TEST BANK
Pediatric Nursing Care: A Concept-Based Approach
Luanne Linnard-Palmer, RN, MSN, EdD, CPN
2nd Edition
,Table of Contents
Chapter 01 Introduction to Children's Health Care 1
Chapter 02 Care Across Clinical Settings 10
Chapter 03 Essential Safety Models 18
Chapter 04 Cultural and Religious Influences to Care 25
Chapter 05 Working and Communicating with an Interdisciplinary Team 33
Chapter 06 Caring for Neonates and Infants 42
Chapter 07 Caring for Toddlers 50
Chapter 08 Caring for Preschoolers 58
Chapter 09 Caring for School-Age Children 66
Chapter 10 Caring for Adolescents 74
Chapter 11 Symptom Management Across Childhood 82
Chapter 12 Caring for Families Under Stress 90
Chapter 13 Caring for an Abused Child 98
Chapter 14 Gastrointestinal Elimination 106
Chapter 15 Metabolism 114
Chapter 16 Gas Exchange and Oxygenation 122
Chapter 17 Skin Integrity 130
Chapter 18 Cellular Regulation 137
Chapter 19 Cardiovascular: Perfusion 145
Chapter 20 Sensory Perceptions: Impairments and Disorders 154
Chapter 21 Intracranial Regulation 162
Chapter 22 Genitourinary Elimination 170
Chapter 23 Mobility 178
Chapter 24 Cognition and Mental Health 186
Chapter 25 Immune System Disorders 194
Chapter 26 Infection and Communicable Diseases in Childhood 202
Chapter 27 Essential Skills for Pediatric Nursing 209
Chapter 28 Safe and Legal Aspects of Care 218
Chapter 29 Care of the Acutely Ill or Critically Ill Child 227
Chapter 30 The Dying Child 235
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Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
Import Settings:
Base Settings: Brownstone Default
Information Field: Complexity
Information Field: Ahead
Information Field: Subject
Information Field: Feedback
Information Field: Taxonomy
Information Field: Objective
Highest Answer Letter: D
Multiple Keywords in Same Paragraph: No
Chapter: Chapter 1 – Introduction to Children's Health Care
Multiple Choice
1. A family presents with an infant who has recently been diagnosed with cerebral palsy. Which of the
following is an appropriate task for a pediatric nurse regarding the care of this infant?
A) Reassure the family that everything is alright and the infant is receiving the best quality care
B) Recuse yourself from the situation and let the pediatrician handle this situation
C) Segregate the majority of the family so that you can deal with just the infant and primary caregiver
D) Provide education to the parents so that can expect, plan for, and cope with problem associated with
normal growth and development of the child
Ans: D
Complexity: Moderate
Ahead: Introduction: Contemporary Issues in Children’s Health
Subject: Chapter 1
Taxonomy: Application
Multiple Choice
2. As a pediatric nurse, what advice would you give to a new mother that would be in compliance with the
goals of Healthy People 2030?
A) Encourage breast feeding
B) Encourage bottle-feeding
C) Encourage reading aloud
D) Encourage postpartum vitamins
Ans: A
Complexity: Moderate
Ahead: Frameworks of Pediatric Health
Subject: Chapter 1
Taxonomy: Analysis
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Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
Multiple Choice
3. A pediatric nurse received an order for a STAT brain MRI on a 6-year-old client. Which individual
should be involved in preparing the child and family members?
A) Charge nurse
B) Child life specialist
C) Pediatric physical therapist
D) Unlicensed assistive personnel
Ans: B
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Analysis
Multiple Choice
4. As a pediatric nurse, what can you infer from an adolescent who lives in a distressed neighborhood
with food insecurity?
A) The adolescent is likely to engage in risky behavior.
B) The adolescent is less likely to engage in risky behavior.
C) The adolescent is at increased risk for poor physical and mental health.
D) The adolescent will have a greater chance of educational achievement.
Ans: C
Complexity: Moderate
Ahead: Introduction: Contemporary Issues in Child Health
Subject: Chapter 1
Taxonomy: Recall
Multiple Choice
5. As a pediatric nurse, you can assist family members to develop components of the family strengths
models. Which action would be indicative of a nurse promoting components of this model?
A) Encouraging positive communication
B) Ensuring the family knows the child’s needs
C) Educating the family on the child’s needs
D) Determining who the primary decision maker of the family is
Ans: A
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Application
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Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
Multiple Choice
6. If a child has a chronic illness and the family cares for the child, as a pediatric nurse, what can you
assume from this situation?
A) The family is seeking advice on the care of their child.
B) The family thinks of you as an expert on the care of their child.
C) The family knows what the child needs and how to respond to their needs.
D) The child requires more care than the family is able to provide.
Ans: C
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Analysis
Multiple Choice
7. As a pediatric nurse, how can you be sure you that have successfully empowered a family to care for
their child?
A) The child is safe and well-taken care of.
B) The child’s condition is showing signs of improvement.
C) You have educated the family on how to properly care for their child.
D) The family feels competent to provide care for their child as a result of your support.
Ans: D
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Application
Multiple Choice
8. Critical thinking is a means of problem-solving that is often used by the pediatric nurse. What does the
pediatric nurse accomplish when incorporating this method of problem solving?
A) Confirms the diagnosis
B) Separates what is known from what is unknown
C) Identifies who the primary decision maker of the family is
D) Gathers a complete medical history of the child
Ans: B
Complexity: Moderate
Ahead: Concept-Based Care in Pediatrics
Subject: Chapter 1
Taxonomy: Application
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Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
Multiple Choice
9. As a pediatric nurse, what is the most important consideration when you are assessing the structure of
a child’s family?
A) Identifying the primary decision maker
B) Accepting that a family is who they say they are
C) Recognizing the family as the primary caregiver of the child
D) Instructing all family members on how to care for the child
Ans: B
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Recall
Multiple Choice
10. As a pediatric nurse, which action would you perform if you were asked to enable a family to care for
their child?
A) Use the tools promoted by the Bright Futures Tool Kit
B) Allow the family to make decisions on their own, without guidance
C) Educate and demonstrate to the family how to properly care for their child
D) Ensure the family feels competent to provide care for their child as a result of your support
Ans: C
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Application
Trend Extended Multiple Response
Chart information:
Health History: 14-year-old female complaining of sore throat, fever, and loss of appetite. Began 1 day
ago, sudden onset. Temperature max of 102.2°F at home. Tylenol was administered at home 1 hour ago.
History includes ADHD, anxiety disorder, eczema, and asthma. Both parents present at this visit.
A&Ox3. Follows command. Moves all extremities well. PERRLA. Swollen lymph nodes in neck; tonsils
appear swollen, erythematous, with white exudate. Chapped lips. Presence of multiple papules and
pustules over forehead, nose, chin, and upper back. Lungs clear to auscultation. Heart with regular rate
and rhythm. Bowel sounds present. Pulses palpable. Last urination this morning. Last stool yesterday
evening.
Laboratory Results:
WBC 16,000 cells/mcL (3,000-10,000 cells/mcL)
Influenza A –
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Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
Influenza B –
Rapid Strep Test +
11. Based on the client’s health record, which condition does the nurse identify as being a new morbidity
affecting children? Select all that apply.
A) Acne
B) ADHD
C) Anxiety disorder
D) Asthma
E) Strep throat
F) Suicidal ideation
Ans: B, C
Rationale/feedback:
A) Acne, while a condition affecting this adolescent, is not considered part of the new morbidity present in
the pediatric population.
B) ADHD, which this client has a history of, is considered part of the new morbidity, conditions that are the
result of current environmental and social issues.
C) Anxiety disorder, which this client has a history of, is considered part of the new morbidity, conditions
that are the result of current environmental and social issues.
D) Asthma, while a condition affecting this adolescent, is not considered part of the new morbidity present
in the pediatric population.
E) Strep throat, while a condition affecting this adolescent, is not considered part of the new morbidity
present in the pediatric population.
F) Suicidal ideation is considered part of the new morbidity, conditions that are the result of current
environmental and social issues, but it does not affect this client.
Complexity: Moderate
Ahead: Frameworks of Pediatric Health
Subject: Chapter 1
Taxonomy: Application
Trend Extended Multiple Response
Chart information:
Health History: Thirteen-year-old female is admitted to the pediatric unit for head trauma following a
domestic dispute at home. Child and 9-month-old sibling were in the home when the mother’s boyfriend
fatally injured the mother with a baseball bat. Neighbor reported domestic dispute and witnessed
adolescent being pushed down the front steps, injuring head.
Follows commands. Moves all extremities well; PERRLA. Lungs clear to auscultation. Heart with regular
rate and rhythm. Bowel sounds present. Pulses palpable. Multiple bruises over body.
Diagnostic Tests:
Brain MRI: Brain, ventricles, and orbits appear normal.
Skeletal Survey: no acute fractures, clavicle with previous fracture that is healing.
12. The nurse is caring for an adolescent in the pediatric unit. After reviewing the client’s health record,
which health impact does the nurse anticipate for this client? Select all that apply.
A) Increased risk of abortion
B) Increased risk of depression
C) Increased risk of infections
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Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
D) Increased risk of injuries
E) Increased risk of malnutrition
F) Increased risk of opioid abuse
Ans: A, B, D, F
Rationale/feedback:
A) An adverse childhood experience increases the risk of unintended pregnancies and pregnancy
complications in women.
B) An adverse childhood experience increases the risk of mental health illnesses, including depression.
C) An adverse childhood experience does not increase the risk of infections.
D) An adverse childhood experience does increase the risk of injuries, such as fractures and traumatic
brain injuries.
E) An adverse childhood experience does not increase the risk of malnutrition, although it can cause
financial challenges through difficulty with employment.
F) An adverse childhood experience increases the risk of substance abuse, such as opioid abuse.
Complexity: Moderate
Ahead: Frameworks for Pediatric Health
Subject: Chapter 1
Taxonomy: Analysis
Trend Extended Multiple Response
Chart information:
Health History: A 9-month-old male is brought into the pediatrician’s office for a well-baby visit. No
concerns. Immunizations up to date. Birth history includes vaginal delivery following induction for
oligohydramnios. No past medical or surgical history.
Nurses’ Notes: Playful and interactive. Mother reports rolling over, sitting up, eating pureed foods and
finger foods, and babbling. Concerned about when baby will start crawling.
Vital Signs:
Temperature 98.9°F (37.2°C)
Pulse 98 bpm
Respirations 28 breaths/minute
13. The nurse is preparing to provide anticipatory guidance in the pediatric clinic after reviewing the
client’s medical record. Which topic would the nurse include? Select all that apply.
A) Need for child safety gates at stairs
B) Choking hazards such as grapes and hot dogs
C) Use of a booster seat for car safety
D) Use of outlet covers
E) Securing of dressers to wall
F) Storage of matches and lighters
Ans: A, B, D, E
Rationale/feedback:
A) Safety gates at the stairs should be included in anticipatory guidance. Because the mobility of the child
is increasing, it is important to childproof the home.
B) Choking hazards, especially with the introduction of solid foods, should be discussed as part of
anticipatory guidance.
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Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
C) Booster seats are not recommended until school age. A 9-month-old should be in a 5-point rear-facing
car seat.
D) Use of outlet covers should be included in anticipatory guidance because of the increasing mobility
and curiosity of the child.
E) Securing dressers to the wall should be included in anticipatory guidance because of the increasing
mobility of the child.
F) Infants and toddlers do not have the skills to light a match or lighter. This topic does not need to be
included in anticipatory guidance yet. It should be covered as the child nears school age.
Complexity: Moderate
Ahead: Introduction: Contemporary Issues in Children’s Health
Subject: Chapter 1
Taxonomy: Application
Trend Extended Multiple Response
Chart information:
Health History: An 8-year-old male is admitted to the oncology unit for febrile neutropenia. Both parents
and 5-year-old sister accompanying child. History of acute lymphoblastic leukemia diagnosed 4 months
ago. Dual-lumen Medi port inserted to right chest. Currently on Vincristine, Daunorubicin, methotrexate,
and dexamethasone.
Nurses’ Notes: Administered normal saline bolus into right chest Medi port. Antibiotic running
simultaneously. Pallor, chapped lips, and lethargy noted. Mother at bedside, tearful. Father is attempting
to distract sister.
14. The nurse is caring for a child on the pediatric unit and reviews the client’s information. Which
statement by the nurse would promote best practice? Select all that apply.
A) “This fluid I am hanging is to keep his blood pressure up so his organs can get the blood they need.”
B) “Is there anyone you would like me to call to come babysit his sister?”
C) “I am sorry, but fresh flowers are not allowed on this unit.”
D) “Let me contact the child life specialist. She is great working with families.”
E) “Why don’t you let me wash him up. It looks like you are struggling around the lines.”
F) “What do you think caused his sudden illness?”
Ans: A, D, F
Rationale/feedback:
A) Educating about the normal saline bolus, or information sharing, is a critical part of family-centered
care.
B) Assuming that the parents would like a babysitter for the sister is not family-centered and may hinder
trust and respect between the family and healthcare team.
C) While fresh flowers should not be in a neutropenic client’s room, further explanation is needed when
providing family-centered care.
D) Contacting the child life specialist is a therapeutic, family-centered intervention since the specialist is
trained to help the child, sister, and parents.
E) Offering to take over washing the child is not a family-centered approach to care. It hinders
empowerment by the parents.
F) Asking open-ended questions encourages information sharing which is part of family-centered care.
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Application
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Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
Trend Extended Multiple Response
Chart information:
Health History: A 7-year-old male is brought to the emergency department for respiratory distress, fever,
and dehydration. Father, stepmother, older brother, and two younger sisters accompany child. Past
medical history includes trisomy 21 and AV canal. Surgical history includes AV canal repair in infancy, a
myringotomy 5 years ago, and a tonsillectomy and adenoidectomy 4 years ago. Lives with mother,
mother’s boyfriend, older brother, and baby sister during the week and with father, stepmother, older
brother, and two younger sisters every other weekend.
Alert, developmentally delayed, appropriate for diagnosis. Follows commands. PERRLA, dry mucous
membranes. Refuses to drink. Crackles at bilateral lung bases, wheezing throughout. Productive cough.
Mild subcostal retractions. Heart rate tachycardic without murmur. Pulses palpable. Capillary refill 3
seconds. Bowel sounds present. Last urination 12 hours ago. Last bowel movement 2 days ago.
Nurses’ Note: Mother arrived at emergency department and provided the child’s home medications and
more details regarding his history. Mother apologized to father for getting upset about bringing him to the
ER. States, “You were right. I’m glad you took him.” Child began to cry when the nurse came in, but the
older brother was able to calm him down. Parents appeared calm and knowledgeable about child. Agreed
with child’s plan of care and admission to pediatric unit. Mother initiated the discussion regarding which
parent would be present at the hospital. Parents agreed that a parent or step-parent would always be with
child during admission.
15. The nurse is caring for a child in the emergency department. After reviewing the child’s data, which
assessment finding would the nurse document regarding the structure of the child’s family? Select all
that apply.
A) A collaborative partnership is forming between the family and the healthcare team.
B) For the child’s well-being and cooperation, the older brother should remain present.
C) One of the family’s strengths is their ability to cope with stress and crisis.
D) The family’s weakness is positive communication.
E) The family’s economic status will hinder their presence at the child’s bedside.
F) The mother is the primary decision maker.
Ans: A, B, C, F
Rationale/feedback:
A) A collaborative partnership is forming between the family and the healthcare team as evidenced by
their cooperation and agreement regarding their child’s medical decisions. The parents were also able to
supply the healthcare team with valuable information and the child’s home medications.
B). Siblings should be able to be involved in the child’s care. The older brother in this scenario provided a
calming presence for the child.
C) One of the family’s strengths is the ability to cope as evidenced by the parents’ calm demeanor,
collaboration with the healthcare team, and problem-solving in the midst of crisis.
D) One of the family’s strengths, not weaknesses, is positive communication as evidenced by the mother
apologizing to the father, and all parties being able to work together for the benefit of the child.
E) The family’s economic status is not hindering their presence at the bedside.
F) The mother is the primary decision maker in this family, as evidenced by her providing more details
regarding the child and initiating the discussion among the adults about who will be present with the child.
Complexity: Difficult
Ahead: Caring for Families
Subject: Chapter 1
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Pediatric Nursing Care: A Concept-Based Approach
Luanne Linnard-Palmer, RN, MSN, EdD, CPN
2nd Edition
,Table of Contents
Chapter 01 Introduction to Children's Health Care 1
Chapter 02 Care Across Clinical Settings 10
Chapter 03 Essential Safety Models 18
Chapter 04 Cultural and Religious Influences to Care 25
Chapter 05 Working and Communicating with an Interdisciplinary Team 33
Chapter 06 Caring for Neonates and Infants 42
Chapter 07 Caring for Toddlers 50
Chapter 08 Caring for Preschoolers 58
Chapter 09 Caring for School-Age Children 66
Chapter 10 Caring for Adolescents 74
Chapter 11 Symptom Management Across Childhood 82
Chapter 12 Caring for Families Under Stress 90
Chapter 13 Caring for an Abused Child 98
Chapter 14 Gastrointestinal Elimination 106
Chapter 15 Metabolism 114
Chapter 16 Gas Exchange and Oxygenation 122
Chapter 17 Skin Integrity 130
Chapter 18 Cellular Regulation 137
Chapter 19 Cardiovascular: Perfusion 145
Chapter 20 Sensory Perceptions: Impairments and Disorders 154
Chapter 21 Intracranial Regulation 162
Chapter 22 Genitourinary Elimination 170
Chapter 23 Mobility 178
Chapter 24 Cognition and Mental Health 186
Chapter 25 Immune System Disorders 194
Chapter 26 Infection and Communicable Diseases in Childhood 202
Chapter 27 Essential Skills for Pediatric Nursing 209
Chapter 28 Safe and Legal Aspects of Care 218
Chapter 29 Care of the Acutely Ill or Critically Ill Child 227
Chapter 30 The Dying Child 235
,______________________________________________________________________________________________
Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
Import Settings:
Base Settings: Brownstone Default
Information Field: Complexity
Information Field: Ahead
Information Field: Subject
Information Field: Feedback
Information Field: Taxonomy
Information Field: Objective
Highest Answer Letter: D
Multiple Keywords in Same Paragraph: No
Chapter: Chapter 1 – Introduction to Children's Health Care
Multiple Choice
1. A family presents with an infant who has recently been diagnosed with cerebral palsy. Which of the
following is an appropriate task for a pediatric nurse regarding the care of this infant?
A) Reassure the family that everything is alright and the infant is receiving the best quality care
B) Recuse yourself from the situation and let the pediatrician handle this situation
C) Segregate the majority of the family so that you can deal with just the infant and primary caregiver
D) Provide education to the parents so that can expect, plan for, and cope with problem associated with
normal growth and development of the child
Ans: D
Complexity: Moderate
Ahead: Introduction: Contemporary Issues in Children’s Health
Subject: Chapter 1
Taxonomy: Application
Multiple Choice
2. As a pediatric nurse, what advice would you give to a new mother that would be in compliance with the
goals of Healthy People 2030?
A) Encourage breast feeding
B) Encourage bottle-feeding
C) Encourage reading aloud
D) Encourage postpartum vitamins
Ans: A
Complexity: Moderate
Ahead: Frameworks of Pediatric Health
Subject: Chapter 1
Taxonomy: Analysis
______________________________________________________________________________________________
1|Page
,______________________________________________________________________________________________
Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
Multiple Choice
3. A pediatric nurse received an order for a STAT brain MRI on a 6-year-old client. Which individual
should be involved in preparing the child and family members?
A) Charge nurse
B) Child life specialist
C) Pediatric physical therapist
D) Unlicensed assistive personnel
Ans: B
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Analysis
Multiple Choice
4. As a pediatric nurse, what can you infer from an adolescent who lives in a distressed neighborhood
with food insecurity?
A) The adolescent is likely to engage in risky behavior.
B) The adolescent is less likely to engage in risky behavior.
C) The adolescent is at increased risk for poor physical and mental health.
D) The adolescent will have a greater chance of educational achievement.
Ans: C
Complexity: Moderate
Ahead: Introduction: Contemporary Issues in Child Health
Subject: Chapter 1
Taxonomy: Recall
Multiple Choice
5. As a pediatric nurse, you can assist family members to develop components of the family strengths
models. Which action would be indicative of a nurse promoting components of this model?
A) Encouraging positive communication
B) Ensuring the family knows the child’s needs
C) Educating the family on the child’s needs
D) Determining who the primary decision maker of the family is
Ans: A
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Application
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2|Page
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Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
Multiple Choice
6. If a child has a chronic illness and the family cares for the child, as a pediatric nurse, what can you
assume from this situation?
A) The family is seeking advice on the care of their child.
B) The family thinks of you as an expert on the care of their child.
C) The family knows what the child needs and how to respond to their needs.
D) The child requires more care than the family is able to provide.
Ans: C
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Analysis
Multiple Choice
7. As a pediatric nurse, how can you be sure you that have successfully empowered a family to care for
their child?
A) The child is safe and well-taken care of.
B) The child’s condition is showing signs of improvement.
C) You have educated the family on how to properly care for their child.
D) The family feels competent to provide care for their child as a result of your support.
Ans: D
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Application
Multiple Choice
8. Critical thinking is a means of problem-solving that is often used by the pediatric nurse. What does the
pediatric nurse accomplish when incorporating this method of problem solving?
A) Confirms the diagnosis
B) Separates what is known from what is unknown
C) Identifies who the primary decision maker of the family is
D) Gathers a complete medical history of the child
Ans: B
Complexity: Moderate
Ahead: Concept-Based Care in Pediatrics
Subject: Chapter 1
Taxonomy: Application
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3|Page
,______________________________________________________________________________________________
Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
Multiple Choice
9. As a pediatric nurse, what is the most important consideration when you are assessing the structure of
a child’s family?
A) Identifying the primary decision maker
B) Accepting that a family is who they say they are
C) Recognizing the family as the primary caregiver of the child
D) Instructing all family members on how to care for the child
Ans: B
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Recall
Multiple Choice
10. As a pediatric nurse, which action would you perform if you were asked to enable a family to care for
their child?
A) Use the tools promoted by the Bright Futures Tool Kit
B) Allow the family to make decisions on their own, without guidance
C) Educate and demonstrate to the family how to properly care for their child
D) Ensure the family feels competent to provide care for their child as a result of your support
Ans: C
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Application
Trend Extended Multiple Response
Chart information:
Health History: 14-year-old female complaining of sore throat, fever, and loss of appetite. Began 1 day
ago, sudden onset. Temperature max of 102.2°F at home. Tylenol was administered at home 1 hour ago.
History includes ADHD, anxiety disorder, eczema, and asthma. Both parents present at this visit.
A&Ox3. Follows command. Moves all extremities well. PERRLA. Swollen lymph nodes in neck; tonsils
appear swollen, erythematous, with white exudate. Chapped lips. Presence of multiple papules and
pustules over forehead, nose, chin, and upper back. Lungs clear to auscultation. Heart with regular rate
and rhythm. Bowel sounds present. Pulses palpable. Last urination this morning. Last stool yesterday
evening.
Laboratory Results:
WBC 16,000 cells/mcL (3,000-10,000 cells/mcL)
Influenza A –
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Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
Influenza B –
Rapid Strep Test +
11. Based on the client’s health record, which condition does the nurse identify as being a new morbidity
affecting children? Select all that apply.
A) Acne
B) ADHD
C) Anxiety disorder
D) Asthma
E) Strep throat
F) Suicidal ideation
Ans: B, C
Rationale/feedback:
A) Acne, while a condition affecting this adolescent, is not considered part of the new morbidity present in
the pediatric population.
B) ADHD, which this client has a history of, is considered part of the new morbidity, conditions that are the
result of current environmental and social issues.
C) Anxiety disorder, which this client has a history of, is considered part of the new morbidity, conditions
that are the result of current environmental and social issues.
D) Asthma, while a condition affecting this adolescent, is not considered part of the new morbidity present
in the pediatric population.
E) Strep throat, while a condition affecting this adolescent, is not considered part of the new morbidity
present in the pediatric population.
F) Suicidal ideation is considered part of the new morbidity, conditions that are the result of current
environmental and social issues, but it does not affect this client.
Complexity: Moderate
Ahead: Frameworks of Pediatric Health
Subject: Chapter 1
Taxonomy: Application
Trend Extended Multiple Response
Chart information:
Health History: Thirteen-year-old female is admitted to the pediatric unit for head trauma following a
domestic dispute at home. Child and 9-month-old sibling were in the home when the mother’s boyfriend
fatally injured the mother with a baseball bat. Neighbor reported domestic dispute and witnessed
adolescent being pushed down the front steps, injuring head.
Follows commands. Moves all extremities well; PERRLA. Lungs clear to auscultation. Heart with regular
rate and rhythm. Bowel sounds present. Pulses palpable. Multiple bruises over body.
Diagnostic Tests:
Brain MRI: Brain, ventricles, and orbits appear normal.
Skeletal Survey: no acute fractures, clavicle with previous fracture that is healing.
12. The nurse is caring for an adolescent in the pediatric unit. After reviewing the client’s health record,
which health impact does the nurse anticipate for this client? Select all that apply.
A) Increased risk of abortion
B) Increased risk of depression
C) Increased risk of infections
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Test Bank - Pediatric Nursing Care: A Concept-Based Approach, 2nd Edition (Linnard-Palmer, 2024)
D) Increased risk of injuries
E) Increased risk of malnutrition
F) Increased risk of opioid abuse
Ans: A, B, D, F
Rationale/feedback:
A) An adverse childhood experience increases the risk of unintended pregnancies and pregnancy
complications in women.
B) An adverse childhood experience increases the risk of mental health illnesses, including depression.
C) An adverse childhood experience does not increase the risk of infections.
D) An adverse childhood experience does increase the risk of injuries, such as fractures and traumatic
brain injuries.
E) An adverse childhood experience does not increase the risk of malnutrition, although it can cause
financial challenges through difficulty with employment.
F) An adverse childhood experience increases the risk of substance abuse, such as opioid abuse.
Complexity: Moderate
Ahead: Frameworks for Pediatric Health
Subject: Chapter 1
Taxonomy: Analysis
Trend Extended Multiple Response
Chart information:
Health History: A 9-month-old male is brought into the pediatrician’s office for a well-baby visit. No
concerns. Immunizations up to date. Birth history includes vaginal delivery following induction for
oligohydramnios. No past medical or surgical history.
Nurses’ Notes: Playful and interactive. Mother reports rolling over, sitting up, eating pureed foods and
finger foods, and babbling. Concerned about when baby will start crawling.
Vital Signs:
Temperature 98.9°F (37.2°C)
Pulse 98 bpm
Respirations 28 breaths/minute
13. The nurse is preparing to provide anticipatory guidance in the pediatric clinic after reviewing the
client’s medical record. Which topic would the nurse include? Select all that apply.
A) Need for child safety gates at stairs
B) Choking hazards such as grapes and hot dogs
C) Use of a booster seat for car safety
D) Use of outlet covers
E) Securing of dressers to wall
F) Storage of matches and lighters
Ans: A, B, D, E
Rationale/feedback:
A) Safety gates at the stairs should be included in anticipatory guidance. Because the mobility of the child
is increasing, it is important to childproof the home.
B) Choking hazards, especially with the introduction of solid foods, should be discussed as part of
anticipatory guidance.
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C) Booster seats are not recommended until school age. A 9-month-old should be in a 5-point rear-facing
car seat.
D) Use of outlet covers should be included in anticipatory guidance because of the increasing mobility
and curiosity of the child.
E) Securing dressers to the wall should be included in anticipatory guidance because of the increasing
mobility of the child.
F) Infants and toddlers do not have the skills to light a match or lighter. This topic does not need to be
included in anticipatory guidance yet. It should be covered as the child nears school age.
Complexity: Moderate
Ahead: Introduction: Contemporary Issues in Children’s Health
Subject: Chapter 1
Taxonomy: Application
Trend Extended Multiple Response
Chart information:
Health History: An 8-year-old male is admitted to the oncology unit for febrile neutropenia. Both parents
and 5-year-old sister accompanying child. History of acute lymphoblastic leukemia diagnosed 4 months
ago. Dual-lumen Medi port inserted to right chest. Currently on Vincristine, Daunorubicin, methotrexate,
and dexamethasone.
Nurses’ Notes: Administered normal saline bolus into right chest Medi port. Antibiotic running
simultaneously. Pallor, chapped lips, and lethargy noted. Mother at bedside, tearful. Father is attempting
to distract sister.
14. The nurse is caring for a child on the pediatric unit and reviews the client’s information. Which
statement by the nurse would promote best practice? Select all that apply.
A) “This fluid I am hanging is to keep his blood pressure up so his organs can get the blood they need.”
B) “Is there anyone you would like me to call to come babysit his sister?”
C) “I am sorry, but fresh flowers are not allowed on this unit.”
D) “Let me contact the child life specialist. She is great working with families.”
E) “Why don’t you let me wash him up. It looks like you are struggling around the lines.”
F) “What do you think caused his sudden illness?”
Ans: A, D, F
Rationale/feedback:
A) Educating about the normal saline bolus, or information sharing, is a critical part of family-centered
care.
B) Assuming that the parents would like a babysitter for the sister is not family-centered and may hinder
trust and respect between the family and healthcare team.
C) While fresh flowers should not be in a neutropenic client’s room, further explanation is needed when
providing family-centered care.
D) Contacting the child life specialist is a therapeutic, family-centered intervention since the specialist is
trained to help the child, sister, and parents.
E) Offering to take over washing the child is not a family-centered approach to care. It hinders
empowerment by the parents.
F) Asking open-ended questions encourages information sharing which is part of family-centered care.
Complexity: Moderate
Ahead: Caring for Families
Subject: Chapter 1
Taxonomy: Application
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Trend Extended Multiple Response
Chart information:
Health History: A 7-year-old male is brought to the emergency department for respiratory distress, fever,
and dehydration. Father, stepmother, older brother, and two younger sisters accompany child. Past
medical history includes trisomy 21 and AV canal. Surgical history includes AV canal repair in infancy, a
myringotomy 5 years ago, and a tonsillectomy and adenoidectomy 4 years ago. Lives with mother,
mother’s boyfriend, older brother, and baby sister during the week and with father, stepmother, older
brother, and two younger sisters every other weekend.
Alert, developmentally delayed, appropriate for diagnosis. Follows commands. PERRLA, dry mucous
membranes. Refuses to drink. Crackles at bilateral lung bases, wheezing throughout. Productive cough.
Mild subcostal retractions. Heart rate tachycardic without murmur. Pulses palpable. Capillary refill 3
seconds. Bowel sounds present. Last urination 12 hours ago. Last bowel movement 2 days ago.
Nurses’ Note: Mother arrived at emergency department and provided the child’s home medications and
more details regarding his history. Mother apologized to father for getting upset about bringing him to the
ER. States, “You were right. I’m glad you took him.” Child began to cry when the nurse came in, but the
older brother was able to calm him down. Parents appeared calm and knowledgeable about child. Agreed
with child’s plan of care and admission to pediatric unit. Mother initiated the discussion regarding which
parent would be present at the hospital. Parents agreed that a parent or step-parent would always be with
child during admission.
15. The nurse is caring for a child in the emergency department. After reviewing the child’s data, which
assessment finding would the nurse document regarding the structure of the child’s family? Select all
that apply.
A) A collaborative partnership is forming between the family and the healthcare team.
B) For the child’s well-being and cooperation, the older brother should remain present.
C) One of the family’s strengths is their ability to cope with stress and crisis.
D) The family’s weakness is positive communication.
E) The family’s economic status will hinder their presence at the child’s bedside.
F) The mother is the primary decision maker.
Ans: A, B, C, F
Rationale/feedback:
A) A collaborative partnership is forming between the family and the healthcare team as evidenced by
their cooperation and agreement regarding their child’s medical decisions. The parents were also able to
supply the healthcare team with valuable information and the child’s home medications.
B). Siblings should be able to be involved in the child’s care. The older brother in this scenario provided a
calming presence for the child.
C) One of the family’s strengths is the ability to cope as evidenced by the parents’ calm demeanor,
collaboration with the healthcare team, and problem-solving in the midst of crisis.
D) One of the family’s strengths, not weaknesses, is positive communication as evidenced by the mother
apologizing to the father, and all parties being able to work together for the benefit of the child.
E) The family’s economic status is not hindering their presence at the bedside.
F) The mother is the primary decision maker in this family, as evidenced by her providing more details
regarding the child and initiating the discussion among the adults about who will be present with the child.
Complexity: Difficult
Ahead: Caring for Families
Subject: Chapter 1
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