Wong’s Nursing Care of Infants and Children (12th Edition) Test Bank by Marilyn J. Hockenberry

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Wong’s Nursing Care of Infants and Children
(12th Edition) Test Bank by Marilyn J.
Hockenberry
1. The nurse is preparing to administer a liquid medication by a nasogastric feeding
tube. What is the first thing the nurse should do?
a. Check placement of the tube.
b. Check the pH of the gastric aspirate.
c. Flush the tube with a small amount of water.
d. Give the medication and then flush with a small amount of water. - ANSWER
ANS: B
The most accurate way to check the position of the nasogastric tube is by checking
the pH. Auscultation as a verification tool is not reliable and should not be used
without additional methods. The tube should not be flushed, or the medication
administered until placement of the tube is checked.
DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation MSC:
Client Needs: Safe and Effective Care Environment

2. The nurse is caring for a 12-year-old child who is on fall precautions secondary
to seizures. What interventions should be included in the child's care plan? (Select
all that apply.)
a. Place a call light and desired items within reach.
b. Keep the bed in the highest position with the two side rails up.
c. Turn off the lights and television at night.
d. Keep personal belongings and clutter contained in one area of the floor.
e. Have the child wear an appropriate-size gown and nonskid footwear. -
ANSWER ANS: A, E
Prevention of falls requires alterations in the environment, including keeping call
light and desired items within reach and having the child wear appropriate-size
gowns and nonskid footwear. The bed should be in the lowest position possible
with all the side rails up: at least a dim light should be left on at night: and personal
belongings and clutter should not be on the floor—they should be in a cabinet.
DIF: Cognitive Level: Applying TOP: Nursing Process: Planning MSC: Client
Needs: Physiological Integrity

3. What methods should the nurse use to measure compliance to a treatment plan?
(Select all that apply.)

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a. Pill counts
b. Chemical assays
c. Direct observation
d. Third-party reporting
e. Monitoring therapeutic response - ANSWER ANS: A, B, C, E
Assessment of compliance must include direct measurement techniques. Pill
counts, chemical assays, direct observation, and monitoring therapeutic response
are direct measurement techniques. Third- party reporting would not always be
available and would not be a method to measure compliance.
DIF: Cognitive Level: Applying TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity

4. What interventions should the nurse implement to prevent a pressure ulcer in a
critically ill child? (Select all that apply.)
a. Nutrition consults
b. Using skin moisturizers
c. Turning the child every 2 hr
d. Using plastic disposable underpads
e. Using draw sheets to minimize shear - ANSWER ANS: A, B, C, E
Interventions found to prevent pressure ulcers in critically ill children include
nutrition consults, using skin moisturizers, turning the child every 2 hr, and using
draw sheets to minimize shear. Dry-weave underpads, not underpads with plastic,
should be used to reduce moisture.
DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation MSC:
Client Needs: Physiological Integrity
1. What is the major cause of death for children in the United States?
a. Heart disease
b. Childhood cancer
c. Injuries
d. Congenital anomalies - ANSWER ANS: C
Unintentional injuries (accidents) are the leading cause of death after age 1 year
through adolescence. The leading cause of death for those
younger than 1 year is congenital anomalies, and childhood cancers and heart
disease cause a significantly lower percentage of deaths in children older than 1
year of age.
DIF: Cognitive Level: Understanding TOP: Nursing Process:
Planning MSC: Client Needs: Health Promotion and Maintenance

5. Parents of a hospitalized toddler ask the nurse, "What is meant by family-
centered care?" The nurse should respond with which statement?

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a. Family-centered care reduces the effect of cultural diversity on the family.
b. Family-centered care encourages family dependence on the health care system.
c. Family-centered care recognizes that the family is the constant in a child's life.
d. Family-centered care avoids expecting families to be part of the decision-
making process. - ANSWER ANS: C
The three key components of family-centered care are respect, collaboration, and
support. Family- centered care recognizes the family as the constant in the child's
life. The family should be enabled and empowered to work with the health care
system and is expected to be part of the decision-making process. The nurse should
also support the family's cultural diversity, not reduce its effect.
DIF: Cognitive Level: Applying TOP: Nursing Process:
Implementation MSC: Client Needs: Health Promotion and Maintenance

6. Evidence-based practice (EBP), a decision-making model, is best described as
which?
a. Using information in textbooks to guide care
b. Combining knowledge with clinical experience and intuition
c. Using a professional code of ethics as a means for decision making
d. Gathering all evidence that applies to the child's health and family situation -
ANSWER ANS: B
EBP helps focus on measurable outcomes: the use of demonstrated, effective
interventions: and questioning the best approach. EBP involves decision making
based on the integration of the best research evidence combined with clinical
expertise and patient values.

7. The nurse is talking to a group of parents of school-age children at an after-
school program about childhood health problems. Which statement should the
nurse include in the teaching?
a. Childhood obesity is the most common nutritional problem among children.
b. Immunization rates are the same among children of different races and ethnicity.
c. Dental caries is not a problem commonly seen in children since the introduction
of fluorinated water.
d. Mental health problems are typically not seen in school-age children but may be
diagnosed in adolescents. - ANSWER ANS: A
When teaching parents of school-age children about childhood health problems,
the nurse should include information about childhood obesity because it is the most
common problem among children and is associated with type 2 diabetes. Teaching
parents about ways to prevent obesity is important to include. Immunization rates
differ depending on the child's race and ethnicity: dental caries continues to be a

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common chronic disease in childhood: and mental health problems are seen in
children as young as school age, not just in adolescents.
DIF: Cognitive Level: Applying TOP: Integrated Process:
Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance

8. The nurse is planning care for a hospitalized preschool-aged child. Which
should the nurse plan to ensure atraumatic care?
a. Limit explanation of procedures because the child is preschool aged.
b. Ask that all family members leave the room when performing procedures.
c. Allow the child to choose the type of juice to drink with the administration of
oral medications.
d. Explain that EMLA cream cannot be used for the morning lab draw because
there is not time for it to be effective. - ANSWER ANS: C
The overriding goal in providing atraumatic care is first, do no harm. Allowing the
child, a choice of juice to drink when taking oral medications provides the child
with a sense of control. The preschool child should be prepared before procedures,
so limiting explanations of procedures would increase anxiety. The family should
be allowed to stay with the child during procedures, minimizing stress.
Lidocaine/prilocaine (EMLA) cream is a topical local anesthetic. The nurse should
plan to use the prescribed cream in time for morning laboratory draws to minimize
pain.
DIF: Cognitive Level: Applying TOP: Nursing Process: Planning MSC: Client
Needs: Health Promotion and Maintenance

9. Which situation denotes a nontherapeutic nurse-patient-family relationship?
a. The nurse is planning to read a favorite fairy tale to a patient.
b. During shift report, the nurse is criticizing parents for not visiting their child.
c. The nurse is discussing with a fellow nurse the emotional draw to a certain
patient.
d. The nurse is working with a family to find ways to decrease the family's
dependence on health care providers. - ANSWER ANS: B
Criticizing parents for not visiting in shift report is nontherapeutic and shows an
under involvement with the parents. Reading a fairy tale is a therapeutic and age-
appropriate action. Discussing feelings of an emotional draw with a fellow nurse is
therapeutic and shows a willingness to understand feelings. Working with parents
to decrease dependence on health care providers is therapeutic and helps to
empower the family.
DIF: Cognitive Level: Analyzing TOP: Integrated Process:
Caring MSC: Client Needs: Psychosocial Integrity