.
D. Contact child protective services immediately.
Correct Answer: C
Rationale (Correct): Ethical, legal, and culturally competent care
begins with exploring beliefs, providing information about
risks/alternatives, and shared decision-making. Wong: Chapter
2 — Family, Social, Cultural, and Religious Influences.
Incorrect: A — Violates informed consent and family rights. B —
Documentation alone is insufficient. D — CPS is reserved for
harm or neglect after informed options exhausted.
Teaching Point: Respectful exploration of beliefs enables shared
decisions and safer alternatives.
3. Chapter 4 – Communication and Physical Assessment of
the Child and Family
Key Concept: Developmentally appropriate assessment
techniques
,Question Stem: During a toddler well visit, which technique is
best to assess heart and lung sounds? (≤65 words)
A. Begin with auscultation while child sits on parent’s lap, using
play to introduce stethoscope.
B. Force the child to lie supine alone for a full exam.
C. Skip auscultation to avoid distress.
D. Ask the parent to hold the child down for a quick exam.
Correct Answer: A
Rationale (Correct): Using play and parent support facilitates
cooperation and accurate assessment. Wong: Chapter 4 —
Communication and Physical Assessment.
Incorrect: B — Forcing separation is traumatic. C — Omitting
essential assessment risks missed findings. D — Holding down is
traumatic and unnecessary.
Teaching Point: Use play and parental support for accurate,
atraumatic pediatric assessments.
4. Chapter 5 – Pain Assessment in Children
Key Concept: Pain assessment tools matched to
developmental level
Question Stem: A nonverbal 8-month-old postoperative infant
is fussy, with increased HR and decreased O₂ sats. Best pain
assessment approach? (≤65 words)
, A. Assume crying equals pain and give opioid.
B. Use FLACC behavioral pain scale and physiologic indicators to
guide management.
C. Wait until infant can self-report.
D. Give acetaminophen only.
Correct Answer: B
Rationale (Correct): Behavioral scales (FLACC) plus physiologic
signs guide assessment and analgesia in nonverbal infants.
Wong: Chapter 5 — Pain Assessment in Children.
Incorrect: A — Crying is nonspecific; assessment should be
structured. C — Waiting delays relief. D — Acetaminophen may
be insufficient for moderate-severe postoperative pain.
Teaching Point: Use validated behavioral and physiologic
measures for infant pain assessment.
5. Chapter 7 – Health Promotion of the Newborn and Family
Key Concept: Safe sleep to reduce SIDS risk
Question Stem: Which caregiver teaching best reduces SIDS risk
in a 2-month-old? (≤65 words)
A. Place infant prone with a soft pillow for comfort.
B. Place infant supine on a firm mattress, no bedding or soft
objects.
C. Share bed with infant to facilitate feeding.
D. Use crib bumper pads to prevent drafts.
Chapter 1: Perspectives of Pediatric Nursing.
1. Chapter 1 – Perspectives of Pediatric Nursing
Key Concept: Family-centered care; atraumatic care
Question Stem: A hospitalized 4-year-old is anxious during
dressing change. Which nursing action best reflects atraumatic,
family-centered care? (≤65 words)
A. Ask parents to wait outside to reduce distractions.
B. Provide age-appropriate explanation and allow parent to
hold child.
C. Restrain the child to prevent movement and speed
procedure.
D. Perform the dressing quickly without explanation.
Correct Answer: B
Rationale (Correct): Providing age-appropriate explanation and
parental presence reduces stress and supports family-centered,
atraumatic care. Wong: Chapter 1 — Perspectives of Pediatric
Nursing; Family-centered and atraumatic care sections.
Incorrect: A — Excluding parents increases child distress;
family-centered care encourages involvement. C — Restraint
causes trauma and is last resort. D — Lack of explanation
increases fear and reduces cooperation.
Teaching Point: Atraumatic care minimizes physical and
psychological stress through family involvement.
, 2. Chapter 2 – Family, Social, Cultural, and Religious
Influences on Child Health Promotion
Key Concept: Cultural competence in care planning
Question Stem: A nurse caring for a child whose family declines
a blood transfusion for religious reasons should first: (≤65
words)
A. Administer the transfusion because it’s life-saving.
B. Document refusal and proceed with another provider’s order.
C. Explore family’s beliefs and discuss alternatives and risks.
D. Contact child protective services immediately.
Correct Answer: C
Rationale (Correct): Ethical, legal, and culturally competent care
begins with exploring beliefs, providing information about
risks/alternatives, and shared decision-making. Wong: Chapter
2 — Family, Social, Cultural, and Religious Influences.
Incorrect: A — Violates informed consent and family rights. B —
Documentation alone is insufficient. D — CPS is reserved for
harm or neglect after informed options exhausted.
Teaching Point: Respectful exploration of beliefs enables shared
decisions and safer alternatives.
3. Chapter 4 – Communication and Physical Assessment of
the Child and Family
Key Concept: Developmentally appropriate assessment
techniques
,Question Stem: During a toddler well visit, which technique is
best to assess heart and lung sounds? (≤65 words)
A. Begin with auscultation while child sits on parent’s lap, using
play to introduce stethoscope.
B. Force the child to lie supine alone for a full exam.
C. Skip auscultation to avoid distress.
D. Ask the parent to hold the child down for a quick exam.
Correct Answer: A
Rationale (Correct): Using play and parent support facilitates
cooperation and accurate assessment. Wong: Chapter 4 —
Communication and Physical Assessment.
Incorrect: B — Forcing separation is traumatic. C — Omitting
essential assessment risks missed findings. D — Holding down is
traumatic and unnecessary.
Teaching Point: Use play and parental support for accurate,
atraumatic pediatric assessments.
4. Chapter 5 – Pain Assessment in Children
Key Concept: Pain assessment tools matched to
developmental level
Question Stem: A nonverbal 8-month-old postoperative infant
is fussy, with increased HR and decreased O₂ sats. Best pain
assessment approach? (≤65 words)
, A. Assume crying equals pain and give opioid.
B. Use FLACC behavioral pain scale and physiologic indicators to
guide management.
C. Wait until infant can self-report.
D. Give acetaminophen only.
Correct Answer: B
Rationale (Correct): Behavioral scales (FLACC) plus physiologic
signs guide assessment and analgesia in nonverbal infants.
Wong: Chapter 5 — Pain Assessment in Children.
Incorrect: A — Crying is nonspecific; assessment should be
structured. C — Waiting delays relief. D — Acetaminophen may
be insufficient for moderate-severe postoperative pain.
Teaching Point: Use validated behavioral and physiologic
measures for infant pain assessment.
5. Chapter 7 – Health Promotion of the Newborn and Family
Key Concept: Safe sleep to reduce SIDS risk
Question Stem: Which caregiver teaching best reduces SIDS risk
in a 2-month-old? (≤65 words)
A. Place infant prone with a soft pillow for comfort.
B. Place infant supine on a firm mattress, no bedding or soft
objects.
C. Share bed with infant to facilitate feeding.
D. Use crib bumper pads to prevent drafts.
