Wong’s Nursing Care of Infants and Children, 12th Edition —
Chapter 1: Perspectives of Pediatric Nursing.
1. Chapter 1 – Perspectives of Pediatric Nursing, Health Care
for Children
Subtopic: Infant Mortality
Question Stem
A 22-year-old primipara asks the nurse why the U.S. ranks
below most OECD nations in infant mortality despite high per-
capita health spending. Which single factor is the principal
driver of this disparity?
A. Congenital malformations
B. Preterm-related conditions
C. Unintentional injuries
D. Vaccine-preventable infections
Correct Answer: B. Preterm-related conditions
Rationales
Correct: Wong (Ch 1, “Infant Mortality”) cites preterm birth &
low birth weight as the leading U.S. cause, accounting for ≈65 %
of infant deaths <1 yr; survival lags behind nations with better
prenatal access.
Incorrect:
A—Malformations are #2, but rates are similar globally.
C—Injuries affect toddlers more than infants and have low
mortality <1 yr.
,D—Vaccine coverage is high; outbreaks rarely contribute to
neonatal death.
Teaching Point
Preterm birth is the #1 modifiable target to lower U.S. infant
mortality.
2. Chapter 1 – Health Promotion
Subtopic: Disease Prevention & Health Promotion
Question Stem
A public-health nurse is planning a primary prevention program
for 4-year-olds. Which intervention best exemplates primary
prevention?
A. Screening vision with a Snellen chart
B. Administering measles-mumps-rubella (MMR) vaccine
C. Providing albuterol for exercise-induced wheeze
D. Applying a cast after a forearm fracture
Correct Answer: B. Administering measles-mumps-rubella
(MMR) vaccine
Rationales
Correct: Vaccination prevents disease onset—classic primary
prevention (Wong Ch 1, “Levels of Prevention”).
Incorrect:
A—Vision screening is secondary (early detection).
C—Rescue medication is tertiary (limiting disability).
D—Fracture treatment is tertiary.
,Teaching Point
Primary prevention = keep disease from ever occurring.
3. Chapter 1 – Development
Subtopic: Developmentally Appropriate Health Teaching
Question Stem
The nurse prepares to teach a 5-year-old about wearing a
bicycle helmet. Which teaching strategy aligns with the child’s
cognitive stage?
A. Show a 10-minute statistical video on head injuries
B. Explain the physics of momentum and cranial impact
C. Allow the child to decorate a helmet sticker chart
D. Quote hospital cost data for ICU admissions
Correct Answer: C. Allow the child to decorate a helmet sticker
chart
Rationales
Correct: Pre-operational children (2–7 yr) learn through
concrete, play-based activities; sticker charts provide tactile
reinforcement (Wong Ch 1, “Development & Teaching”).
Incorrect:
A/B—Abstract stats and physics exceed pre-operational
cognition.
D—Financial data is irrelevant to a 5-year-old’s thinking.
Teaching Point
Match teaching modality to Piagetian stage.
, 4. Chapter 1 – Nutrition
Subtopic: Obesity & Type 2 Diabetes
Question Stem
A 10-year-old BMI ≥95th percentile drinks 20 oz soda daily.
Which pathophysiologic mechanism most directly links this
habit to type 2 diabetes risk?
A. High fructose load ↑ hepatic LDL production
B. Sucrose spikes post-prandial insulin, promoting insulin
resistance
C. Caffeine content raises systolic BP
D. Carbonic acid erodes dental enamel
Correct Answer: B. Sucrose spikes post-prandial insulin,
promoting insulin resistance
Rationales
Correct: Wong (Ch 1, “Obesity & T2DM”) notes repeated
glycemic surges exhaust β-cells → insulin resistance.
Incorrect:
A—LDL ↑ is atherogenic but not the primary diabetes pathway.
C—BP effect is cardiovascular, not glucose.
D—Dental erosion is an oral-health issue.
Teaching Point
Repeated soda-related insulin spikes accelerate T2DM onset.
Chapter 1: Perspectives of Pediatric Nursing.
1. Chapter 1 – Perspectives of Pediatric Nursing, Health Care
for Children
Subtopic: Infant Mortality
Question Stem
A 22-year-old primipara asks the nurse why the U.S. ranks
below most OECD nations in infant mortality despite high per-
capita health spending. Which single factor is the principal
driver of this disparity?
A. Congenital malformations
B. Preterm-related conditions
C. Unintentional injuries
D. Vaccine-preventable infections
Correct Answer: B. Preterm-related conditions
Rationales
Correct: Wong (Ch 1, “Infant Mortality”) cites preterm birth &
low birth weight as the leading U.S. cause, accounting for ≈65 %
of infant deaths <1 yr; survival lags behind nations with better
prenatal access.
Incorrect:
A—Malformations are #2, but rates are similar globally.
C—Injuries affect toddlers more than infants and have low
mortality <1 yr.
,D—Vaccine coverage is high; outbreaks rarely contribute to
neonatal death.
Teaching Point
Preterm birth is the #1 modifiable target to lower U.S. infant
mortality.
2. Chapter 1 – Health Promotion
Subtopic: Disease Prevention & Health Promotion
Question Stem
A public-health nurse is planning a primary prevention program
for 4-year-olds. Which intervention best exemplates primary
prevention?
A. Screening vision with a Snellen chart
B. Administering measles-mumps-rubella (MMR) vaccine
C. Providing albuterol for exercise-induced wheeze
D. Applying a cast after a forearm fracture
Correct Answer: B. Administering measles-mumps-rubella
(MMR) vaccine
Rationales
Correct: Vaccination prevents disease onset—classic primary
prevention (Wong Ch 1, “Levels of Prevention”).
Incorrect:
A—Vision screening is secondary (early detection).
C—Rescue medication is tertiary (limiting disability).
D—Fracture treatment is tertiary.
,Teaching Point
Primary prevention = keep disease from ever occurring.
3. Chapter 1 – Development
Subtopic: Developmentally Appropriate Health Teaching
Question Stem
The nurse prepares to teach a 5-year-old about wearing a
bicycle helmet. Which teaching strategy aligns with the child’s
cognitive stage?
A. Show a 10-minute statistical video on head injuries
B. Explain the physics of momentum and cranial impact
C. Allow the child to decorate a helmet sticker chart
D. Quote hospital cost data for ICU admissions
Correct Answer: C. Allow the child to decorate a helmet sticker
chart
Rationales
Correct: Pre-operational children (2–7 yr) learn through
concrete, play-based activities; sticker charts provide tactile
reinforcement (Wong Ch 1, “Development & Teaching”).
Incorrect:
A/B—Abstract stats and physics exceed pre-operational
cognition.
D—Financial data is irrelevant to a 5-year-old’s thinking.
Teaching Point
Match teaching modality to Piagetian stage.
, 4. Chapter 1 – Nutrition
Subtopic: Obesity & Type 2 Diabetes
Question Stem
A 10-year-old BMI ≥95th percentile drinks 20 oz soda daily.
Which pathophysiologic mechanism most directly links this
habit to type 2 diabetes risk?
A. High fructose load ↑ hepatic LDL production
B. Sucrose spikes post-prandial insulin, promoting insulin
resistance
C. Caffeine content raises systolic BP
D. Carbonic acid erodes dental enamel
Correct Answer: B. Sucrose spikes post-prandial insulin,
promoting insulin resistance
Rationales
Correct: Wong (Ch 1, “Obesity & T2DM”) notes repeated
glycemic surges exhaust β-cells → insulin resistance.
Incorrect:
A—LDL ↑ is atherogenic but not the primary diabetes pathway.
C—BP effect is cardiovascular, not glucose.
D—Dental erosion is an oral-health issue.
Teaching Point
Repeated soda-related insulin spikes accelerate T2DM onset.
